Beta-Blocker Influences on Inflammatory and Neural Responses to Stress

October 27, 2025 updated by: University of North Carolina, Chapel Hill
The purpose of this study is to map the neural and molecular mechanisms underlying psychological stress-induced changes in inflammation which could reveal new targets for intervention to reduce the risk of cardiovascular disease.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The proposed work will conduct a mechanistic clinical trial utilizing the non-selective beta-adrenergic receptor blocker propranolol to examine the role of beta-adrenergic signaling in shaping neural and inflammatory responses to stress. The investigators will focus on beta-adrenergic signaling given seminal pre-clinical work showing that this molecular pathway is an important driver of stress-related increases in inflammation, and initial human neuroimaging work showing that beta-blockade leads to changes in neural responses to negative stimuli. Here, the investigators will bring these two previously disparate lines of work together to determine how experimentally blocking one critical stress-signaling pathway shapes neural activity and inflammatory responses to stress. In doing so, the investigators will be advancing knowledge by mapping mechanisms (i.e., beta-adrenergic signaling), offering methodological improvements (i.e., moving beyond correlation to using pharmacological manipulations to provide causal evidence), and identifying intervention targets (i.e., the neurocognitive systems that shift activity/connectivity in response to beta-blockade). In sum, the work proposed herein is significant because it will address the mechanisms by which one critical risk factor, psychological stress, may ultimately lead to cardiovascular disease via inflammation. The proposed study also offers significant methodological improvements over past work by using neuroimaging to identify neurocognitive pathways, and pharmacology to provide causal experimental evidence to move us beyond correlation. Finally, this project is significant because it could provide insight into novel targets for future interventions.

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Jonathan Bunting, BS
  • Phone Number: 9164957661
  • Email: jonb@unc.edu

Study Locations

  • United States
    • North Carolina
      • Chapel Hill, North Carolina, United States, 27514
        • Recruiting
        • Social Neuroscience and Health Laboratory
        • Contact:
        • Sub-Investigator:
          • Jessica R Cohen, PhD
        • Sub-Investigator:
          • Kristen A Lindquist, PhD
        • Sub-Investigator:
          • Zev Nakamura, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Ages 18-30 years
  • Right-handed
  • Fluent in English reading, writing, and speaking at least at a 10th grade level
  • Body mass index (BMI) less than or equal to 35 kg/m^2

Exclusion Criteria:

Assessed as screening, reassessed at Session I:

  • Non-removeable metal devices/implants/objects in the body
  • Severe claustrophobia (assessed by self-report)
  • Currently pregnant
  • Left-handed
  • Body mass index (BMI) greater than 35 kg/m^2
  • History of fainting spells or any heart condition
  • History of or present low resting heart rate (< 60 BPM) and/or low blood pressure (systolic blood pressure < 80mmHg)
  • Self-reported physical illnesses: diabetes, cardiovascular diseases, high blood pressure, inflammatory bowel diseases, rheumatoid arthritis, asthma, autoimmune disease, Crohn's disease, ulcerative colitis, lupus
  • Any self-reported diagnosed mental illness
  • Current use of prescription medications (except hormonal contraceptives)
  • Current or recent regular nicotine/tobacco use (cigarettes, e-cigarettes, vape, chewing tobacco, nicotine gum)
  • Current regular (daily or almost daily) recreational drug use = 4 or more times per week

Instructed against during Session I, reassessed at Session II:

  • Received any vaccine within the past two weeks
  • Severe sleep disturbance (3-4 hours of sleep loss) the night before Session II
  • Vigorous physical activity on the day of Session II
  • Acute illness or allergy symptoms on the day of Session II
  • Usage of over-the-counter medications on the day of Session II
  • Usage of recreational drugs within 48 hours of Session II
  • Usage of alcohol on the day of Session II

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Propranolol
Propranolol tablet, 40mg, one-time, orally
Drug: Propranolol
Tablet encapsulated to visually look identical to the placebo.
Other Names:
  • Inderal
  • Propranolol hydrochloride
Placebo Comparator: Placebo
Encapsulated placebo tablet
Drug: Placebo
Encapsulated sugar pill to visually look identical to the experimental condition.
Other Names:
  • Sugar pill

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in levels of pro-inflammatory cytokine interleukin-6 in response to social stress
Time Frame: Post-drug baseline to 90-minutes post-stress task (T-90)
Blood plasma will be analyzed for levels of pro-inflammatory cytokine interleukin-6 (IL-6), from baseline, a baseline after drug administration, a sample 90-minutes after the stress task (T-90) measured in pg/mL. The timeline was determined on meta-analytic work showing changes in the inflammatory cytokine IL-6 are largest at 90 minutes post-stress.
Post-drug baseline to 90-minutes post-stress task (T-90)
Change in levels of inflammatory gene expression in response to social stress
Time Frame: Post-drug baseline to 30-minutes post-stress task (T-30)
Whole blood samples will be collected in PaxGene tubes and analyzed for changes in inflammatory gene expression from baseline, a baseline after drug administration, and 30-minutes after the stress task (T-30), measured in gene transcript counts per million. The timeline is based on the Principal Investigator's work showing that changes in pro-inflammatory gene expression are observed 30-minutes post-stress.
Post-drug baseline to 30-minutes post-stress task (T-30)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of North Carolina, Chapel Hill

Collaborators

National Heart, Lung, and Blood Institute (NHLBI)
University of California, Los Angeles
Dartmouth College

Investigators

  • Principal Investigator: Keely Muscatell, PhD, University of North Carolina, Chapel Hill

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2024

Primary Completion (Estimated)

May 1, 2026

Study Completion (Estimated)

May 1, 2026

Study Registration Dates

First Submitted

January 31, 2024

First Submitted That Met QC Criteria

February 8, 2024

First Posted (Actual)

February 16, 2024

Study Record Updates

Last Update Posted (Estimated)

October 29, 2025

Last Update Submitted That Met QC Criteria

October 27, 2025

Last Verified

October 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 23-2768
  • 1R01HL157422-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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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