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DepressionNCT04823806

An Exploratory Clinical Study on Autophagy and Multi-level Molecular Profiling During Spermidine Supplementation

A study of Depression and Healthy, run by University Hospital, Bonn at 1 site in Germany.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Recently, the autophagy inducing caloric restriction mimic spermidine became available. Autophagy is essential for energy and cellular homeostasis through protein catabolism and dysregulation results in compromised proteostasis, stress-coping behavior, and in excessive secretion of signaling molecules and inflammatory… Read more about this study

Who is it for?
Ages 18 to 75 yearsHealthy volunteers can take part
Conditions the study is for
Depression, Healthy
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
1 siteGermany
Study dates
1 Dec 2020to 1 Dec 2024
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 75 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Present written declaration of consent
  • Healty or diagnosed with depression
  • BMI between 17 and 40

Who cannot join

  • Insufficient linguistic communication
  • Pregnancy or lactation
  • Gluten, histamine or wheat seedling intolerance
  • Drug abuse or alcohol dependency
  • Current spermidine substitution

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • University Hospital Bonn, Clinic for psychiatry and psychotherapy

    Bonn, 53111

Other trials in Germany

About this study

Official title: Autophagy Characterization and Multi-level Molecular Profiling of Spermidine Supplementation: a Clinical Study

Recently, the autophagy inducing caloric restriction mimic spermidine became available. Autophagy is essential for energy and cellular homeostasis through protein catabolism and dysregulation results in compromised proteostasis, stress-coping behavior, and in excessive secretion of signaling molecules and inflammatory cytokines. Antidepressants for example effect autophagy dependent pathways to exert their beneficial effects. It can therefore be hypothesized that autophagy induction through spermidine supplementation also shows beneficial clinical effect, particularly in the field of psychiatric conditions. It would be safe, low cost and easy to implement in relay to psychotropic medication in the treatment of psychiatric patients.Therefore, the aim of the project is to analyze clinical effects of spermidine supplementation in correlation to the underlying, multi-level molecular profiling.

Read the detailed description

Recently, the autophagy inducing caloric restriction mimic spermidine-rich wheat germ extract (spermidineLIFE ®, from here onwards: spermidine) was approved by the European Food Safety Authority (EFSA) and became commercially available for use. Spermidine is safe, well tolerated and as caloric restriction mimetic an easy alternative if fasting is too challenging, e.g. for psychiatric patients. Research on spermidine in animal models is limited, but a study with mice overexpressing spermidine/spermine N1-acetyltransferase (SSAT) an enzyme of spermidine catabolism, suggests that these mice may be more prone to stress. An association between spermidine supplementation and improved memory performance as well as reduced mortality has been shown in an epidemiological correlation. So far laboratory and molecular assessments are missing. It is therefore of great interest to perform broad multidisciplinary studies of behavioral changes with plasma spermidine levels, the quantification of autophagic flux, and protein acetylation levels as well as molecular signaling in a longitudinal fashion to establish an epidemiological triangulation between spermidine, autophagy and (mental) health.

This study is a monocentric, randomized, double-blind, placebo-controlled trial in which a 3-week spermidine-based nutritional supplementation (6 mg/d; target intervention) will be compared to 3-weeks of placebo administration (control intervention). Recruitment of 40 healthy individuals and 40 individuals with diagnosed depressive disorder is planned, who will be allocated to one of the two study arms (n = 20 per intervention). At different time points (baseline, intervention day 7, 14 and 21, as well as one week follow up after the last intervention day) serval psychometrical questionnaires will be gathered and blood will be collected. Sleep quality will be additionally assessed by actigraphy. At selected days blood will be collected. Following, autophagy activity will be assessed by Western Blot analysis, and mass spectrometry based proteomics, phosphoproteomics, metabolomics and lipidomics will be performed. Bioinformatic analysis, statistical evaluation, quality control, and in silico pathway analyses will then specifically identify factors and cascades of relevance. Furthermore it is of great interest, whether epigenetic changes take place during spermidine supplementation and whether these are stable throughout the follow up analysis.

The aim of the project is to analyze clinical effects of spermidine supplementation in correlation to the underlying, multi-level molecular profiling. Longitudinal multi-omic profiling including proteome, metabolome, lipidome, and epigenetic changes will reveal time-series analysis of thousands of molecular changes and an orchestrated composition of autophagy depended signaling. The resulting findings will advance the role of autophagy in the development of psychiatric disorders, investigate alternative treatment options on a molecular level, and finally contribute to a better clinical outcome.

Conditions
Depression, Healthy
Being tested
Spermidine (spermidineLIFE ®) OR Placebo
Keywords
Spermidine, Autophagy, Depression
Medical subject headings
Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Spermidine (spermidineLIFE ®) OR PlaceboDietary supplement

    21 day of 6mg spermidine OR Placebo supplementation per day

Study groups in NCT04823806
Study groupRoleWhat they receive
Healthy participants and participants with depressive disorder: dietary spermidine supplementationExperimentalDietary Supplement: Polyamine 21 days of spermidine supplementation (3 sachets/day = 6mg spermidine/day)
Receives: Dietary Supplement: Spermidine (spermidineLIFE ®) OR Placebo
Healthy participants and participants with depressive disorder: dietary placebo supplementationPlacebo comparatorDietary Supplement: Placebo 21 days of Placebo supplementation (3 sachets/day)
Receives: Dietary Supplement: Spermidine (spermidineLIFE ®) OR Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proteomics and autophagy processes

    Change in protein levels of autophagy biomarkers (LC3II \& p62) of isolated PBMCs (peripheral blood mononuclear cells) by Western Blotting.

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

Secondary outcomes (25)
  1. Epigenetic patterns

    Evaluate epigenetic methylation patterns through blood based epigenome analysis

    Measured: change from baseline to day 21 of supplementation to 7 day follow up

  2. Proteome/phosphoproteome/ubiquitinome patterns

    Change in protein levels and protein phosphorylation by untargeted mass spectrometry-based proteomics and phosphoproteomics of isolated PBMCs (peripheral blood mononuclear cells).

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  3. Metabolic processes

    Targeted and quantitative analysis by mass spectrometry of change in metabolites of Plasma.

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  4. Lipid profiling

    Targeted and quantitative analysis by mass spectrometry of change in plasma Lipids.

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  5. Exosomal protein patterns

    Evaluate exosomal protein content through mass spectrometry based analysis

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  6. Glomerular filtration rate

    Estimated glomerular filtration rate (eGFR) in milliliter per minute (mL/min)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  7. Cystatin C

    Cystatin C in Milligram per Liter (mg/L)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  8. Liver Enzymes

    Alanine transaminase (ALT) and aspartate transaminase (AST) (U/L)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  9. White blood cell differential

    Absolute number (per Liter) and relative amounts of neutrophils, lymphocytes, monocytes, eosinophils, basophils, and immature granulocytes (in %)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  10. Saliva Cortisol Levels (dexamethasone suppression test)

    Comparison of Saliva Cortisol Levels in nmol per Liter (nmol/L) after Dexamethason intake between spermidine and Placebo group

    Measured: on day 19 and 20 of supplementation

  11. Sleep Efficiency

    Assessment of Sleep Efficiency (total time in bed/time asleep during night) by GenActive Aktigraphs

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  12. Overall sleep Quality

    Sleep diary to assess overall sleep quality assessed as ratio of the total time spent asleep (in hours) to the total amount of time spent in bed (in hours) per night

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  13. Sleep Quality (PSQI)

    Pittsburgh Sleep Quality Index (PSQI): self-report questionnaire to assess sleep quality over a 1-month time interval consisting of 19 individual items.

    Measured: Change from baseline to day 7 day follow up visit

  14. Mental well-being (WEMWBS)

    Warwick-Edinburgh Mental Well-being Scale (WEMWBS): self-reported 14-item scale to assess Overall mental well-being

    Measured: Change from baseline to day 14 of supplementation to the 7 day follow up visit

  15. Resilience behavior (Wagnild &Young)

    Resilience scale (Wagnild \&Young): self-reported 25-item scale to assess overall resilience

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  16. Spermidine blood concentration

    Assessment of spermidine blood Levels by HPLC (high pressure liquid chromatography) analysis

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  17. white cell count

    Complete white cell count (per liter)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  18. Hemoglobin

    Hemoglobin (g/dL)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  19. Hematocrit

    Hematocrit (%)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  20. red cell count

    complete red cell count (per liter)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  21. MCV

    mean corpuscular volume (fl)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  22. MCH

    mean corpuscular hemoglobin (pg)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  23. thrombocytes

    thrombocytes per Liter

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  24. MCHC

    mean corpuscular hemoglobin concentration (g/dL)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

  25. RDW

    red cell distribution width (%)

    Measured: change from baseline over 21 days of supplementation to 7 day follow up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Apr 2021
  2. Study start1 Dec 2020
  3. Primary completion1 Jun 2022
  4. Study completion1 Dec 2024 (estimated)

Resources

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
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Model description
2 groups of different inclusion criteria (healthy or depressive disorder) each group undergoing one out of two conditions (spermidine vs. placebo Supplementation) (randomized)
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04823806
Sponsor's protocol ID
StressLess
Status last verified
Nov 2022
First submitted
24 Mar 2021
Last updated
10 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Eisenberg T, Knauer H, Schauer A, Buttner S, Ruckenstuhl C, Carmona-Gutierrez D, Ring J, Schroeder S, Magnes C, Antonacci L, Fussi H, Deszcz L, Hartl R, Schraml E, Criollo A, Megalou E, Weiskopf D, Laun P, Heeren G, Breitenbach M, Grubeck-Loebenstein B, Herker E, Fahrenkrog B, Frohlich KU, Sinner F, Tavernarakis N, Minois N, Kroemer G, Madeo F. Induction of autophagy by spermidine promotes longevity. Nat Cell Biol. 2009 Nov;11(11):1305-14. doi: 10.1038/ncb1975. Epub 2009 Oct 4.

    PubMed 19801973
  • Madeo F, Eisenberg T, Pietrocola F, Kroemer G. Spermidine in health and disease. Science. 2018 Jan 26;359(6374):eaan2788. doi: 10.1126/science.aan2788.

    PubMed 29371440
  • Fond G, Macgregor A, Leboyer M, Michalsen A. Fasting in mood disorders: neurobiology and effectiveness. A review of the literature. Psychiatry Res. 2013 Oct 30;209(3):253-8. doi: 10.1016/j.psychres.2012.12.018. Epub 2013 Jan 15.

    PubMed 23332541
  • Galluzzi L, Bravo-San Pedro JM, Levine B, Green DR, Kroemer G. Pharmacological modulation of autophagy: therapeutic potential and persisting obstacles. Nat Rev Drug Discov. 2017 Jul;16(7):487-511. doi: 10.1038/nrd.2017.22. Epub 2017 May 19.

    PubMed 28529316
  • Jia J, Le W. Molecular network of neuronal autophagy in the pathophysiology and treatment of depression. Neurosci Bull. 2015 Aug;31(4):427-34. doi: 10.1007/s12264-015-1548-2. Epub 2015 Aug 8.

    PubMed 26254058

Questions about this trial

What is this clinical trial studying?

A study of Depression and Healthy, run by University Hospital, Bonn at 1 site in Germany.

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 3 inclusion and 5 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: status not confirmed, as of the sponsor's last update on 10 Nov 2022. 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 Germany. 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. Some participants in this study may receive a placebo. 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?

Results are not available in the source record.

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?

Proteomics and autophagy processes (time frame: change from baseline over 21 days of supplementation to 7 day follow up). 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 NCT04823806, which also lists 5 linked publications.

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 10 Nov 2022.

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