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The Effects of Nitrate-Rich Mouthwash on Vascular Tone (NITRATONE)

19. května 2026 aktualizováno: Amina Basic, Göteborg University

The Short-Term Effects of Nitrate-Rich Mouthwash on Oral Bacterial Nitrite Production, Blood Pressure, and Nitrate and Nitrite Concentrations in Plasma and Saliva of Healthy Adults

High blood pressure (hypertension) is a major risk factor for cardiovascular disease. One important contributing factor to high blood pressure is reduced availability of nitric oxide (NO). Therefore, NO is an important molecule in maintaining healthy blood vessel function.

Dietary nitrate, found in leafy greens, can serve as an alternative source of nitric oxide in the body. After ingestion, nitrate is converted to nitrite by bacteria residing in the oral cavity. Nitrite can subsequently be converted to NO when swallowed. Therefore, this nitrate-nitrite-nitric oxide pathway is dependent on oral bacteria.

This study aims to assess whether rinsing the mouth with a nitrate-rich mouth rinse influences blood pressure in healthy adults. Also, concentrations of nitrate and nitrite in plasma and saliva will be measured following the nitrate-mouth rinse exposure.

Přehled studie

Detailní popis

This study investigates the potential acute blood pressure lowering effects of a simple nitrate-rich mouth rinse and drink, while also monitoring their effects on oral nitrite production capacity (NPC), plasma and salivary nitrate and nitrite levels, oral pH levels and the oral microbiology.

The study is a short-term, double-blind, randomized, placebo-controlled, crossover trial.

Participants will receive interventions and donate samples at four separate sessions. At session (i), baseline measurements are taken prior to intervention, and samples are subsequently taken (as described under outcome measures). At session (i) and (ii), the participants will rinse the oral cavity with a nitrate-rich fluid (or placebo). Similarly for sessions (iii) and (iv), the participants will drink the same fluid (or placebo). When donating samples, the participants will be in fasting condition. In total there will be four sessions per participant with wash-out periods in-between.

To elucidate the short-term effects of the above-described interventions, sampling will be performed in the clinic at multiple time points during the first 2 hours after each intervention, as well as at 24 hours. Participants will also monitor their blood pressure at home at four different time points for all four interventions. No sampling or measurements will be performed during night-time.

For both the intervention and the placebo, potassium (K) salts are used (KNO3 and KCl). For chairside measurement of NPC in oral samples, the rapid Griess assay (RGA) will be used. Blood pressure will be measured at the study facilities as clinic blood pressure and orthostatic blood pressure (CBP and OBP, respectively) using a clinically validated blood pressure monitor. The same device will be used by the participants for home blood pressure measurements (HBP). Saliva pH will be measured using pH-sticks or a pH-meter. Plasma and saliva nitrate- and nitrite levels are analyzed using commercial laboratory kits. Salivary secretion rate (SCR) is recorded during saliva donation, and measured as volume per unit time. Microbiological effects will be analyzed with appropriate methods in the laboratory.

Typ studie

Intervenční

Zápis (Odhadovaný)

20

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní záloha kontaktů

  • Jméno: Amina Basic, PhD, DDS
  • Telefonní číslo: +46766185930
  • E-mail: amina.basic@gu.se

Studijní místa

    • Västra Götaland County
      • Gothenburg, Västra Götaland County, Švédsko, 41390
        • Odontologen, University of Gothenburg
        • Kontakt:

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ano

Popis

Inclusion Criteria:

  • ≥18 years of age; and
  • clinic blood pressure <140/<90 mmHg.

Exclusion criteria:

  • hypertension;
  • systemic medication (other than the oral contraceptive pill);
  • antibiotic treatment within the last 3 months;
  • active smoking status and BMI > 30;
  • prior gastric by-pass surgery;
  • self-reported use of antiseptic mouthwash or toothpaste;
  • self-reported use of tongue scrapes; and
  • active periodontal disease or caries that needs treatment.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Základní věda
  • Přidělení: Randomizované
  • Intervenční model: Crossover Assignment
  • Maskování: Čtyřnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Test mouth rinse
In this arm participants will receive nitrate rich-mouth rinse
The oral cavity is rinsed with nitrate from mouth rinse, rather than ingested.
Ostatní jména:
  • Nitrate mouth rinse
Komparátor placeba: Placebo mouth rinse
In this arm participants will receive placebo mouth rinse
This mouth rinse is devoid of nitrates
This drink is devoid of nitrates
Aktivní komparátor: Test drink
In this arm participants will receive nitrate-rich drink
Nitrate is ingested, rather than rinsed and spit out
Ostatní jména:
  • Nitrate drink
Komparátor placeba: Placebo drink
In this arm participants will receive placebo drink
This mouth rinse is devoid of nitrates
This drink is devoid of nitrates

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Blood pressure before and at regular intervals within the 24 hours after nitrate exposure.
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Blood pressure will be measured before and with regular intervals after nitrate exposure. The measurements will be registered as systolic and diastolic measurements from clinic blood pressure and home blood pressure.
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Oral nitrite production before and at regular intervals within the 24 hours after nitrate exposure.
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure
The nitrite production is measured using the rapid Griess assay (RGA) - a chairside semi-quantitative nitrite concentration estimation tool for use in several different oral samples. The RGA provides nitrite estimation on a grading scale of 0-5 with nitrite concentrations intervals.
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Plasma and salivary nitrate and nitrite levels before and after nitrate exposure.
Časové okno: Baseline (prior to nitrate exposure) and 1 hour after nitrate exposure.
Blood samples are drawn from venous blood before and 1 hour after nitrate exposure, and plasma is separated. Saliva nitrate/nitrite is extracted from saliva samples donated before and 1 hour after nitrate exposure. Both are analyzed using commercial laboratory kits.
Baseline (prior to nitrate exposure) and 1 hour after nitrate exposure.
Salivary pH levels at regular intervals.
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Salivary pH will be measured using a pH-stick at regular intervals before and after nitrate exposure.
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Orthostatic blood pressure before and at regular intervals within the 24 hours after nitrate exposure.
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Orthostatic blood pressure will be measured at regular intervals before and after nitrate exposure and reported as systolic and diastolic blood pressure values in mmHg.
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Salivary secretion rate before and after nitrate exposure.
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Salivary secretion rate will be registered as volume per unit time when donating saliva before and after nitrate exposure with regular intervals.
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Relative abundance in cultivable oral microbial composition after nitrate exposure
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Microbial samples from multiple oral sites will be collected before and after nitrate exposure. Oral microbial composition will be analyzed and reported as the relative abundance (%).
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Absolute abundance in cultivable oral microbial composition after nitrate exposure
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Microbial samples from multiple oral sites will be collected before and after nitrate exposure. Cultivable oral microbial composition will be analyzed and reported as absolute abundance and expressed as colony-forming units per milliliter (CFU/mL).
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
PCR detection of specific oral bacterial after nitrate exposure
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Microbial samples from multiple oral sites will be collected before and after nitrate exposure. Quantitative PCR analysis will be performed for selected oral bacterial species and reported as bacterial counts or copy numbers.
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Oral microbial metabolite concentrations after nitrate exposure
Časové okno: Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.
Microbial samples from multiple oral sites will be collected before and after nitrate exposure. Oral microbial metabolites will be analyzed and reported as metabolite concentration values.
Baseline (prior to nitrate exposure) and during the 24 hours after nitrate exposure.

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Vyšetřovatelé

  • Vrchní vyšetřovatel: Amina Basic, PhD, DDS, Göteborg University

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. dubna 2026

Primární dokončení (Odhadovaný)

1. prosince 2028

Dokončení studie (Odhadovaný)

1. prosince 2028

Termíny zápisu do studia

První předloženo

29. prosince 2025

První předloženo, které splnilo kritéria kontroly kvality

19. května 2026

První zveřejněno (Aktuální)

22. května 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

22. května 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

19. května 2026

Naposledy ověřeno

1. prosince 2025

Více informací

Termíny související s touto studií

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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