- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05227170
Impact of Lp299v on Vascular Function in Patients With PASC
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The intestinal immune system plays a critical role in systemic immunity, and its interaction with the systemic immune system plays a crucial role in determining the severity and outcomes of common pulmonary infections. SARS-CoV-2 infection alters the composition and metabolism of the gut microbiome. Greater losses of beneficial species in the human gut microbiome of SARS-CoV-2 patients are associated with severe disease and greater systemic inflammation. These pathological alterations are observed at least 6 months post-infection and are associated with greater residual systemic inflammation and PASC symptoms.
Six weeks of Lp299v supplementation in otherwise healthy smokers reduces circulating levels of the pro-inflammatory IL-6 and reduces monocyte adhesion to endothelial cells. IL-6 is elevated in patients with PASC and strongly correlates with TLR9 activation in disease states with high circulating cf-mtDNA levels. We published trial data showing once daily Lp299v supplementation (20 billion colony forming units/day) in men with coronary artery disease (CAD) improves endothelium-dependent vasodilation in the brachial artery and NO-dependent vasodilation of resistance arterioles from CAD patients. Further, preliminary data suggest Lp299v reduces circulating levels of cf-mtDNA (Fig. 2B). We also published data showing that 6 weeks of Lp299v has a significant anti-inflammatory effect on PBMC gene transcription, with gene ontology analyses indicating Lp299v supplementation inhibits TLR9 activation (z-score -3.48, P<0.0000000023). Combining the evidence that Lp299v reduces (1) circulating cf-mtDNA; (2) TLR9 activation; and (3) IL-6 levels while improving micro- and macrovascular endothelial function make Lp299v an excellent candidate to test as an intervention to improve vascular function in PASC patients.
Therefore, we will recruit subjects ages ≥18-89 who carry a clinical diagnosis of PASC and are within a window of 30-180-day post-acute symptom resolution into an 8-week, double-blind, randomized, placebo-controlled clinical trial of Lp299v supplementation. Measurements of micro- and macrovascular function, systemic inflammation, and stool microbiota composition will be made.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Michael E Widlansky, MD, MPH
- Phone Number: 414-955-6759
- Email: mwidlans@mcw.edu
Study Contact Backup
- Name: Ryan Kacala
- Phone Number: 414-955-6885
- Email: rkacala@mcw.edu
Study Locations
-
-
Wisconsin
-
Milwaukee, Wisconsin, United States, 53226
- Recruiting
- Medical College of Wisconsin
-
Contact:
- Molly Siegel
- Phone Number: 414-955-6759
- Email: msiegel@mcw.edu
-
Contact:
- Michael E Widlansky, MD, MPH
- Phone Number: 414-955-6759
- Email: mwidlans@mcw.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Ages 18 to 89 years
- 30-180 days post-COVID-19 diagnosis
- PASC diagnosed based on symptom report/expert physician judgement
Exclusion Criteria:
- Antibiotics within four weeks of enrollment
- History of chronic diseases (renal insufficiency, liver dysfunction, cancer requiring systemic treatment within 3 years of enrollment)
- History of cognitive impairment/inability to follow study procedures
- Short gut syndrome, inflammatory bowel disease, or an ileostomy.
- Subjects currently taking Vitamin K antagonists such as coumadin or warfarin
- Pregnant at the time of screening
- Unstable coronary artery disease (new symptoms or event within 30 days of enrollment)
- Daily alcohol use (may interfere with Lp299v's action)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Lp299v
Subjects will consume 20 billion colony forming units of Lp299v (2 capsules) once daily for 8 weeks.
|
The intervention is a probiotic lactobacillus that is contained in food products in the US
|
Placebo Comparator: Heat-killed placebo control
Subjects will consume potato starch (2 capsules) once daily for 8 weeks.
|
The intervention is potato starch that is freeze dried designed to mimic the lp299v capsule.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Brachial Artery Flow Mediated Dilation (FMD%)
Time Frame: 8 weeks
|
This is a measurement of endothelial function in the brachial artery
|
8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Nitroglycerin-Mediated Vasodilation of the brachial artery (NMD)
Time Frame: 8 weeks
|
Measurement of vascular smooth muscle reactivity
|
8 weeks
|
Hyperemic Flow Velocity
Time Frame: 8 weeks
|
Measurement of microvascular endothelial function
|
8 weeks
|
Carotid-Femoral Pulse Wave Velocity (cfPWV)
Time Frame: 8 weeks
|
Measurement of vascular stiffness
|
8 weeks
|
Percentage of Laser Doppler Signal
Time Frame: 8 weeks
|
Measurement of skin microvascular function
|
8 weeks
|
interleukin-6
Time Frame: 8 weeks
|
circulating inflammatory marker
|
8 weeks
|
Stool microbiota alpha diversity
Time Frame: 8 weeks
|
Diversity of bacterial species in the individual microbiome
|
8 weeks
|
Stool microbiota beta diversity
Time Frame: 8 weeks
|
Differences in bacterial composition between intervention arms
|
8 weeks
|
Cell-Free Mitochondrial DNA (cf-mtDNA)
Time Frame: 8 weeks
|
Level of circulating cf-mtDNA in the plasma
|
8 weeks
|
Brachial Artery Resting Diameter
Time Frame: 8 weeks
|
resting diameter of the brachial artery - representative of resting vascular tone
|
8 weeks
|
Myeloid Cell Population phenotypes
Time Frame: 8 weeks
|
Quantification and identification of mononuclear cell and neutrophil types
|
8 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Michael E Widlansky, MD, MPH, Medical College of Wisconsin
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PRO42931
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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