Biomarkers of Neuroinflammation and Anti-Inflammatory Treatments in Major Depressive Disorder
調査の概要
詳細な説明
There will be three Phases in the study. Only MDE subjects will be invited to continue to Phase 2 and 3. Subjects will be invited to continue to the subsequent Phase given they meet entry criteria described below:
Phase 1: The investigators will evaluate whether TSPO is elevated in individuals during a current MDE compared to healthy controls. Eligible participants will receive one [18F]FEPPA PET scan and one MRI scan. Other measures will include urine sample, blood samples for genetic and peripheral biomarker analysis, a neurocognitive battery, mood scales and questionnaires.
Phase 2: Participants who have elevated TSPO VT in Phase 1 and are agreeable to receiving minocycline will be invited to participate in Phase 2. Based on our previous results participants will be considered candidates for Phase 2 if TSPO VT ≥ 10.5 (HAB) or ≥8.5 (MAB) in any of the primary regions of interest (prefrontal cortex, anterior cingulate cortex or insula). Eligible participants will be invited to participate in a randomized, double blind, placebo controlled trial, to receive either minocycline or placebo. After the eight weeks of treatment, participants will receive one [18F]FEPPA PET scan. Other measures will include urine samples, blood samples, mood scales and questionnaires.
Phase 3: If, after the initial eight week treatment period with either minocycline or placebo, any participant continues to have depressive symptoms (17-item Hamilton Depression Rating Scale score ≥ 8) they will be invited to participate in an eight week open label trial of celecoxib. Participants not eligible for Phase 2 may also be invited to participate in Phase 3 directly from Phase 1.
研究の種類
入学 (予想される)
段階
- 初期フェーズ 1
連絡先と場所
研究場所
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Ontario
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Toronto、Ontario、カナダ、M5T 1R8
- Centre for Addiction and Mental Health
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Group 1 - Current major depressive episode (MDE) secondary to MDD
Inclusion Criteria:
- good physical health with no active medical conditions
- non-cigarette smoking
- no past or current substance abuse or dependence
- negative urine pregnancy test at screening and scan days (for women)
- primary diagnosis of current major depressive episode (MDE) and major depressive disorder (MDD) verified by SCID for DSM IV
- score greater than 19 on the 17 item HDRS
- non-response to a clinical trial of at least one antidepressant given at appropriate clinical dose
- willing to take medication for the duration of the trial and has previously taken antidepressants for the duration of the trial
- presently taking an antidepressant at a standard clinical dose.
Exclusion Criteria:
- history of neurological illness or autoimmune disorders
- never taken a tricyclic antidepressant or an antidepressant that raises norepinephrine
- received treatment with electroconvulsive therapy or mechanical brain stimulation in the previous 6 months
- currently taking medication contraindicated or that may possibly interact with either minocycline or celecoxib
- known intolerance or allergy to minocycline, other tetracyclines, sulfonamides or NSAIDs
- taken diazepam or other benzodiazepine use within the past month, except for lorazepam and clonazepam
- use of anti-inflammatory drugs or tetracyclines lasting ≥1 week within the past month
- history of severe hepatic or renal insufficiency, asthma, allergies, gastrointestinal disease, ischemic heart disease, cerebrovascular disease or congestive heart failure
- lactose intolerance
Group 2 - Healthy Controls - Phase 1 (baseline scan) only
Inclusion criteria:
- score below 8 on the 17 item HDRS
- good physical health
- non-cigarette smoking
- negative urine pregnancy test at screening and scan days (for women)
- negative urine screen for drugs of abuse
Exclusion criteria:
- past or current diagnosis of axis I or axis II disorder as determined by the SCID I and SCID II for DSM IV
- history of psychotropic medication use
- history of neurological illness or autoimmune disorder
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：基礎科学
- 割り当て：ランダム化
- 介入モデル：単一グループの割り当て
- マスキング：4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Minocycline
The dose of minocycline would be 50mg per day on week 1, 50mg bid on week 2 and 100mg bid weeks 3-8.
For tapering, the dose will be reduced to 50mg bid for a week, and then stopped.
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50 mg and 100 mg capsule, oral administration
他の名前：
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プラセボコンパレーター：Placebo
The number and appearance of the pills would be identical to those in the minocycline arm.
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Lactose monohydrate in identical gel capsules to minocycline, oral administration.
他の名前：
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他の：Celecoxib
This will be an open label trial for those with Hamilton Depression Rating Scale score ≥ 8 following the minocycline v. placebo trial or those not eligible for Phase 2. Dose of celecoxib will be 100 mg bid for the first week and 200mg bid for weeks 2-8.
For tapering, the dose of celecoxib will be reduced to 100mg bid for one week, and then stopped.
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100 mg and 200 mg capsules, oral administration.
他の名前：
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Translocator total distribution volume (TSPO VT): Treatment Effect of Minocycline in MDE Subjects
時間枠：Pre- and post-minocycline or placebo treatment= 8 weeks total between pretreatment and posttreatment scans
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TSPO VT will be measured using [18F]FEPPA positron emission tomography brain scans.
Eligible MDE participants will be randomized to either minocycline or placebo.
Following 8 weeks of either minocycline or placebo treatment, MDE participants will have a second PET scan .
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Pre- and post-minocycline or placebo treatment= 8 weeks total between pretreatment and posttreatment scans
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Translocator total distribution volume (TSPO VT): Difference between MDE and healthy subjects
時間枠：Pre-treatment scan will take place up to 8 weeks from initial assessment
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Compare baseline TSPO VT prior to treatment between MDE group and healthy group
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Pre-treatment scan will take place up to 8 weeks from initial assessment
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in Hamilton Depression Rating Scale Score
時間枠：Pre- and post-minocycline treatment (8 weeks total between pre- and post-treatment). Pre- and post-celecoxib treatment (8 weeks total between pre- and post-treatment).
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Change in HDRS score following minocycline vs. placebo treatment.
Change in HDRS score following celecoxib treatment.
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Pre- and post-minocycline treatment (8 weeks total between pre- and post-treatment). Pre- and post-celecoxib treatment (8 weeks total between pre- and post-treatment).
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Hopkins Verbal Learning Test-Revised
時間枠：Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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To assess verbal memory we will administer the Hopkins Verbal Learning Test-Revised to MDE participants before and after treatment.
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Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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Brief Visuospatial Memory Test-Revised
時間枠：Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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To assess visuospatial memory we will administer the Brief Visuospatial Memory Test-Revised to MDE participants before and after treatment.
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Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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Comprehensive Trails Making Test
時間枠：Pre- and post-minocycline or placebo treatment.
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To assess psychomotor speed and attention we will administer the Comprehensive Trails Making Test to MDE participants before and after treatment.
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Pre- and post-minocycline or placebo treatment.
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Genetic sample
時間枠：Phase 1-single sample
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The priority of the genetic sample is to analyze the alleles of polymorphism rs6971 which has an association with the affinity of most second generation TSPO ligands including [18F]FEPPA.
The genetic sample will also be used to study sequences of genes that are believed to affect TSPO expression, inflammation, mood and conditions that may predispose to mood disorders.
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Phase 1-single sample
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Blood samples (serum and plasma)
時間枠：Pre- and post-minocycline or placebo treatment (8 weeks between measures). Pre- and post-celecoxib treatment (8 weeks between measures).
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Analyses will include complete blood cell count (CBC), ESR, hepatic and renal function.
Peripheral marker analyses will include proteins related to TSPO expression and inflammation.
Plasma minocycline and celecoxib levels will be analyzed.
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Pre- and post-minocycline or placebo treatment (8 weeks between measures). Pre- and post-celecoxib treatment (8 weeks between measures).
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協力者と研究者
捜査官
- 主任研究者：Jeffrey H Meyer, MD, PhD、Centre for Addiction and Mental Health; University of Toronto
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- REB056/2014
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