Hormonal, Metabolic, and Signaling Interactions in PAH

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Total Enrollment

1899 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-09-30

Study Completion Date

2032-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Our hypothesis is that optimal treatment of the dysfunctional metabolic pathways which underlie PAH will improve pulmonary vascular function and consequences of the disease.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Transforming Growth Factor Beta Signalling in the Development of Muscle Weakness in Pulmonary Arterial Hypertension

NCT01847716

Muscle Weakness Pulmonary Arterial Hypertension

TERMINATED

Effect of Pharmacologic Interaction Between ERAs and PDE-5 Inhibitors on Medication Serum Levels and Clinical Disease Status in Patients With PAH

NCT02484807

Pulmonary Arterial Hypertension

COMPLETED

Pulmonary Hypertension--Mechanisms and Family Registry

NCT00005357

Lung Diseases Hypertension, Pulmonary

COMPLETED

A Study of Real-world Cohort of Pulmonary Arterial Hypertension (PAH) Participants

NCT04955990

Pulmonary Arterial Hypertension

TERMINATED PHASE4

Study Roles of Heavy Metals and Essential Metal Dyshomeostasis in Pulmonary Arterial Hypertension Patients

NCT04756076

Pulmonary Hypertension Metal Poison

RECRUITING

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Project 1: This project will work to understand why women are affected by pulmonary arterial hypertension (PAH) so much more often than men. This observation is true in heritable, idiopathic and associated forms of PAH. While males and females have some similar hormone levels, certain hormones exist at higher levels in each gender. For example, estrogen levels are much higher in females, and thus seemed the most sensible place to start looking for differences that may be affecting disease. In a small, early study of our heritable patients, we found differences in how patients break down estrogens as compared to healthy control subjects. Now, we want to confirm that what we found is true in a much larger group of patients that includes idiopathic and associated forms of PAH. We will also look to see if testosterone and other androgenic hormones are somehow protective for males. If the observation holds true in the larger group of patients, then we may try to "fix" the hormone imbalance in a mouse model of PAH with a drug therapy, and see if it helps improve the mouse pulmonary hypertension without bad side effects to the animals. If the animal drug studies work, then we may be able to try this drug in patients to see if it will work as a human treatment.

Project 2: Despite major advances in understanding PAH in recent decades, safe, effective and tolerable therapies remain elusive. The metabolic syndrome (central obesity, insulin resistance, high blood pressure and hyperlipidemia-fats in the blood) has been implicated in PAH. Treating the downstream consequences of insulin resistance in the pulmonary vasculature is a new approach to effective intervention against this highly mortal disease. This project will study the role of insulin resistance in pulmonary arterial hypertension and determine if therapies to treat insulin resistance will improve pulmonary arterial hypertension.

Project 3: In Project 3, we are working on the theory that PAH can be treated by fixing cell-cell junctions in blood vessels with a drug called recombinant ACE2(angiotensin converting enzyme 2). This is the only approach so far that has worked to reverse disease in mouse models of heritable PAH, but we need to better understand how it is working and make sure it has long term safety in animal models before starting human trials, hopefully within a few years. Definition: Cell-cell junctions-all of our organs and body structures are made from cells. Normally, these cells (think of a balloon filled with water) line up right next to each other so that the cell membranes touch each other. Materials can flow from one cell to the next. In PAH patients it is believed that the cells in the linings of the small arteries are not able to line up together as they should.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Idiopathic Pulmonary Arterial Hypertension Heritable Pulmonary Arterial Hypertension Scleroderma Associated Pulmonary Arterial Hypertension Appetite Suppressant Associate PAH

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

PAH patients

Patients diagnosed with WHO Group 1 PAH

No interventions assigned to this group

Healthy subjects

Subjects who have been evaluated for heart and lung disease and found to be healthy

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

Project 1

Inclusion:

1. Diagnosis of IPAH (idiopathic pulmonary arterial hypertension), HPAH (heritable pulmonary arterial hypertension), or APAH (associated pulmonary arterial hypertension), family members of affected persons
2. Age 0-90, age 12-90 for skin biopsy

Exclusion:

1. Other diagnosis
2. Age greater than 90, age less than 12 or greater than 90 for skin biopsy

Project 2

Inclusion:

1. Diagnosis of IPAH, HPAH, or APAH, family members of affected persons
2. 0-90
3. Subjects with reasonably easy access to clinic for blood collection and other testing
4. Subject able to tolerate fasting state prior to sample collection and EndoPAT (endothelial function assessment) testing

Exclusion:

1. Other diagnosis
2. 0-90
3. Subjects with difficulty reaching clinic for blood collection and other testing
4. Subjects unable to tolerate fasting state

Project 3

Inclusion:

1. Diagnosis of IPAH, HPAH, or APAH, family members of affected persons
2. 7-90

Exclusion:

1. Other diagnosis
2. Age less than 7 or greater than 90

\-