Nucleophilic Defense Against PM Toxicity (NEAT Trial)

NCT ID: NCT03314987

Last Updated: 2026-01-06

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

299 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-01

Study Completion Date

2022-11-01

Brief Summary

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Carnosine is a naturally occurring peptide found in high levels in skeletal muscle and the brain and is also available commercially as a dietary supplement. Since carnosine has anti-oxidant properties and air pollution exposure induces a state of oxidative stress, the purpose of this study is to see if those taking carnosine as a dietary supplement are protected from air pollution-induced oxidative stress and adverse cardiovascular outcomes.

Detailed Description

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This is a placebo controlled, randomized, double-blind, interventional trial investigating the efficacy of carnosine in reducing the effects of particulate matter air pollution (PM2.5). A total of 240 participants from the Louisville metropolitan and neighboring areas will be randomized into two dietary supplement study groups - carnosine (n=120) versus placebo (n=120). Intervention of study dietary supplements will occur from May through September, when the levels of PM2.5.are highest in the Louisville, KY area. Study participants will be given a daily oral dose of total of 2 grams of carnosine (or placebo) for a total of 12 consecutive weeks (during May through September).

Urinary levels of carnosine will be used to screen and identify potential candidates with low carnosine levels. Those with levels less than the median levels of the population, will be invited to participate in the study. The following measurements will be performed - blood and urine sample collection, physical examination, arterial stiffness, physical function, and self-reported surveys on environmental exposure, sleep, diet, and exercise. Supplement intervention (carnosine or placebo) will be initiated at the time of Baseline Assessment and will continue for 12 weeks from that date. Two follow up visits will occur at 6 weeks and 12 weeks respectively after initiating supplementation.

This innovative clinical investigation will provide an insight into the pre and post intervention effects of a cheap, safe, and over-the-counter available dietary supplement in countering the effects of air pollution.

Conditions

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Air Pollution Toxicity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

placebo controlled, randomized, double-blind
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Investigators
double blind (participant, investigator)

Study Groups

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intervention group

Each participant will be given a daily oral dose of 2 grams of carnosine for 12 weeks

Group Type ACTIVE_COMPARATOR

L-carnosine

Intervention Type DIETARY_SUPPLEMENT

a naturally occurring di-peptide

placebo group

Each participant will be given a daily oral dose of 2 grams of placebo for 12 weeks

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type OTHER

an identically appearing supplement

Interventions

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L-carnosine

a naturally occurring di-peptide

Intervention Type DIETARY_SUPPLEMENT

placebo

an identically appearing supplement

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Individuals between 22-65 years of age of either gender and all ethnicities,
2. All genders and all ethnicities
3. Residing in or near the Louisville metropolitan area
4. Consumes some type of meat/fish at least once a month during the past 3 months
5. Carnosine levels below the median level of the population
6. Agrees to complete all study visits and follow study intervention regimen
7. Will be living in the study area throughout the study period, with no more than 1 week away from the study area.

Exclusion Criteria

1. Consumed any dietary supplement more than 3 times per week in the past 4 weeks (one month)
2. Current / ongoing treatment for substance abuse
3. Currently undergoing treatment or have conditions which may cause participant to be immunosuppressed
4. Diseases Affecting Peripheral Cell Count (i.e. Autoimmune Diseases - Hashimoto, Rheumatoid Arthritis, SLE, Rheumatoid Arthritis, Sjogren syndrome, Ankylosing Spondylitis, Takayasu arteritis, Kawasaki disease, Polyarteritis nodosa.)
5. Diseases Affecting Bone Marrow capacity
6. Diagnosis of any active cancer
7. Recent organ / kidney transplant or replacement (Active/Long-Term Medications)
8. Type 1 Diabetes Mellitus
9. Untreated thyroid disease
10. Untreated anemia
11. Current acute infections (Influenza, fever, etc.)
12. HIV positive status
13. Active/current Hepatitis HepA, HepB or HepC or in past 6 months
14. Currently or planning to be Pregnant / lactating
15. Prisoners / vulnerable populations
16. Other medical conditions that compromise completion of study
17. Unwilling to provide consent
Minimum Eligible Age

22 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Environmental Health Sciences (NIEHS)

NIH

Sponsor Role collaborator

University of Louisville

OTHER

Sponsor Role lead

Responsible Party

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Timothy Edward O'Toole

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Timothy E. O'Toole

Role: PRINCIPAL_INVESTIGATOR

University of Louisville

Locations

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Clinical Trials Unit

Louisville, Kentucky, United States

Site Status

Countries

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United States

References

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O'Toole TE, Hellmann J, Wheat L, Haberzettl P, Lee J, Conklin DJ, Bhatnagar A, Pope CA 3rd. Episodic exposure to fine particulate air pollution decreases circulating levels of endothelial progenitor cells. Circ Res. 2010 Jul 23;107(2):200-3. doi: 10.1161/CIRCRESAHA.110.222679. Epub 2010 Jul 1.

Reference Type BACKGROUND
PMID: 20595651 (View on PubMed)

Barski OA, Xie Z, Baba SP, Sithu SD, Agarwal A, Cai J, Bhatnagar A, Srivastava S. Dietary carnosine prevents early atherosclerotic lesion formation in apolipoprotein E-null mice. Arterioscler Thromb Vasc Biol. 2013 Jun;33(6):1162-70. doi: 10.1161/ATVBAHA.112.300572. Epub 2013 Apr 4.

Reference Type RESULT
PMID: 23559625 (View on PubMed)

Pope CA 3rd, Bhatnagar A, McCracken JP, Abplanalp W, Conklin DJ, O'Toole T. Exposure to Fine Particulate Air Pollution Is Associated With Endothelial Injury and Systemic Inflammation. Circ Res. 2016 Nov 11;119(11):1204-1214. doi: 10.1161/CIRCRESAHA.116.309279. Epub 2016 Oct 25.

Reference Type RESULT
PMID: 27780829 (View on PubMed)

Baba SP, Amraotkar AR, Hoetker D, Gao H, Gomes D, Zhao J, Wempe MF, Rice PJ, DeFilippis AP, Rai SN, Pope CA 3rd, Bhatnagar A, O'Toole TE. Evaluation of supplementary carnosine accumulation and distribution: an initial analysis of participants in the Nucleophilic Defense Against PM Toxicity (NEAT) clinical trial. Amino Acids. 2024 Aug 31;56(1):55. doi: 10.1007/s00726-024-03414-5.

Reference Type DERIVED
PMID: 39215872 (View on PubMed)

O'Toole TE, Amraotkar AA, DeFilippis AP, Rai SN, Keith RJ, Baba SP, Lorkiewicz P, Crandell CE, Pariser GL, Wingard CJ, Pope Iii CA, Bhatnagar A. Protocol to assess the efficacy of carnosine supplementation in mitigating the adverse cardiovascular responses to particulate matter (PM) exposure: the Nucleophilic Defense Against PM Toxicity (NEAT) trial. BMJ Open. 2020 Dec 28;10(12):e039118. doi: 10.1136/bmjopen-2020-039118.

Reference Type DERIVED
PMID: 33372072 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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5R01ES019217

Identifier Type: NIH

Identifier Source: secondary_id

View Link

20.0258

Identifier Type: -

Identifier Source: org_study_id

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