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MitoQ pour améliorer la fonction vasculaire dans la pré-éclampsie (MAVEN)

29 septembre 2026 mis à jour par: Jennifer McIntosh, Medical College of Wisconsin

MitoQ (Mésylate de Mitoquinol) pour Améliorer la Fonction Vasculaire dans la Pré-éclampsie : une Approche Novatrice

Preeclampsia is a leading cause of maternal and neonatal morbidity and mortality. There is a lack of effective therapeutics for prevention or treatment. Our previous ex vivo work demonstrated that mitochondrial-antioxidants can reverse placental microvascular damage. Therefore, this study will evaluate whether MitoQ (Mitoquinol Mesylate, a mitochondrial-antioxidant) has the potential to restore vasodilation, improve placental function, and therefore promote pregnancy prolongation in patients with gestational hypertension (gHTN) and/or preeclampsia. This evaluation of clinical data, patient samples, and vascular function studies in patients with gHTN and/or preeclampsia could translate into a viable therapeutic option.

Aperçu de l'étude

Statut

Recrutement

Les conditions

Intervention / Traitement

Description détaillée

Preeclampsia (PreE) impacts ~10% of pregnancies and has severe outcomes both during and after pregnancy. It is a leading cause of pregnancy-related deaths and has long term cardiovascular consequences for maternal and child health. Despite advances in the understanding of preeclampsia over the past 50 years, the underlying unifying mechanism causing preeclampsia remains elusive. This critical gap not only encompasses lack of understanding of the pathophysiology, but it also includes a lack of therapeutics for prevention or treatment. Success in this study could translate into a clinical trial that could finally offer a treatment for PreE.

The investigators have recently demonstrated that endothelial function in the human placental microcirculation is impacted by excess reactive oxygen and nitrogen species (ROS, RNS) from the mitochondria (MT), which in preeclampsia, impairs vasodilation. Excess ROS causes decreased nitric oxide (NO) bioavailability, increased lipid peroxidation, uncoupled eNOS, peroxynitrite, and exacerbates MT dysfunction and MT DNA damage via alterations in NO. Microvascular function can be improved by mechanisms that rebalance the oxidative stress response. The investigators have shown that MitoTempol, a MT antioxidant, improves vasodilation. Moreover, the investigators have shown that a major part of the cycle of excessive oxidative stress is caused by MT DNA damage and subsequent activation of toll like receptor 9 (TLR9), and that inhibiting TLR9 prevents this dysfunction. The finding that MT antioxidants given ex-vivo can reverse placental vascular damage after delivery gives promise that treatment of patients during pregnancy could restore vasodilation and allow for safer prolongation of pregnancy.

MitoQ (Mitoquinol Mesylate) is a nutritional supplement, and mitochondrial antioxidant. MitoQ has been extensively studied pre- clinically in cell-culture, and pregnant mouse, rat, and sheep models of PreE or oxidative stress and demonstrated beneficial fetal results. It has been used in clinical trials for heart failure, hepatitis C, Parkinson's, and multiple sclerosis with doses from 10mg to 80mg per day.

Overall Hypothesis: The investigators hypothesize that MitoQ (Mitoquinol Mesylate)-treated preeclampsia and/or gHTN patients will have improved brachial artery flow-mediated dilation (FMD) and laser Doppler flowmetry assessments of the cutaneous microvasculature, and that placental endothelial function in micro-vessels and placental pathology will be improved in treated patients. To demonstrate this, the investigators will enroll two pilot human cohorts- one of admitted patients with preeclampsia with severe features who will either continue standard in-patient clinical care or be supplemented daily with MitoQ (Mitoquinol Mesylate) and a second outpatient cohort of patients with preeclampsia without severe features or gHTN who will received standard outpatient care or be supplemented daily with MitoQ

Aim: Test whether with MitoQ (Mitoquinol Mesylate) treatment in gHTN/preeclamptic patients improves endothelial function Hypothesis: MitoQ (Mitoquinol Mesylate)-treated patients will have improved brachial artery FMD and laser Doppler flowmetry assessments of the cutaneous microvasculature and placental endothelial function in micro-vessels and placental pathology will be improved in treated patients.

Type d'étude

Interventionnel

Inscription (Estimé)

80

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

  • Nom: Jennifer McIntosh, D.O., M.S.
  • Numéro de téléphone: 14148059019
  • E-mail: jmcintosh@mcw.edu

Lieux d'étude

    • Wisconsin
      • Milwaukee, Wisconsin, États-Unis, 53226
        • Recrutement
        • Froedtert & the Medical College of Wisconsin
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 50 ans (Adulte)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Femelle

La description

Inclusion Criteria:

  • Inpatient Cohort

    • pregnant patients with a clinical diagnosis of preeclampsia with severe features
    • gestational age between 23+0 and 33+0 weeks' gestation
    • singleton pregnancy
    • age 18-50 years old
    • No indication for immediate delivery (e.g. the patient and their physician team have planned expectant management of preeclampsia with severe features
    • Able to consent and follow a 2-step commend
    • English speaking
  • Outpatient Cohort

    • Pregnant patients with a clinical diagnosis of preeclampsia without severe features or gestational hypertension
    • gestational age between 23+0 and 34+0 weeks gestation
    • singleton pregnancy
    • age 18-50 years old
    • No indication for immediate delivery
    • Planned outpatient management of preeclampsia
    • Able to consent and follow a 2-step commend
    • English speaking

Exclusion Criteria:

  • Unable to stand from chair without physical assistance from another person (able to use assistive device).
  • History of blood clots in the extremities or any condition in which compression of the thigh or transient ischemia is contraindicated (i.e., wounds in the leg).
  • Chronic lasting symptoms (> 6 months) of severe COVID-19 (i.e., hospitalization)
  • History of head trauma or concussion within the past 6 months
  • Comorbid neurological disorder
  • Peripheral vascular disease
  • Diagnosed myocardial infarction or arrhythmia in the previous year
  • Resting SBP ≥180 mmHg or DBP ≥ 100 mmHg
  • Other significant medical condition likely to influence study or jeopardize safety as assessed by the Primary Investigator

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Quadruple

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Preeclampsia with Severe Features taking Mitoquinol Mesylate

Patients allocated to this arm will be inpatients who have preeclampsia with severe features. They will receive 10mg of Mitoquinol Mesylate daily from enrollment until delivery.

Patients randomized to the intervention will receive 10mg of Mitoquinol Mesylate daily from enrollment until delivery.

Comparateur placebo: Preeclampsia with Severe Features taking placebo

Patients allocated to this arm will be inpatients who have preeclampsia with severe features. They will receive Placebo daily from enrollment until delivery.

Patients randomized to the placebo groups will take 1 placebo capsule daily until delivery.

Expérimental: Preeclampsia without Severe Features or Gestational Hypertension taking MitoQ

Patients allocated to this arm will be out-patients who have gestational hypertension or preeclampsia without severe features. They will receive 10mg of Mitoquinol Mesylate daily from enrollment until delivery.

Patients randomized to the intervention will receive 10mg of Mitoquinol Mesylate daily from enrollment until delivery.

Comparateur placebo: Preeclampsia without Severe Features or Gestational Hypertension taking placebo

Patients allocated to this arm will be out-patients who have gestational hypertension or preeclampsia without severe features. They will receive placebo daily from enrollment until delivery.

Patients randomized to the placebo groups will take 1 placebo capsule daily until delivery.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Brachial Artery Flow Mediated Dilation (FMD)
Délai: 1-2 times per week from enrollment until delivery, up to 10 months

We will measure brachial artery vascular health in the arm. Baseline brachial artery diameter and blood flow velocity through the artery will be measured before and after a pneumatic forearm cuff is inflated to 225 mmHg for five minutes.

1-2 times per week from enrollment until delivery, up to 10 months

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Cutaneous Microvascular Function
Délai: 1-2 times per week From enrollment until delivery, up to to months.

Laser Doppler Flowmetry (LDF) will measure blood flow flux during local skin heating to examine microvessel vasodilation

1-2 times per week From enrollment until delivery, up to to months.
Placental Microvascular Function
Délai: At Delivery

After delivery, placental vessels will be isolated from the placenta and a videomicroscopy technique will be used to evaluate flow-mediated dilation in vessels from placebo and MitoQ treated pregnancies.

At Delivery
Time from Enrollment to Delivery
Délai: Time in days from enrollment to delivery, up to 10 months

Time from diagnosis and initiation of MitoQ or placebo to delivery

Time in days from enrollment to delivery, up to 10 months
Blood Draw
Délai: Weekly from enrollment until Delivery, up to 10 months

We will collect blood each week. The blood draw analysis may include but will not be limited to examining sFlt:PlGF ratio, plasma redox and bioenergetic analyses.

Weekly from enrollment until Delivery, up to 10 months
Maternal Preeclampsia Severity
Délai: From enrollment until delivery, up to 10 months

A composite outcome of Maternal Severity of preeclampsia will be assessed and include laboratory, blood pressure, and ultrasound data relevant to preeclampsia

From enrollment until delivery, up to 10 months
Composite Neonatal Delivery Outcome
Délai: Collected from delivery until hospital discharge; up to 1 week after birth.

A composite outcome of neonatal delivery information including (but not limited to): cord blood, gestational age, weight, APGARs

Collected from delivery until hospital discharge; up to 1 week after birth.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Collaborateurs

Les enquêteurs

  • Chercheur principal: Jennifer J McIntosh, D.O.,, Medical College of Wisconsin

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

18 mars 2026

Achèvement primaire (Estimé)

30 septembre 2027

Achèvement de l'étude (Estimé)

30 septembre 2027

Dates d'inscription aux études

Première soumission

13 novembre 2025

Première soumission répondant aux critères de contrôle qualité

13 novembre 2025

Première publication (Réel)

14 novembre 2025

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

2 octobre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

29 septembre 2026

Dernière vérification

1 septembre 2026

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • PRO00056100

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

OUI

Description du régime IPD

The cleaned, item-level spreadsheet data for all variables will be shared openly, along with example quantifications and transformations from initial raw data. Final files used to generate specific analyses as well as related results will also be shared. The rationale for sharing only cleaned data is to foster ease of data reuse. The final dataset will include clinical data procured from demographic and relevant medical record information from participants. We will share de-identified individual-participant level (IPD) data. Appropriate de-identification measures will be utilized from IRB approved protocols and informed consents.

Délai de partage IPD

Data will be made available 2 years after the completion of the study.

Critères d'accès au partage IPD

Those interested in accessing the data will contact the PI and the study team will review requests and share relevant de-identified individual-participant level (IPD) data .

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .