InflammationNCT01452958
Endotoxin & Cytokines. Do Protein Loss and Metabolic Effects Depend on Central Nervous System (CNS) Activation of Stress Hormones or on Local Mechanisms in Muscle and Fat?
A study testing TNF-alpha and Endotoxin in people with Inflammation and Glucose Metabolism Disorders, run by Aarhus University Hospital at 1 site in Denmark.
Trial summary
Main objective : The purpose of this study is to prove that the effects of bacterial endotoxin and cytokine TNF-α, on protein loss, fatty acid release, and glucose metabolism depend on two mechanisms: 1. Direct local effects in muscle tissue. 2. Read more about this study
- Who is it for?
- Ages 18 to 70 years, men onlyHealthy volunteers can take part
- Conditions the study is for
- Inflammation, Glucose Metabolism Disorders
- What is being tested?
- TNF-alpha and Endotoxin
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 24 participants
- Where
- 1 siteDenmark
- Study dates
- Jun 2010to Jan 2013
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- Men only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Male
- 19 < BMI < 28
- 18 ≤ Age ≤ 50
- Healthy
- Male
- 20 < BMI < 30
- Age > 25
- Healthy
Who cannot join
- Diseases
- Allergy
Trial locations and contacts
1 site in 1 country.
Denmark1 site
Medical Department MEA, NBG, Aarhus University Hospital
Aarhus, 8000
About this study
Official title: Endotoxin & Cytokines. Do Protein Loss and Metabolic Effects Depend on CNS Activation of Stress Hormones or on Local Mechanisms in Muscle and Fat?
Main objective :
The purpose of this study is to prove that the effects of bacterial endotoxin and cytokine TNF-α, on protein loss, fatty acid release, and glucose metabolism depend on two mechanisms:
Read more
- Direct local effects in muscle tissue.
- Activation of the hypothalamo-pituitary axis and a stress-hormone response
Study protocols:
- Acute metabolic effects of TNF-α(Beromun, Boehringer-Ingelheim Germany) vs placebo perfused into the femoral artery of the leg in 8 healthy subjects.
- Acute metabolic effects of
- placebo(saline)
- endotoxin(US standard reference E.Coli, endotoxin)
- TNF-α(Beromun, Boehringer-Ingelheim Germany) given systemically
- in 8 patients with hypopituitarism(to block stress hormone release) and in 8 healthy subjects all studied thrice.
Read the detailed description
PURPOSE:
Knowledge about the effects of bacterial endotoxin and cytokines (and inflammation in general) in humans on protein, glucose and lipid metabolism and intracellular signalling in muscle and fat is sporadic and it is uncertain whether endotoxin and cytokines act directly in fat and muscle tissue or indirectly via central nervous system (CNS) mediated stress hormone release.
The investigators hypothesize that the metabolic effects of endotoxin and cytokine TNF-α, including protein loss, fatty acid release and decreased glucose uptake depend on two mechanisms:
- Direct local effects in muscle tissue (Study protocol 1)
- Activation of the hypothalamo-pituitary axis and generalized stress hormone response (Study protocol 2)
METHODOLOGY:
Study protocol 1:
Acute metabolic effects of TNF-α (Beromun, Boehringer-Ingelheim, Germany) versus placebo perfused into the femoral artery of the leg in 8 healthy subjects, studied once. Femoral vein sampling allows assessment of local metabolic events in the leg. The vessels were cannulated using the Seldinger technique. Each study comprises a 3 hour basal period and a 3 hour Hyperinsulinemic-Euglycemic Clamp. Muscle biopsies were obtained simultaneously from both lateral vastus muscles.
Study protocol 2:
Acute metabolic effects of (i)placebo (saline), (ii)endotoxin (US standard reference E.Coli, endotoxin) and (iii)TNF-α (Beromun, Boehringer-Ingelheim, Germany) given systemically intravenously (i.v.) in 8 patients with hypopituitarism (to block stress hormone release) and in 8 healthy subjects all studied thrice. Every study comprises a 4 hour basal period and a 2 hour Hyperinsulinemic-Euglycemic Clamp. Muscle and fat biopsies were obtained.
Study protocol 1 and Study protocol 2:
Assays: Mass spectrometry (15N-phenylalanine, 13C-urea), 3H-glucose, 3H-palmitate quantification, hormone and metabolite analysis, cytokine assays, intracellular signaling.
- Conditions
- Inflammation, Glucose Metabolism Disorders
- Being tested
- TNF-alpha, Endotoxin
- Keywords
- Endotoxin, LPS, TNF-α, insulin resistance, metabolism
- Medical subject headings
- Inflammation, Glucose Metabolism Disorders, Insulin Resistance
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TNF-alphaBiological
Also called Beromun, Boehringer-Ingelheim, Germany
Study protocol 1: 6 ng/kg/h intraarterial Study protocol 2: 18 ng/kg/h intravenous
EndotoxinBiological
Also called E. coli endotoxin, US standard
Study protocol 2:0,075 ng/kg/h intravenous
| Study group | Role | What they receive |
|---|---|---|
| TNF-α | Experimental | Beromun, Boehringer-Ingelheim, Germany Receives: Biological: TNF-alpha |
| Endotoxin | Experimental | Not described Receives: Biological: Endotoxin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Acute metabolic effects of endotoxin and cytokine TNF-α (Study 2)
During a basal period.
Acute metabolic effects: Glucose metabolism was quantified with raw arterio-venous differences and 3H3-Glucose tracer. Lactate was quantified with raw arterio-venous differences. Lipid metabolism was quantified with [9,10-3H]-Palmitate tracer and amino acid metabolism with 15N-Phenylalanine tracer and 13C-Urea tracer.
Measured: 2 hours
Acute metabolic effects of endotoxin and cytokine TNF-α (Study 2)
During a hyperinsulinaemic euglycaemic clamp.
Acute metabolic effects: Glucose metabolism was quantified with raw arterio-venous differences and 3H3-Glucose tracer. Lactate was quantified with raw arterio-venous differences. Lipid metabolism was quantified with [9,10-3H]-Palmitate tracer and amino acid metabolism with 15N-Phenylalanine tracer and 13C-Urea tracer.
Measured: 4 hours
Acute metabolic effects of cytokine TNF-α (Study 1)
During a basal period.
Acute metabolic effects: Glucose and lactate were quantified with raw arterio-venous differences; lipid metabolism was quantified with [9,10-3H]-palmitate and amino acid metabolism with 15N-phenylalanine.
Measured: 3 hours
Acute metabolic effects of cytokine TNF-α (Study 1)
During a hyperinsulinaemic euglycaemic clamp.
Acute metabolic effects: Glucose and lactate were quantified with raw arterio-venous differences; lipid metabolism was quantified with [9,10-3H]-palmitate and amino acid metabolism with 15N-phenylalanine.
Measured: 3 hours
Secondary outcomes (2)
Intracellular insulin signaling, growth hormone signalling and inflammatory signalling pathways.
Musle and fat biopsies during a basal period (120 min. from the beginning of a basal period)
Measured: 120 min.
Intracellular insulin signaling, growth hormone signalling and inflammatory signalling pathways.
Musle and fat biopsies during a hyperinsulinaemic euglycaemic clamp (30 min. from the beginning of clamp)
Measured: 30 min.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Oct 2011 (estimated)
- Study startJun 2010
- Primary completionJan 2013
- Study completionJan 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for InflammationStudies of the same condition, open and under way.
- More trials run by Aarhus University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 24 participants (actual)
Sponsor and investigators
- Lead sponsor
- Aarhus University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- University of Aarhus, Lundbeck Foundation
- Responsible party
- Principal investigator, Ermina Bosnjak, Aarhus University Hospital
- Investigators
- Niels Møller, Professor, Principal investigator, Aarhus University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01452958
- Sponsor's protocol ID
- 2010/0604
- Status last verified
- Jan 2013
- First submitted
- 22 Sep 2011
- Last updated
- 30 Jan 2013
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Bach E, Nielsen RR, Vendelbo MH, Moller AB, Jessen N, Buhl M, K-Hafstrom T, Holm L, Pedersen SB, Pilegaard H, Bienso RS, Jorgensen JO, Moller N. Direct effects of TNF-alpha on local fuel metabolism and cytokine levels in the placebo-controlled, bilaterally infused human leg: increased insulin sensitivity, increased net protein breakdown, and increased IL-6 release. Diabetes. 2013 Dec;62(12):4023-9. doi: 10.2337/db13-0138. Epub 2013 Jul 8.
PubMed 23835341
Study at a glance
From the registry record, last updated by the sponsor on 30 Jan 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Endotoxin & Cytokines. Do Protein Loss and Metabolic Effects Depend on CNS Activation of Stress Hormones or on Local Mechanisms in Muscle and Fat?
- ClinicalTrials.gov ID
- NCT01452958
- Acronym / sponsor ID
- 2010/0604
- Conditions
- Inflammation, Glucose Metabolism Disorders
- Keywords
- Endotoxin, LPS, TNF-α, insulin resistance, metabolism
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 24 participants (actual)
- Lead sponsor
- Aarhus University HospitalUniversity, hospital or other
- Collaborators
- University of Aarhus, Lundbeck Foundation
- Study start
- Jun 2010
- Primary completion
- Jan 2013 (actual)
- Study completion
- Jan 2013 (actual)
- First posted
- 17 Oct 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Main objective :
The purpose of this study is to prove that the effects of bacterial endotoxin and cytokine TNF-α, on protein loss, fatty acid release, and glucose metabolism depend on two mechanisms:
- Direct local effects in muscle tissue.
- Activation of the hypothalamo-pituitary axis and a stress-hormone response
Study protocols:
- Acute metabolic effects of TNF-α(Beromun, Boehringer-Ingelheim Germany) vs placebo perfused into the femoral artery of the leg in 8 healthy subjects.
- Acute metabolic effects of
- placebo(saline)
- endotoxin(US standard reference E.Coli, endotoxin)
- TNF-α(Beromun, Boehringer-Ingelheim Germany) given systemically
- in 8 patients with hypopituitarism(to block stress hormone release) and in 8 healthy subjects all studied thrice.
Detailed description
PURPOSE:
Knowledge about the effects of bacterial endotoxin and cytokines (and inflammation in general) in humans on protein, glucose and lipid metabolism and intracellular signalling in muscle and fat is sporadic and it is uncertain whether endotoxin and cytokines act directly in fat and muscle tissue or indirectly via central nervous system (CNS) mediated stress hormone release.
The investigators hypothesize that the metabolic effects of endotoxin and cytokine TNF-α, including protein loss, fatty acid release and decreased glucose uptake depend on two mechanisms:
- Direct local effects in muscle tissue (Study protocol 1)
- Activation of the hypothalamo-pituitary axis and generalized stress hormone response (Study protocol 2)
METHODOLOGY:
Study protocol 1:
Acute metabolic effects of TNF-α (Beromun, Boehringer-Ingelheim, Germany) versus placebo perfused into the femoral artery of the leg in 8 healthy subjects, studied once. Femoral vein sampling allows assessment of local metabolic events in the leg. The vessels were cannulated using the Seldinger technique. Each study comprises a 3 hour basal period and a 3 hour Hyperinsulinemic-Euglycemic Clamp. Muscle biopsies were obtained simultaneously from both lateral vastus muscles.
Study protocol 2:
Acute metabolic effects of (i)placebo (saline), (ii)endotoxin (US standard reference E.Coli, endotoxin) and (iii)TNF-α (Beromun, Boehringer-Ingelheim, Germany) given systemically intravenously (i.v.) in 8 patients with hypopituitarism (to block stress hormone release) and in 8 healthy subjects all studied thrice. Every study comprises a 4 hour basal period and a 2 hour Hyperinsulinemic-Euglycemic Clamp. Muscle and fat biopsies were obtained.
Study protocol 1 and Study protocol 2:
Assays: Mass spectrometry (15N-phenylalanine, 13C-urea), 3H-glucose, 3H-palmitate quantification, hormone and metabolite analysis, cytokine assays, intracellular signaling.
Study design
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| TNF-α | Experimental | Biological: TNF-alphaBeromun, Boehringer-Ingelheim, Germany |
| Endotoxin | Experimental | Biological: Endotoxin |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- Male only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Male
- 19 < BMI < 28
- 18 ≤ Age ≤ 50
- Healthy
- Male
Key exclusion criteria (2 listed)
- Diseases
- Allergy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TNF-alphaAlso: Beromun, Boehringer-Ingelheim, GermanyStudy protocol 1: 6 ng/kg/h intraarterial Study protocol 2: 18 ng/kg/h intravenous | Biological | TNF-α |
| EndotoxinAlso: E. coli endotoxin, US standardStudy protocol 2:0,075 ng/kg/h intravenous | Biological | Endotoxin |
Primary outcome
Acute metabolic effects of endotoxin and cytokine TNF-α (Study 2)
Time frame: 2 hours
During a basal period. Acute metabolic effects: Glucose metabolism was quantified with raw arterio-venous differences and 3H3-Glucose tracer. Lactate was quantified with raw arterio-venous differences. Lipid metabolism was quantified with [9,10-3H]-Palmitate tracer and amino acid metabolism with 15N-Phenylalanine tracer and 13C-Urea tracer.
Acute metabolic effects of endotoxin and cytokine TNF-α (Study 2)
Time frame: 4 hours
During a hyperinsulinaemic euglycaemic clamp. Acute metabolic effects: Glucose metabolism was quantified with raw arterio-venous differences and 3H3-Glucose tracer. Lactate was quantified with raw arterio-venous differences. Lipid metabolism was quantified with [9,10-3H]-Palmitate tracer and amino acid metabolism with 15N-Phenylalanine tracer and 13C-Urea tracer.
Acute metabolic effects of cytokine TNF-α (Study 1)
Time frame: 3 hours
During a basal period. Acute metabolic effects: Glucose and lactate were quantified with raw arterio-venous differences; lipid metabolism was quantified with [9,10-3H]-palmitate and amino acid metabolism with 15N-phenylalanine.
Acute metabolic effects of cytokine TNF-α (Study 1)
Time frame: 3 hours
During a hyperinsulinaemic euglycaemic clamp. Acute metabolic effects: Glucose and lactate were quantified with raw arterio-venous differences; lipid metabolism was quantified with [9,10-3H]-palmitate and amino acid metabolism with 15N-phenylalanine.
2 secondary outcomes
Intracellular insulin signaling, growth hormone signalling and inflammatory signalling pathways.
Time frame: 120 min.
Intracellular insulin signaling, growth hormone signalling and inflammatory signalling pathways.
Time frame: 30 min.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jan 2013.
- Derived from this study: PubMed 23835341Bach E, Nielsen RR, Vendelbo MH, Moller AB, Jessen N, Buhl M, K-Hafstrom T, Holm L, Pedersen SB, Pilegaard H, Bienso RS, Jorgensen JO, Moller N. Direct effects of TNF-alpha on local fuel metabolism and cytokine levels in the placebo-controlled, bilaterally infused human leg: increased insulin sensitivity, increased net protein breakdown, and increased IL-6 release. Diabetes. 2013 Dec;62(12):4023-9. doi: 10.2337/db13-0138. Epub 2013 Jul 8.
Related trials for Inflammation
Not yet recruitingPhase 2/3
A Pivotal Safety and Immunogenicity GBS-NN/NN2 Vaccine Maternal Immunisation Trial
Streptococcus Agalactiae Infection, Neonatal Sepsis
RecruitingPhase 1
Pilot Study to Identify the Mediators and Inflammatory Cell Surface Receptors Involved in Allergic Airway Inflammation
Asthma
RecruitingPhase 4
Lidocaine Infiltration and Neuroimmunomodulation in Head and Neck Cancer Surgery
Head and Neck Cancer (H&N)
Active, not recruiting
CT for Personalized Mechanical Ventilation
Ventilator-Induced Lung Injury, Sepsis Syndrome
RecruitingPhase 4
A Study to Compare the Efficacy and Safety of Extended and Intermittent Infusion of Beta-lactams in Critically Ill Paediatric Patients
Infection, Sepsis
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Niels Møller, Professor principal investigator
Aarhus University Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing TNF-alpha and Endotoxin in people with Inflammation and Glucose Metabolism Disorders, run by Aarhus University Hospital at 1 site in Denmark.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Jan 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Acute metabolic effects of endotoxin and cytokine TNF-α (Study 2) (time frame: 2 hours). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01452958, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jan 2013.