NCT03038750

Brief Summary

The risk of cardiovascular disease is determined by the complex interplay between an individual's genetic make-up, lifestyle, and the environment. We are investigating three potential genetic risk factors in this observational, cross-sectional, epidemiology pilot study to investigate if and how functional variants identified in large-scale genome wide association studies can explain a predisposition to cardiovascular disease. By determining the molecular mechanisms that are regulated at the EDNRA, PNPLA3 and PROCR CVD risk loci, we hope to translate findings from this study into the clinical setting for better diagnosis, prevention and treatment for patients suffering with cardiovascular disease. Volunteers will enter into one of the study's three arms based on their genotype: EDNRA locus (Arm 1), PNPLA3 locus (Arm 2), or PROCR locus (Arm 3). Members of the Cambridge Bioresource who match for the target alleles will be invited to participate and will enter into one of the three study arms. All study assessment visits will take place at Addenbrooke's Hospital in collaboration with the University of Cambridge. Volunteers will participate in the study for a maximum of 12 months and depending on study arm they are assigned to, they will complete procedures including a medical, demographic and lifestyle factors questionnaire; height, weight and body fat assessments; in addition to blood pressure/heart rate measurements. Minimally invasive procedures including forearm blood flow and venepuncture will be performed to assess the primary objectives of the study. The hypothesis for arm 1 is that the genetic variant we are investigating at the EDNRA gene locus alters the function of the endothelin receptor A leading to an increased risk of coronary artery disease and large artery stroke. For study arm 2, we hypothesize that the genetic variant we are investigating in PNPLA3 will increase the risk of Non-alcoholic fatty liver disease but reduce the risk of Coronary Heart Disease. For study arm 3, we hypothesize that the genetic variant we are investigating in the PROCR locus triggers molecular events that potentially increase the risk of Venous Thrombosis/Venous Thromboembolism nut reducing blood pressure. Furthermore we aim to investigate the anti-inflammatory effects to see if there is an effect on explaining reduced risk of CHD. This study is funded from the BHF Cambridge Center of Excellence and the Wellcome Trust Institutional Strategic Support Fund.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
74

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Aug 2017

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 25, 2017

Completed
7 days until next milestone

First Posted

Study publicly available on registry

February 1, 2017

Completed
6 months until next milestone

Study Start

First participant enrolled

August 14, 2017

Completed
5.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 6, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 6, 2023

Completed
Last Updated

February 2, 2024

Status Verified

February 1, 2024

Enrollment Period

5.8 years

First QC Date

January 25, 2017

Last Update Submit

February 1, 2024

Conditions

Keywords

Healthy VolunteersGenetic Risk Markers for Cardiovascular DiseaseNon-Alcoholic Fatty Liver DiseaseCoronary DiseaseHypertensionVenous ThrombosesVenous ThromboembolismCoronary Heart DiseaseCoronary Artery Disease

Outcome Measures

Primary Outcomes (6)

  • Forearm Blood Flow (Arterial contractility)

    Arm 1 specific measurement to be measured using venous occlusion plethysmography. Outcome measure will compare results between case vs control groups.

    2 years

  • Blood Biochemistry (Lipoprotein composition/dynamics)

    Arm 2 specific measurement collectively comparing the lipid dynamic results between case vs control groups.

    2 years

  • EPCR levels/shedding

    Arm 3 specific measurement comparing results between case vs control groups.

    2 years

  • Platelet aggregation/function

    Arm 3 specific measurement to be measured by platelet coagulation function assay comparing results between case vs control groups.

    2 years

  • Endothelial permeability

    Arm 3 specific measurement to be measured by an endothelial permeability assay comparing results between case vs control groups.

    2 years

  • Leukocyte-endothelium adhesion

    Arm 3 specific measurement to be measured by a leukocyte-endothelium adhesion assay comparing results between case vs control groups.

    2 years

Secondary Outcomes (2)

  • Blood pressure

    2 years

  • Heart rate

    2 years

Study Arms (3)

EDNRA Sub-study

Study population will be split into two groups defined by the allele of EDNRA the participant possesses: Participants Homozygous for the A-allele of EDNRA, are assigned to the 'case' group. Participants that are Homozygous for the G-allele will be assigned to the 'control' group. 20 participants will be recruited to each group, 40 in total.

Other: Eligibility and lifestyle restrictions check.Other: Medical history, demographic and lifestyle factorsOther: Anthropometric measurements: height, weight, and body fatOther: Blood pressure and heart rateOther: Forearm blood flow: Visit 1 (EDNRA)Other: Forearm blood flow: Visit 2 (EDNRA)

PNPLA3 Sub-study

Study population will be split into two groups defined by the allele of PNPLA3 the participant possesses: Participants Homozygous for the G-allele of PNPLA3, are assigned to the 'case' group. Participants that are Homozygous for the C-allele of PNPLA3 will be assigned to the 'control' group. 60 participants will be recruited to each group, 120 in total.

Other: Eligibility and lifestyle restrictions check.Other: Medical history, demographic and lifestyle factorsOther: Anthropometric measurements: height, weight, and body fatOther: Blood pressure and heart rateOther: Blood biochemistry (PNPLA3)Other: Baseline Venepuncture (PNPLA3, Visit 1)Other: Deuterium water - Loading dose 1 (PNPLA3, Visit 1)Other: Deuterium water - Loading dose 2 (PNPLA3, Visit 1)Other: Energy-balanced dinner (PNPLA3, Visit 1)Other: Fasting venepuncture (PNPLA3, Visit 2)Other: Deuterium water - Maintenance dose (PNPLA3, Visit 2)Other: Consumption of high carbohydrate meal (PNPLA3, Visit 2)Other: Postprandial Venepuncture (PNPLA3, Visit 2)

PROCR Sub-study

Study population will be split into two groups defined by the allele of PROCR the participant possesses: Participants Homozygous for the G-allele of PROCR, are assigned to the 'case' group. Participants that are Homozygous for the A-allele of PROCR will be assigned to the 'control' group. 30 participants will be recruited to each group, 60 in total.

Other: Eligibility and lifestyle restrictions check.Other: Medical history, demographic and lifestyle factorsOther: Anthropometric measurements: height, weight, and body fatOther: Blood pressure and heart rateOther: Blood EPCR function (PROCR)Other: Blood platelet coagulation and function (PROCR)Other: Blood endothelial permeability (PROCR)Other: Blood leukocyte-endothelium adhesion (PROCR)Other: Venepuncture (PROCR)

Interventions

Eligibility will be assessed at each study visit and participants will be informed in advance of their visit.

EDNRA Sub-studyPNPLA3 Sub-studyPROCR Sub-study

Medical History, participants demographics and lifestyle factors will be assessed by the participant completion of the medical history and ethnicity questionnaires.

EDNRA Sub-studyPNPLA3 Sub-studyPROCR Sub-study

Height measured by stadiometer. Weight and body fat measured by Tanita scale bioelectrical impedance analysis.

EDNRA Sub-studyPNPLA3 Sub-studyPROCR Sub-study

Parameters will be measured using a validated, automated device while seated and again after 3-5 min standing. All measurements will be done in triplicate.

EDNRA Sub-studyPNPLA3 Sub-studyPROCR Sub-study

Intra-arterial infusion of Phenylephrine at doses of 0.75, 2.5, and 7.5 μg/min for 6 min each (18 min in total). FBF measured in the last 3 minutes. There will be a 30 minute washout with saline followed by Endothelin-1 infusion of at a dose of 5 pmol/min for 90 min.

EDNRA Sub-study

Intra-arterial infusion of Sodium nitroprusside infusion at doses of 1, 3, and 10 μg/min for 6 min each (18 min in total). FBF measured in the last 3 minutes. There will be a 20 minute washout with saline followed by infusion of BQ-123 at a dose of 10 nmol/min for 90 min.

EDNRA Sub-study

25ml blood will be taken from the participant in a glucose fasting state. Following a high carbohydrate meal, a second 25ml blood sample will be taken. Clinical Biochemistry tests and detailed lipid analysis will be performed.

PNPLA3 Sub-study

Blood sample taken will be analysed via ELISA and FACS.

PROCR Sub-study

Blood sample taken will be analysed using a Platelet coagulation and function assay.

PROCR Sub-study

Blood sample will be analysed in vitro using a permeability assay kit.

PROCR Sub-study

Blood sample will be analysed in vitro using a leukocyte-endothelium adhesion assay.

PROCR Sub-study

Up to 25ml Blood will be taken.

PNPLA3 Sub-study

Loading dose of 3 g/kg body water.

PNPLA3 Sub-study

Loading dose of 3 g/kg body water.

PNPLA3 Sub-study

Provided following baseline bloods and loading dose 1.

PNPLA3 Sub-study

Up to 25ml Blood will be taken.

PNPLA3 Sub-study

every hour, maintenance dose 0.04 g/kg body water

PNPLA3 Sub-study

Provided following fasting blood sample.

PNPLA3 Sub-study

Up to 25ml Blood will be taken.

PNPLA3 Sub-study

Up to 50ml Blood will be taken.

PROCR Sub-study

Eligibility Criteria

Age18 Years - 50 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)
Sampling MethodNon-Probability Sample
Study Population

The study will only recruit healthy volunteers who have previously consented to being contacted for future studies by the NIHR Cambridge BioResource which is a panel of around 20,000 volunteers, both with and without health conditions, who are willing to be approached to participate in research studies investigating the links between genes, the environment, health and disease. Volunteers who join the Cambridge BioResource have donated their DNA via a blood or saliva sample which is used together with other information, such as gender and ethnicity, to match them to specific research studies. Participants for this study are therefore identified by having the appropriate genetic sequence in one of the three genetic loci we are investigating (EDNRA, PNPLA3 or PROCR).

You may qualify if:

  • Volunteers are homozygous for:
  • Arm 1: The A-allele of rs6841581, they are assigned to the 'case' group. If they are homozygous for the G-allele, they are assigned to the 'control' group
  • Arm 2: The G-allele of rs738409, they are assigned to the 'case' group. If they are homozygous for the C-allele, they are assigned to the 'control' group
  • Arm 3: The G-allele of rs867186, they are assigned to the 'case' group. If they are homozygous for the A-allele, they are assigned to the 'control' group
  • Volunteers are aged between 18-50 years old
  • Volunteers have a BMI:
  • Arm 1: Between18.5-29.9
  • Arm 2: Between 25.0-39.9
  • Arm 3: Between 18.5-29.9
  • Volunteers are willing not to consume products containing alcohol or caffeine 12 hours prior to procedures. Additionally, volunteers must agree to fast before procedures for:
  • Arm 1: At least 4 hours
  • Arm 2: At least 8 hours (for visit 2 only)
  • Arm 3: At least 4 hours
  • Have given written informed consent to participate

You may not qualify if:

  • Volunteers with chronic diseases, including cardiovascular diseases, liver diseases, type 1 and type 2 diabetes autoimmune diseases and cancer
  • Biological first-degree relatives (parents, brothers, sisters or children) who are or have suffered from one of the conditions described above
  • Current smokers. Ex-smokers are suitable if they stopped smoking \>10 years ago
  • Volunteers with a diagnosis of hypertension, or history of consistently high blood pressure readings, \>140/90 mmHg
  • Volunteers with a diagnosis of hypercholesterolemia, or history of consistently high cholesterol levels, e.g. total cholesterol level \>6 mmol/l
  • Volunteers have ≥3 alcoholic drinks per day

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Public Health and Primary Care

Cambridge, CB1 8RN, United Kingdom

Location

MeSH Terms

Conditions

Cardiovascular DiseasesNon-alcoholic Fatty Liver DiseaseCoronary DiseaseHypertensionVenous ThrombosisVenous ThromboembolismCoronary Artery Disease

Interventions

Eligibility DeterminationHealth Records, PersonalDemographyWeights and MeasuresBlood PressureHeart RateReceptor, Endothelin AadiponutrinEndothelial Protein C ReceptorFunctional StatusBlood Specimen Collection

Condition Hierarchy (Ancestors)

Fatty LiverLiver DiseasesDigestive System DiseasesMyocardial IschemiaHeart DiseasesVascular DiseasesThrombosisEmbolism and ThrombosisThromboembolismArteriosclerosisArterial Occlusive Diseases

Intervention Hierarchy (Ancestors)

Organization and AdministrationHealth Services AdministrationMedical RecordsRecordsData CollectionEpidemiologic MethodsInvestigative TechniquesPopulation CharacteristicsEpidemiologic MeasurementsPublic HealthEnvironment and Public HealthVital SignsPhysical ExaminationDiagnostic Techniques and ProceduresDiagnosisHemodynamicsCardiovascular Physiological PhenomenaCirculatory and Respiratory Physiological PhenomenaReceptors, EndothelinReceptors, G-Protein-CoupledReceptors, Cell SurfaceMembrane ProteinsProteinsAmino Acids, Peptides, and ProteinsReceptors, PeptideMembrane GlycoproteinsGlycoproteinsGlycoconjugatesCarbohydratesActivities of Daily LivingRehabilitationHealth ServicesHealth Care Facilities Workforce and ServicesHealth StatusSpecimen HandlingClinical Laboratory TechniquesPuncturesSurgical Procedures, Operative

Study Officials

  • Dirk Paul, PhD

    University of Cambridge

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
CROSS SECTIONAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

January 25, 2017

First Posted

February 1, 2017

Study Start

August 14, 2017

Primary Completion

June 6, 2023

Study Completion

June 6, 2023

Last Updated

February 2, 2024

Record last verified: 2024-02

Data Sharing

IPD Sharing
Will not share

Participant identifiable information is securely held, with restricted access, by the NIHR BioResource. Members of the research team carrying out the procedures will not be able to request the link to decode this information. Only the minimum required participant identifiable information (name and contact details) will be provided to the research team for the purpose of arranging study visits and completing the informed consent process. All research personnel will be sufficiently blinded of the genotype status of the healthy volunteers. All delegated research personnel that is responsible to conduct the data/statistical analysis will only analyse data that is anonymised of any patient identifiable data.

Locations