The Role of Minerelocorticoid Receptor on Modulating Aldosterone Production

NCT02871648 — Phase 1, Completed, 23 participants, Brigham and Women's Hospital

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RegistryNCT02871648
StatusCompleted
PhasePhase 1
Study typeInterventional; randomized, crossover, masking: double, other
Enrollment23 (Actual)
SponsorBrigham and Women's Hospital (Other)
ConditionsHealthy Volunteers
InterventionsPlacebo, Fludrocortisone, Eplerenone (Drug)
Datesstart 2016-01-01, primary completion 2019-10-01, completion 2019-12-01, first posted 2016-08-18, last updated 2021-06-08
Locations1 site in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Healthy Volunteers All trials of Placebo All trials of Fludrocortisone

-Summary

The purpose of this research protocol is to determine if the same effects are observed in vivo in humans using a similar approach. Demonstrating that mineralocorticoid acts on zona glomerulosa cells to regulate aldosterone production in a short feedback loop would provide important insight into hormone regulation, and explain variability in pathophysiologic states such as hypertension and cardiovascular diseases.

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+Detailed description

In order to provide additional evidence indicating the presence of functional and in order to provide additional evidence indicating the presence of functional mineralocorticoid receptors (MR) on zona glomerulosa (ZG) cells, the investigators propose the following protocol in healthy volunteers. The investigators will evaluate aldosterone and cortisol production in response to an angiotensin II infusion after three separate test conditions: 1) placebo, 2) following a single dose of fludrocortisone, and 3) following a single dose of eplerenone (a MR antagonist).

+Arms and interventions

ArmTypeInterventionsDescription
PlaceboPlacebo comparatorDrug: PlaceboPlacebo prepared by Investigational Drug Services at Brigham and Women's Hospital
FludrocortisoneActive comparatorDrug: FludrocortisoneSubjects will receive 0.1 mg of fludrocortisone (Florinef) on one of three study days.
EplerononeActive comparatorDrug: EplerenoneSubjects will receive 100 mg of epleronone on one of three study days.
  • Placebo (Drug): Placebo prepared by Investigation Drug Services at Brigham and Women's Hospital
  • Fludrocortisone (Drug), also known as Florinef: Fludrocortisone 0.1 mg
  • Eplerenone (Drug), also known as Inspra: Epleronone 100 mg

+Outcome measures

Primary outcomes

  • Serum aldosterone after angiotensin II infusion [5 days]: Aldosterone levels after 30 mins AngII infusion

Secondary outcomes

  • Serum aldosterone after cosyntropin infusion [5 days]: Aldosterone levels after 30 mins cosyntropin infusion
  • Serum cortisol after angiotensin II infusion [5 days]: Cortisol levels after 30 mins AngII infusion
  • Serum cortisol after cosyntropin infusion [5 days]: Cortisol levels after 30 mins cosyntropin infusion

+Eligibility

Sex: All, ages: 18 Years to 40 Years, accepts healthy volunteers

Inclusion Criteria:

* Participants must be healthy, with no prior history of hypertension, no family history of hypertension, diabetes, stroke or cardiac disease in first-degree relatives before the age of 70 years and have an average (two measurements) blood pressure of <130/89 mm Hg and >100/50 mmHg at the screening visit.
* All subjects will have body mass index 19-25 kg/m2.
* Subjects must have normal laboratory values for: Complete blood count; serum creatinine, sodium, potassium, glucose, liver enzymes; urinalysis; negative urine HCG in women; normal ECG

Exclusion Criteria:

* Alcohol intake >12oz per week, as well as tobacco or recreational drug use.
* Any subject with a history of coronary disease, diabetes, hypertension, stroke, kidney disease, or illness requiring overnight hospitalization in the past 6 months will be excluded from the study.
* Subjects taking any prescription medications (with the exception of birth control pills) or herbal medications will be excluded.
* Because of the unknown risk of infused angiotensin II in pregnancy, women who are pregnant will be excluded from study and all women will be screened for pregnancy by quantitative serum hCG measurement on the day of each CCI admission.
* Women currently breastfeeding will also be excluded from the study.

+Locations (1)

FacilityCityCountryStatus
Brigham and Women's HospitalBoston, MassachusettsUnited States

+Publications

  • Braley LM, Williams GH. Rat adrenal cell sensitivity to angiotensin II, alpha-1-24-ACTH, and potassium: a comparative study. Am J Physiol. 1977 Nov;233(5):E402-6. doi: 10.1152/ajpendo.1977.233.5.E402. PMID 200147
  • Results publication: Yuan YE, Adler GK, Rosner B, Merino AA, Guzelce EC, Williams GH, Williams JS, Haas AV. Investigating a Mineralocorticoid Receptor Mediation of an Ultra-Short Feedback Loop Regulating Aldosterone Production in Humans. Clin Endocrinol (Oxf). 2026 Aug 12. doi: 10.1111/cen.70189. Online ahead of print. PMID 42581762

+Investigators