Ignite Creation Date:
2024-05-06 @ 1:25 PM
Last Modification Date:
2024-10-26 @ 1:13 PM
Study NCT ID:
NCT04013555
Status:
RECRUITING
Last Update Posted:
2024-07-12
First Post:
2019-06-27
Brief Title:
The Effects of Kynurenine Aminotransferase Inhibition in People With Schizophrenia
Sponsor:
University of Maryland Baltimore
Organization:
University of Maryland Baltimore
Study Overview
Official Title:
The Effects of Kynurenine Aminotransferase Inhibition in People With Schizophrenia
Status:
RECRUITING
Status Verified Date:
2024-07
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
TrypNAC-II
Brief Summary:
Kynurenic acid KYNA is a naturally occurring chemical in the brain Studies with rodents indicate that levels of KYNA can impact levels of the neurotransmitters glutamate and dopamine One way to reliably increase KYNA levels is by ingesting the amino acid tryptophan Tryptophan is a normal part of the human diet Tryptophan gets metabolizedchanged to other chemicals in the body- including KYNA By giving people 6 grams of tryptophan the investigators will be able to increase the KYNA level in a controlled way The investigators will then be able to study the effects of KYNA on neurotransmitters by using cognitive tests and magnetic resonance imaging techniques measuring brain activity and brain chemistry using the MRI magnet
The overall goal of the study is to examine how the medication N-acetylcysteine NAC when added to tryptophan affects various cognitive functions such as verbal and visual memory The investigators will also use magnetic resonance imaging MRI to examine how NAC affects brain activity and chemicals
The overall goal of the study is to examine how the medication N-acetylcysteine NAC when added to tryptophan affects various cognitive functions such as verbal and visual memory The investigators will also use magnetic resonance imaging MRI to examine how NAC affects brain activity and chemicals
Detailed Description:
The purpose of the study is to examine whether high dose N-acetylcysteine NAC blocks the adverse effects of increased kynurenic acid KYNA on selected measures of brain chemistry function and behavior through the inhibition of kynurenine aminotransferase KAT II which converts kynurenine to KYNA The study will be a double-blind placebo-controlled randomized cross-over challenge study in which people with schizophrenia are pretreated with either high-dose NAC 140 mgkg up to a maximum of 15 g or placebo then receive tryptophan TRYP 6 gms The tryptophan challenge method robustly increases peripheral measures of kynurenine and KYNA in humans and putatively increases brain KYNA levels through the CNS conversion of kynurenine to KYNA a process that is observed in both rodents and nonhuman primates The investigators will evaluate the ability of NAC to inhibit the conversion of kynurenine to KYNA with the following primary outcome measures 1 the investigators will measure serum kynurenine and KYNA before and after NACplacebo pre-treatment and TRYP administration and examine whether NAC compared to placebo blocks the peripheral conversion of kynurenine to KYNA 2 the investigators will use the arterial spin labeling ASL technique to measure whole brain and frontal gray matter cerebral blood flow CBF before and after NACplacebo pre-treatment and TRYP administration and examine whether NAC compared to placebo attenuates the effects of TRYP on ASL CBF measures 3 the investigators will use magnetic resonance spectroscopy MRS to measure glutamate and glutathione levels in the medial prefrontal cortex mPFC before and after NACplacebo pre-treatment and TRYP administration and examine whether NAC compared to placebo increases MRS glutathione and glutamate measures and 4 the investigators will use diffusion tensor imaging DTI to measure white matter fractional anisotropy FA before and after NACplacebo pre-treatment and TRYP administration and examine whether NAC compared to placebo increases white matter FA
The investigators will have two secondary endpoints First if the investigators observe that NAC attenuates the effects of TRYP on ASL andor increases mPFC glutamate levels or white matter DTI FA then the investigators will examine whether these effects are related to changes in cognitive measures of attention verbal and visual memory and working memory Second the investigators will use measures of serum KYNA and peripheral blood mononuclear cell PBMC kynurenine 3-monooxygenase KMO activity levels to examine whether the level of these measures is related to the observed effects of NAC on our neuroimaging and cognitive outcome measures
The investigators hypothesize that NAC will inhibit KAT II which will be reflected in the 1 decreased peripheral conversion of kynurenine to KYNA and 2 increased CBF glutamate and white matter fractional anisotropy FA In addition the investigators hypothesize that the NAC effects on the neuroimaging measures will be related to improved performance on cognitive measures of attention verbal and visual memory and working memory These observed effects of NAC will be greater than those seen with placebo The investigators further hypothesize that the NAC effects on ASL CBF glutamate and FA measures will be independent of NAC-induced changes in MRS glutathione ie not due to the NAC oxidative stress mechanism but rather will be correlated with NAC-induced reductions in the peripheral conversion of kynurenine to KYNA Finally the investigators hypothesize that the observed effects of NAC on CBF glutamate and FA will be related to baseline serum KMO activity and KYNA levels The demonstration that NAC reverses the adverse impact of increased KYNA levels will importantly support the development of KAT II inhibitors for the enhancement of cognition in schizophrenia
The investigators will have two secondary endpoints First if the investigators observe that NAC attenuates the effects of TRYP on ASL andor increases mPFC glutamate levels or white matter DTI FA then the investigators will examine whether these effects are related to changes in cognitive measures of attention verbal and visual memory and working memory Second the investigators will use measures of serum KYNA and peripheral blood mononuclear cell PBMC kynurenine 3-monooxygenase KMO activity levels to examine whether the level of these measures is related to the observed effects of NAC on our neuroimaging and cognitive outcome measures
The investigators hypothesize that NAC will inhibit KAT II which will be reflected in the 1 decreased peripheral conversion of kynurenine to KYNA and 2 increased CBF glutamate and white matter fractional anisotropy FA In addition the investigators hypothesize that the NAC effects on the neuroimaging measures will be related to improved performance on cognitive measures of attention verbal and visual memory and working memory These observed effects of NAC will be greater than those seen with placebo The investigators further hypothesize that the NAC effects on ASL CBF glutamate and FA measures will be independent of NAC-induced changes in MRS glutathione ie not due to the NAC oxidative stress mechanism but rather will be correlated with NAC-induced reductions in the peripheral conversion of kynurenine to KYNA Finally the investigators hypothesize that the observed effects of NAC on CBF glutamate and FA will be related to baseline serum KMO activity and KYNA levels The demonstration that NAC reverses the adverse impact of increased KYNA levels will importantly support the development of KAT II inhibitors for the enhancement of cognition in schizophrenia
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
True
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
True
Is an FDA AA801 Violation?:
None