Targeting endoplasmic reticulum stress to treat hypertension

Targeting Endoplasmic Reticulum Stress in Human Hypertension

This study is testing if a medication called TUDCA can help people with controlled high blood pressure by reducing stress in their cells.

Quick facts

• Phase: PHASE1; PHASE2
• Study type: Interventional
• Enrollment: 70 (estimated)
• Ages: 18 Years to 80 Years
• Sex: All
• Sponsor: University of North Texas Health Science Center (other)
• Locations: 1 site (Fort Worth, Texas)
• Trial ID: NCT06025630 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates the role of endoplasmic reticulum stress in human hypertension by administering tauroursodeoxycholic acid (TUDCA) to participants. It is a single-blind, placebo-controlled trial designed to assess whether inhibiting endoplasmic reticulum stress can improve blood pressure regulation. The study will involve participants aged 18 to 80 with controlled hypertension, who will receive either TUDCA or a placebo over a specified period. The trial aims to fill a gap in understanding how endoplasmic reticulum stress affects hypertension in humans, building on previous animal model findings.

Who should consider this trial

Good fit: Ideal candidates for this study are adults aged 18 to 80 with controlled hypertension and a body mass index under 35.

Not a fit: Patients with uncontrolled hypertension or those with a body mass index over 35 may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could provide a novel treatment option for managing hypertension in patients.

How similar studies have performed: While there is strong evidence from animal models regarding the role of endoplasmic reticulum stress in hypertension, this approach has not been previously tested in humans.

Eligibility criteria

Inclusion Criteria:

1. 18 to 80 years of age
2. No tobacco/nicotine use within preceding 6 months (e.g., cigarettes, chewing tobacco, nicotine gum or patches)
3. Systolic blood pressure \<140 mmHg; diastolic blood pressure \<90 mmHg (obtained at the Screening and Familiarization Visit)
4. Normal 12-lead ECG (obtained at the Screening and Familiarization Visit and reviewed by a board-certified physician)
5. Normal clinical results from a medical exam reviewed by a board-certified physician (e.g., General Health Questionnaire obtained at the Screening and Familiarization Visit)
6. Body mass index (BMI) \<35 unless athletic/muscular build; calculation = body weight (kg)/height (m2);
7. Females only: documentation of a negative pregnancy test prior to the familiarization and experimental sessions unless post-menopausal

Exclusion Criteria:

1. Not meeting the defined age criteria
2. Body mass index (BMI) \>35 unless athletic/muscular build; calculation = body weight (kg)/height (m2)
3. Any tobacco/nicotine use within the last 6 months (e.g., cigarettes, chewing tobacco, nicotine gum or patches)
4. Positive pregnancy test
5. Females with an erratic/irregular menstrual cycle
6. Females who are breastfeeding
7. Women who are prescribed a continually releasing hormonal contraceptive (e.g. NuvaRingTM or other hormone releasing vaginal rings, Depo Provera shot, or birth control implants such as Nexplanon)
8. Subjects who weigh less than 80 lbs.
9. Use of prescription drugs, non-prescription drugs, dietary supplements or herbal medicines known to alter vascular function unless cleared prior to the study
10. Use of beta blockers
11. Daily use of bronchodilators
12. Use of anti-coagulant therapy
13. Implanted medical devices (e.g. cardiac pacemaker)
14. Current or past history of hyperthyroidism, or other thyroid hormone-related disease
15. Current use of hormone replacement therapy (e.g., estrogen, testosterone)
16. HbA1c \>5.6
17. Resting systolic blood pressure of \<100 mmHg; \>140mmHg or diastolic blood pressure \>90mmHg
18. Abnormal 12-lead ECG or uncontrolled heart rhythm issues causing symptoms, or an unstable blood pressure
19. History of cerebrovascular abnormalities (e.g., prior stroke, transient ischemic attacks, epilepsy)
20. Known history of atherosclerosis of the carotid arteries (i.e., plaque formation)
21. History of concussion and or other loss of consciousness within the preceding 30 days
22. Autonomic dysfunction (e.g., Shy-Drager Syndrome, Bradbury-Eggleston syndrome, sinus arrhythmia, idiopathic orthostatic hypotension, fainting disorder)
23. Respiratory illnesses (e.g., chronic asthma (including exercise-induced asthma), Chronic Obstructive Pulmonary Disease, Reactive Airway Disease)
24. Any prior history of anaphylaxis, not just prior reactions to the materials used in this study
25. Severe phobia of needles
26. Latex allergy aa) Known allergies or sensitivities to substances used in the study (e.g., Lidocaine HCL, sodium nitroprusside, acetylcholine, phentolamine, L-NAME, TUDCA, or related drugs) bb) Donated blood within the last 60 days cc) History or family history of abnormal blood clotting, clots in deep veins in the legs or pelvis, or blood clots to the lungs dd) History of alcohol or drug abuse which inhibits the subject's ability to complete this study ee) Individuals who have had mastectomies ff) History of methemoglobinemia gg) Current diagnosis of anemia hh) Current Fever (oral temp \>99.5 °F/ 37.5 °C) ii) Current use of PDE3 inhibitors (e.g., Viagra) or soluble guanylate cyclase (sGC) stimulators (e.g., riociguat), or unwillingness to withhold medication for 2 weeks prior to laboratory testing jj) Current diagnosis of cancer kk) Cardiac surgery or cardiac events (e.g., coronary artery bypass graft surgery, myocardial infarction, heart failure) ll) Diagnosis of neurological disease or cognitive dysfunction

Where this trial is running

Fort Worth, Texas

• University of North Texas Health Science Center — Fort Worth, Texas, United States (RECRUITING)

Conditions: Hypertension, high blood pressure, tauroursodeoxycholic acid, endoplasmic reticulum