Effect of Fatty Liver on TCA Cycle Flux and the Pentose Phosphate Pathway
HPFFF
2 other identifiers
observational
22
1 country
1
Brief Summary
The investigators plan to evaluate sensitivity and specificity of HP 13C-pyruvate as an imaging agent for detection of altered PDH flux in fatty liver.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for all trials
Started Oct 2018
Longer than P75 for all trials
1 active site
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
March 21, 2018
CompletedFirst Posted
Study publicly available on registry
March 29, 2018
CompletedStudy Start
First participant enrolled
October 1, 2018
CompletedPrimary Completion
Last participant's last visit for primary outcome
October 13, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
October 13, 2023
CompletedFebruary 19, 2025
February 1, 2025
5 years
March 21, 2018
February 17, 2025
Conditions
Outcome Measures
Primary Outcomes (1)
Bicarbonate:lactate ratio
1\. The ratio of hyperpolarized \[13C\]bicarbonate relative to hyperpolarized \[1-13C\]lactate. This measurement will be monitored from the subject's liver over a \~4 minute period in the MRI system.
One visit of 6 hours; two injections of HP pyruvate with MRI over 3 hours
Secondary Outcomes (1)
Labeled glycerol fraction
One visit of 6 hours; ingestion of Oral Glycerol with blood draws over 3 hours
Study Arms (2)
Fatty Liver Patients
Hyperpolarized \[13C\] Pyruvate Injection in Fatty Liver patients
Healthy Control Subjects
Hyperpolarized \[13C\] Pyruvate Injection in Healthy Control Subjects
Interventions
Hyperpolarized \[1-13C\] pyruvate for injection under IND133229 used to enhance MRI/MRS/MRSI using a 3T MRI scanner.
Eligibility Criteria
The plan is to study fatty liver patients and healthy subjects
You may qualify if:
- Ages 18 to 99 years.
You may not qualify if:
- Either fatty liver diagnosis (defined as \>5.6% fat content in the liver) or healthy control
- While all races and ethnicities will be included, subjects must be able to read and speak the English language. Once the protocol is established, Spanish-speaking participants will be included.
- Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
- Fatty Liver Subjects
- Subjects with major mental health conditions such as schizophrenia and bipolar disorder that would limit compliance with study requirements will not participate. In general, subjects with any form of medical instability such as seizure disorders, significant COPD, significant asthma, left ventricular dysfunction will not participate.
- Medications for control of hypercholesterolemia, hypertriglyceridemia or hyperglycemia.
- Healthy Control Subjects
- Liver disease or other chronic illness
- Diagnosis of type I or type II diabetes
- A potential subject with any major medical, surgical or psychiatric condition will not participate. These conditions include but are not limited to thyroid disease, chronic metabolic illness, known vascular disease, current cancer diagnosis and/or treatment.
- Subjects with major mental health conditions such as schizophrenia and bipolar disorder that would limit compliance with study requirements will not participate. In general, subjects with any form of medical instability such as seizure disorders, significant COPD, significant asthma, left ventricular dysfunction will not participate.
- Medications for control of hypercholesterolemia, hypertriglyceridemia or hyperglycemia.
- All Subjects
- No prior hepato-biliary surgery.
- Donated blood within the prior 4 weeks.
- +6 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Advanced Imaging Research Center
Dallas, Texas, 75390-8568, United States
Related Publications (21)
Ardenkjaer-Larsen JH, Fridlund B, Gram A, Hansson G, Hansson L, Lerche MH, Servin R, Thaning M, Golman K. Increase in signal-to-noise ratio of > 10,000 times in liquid-state NMR. Proc Natl Acad Sci U S A. 2003 Sep 2;100(18):10158-63. doi: 10.1073/pnas.1733835100. Epub 2003 Aug 20.
PMID: 12930897BACKGROUNDNelson SJ, Kurhanewicz J, Vigneron DB, Larson PE, Harzstark AL, Ferrone M, van Criekinge M, Chang JW, Bok R, Park I, Reed G, Carvajal L, Small EJ, Munster P, Weinberg VK, Ardenkjaer-Larsen JH, Chen AP, Hurd RE, Odegardstuen LI, Robb FJ, Tropp J, Murray JA. Metabolic imaging of patients with prostate cancer using hyperpolarized [1-(1)(3)C]pyruvate. Sci Transl Med. 2013 Aug 14;5(198):198ra108. doi: 10.1126/scitranslmed.3006070.
PMID: 23946197BACKGROUNDCunningham CH, Lau JY, Chen AP, Geraghty BJ, Perks WJ, Roifman I, Wright GA, Connelly KA. Hyperpolarized 13C Metabolic MRI of the Human Heart: Initial Experience. Circ Res. 2016 Nov 11;119(11):1177-1182. doi: 10.1161/CIRCRESAHA.116.309769. Epub 2016 Sep 15.
PMID: 27635086BACKGROUNDNeeland IJ, Hughes C, Ayers CR, Malloy CR, Jin ES. Effects of visceral adiposity on glycerol pathways in gluconeogenesis. Metabolism. 2017 Feb;67:80-89. doi: 10.1016/j.metabol.2016.11.008. Epub 2016 Nov 27.
PMID: 28081781BACKGROUNDNeuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology. 2003 May;37(5):1202-19. doi: 10.1053/jhep.2003.50193.
PMID: 12717402BACKGROUNDSatapati S, Kucejova B, Duarte JA, Fletcher JA, Reynolds L, Sunny NE, He T, Nair LA, Livingston KA, Fu X, Merritt ME, Sherry AD, Malloy CR, Shelton JM, Lambert J, Parks EJ, Corbin I, Magnuson MA, Browning JD, Burgess SC. Mitochondrial metabolism mediates oxidative stress and inflammation in fatty liver. J Clin Invest. 2015 Dec;125(12):4447-62. doi: 10.1172/JCI82204. Epub 2015 Nov 16.
PMID: 26571396BACKGROUNDSatapati S, Sunny NE, Kucejova B, Fu X, He TT, Mendez-Lucas A, Shelton JM, Perales JC, Browning JD, Burgess SC. Elevated TCA cycle function in the pathology of diet-induced hepatic insulin resistance and fatty liver. J Lipid Res. 2012 Jun;53(6):1080-92. doi: 10.1194/jlr.M023382. Epub 2012 Apr 9.
PMID: 22493093BACKGROUNDSunny NE, Parks EJ, Browning JD, Burgess SC. Excessive hepatic mitochondrial TCA cycle and gluconeogenesis in humans with nonalcoholic fatty liver disease. Cell Metab. 2011 Dec 7;14(6):804-10. doi: 10.1016/j.cmet.2011.11.004.
PMID: 22152305BACKGROUNDJones JG. Hepatic glucose and lipid metabolism. Diabetologia. 2016 Jun;59(6):1098-103. doi: 10.1007/s00125-016-3940-5. Epub 2016 Apr 5.
PMID: 27048250BACKGROUNDJin ES, Moreno KX, Wang JX, Fidelino L, Merritt ME, Sherry AD, Malloy CR. Metabolism of hyperpolarized [1-(13)C]pyruvate through alternate pathways in rat liver. NMR Biomed. 2016 Apr;29(4):466-74. doi: 10.1002/nbm.3479. Epub 2016 Feb 2.
PMID: 26836042BACKGROUNDJin ES, Sherry AD, Malloy CR. An Oral Load of [13C3]Glycerol and Blood NMR Analysis Detect Fatty Acid Esterification, Pentose Phosphate Pathway, and Glycerol Metabolism through the Tricarboxylic Acid Cycle in Human Liver. J Biol Chem. 2016 Sep 2;291(36):19031-41. doi: 10.1074/jbc.M116.742262. Epub 2016 Jul 18.
PMID: 27432878BACKGROUNDJin ES, Sherry AD, Malloy CR. Interaction between the pentose phosphate pathway and gluconeogenesis from glycerol in the liver. J Biol Chem. 2014 Nov 21;289(47):32593-603. doi: 10.1074/jbc.M114.577692. Epub 2014 Oct 6.
PMID: 25288790BACKGROUNDLee P, Leong W, Tan T, Lim M, Han W, Radda GK. In vivo hyperpolarized carbon-13 magnetic resonance spectroscopy reveals increased pyruvate carboxylase flux in an insulin-resistant mouse model. Hepatology. 2013 Feb;57(2):515-24. doi: 10.1002/hep.26028. Epub 2013 Jan 10.
PMID: 22911492BACKGROUNDMoreno KX, Moore CL, Burgess SC, Sherry AD, Malloy CR, Merritt ME. Production of hyperpolarized 13CO2 from [1-13C]pyruvate in perfused liver does reflect total anaplerosis but is not a reliable biomarker of glucose production. Metabolomics. 2015 Oct;11(5):1144-1156. doi: 10.1007/s11306-014-0768-1. Epub 2015 Jan 9.
PMID: 26543443BACKGROUNDMerritt ME, Harrison C, Sherry AD, Malloy CR, Burgess SC. Flux through hepatic pyruvate carboxylase and phosphoenolpyruvate carboxykinase detected by hyperpolarized 13C magnetic resonance. Proc Natl Acad Sci U S A. 2011 Nov 22;108(47):19084-9. doi: 10.1073/pnas.1111247108. Epub 2011 Nov 7.
PMID: 22065779BACKGROUNDMoreno KX, Satapati S, DeBerardinis RJ, Burgess SC, Malloy CR, Merritt ME. Real-time detection of hepatic gluconeogenic and glycogenolytic states using hyperpolarized [2-13C]dihydroxyacetone. J Biol Chem. 2014 Dec 26;289(52):35859-67. doi: 10.1074/jbc.M114.613265. Epub 2014 Oct 28.
PMID: 25352600BACKGROUNDMoreno KX, Harrison CE, Merritt ME, Kovacs Z, Malloy CR, Sherry AD. Hyperpolarized delta-[1-13 C]gluconolactone as a probe of the pentose phosphate pathway. NMR Biomed. 2017 Jun;30(6):10.1002/nbm.3713. doi: 10.1002/nbm.3713. Epub 2017 Mar 8.
PMID: 28272754BACKGROUNDJin ES, Szuszkiewicz-Garcia M, Browning JD, Baxter JD, Abate N, Malloy CR. Influence of liver triglycerides on suppression of glucose production by insulin in men. J Clin Endocrinol Metab. 2015 Jan;100(1):235-43. doi: 10.1210/jc.2014-2404.
PMID: 25250633BACKGROUNDHensley CT, Faubert B, Yuan Q, Lev-Cohain N, Jin E, Kim J, Jiang L, Ko B, Skelton R, Loudat L, Wodzak M, Klimko C, McMillan E, Butt Y, Ni M, Oliver D, Torrealba J, Malloy CR, Kernstine K, Lenkinski RE, DeBerardinis RJ. Metabolic Heterogeneity in Human Lung Tumors. Cell. 2016 Feb 11;164(4):681-94. doi: 10.1016/j.cell.2015.12.034. Epub 2016 Feb 4.
PMID: 26853473BACKGROUNDPichumani K, Mashimo T, Vemireddy V, Kovacs Z, Ratnakar J, Mickey B, Malloy CR, DeBerardinis RJ, Bachoo RM, Maher EA. Hepatic gluconeogenesis influences (13)C enrichment in lactate in human brain tumors during metabolism of [1,2-(13)C]acetate. Neurochem Int. 2016 Jul;97:133-6. doi: 10.1016/j.neuint.2016.03.015. Epub 2016 Mar 26.
PMID: 27020407BACKGROUNDCheshkov S, Dimitrov IE, Jakkamsetti V, Good L, Kelly D, Rajasekaran K, DeBerardinis RJ, Pascual JM, Sherry AD, Malloy CR. Oxidation of [U-13 C]glucose in the human brain at 7T under steady state conditions. Magn Reson Med. 2017 Dec;78(6):2065-2071. doi: 10.1002/mrm.26603. Epub 2017 Jan 23.
PMID: 28112825BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Design
- Study Type
- observational
- Observational Model
- CASE CONTROL
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
March 21, 2018
First Posted
March 29, 2018
Study Start
October 1, 2018
Primary Completion
October 13, 2023
Study Completion
October 13, 2023
Last Updated
February 19, 2025
Record last verified: 2025-02
Data Sharing
- IPD Sharing
- Will not share