Identifying brain injury biomarkers in patients with high ammonia levels

Systemic Biomarkers of Brain Injury From Hyperammonemia

Observational Children's National Research Institute · NCT04602325

This study is testing if certain brain injury markers in patients with high ammonia levels can help us understand how ammonia affects the brain and improve care for those with related metabolic disorders.

Quick facts

Study typeObservational
Enrollment24 (estimated)
Ages7 Years to 18 Years
SexAll
SponsorChildren's National Research Institute Academic / other
Locations1 site (Washington D.C., District of Columbia)
Trial IDNCT04602325 on ClinicalTrials.gov

What this trial studies

This observational study aims to investigate the timeline of brain injury biomarkers in patients suffering from inherited hyperammonemic disorders. It focuses on measuring the levels of S100B, NSE, and UCHL1 in relation to blood ammonia levels during hospitalizations for hyperammonemia. Additionally, the study will assess whether these biomarkers are altered in patients with other metabolic disorders, such as Maple Syrup Urine Disease and Glutaric Acidemia. The findings could provide insights into the neurotoxic effects of ammonia and help in managing these conditions more effectively.

Who should consider this trial

Good fit: Ideal candidates include individuals diagnosed with inherited hyperammonemias or specific organic acidemias, such as Maple Syrup Urine Disease.

Not a fit: Patients without any form of hyperammonemia or related neurological conditions may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved monitoring and treatment strategies for patients with hyperammonemia-related brain injuries.

How similar studies have performed: While the approach of identifying biomarkers in response to hyperammonemia is not widely tested, similar studies have shown promise in understanding metabolic disorders.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Inherited Hyperammonemias:

   1. A clinical diagnosis of 1 of 7 diagnosed urea cycle disorders:

      * N-acetylglutamate Synthetase Deficiency (NAGS)
      * Carbamyl Phosphate Synthetase Deficiency (CPSD)
      * Ornithine Transcarbamylase Deficiency (OTCD)
      * Argininosuccinate Synthetase Deficiency (ASD)
      * Argininosuccinate Lyase Deficiency (ALD)
      * Arginase Deficiency (AD)
      * Hyperammonemia-Hyperornithinemia-Homocitrullinuria (HHH)
   2. A clinical diagnosis of 1 of 2 organic acidemias:

      * Propionic Acidemia (PA)
      * Methylmalonic Acidemia (MMA)
2. Acute metabolic disorder without hyperammonemia, with neurological sequelae

   1. Maple Syrup Urine Disease (MSUD)
   2. Glutaric Acidemia (GA1)
3. Acute metabolic disorder without hyperammonemia and without neurological sequelae

   * Fatty Acid Oxidation Disorders:
   * Medium Chain-Acyl CoA Dehydrogenase Deficiency
   * Very Long Chain-Acyl CoA Dehydrogenase Deficiency
   * Trifunctional Protein Deficiency
   * Long Chain Hydroxyacyl-CoA Dehydrogenase Deficiency
   * Carnitine Palmitoyltransferase I or II Deficiency
   * Carnitine/Acylcarnitine Translocase Deficiency
   * Primary Carnitine Transport Deficiency
4. Hypoxic-Ischemic Encephalopathy

Exclusion Criteria:

* Prior Solid-Organ Transplant
* Use of any other investigational drug, biologic, or therapy or any clinical or laboratory abnormality or medical condition that, as determined by the investigator, may interfere with or obscure the biomarker measurements

Where this trial is running

Washington D.C., District of Columbia

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Urea Cycle DisorderOrganic AcidemiaMaple Syrup Urine DiseaseGlutaric Acidemia IFatty Acid Oxidation DisorderHypoxic-Ischemic EncephalopathyN-acetylglutamate Synthetase DeficiencyCarbamyl Phosphate Synthetase Deficiency
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.