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Recruiting NCT06263452

Beta-Blocker Influences on Inflammatory and Neural Responses to Stress

Phase IV Interventional Cardiovascular Disease

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Propranolol, Placebo.
Who it may be relevant to
Registry conditions: Cardiovascular Disease. Basic parameters: 18 years — 30 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
United States
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Overview

The purpose of this study is to map the neural and molecular mechanisms underlying psychological stress-induced changes in inflammation which could reveal new targets for intervention to reduce the risk of cardiovascular disease.

Detailed description

The proposed work will conduct a mechanistic clinical trial utilizing the non-selective beta-adrenergic receptor blocker propranolol to examine the role of beta-adrenergic signaling in shaping neural and inflammatory responses to stress. The investigators will focus on beta-adrenergic signaling given seminal pre-clinical work showing that this molecular pathway is an important driver of stress-related increases in inflammation, and initial human neuroimaging work showing that beta-blockade leads to changes in neural responses to negative stimuli. Here, the investigators will bring these two previously disparate lines of work together to determine how experimentally blocking one critical stress-signaling pathway shapes neural activity and inflammatory responses to stress. In doing so, the investigators will be advancing knowledge by mapping mechanisms (i.e., beta-adrenergic signaling), offering methodological improvements (i.e., moving beyond correlation to using pharmacological manipulations to provide causal evidence), and identifying intervention targets (i.e., the neurocognitive systems that shift activity/connectivity in response to beta-blockade). In sum, the work proposed herein is significant because it will address the mechanisms by which one critical risk factor, psychological stress, may ultimately lead to cardiovascular disease via inflammation. The proposed study also offers significant methodological improvements over past work by using neuroimaging to identify neurocognitive pathways, and pharmacology to provide causal experimental evidence to move us beyond correlation. Finally, this project is significant because it could provide insight into novel targets for future interventions.

Interventions

  • Drug Propranolol
    Tablet encapsulated to visually look identical to the placebo.
  • Drug Placebo
    Encapsulated sugar pill to visually look identical to the experimental condition.

Primary outcome measures

  • Change in levels of pro-inflammatory cytokine interleukin-6 in response to social stress [Time frame: Post-drug baseline to 90-minutes post-stress task (T-90)]
  • Change in levels of inflammatory gene expression in response to social stress [Time frame: Post-drug baseline to 30-minutes post-stress task (T-30)]

Eligibility criteria

Inclusion criteria

  • Ages 18-30 years
  • Right-handed
  • Fluent in English reading, writing, and speaking at least at a 10th grade level
  • Body mass index (BMI) less than or equal to 35 kg/m\^2

Exclusion criteria

Assessed as screening, reassessed at Session I:

  • Non-removeable metal devices/implants/objects in the body
  • Severe claustrophobia (assessed by self-report)
  • Currently pregnant
  • Left-handed
  • Body mass index (BMI) greater than 35 kg/m\^2
  • History of fainting spells or any heart condition
  • History of or present low resting heart rate (< 60 BPM) and/or low blood pressure (systolic blood pressure < 80mmHg)
  • Self-reported physical illnesses: diabetes, cardiovascular diseases, high blood pressure, inflammatory bowel diseases, rheumatoid arthritis, asthma, autoimmune disease, Crohn's disease, ulcerative colitis, lupus
  • Any self-reported diagnosed mental illness
  • Current use of prescription medications (except hormonal contraceptives)
  • Current or recent regular nicotine/tobacco use (cigarettes, e-cigarettes, vape, chewing tobacco, nicotine gum)
  • Current regular (daily or almost daily) recreational drug use = 4 or more times per week

Instructed against during Session I, reassessed at Session II:

  • Received any vaccine within the past two weeks
  • Severe sleep disturbance (3-4 hours of sleep loss) the night before Session II
  • Vigorous physical activity on the day of Session II
  • Acute illness or allergy symptoms on the day of Session II
  • Usage of over-the-counter medications on the day of Session II
  • Usage of recreational drugs within 48 hours of Session II
  • Usage of alcohol on the day of Session II

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Triple blind
Primary purpose
Basic science

Study locations

United States · 1 center
  • Social Neuroscience and Health Laboratory — Chapel Hill

Publications

  • Mehta NK, Abrams LR, Myrskyla M. US life expectancy stalls due to cardiovascular disease, not drug deaths. Proc Natl Acad Sci U S A. 2020 Mar 31;117(13):6998-7000. doi: 10.1073/pnas.1920391117. Epub 2020 Mar 16. PMID 32179670
  • Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, PMID 31992061
  • Lagraauw HM, Kuiper J, Bot I. Acute and chronic psychological stress as risk factors for cardiovascular disease: Insights gained from epidemiological, clinical and experimental studies. Brain Behav Immun. 2015 Nov;50:18-30. doi: 10.1016/j.bbi.2015.08.007. Epub 2015 Aug 6. PMID 26256574
  • Gianaros PJ, Jennings JR. Host in the machine: A neurobiological perspective on psychological stress and cardiovascular disease. Am Psychol. 2018 Nov;73(8):1031-1044. doi: 10.1037/amp0000232. PMID 30394781
  • Chida Y, Steptoe A. Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: a meta-analysis of prospective evidence. Hypertension. 2010 Apr;55(4):1026-32. doi: 10.1161/HYPERTENSIONAHA.109.146621. Epub 2010 Mar 1. PMID 20194301
  • Ginty AT, Kraynak TE, Fisher JP, Gianaros PJ. Cardiovascular and autonomic reactivity to psychological stress: Neurophysiological substrates and links to cardiovascular disease. Auton Neurosci. 2017 Nov;207:2-9. doi: 10.1016/j.autneu.2017.03.003. Epub 2017 Mar 16. PMID 28391987
  • Hong S, Dimitrov S, Cheng T, Redwine L, Pruitt C, Mills PJ, Ziegler MG, Green JM, Shaikh F, Wilson K. Beta-adrenergic receptor mediated inflammation control by monocytes is associated with blood pressure and risk factors for cardiovascular disease. Brain Behav Immun. 2015 Nov;50:31-38. doi: 10.1016/j.bbi.2015.08.012. Epub 2015 Aug 20. PMID 26300225
  • Devereux RB, Alderman MH. Role of preclinical cardiovascular disease in the evolution from risk factor exposure to development of morbid events. Circulation. 1993 Oct;88(4 Pt 1):1444-55. doi: 10.1161/01.cir.88.4.1444. PMID 8403291

Identifiers

NCT: NCT06263452 · 23-2768 · 1R01HL157422-01

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗