Effects of Carnosine In Patients With Peripheral Arterial Disease Patients

NCT ID: NCT06480760

Last Updated: 2025-05-29

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

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Recruitment Status

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

144 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-20

Study Completion Date

2028-10-01

Brief Summary

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The purpose of this study is to determine whether carnosine (a food ingredient found in chicken and red meat) supplementation (2 g) for 6 months in participants with non-claudication and claudication peripheral arterial disease (PAD) improves walking ability. Previous studies with heart failure patients have shown that carnosine supplementation increases walking capacity in these patients.

Detailed Description

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The objective of this double-blinded longitudinal study is to determine whether carnosine supplementation (2 g) for 6 months in participants with non-claudication and claudication peripheral arterial disease (PAD) improves walking ability. In this pilot study we will enroll 144 participants that will be divided into placebo (n=72) and carnosine groups (n=72). We will measure the distance covered on the 6-minute walk test (6-MWT) and the pain free walking capacity on the treadmill before and after the placebo or carnosine supplementation. We will measure ankle branchial index (ABI) and blood flow by magnetic resonance imaging (MRI) before and after the carnosine and placebo supplementation. In addition, we will measure carnosine by 1HMRS (Proton magnetic resonance spectroscopy), perform, global metabolomics and proteomics in the skeletal muscle, a comprehensive lipid and metabolic profile of blood, uptake of carnosine in red blood cells (RBCs), and measure carnosine aldehyde conjugates in the urine before and after 6 months of carnosine and placebo supplementation. Following completion of the study, we will follow the participants for another 3 months and examine the durability of carnosine supplementation.

Conditions

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Peripheral Arterial Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A randomized, double-blinded longitudinal study in approximately 144 PAD patients
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Placebo

Cellulose

Group Type NO_INTERVENTION

No interventions assigned to this group

Carnosine

Carnosine 2 g daily for 6 months

Group Type EXPERIMENTAL

Carnosine

Intervention Type DRUG

Food ingredient (supplement)

Interventions

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Carnosine

Food ingredient (supplement)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Participants between 40-80 years of age.
2. White or African American race.
3. Literate in English.
4. ABI \>0.4-\<0.90, obtained within 6 weeks from enrollment.
5. Willing and able to comply with protocol requirements.
6. Participant is able to provide informed consent.

Exclusion Criteria

1. As per physician's discretion, participants with HIV, hepatitis, significant liver disease, anemia, renal disease requiring dialysis, lung disease requiring home oxygen therapy, and active cancer may be excluded.
2. Critical limb ischemia with below or above the knee amputations or any form of foot ulceration over the symptomatic leg.
3. Presence of significant injury within 30 days, or vascular intervention on the symptomatic leg within 6 months before enrollment, as per physician's discretion.
4. Participants with a baseline 6MWT of less than 152.0 meters (498ft) or greater than 487.7 meters (1600ft).
5. Known allergy to L-carnosine.
6. Participants with rare autosomal recessive metabolic disorder carnosinemia or carnosinase deficiency.
7. Currently participating in other clinical trials.
8. Participation in any carnosine supplementation clinical trial anytime in the past.
9. Participants already taking carnosine.
10. Participants unable to provide urine sample (anuric).
11. Pregnant participants.
12. Participants using dual antiplatelet therapies will not be included for biopsy.
13. Participants with internal metallic objects in body will not be eligible for MRI or 1HMRS.
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Shahid Baba

OTHER

Sponsor Role lead

Responsible Party

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Shahid Baba

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Shahid Baba, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Louisville School of Medicine

Locations

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University of Louisville School of Medicine, Department of Medicine, Division of Environmental Medicine

Louisville, Kentucky, United States

Site Status RECRUITING

University Surgical Associates, 401 E. Chestnut St, Suite 710

Louisville, Kentucky, United States

Site Status NOT_YET_RECRUITING

UofL Physicians - Vascular Surgery Associates, 201 Abraham Flexner Way, Suite 1004

Louisville, Kentucky, United States

Site Status NOT_YET_RECRUITING

Countries

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United States

Central Contacts

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Shahid Baba, PhD

Role: CONTACT

502-296-7713

Amit Dwivedi, MD

Role: CONTACT

502-583-8303

Facility Contacts

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Shahid Baba, PhD

Role: primary

502-296-7713

Amit Dwivedi, MD

Role: backup

502-583-8303

Shahid Baba, PhD

Role: primary

502-296-7713

Amit Dwivedi, MD

Role: backup

502-583-8303

Shahid Baba, PhD

Role: primary

502-296-7713

Amit Dwivedi, MD

Role: backup

502-583-8303

References

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de Courten B, Jakubova M, de Courten MP, Kukurova IJ, Vallova S, Krumpolec P, Valkovic L, Kurdiova T, Garzon D, Barbaresi S, Teede HJ, Derave W, Krssak M, Aldini G, Ukropec J, Ukropcova B. Effects of carnosine supplementation on glucose metabolism: Pilot clinical trial. Obesity (Silver Spring). 2016 May;24(5):1027-34. doi: 10.1002/oby.21434. Epub 2016 Apr 4.

Reference Type BACKGROUND
PMID: 27040154 (View on PubMed)

Vincent KA, Shyu KG, Luo Y, Magner M, Tio RA, Jiang C, Goldberg MA, Akita GY, Gregory RJ, Isner JM. Angiogenesis is induced in a rabbit model of hindlimb ischemia by naked DNA encoding an HIF-1alpha/VP16 hybrid transcription factor. Circulation. 2000 Oct 31;102(18):2255-61. doi: 10.1161/01.cir.102.18.2255.

Reference Type BACKGROUND
PMID: 11056102 (View on PubMed)

Hiatt WR, Hoag S, Hamman RF. Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley Diabetes Study. Circulation. 1995 Mar 1;91(5):1472-9. doi: 10.1161/01.cir.91.5.1472.

Reference Type BACKGROUND
PMID: 7867189 (View on PubMed)

Waeckel L, Mallat Z, Potteaux S, Combadiere C, Clergue M, Duriez M, Bao L, Gerard C, Rollins BJ, Tedgui A, Levy BI, Silvestre JS. Impairment in postischemic neovascularization in mice lacking the CXC chemokine receptor 3. Circ Res. 2005 Mar 18;96(5):576-82. doi: 10.1161/01.RES.0000159389.55544.20. Epub 2005 Feb 17.

Reference Type BACKGROUND
PMID: 15718500 (View on PubMed)

Gerhardt H, Golding M, Fruttiger M, Ruhrberg C, Lundkvist A, Abramsson A, Jeltsch M, Mitchell C, Alitalo K, Shima D, Betsholtz C. VEGF guides angiogenic sprouting utilizing endothelial tip cell filopodia. J Cell Biol. 2003 Jun 23;161(6):1163-77. doi: 10.1083/jcb.200302047. Epub 2003 Jun 16.

Reference Type BACKGROUND
PMID: 12810700 (View on PubMed)

Creager MA, Olin JW, Belch JJ, Moneta GL, Henry TD, Rajagopalan S, Annex BH, Hiatt WR. Effect of hypoxia-inducible factor-1alpha gene therapy on walking performance in patients with intermittent claudication. Circulation. 2011 Oct 18;124(16):1765-73. doi: 10.1161/CIRCULATIONAHA.110.009407. Epub 2011 Sep 26.

Reference Type BACKGROUND
PMID: 21947297 (View on PubMed)

Wang GL, Semenza GL. Desferrioxamine induces erythropoietin gene expression and hypoxia-inducible factor 1 DNA-binding activity: implications for models of hypoxia signal transduction. Blood. 1993 Dec 15;82(12):3610-5.

Reference Type BACKGROUND
PMID: 8260699 (View on PubMed)

Silvestre JS, Mallat Z, Tedgui A, Levy BI. Post-ischaemic neovascularization and inflammation. Cardiovasc Res. 2008 May 1;78(2):242-9. doi: 10.1093/cvr/cvn027. Epub 2008 Feb 5.

Reference Type BACKGROUND
PMID: 18252762 (View on PubMed)

Aicher A, Zeiher AM, Dimmeler S. Mobilizing endothelial progenitor cells. Hypertension. 2005 Mar;45(3):321-5. doi: 10.1161/01.HYP.0000154789.28695.ea. Epub 2005 Jan 17.

Reference Type BACKGROUND
PMID: 15655116 (View on PubMed)

Asahara T, Takahashi T, Masuda H, Kalka C, Chen D, Iwaguro H, Inai Y, Silver M, Isner JM. VEGF contributes to postnatal neovascularization by mobilizing bone marrow-derived endothelial progenitor cells. EMBO J. 1999 Jul 15;18(14):3964-72. doi: 10.1093/emboj/18.14.3964.

Reference Type BACKGROUND
PMID: 10406801 (View on PubMed)

Forsythe JA, Jiang BH, Iyer NV, Agani F, Leung SW, Koos RD, Semenza GL. Activation of vascular endothelial growth factor gene transcription by hypoxia-inducible factor 1. Mol Cell Biol. 1996 Sep;16(9):4604-13. doi: 10.1128/MCB.16.9.4604.

Reference Type BACKGROUND
PMID: 8756616 (View on PubMed)

Ziello JE, Jovin IS, Huang Y. Hypoxia-Inducible Factor (HIF)-1 regulatory pathway and its potential for therapeutic intervention in malignancy and ischemia. Yale J Biol Med. 2007 Jun;80(2):51-60.

Reference Type BACKGROUND
PMID: 18160990 (View on PubMed)

Heil M, Schaper W. Influence of mechanical, cellular, and molecular factors on collateral artery growth (arteriogenesis). Circ Res. 2004 Sep 3;95(5):449-58. doi: 10.1161/01.RES.0000141145.78900.44.

Reference Type BACKGROUND
PMID: 15345667 (View on PubMed)

Serrano Hernando FJ, Martin Conejero A. [Peripheral artery disease: pathophysiology, diagnosis and treatment]. Rev Esp Cardiol. 2007 Sep;60(9):969-82. doi: 10.1157/13109651. Spanish.

Reference Type BACKGROUND
PMID: 17915154 (View on PubMed)

Chez MG, Buchanan CP, Aimonovitch MC, Becker M, Schaefer K, Black C, Komen J. Double-blind, placebo-controlled study of L-carnosine supplementation in children with autistic spectrum disorders. J Child Neurol. 2002 Nov;17(11):833-7. doi: 10.1177/08830738020170111501.

Reference Type BACKGROUND
PMID: 12585724 (View on PubMed)

Hobson RM, Saunders B, Ball G, Harris RC, Sale C. Effects of beta-alanine supplementation on exercise performance: a meta-analysis. Amino Acids. 2012 Jul;43(1):25-37. doi: 10.1007/s00726-011-1200-z. Epub 2012 Jan 24.

Reference Type BACKGROUND
PMID: 22270875 (View on PubMed)

Parkhouse WS, McKenzie DC, Hochachka PW, Ovalle WK. Buffering capacity of deproteinized human vastus lateralis muscle. J Appl Physiol (1985). 1985 Jan;58(1):14-7. doi: 10.1152/jappl.1985.58.1.14.

Reference Type BACKGROUND
PMID: 3968004 (View on PubMed)

Beebe HG, Dawson DL, Cutler BS, Herd JA, Strandness DE Jr, Bortey EB, Forbes WP. A new pharmacological treatment for intermittent claudication: results of a randomized, multicenter trial. Arch Intern Med. 1999 Sep 27;159(17):2041-50. doi: 10.1001/archinte.159.17.2041.

Reference Type BACKGROUND
PMID: 10510990 (View on PubMed)

Harwood AE, Smith GE, Cayton T, Broadbent E, Chetter IC. A Systematic Review of the Uptake and Adherence Rates to Supervised Exercise Programs in Patients with Intermittent Claudication. Ann Vasc Surg. 2016 Jul;34:280-9. doi: 10.1016/j.avsg.2016.02.009. Epub 2016 Apr 25.

Reference Type BACKGROUND
PMID: 27126713 (View on PubMed)

Treat-Jacobson D, McDermott MM, Bronas UG, Campia U, Collins TC, Criqui MH, Gardner AW, Hiatt WR, Regensteiner JG, Rich K; American Heart Association Council on Peripheral Vascular Disease; Council on Quality of Care and Outcomes Research; and Council on Cardiovascular and Stroke Nursing. Optimal Exercise Programs for Patients With Peripheral Artery Disease: A Scientific Statement From the American Heart Association. Circulation. 2019 Jan 22;139(4):e10-e33. doi: 10.1161/CIR.0000000000000623. No abstract available.

Reference Type BACKGROUND
PMID: 30586765 (View on PubMed)

Treat-Jacobson D, McDermott MM, Beckman JA, Burt MA, Creager MA, Ehrman JK, Gardner AW, Mays RJ, Regensteiner JG, Salisbury DL, Schorr EN, Walsh ME; American Heart Association Council on Peripheral Vascular Disease; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; and Council on Lifestyle and Cardiometabolic Health. Implementation of Supervised Exercise Therapy for Patients With Symptomatic Peripheral Artery Disease: A Science Advisory From the American Heart Association. Circulation. 2019 Sep 24;140(13):e700-e710. doi: 10.1161/CIR.0000000000000727. Epub 2019 Aug 26.

Reference Type BACKGROUND
PMID: 31446770 (View on PubMed)

McDermott MM, Guralnik JM, Tian L, Zhao L, Polonsky TS, Kibbe MR, Criqui MH, Zhang D, Conte MS, Domanchuk K, Li L, Sufit R, Leeuwenburgh C, Ferrucci L. Comparing 6-minute walk versus treadmill walking distance as outcomes in randomized trials of peripheral artery disease. J Vasc Surg. 2020 Mar;71(3):988-1001. doi: 10.1016/j.jvs.2019.05.058. Epub 2019 Dec 23.

Reference Type BACKGROUND
PMID: 31870756 (View on PubMed)

McDermott MM, Dayanidhi S, Kosmac K, Saini S, Slysz J, Leeuwenburgh C, Hartnell L, Sufit R, Ferrucci L. Walking Exercise Therapy Effects on Lower Extremity Skeletal Muscle in Peripheral Artery Disease. Circ Res. 2021 Jun 11;128(12):1851-1867. doi: 10.1161/CIRCRESAHA.121.318242. Epub 2021 Jun 10.

Reference Type BACKGROUND
PMID: 34110902 (View on PubMed)

McDermott MM, Spring B, Tian L, Treat-Jacobson D, Ferrucci L, Lloyd-Jones D, Zhao L, Polonsky T, Kibbe MR, Bazzano L, Guralnik JM, Forman DE, Rego A, Zhang D, Domanchuk K, Leeuwenburgh C, Sufit R, Smith B, Manini T, Criqui MH, Rejeski WJ. Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients With Peripheral Artery Disease: The LITE Randomized Clinical Trial. JAMA. 2021 Apr 6;325(13):1266-1276. doi: 10.1001/jama.2021.2536.

Reference Type BACKGROUND
PMID: 33821898 (View on PubMed)

Money SR, Herd JA, Isaacsohn JL, Davidson M, Cutler B, Heckman J, Forbes WP. Effect of cilostazol on walking distances in patients with intermittent claudication caused by peripheral vascular disease. J Vasc Surg. 1998 Feb;27(2):267-74; discussion 274-5. doi: 10.1016/s0741-5214(98)70357-x.

Reference Type BACKGROUND
PMID: 9510281 (View on PubMed)

Dawson DL, Cutler BS, Meissner MH, Strandness DE Jr. Cilostazol has beneficial effects in treatment of intermittent claudication: results from a multicenter, randomized, prospective, double-blind trial. Circulation. 1998 Aug 18;98(7):678-86. doi: 10.1161/01.cir.98.7.678.

Reference Type BACKGROUND
PMID: 9715861 (View on PubMed)

Girolami B, Bernardi E, Prins MH, Ten Cate JW, Hettiarachchi R, Prandoni P, Girolami A, Buller HR. Treatment of intermittent claudication with physical training, smoking cessation, pentoxifylline, or nafronyl: a meta-analysis. Arch Intern Med. 1999 Feb 22;159(4):337-45. doi: 10.1001/archinte.159.4.337.

Reference Type BACKGROUND
PMID: 10030306 (View on PubMed)

Peacock JM, Keo HH, Duval S, Baumgartner I, Oldenburg NC, Jaff MR, Henry TD, Yu X, Hirsch AT. The incidence and health economic burden of ischemic amputation in Minnesota, 2005-2008. Prev Chronic Dis. 2011 Nov;8(6):A141. Epub 2011 Oct 17.

Reference Type BACKGROUND
PMID: 22005634 (View on PubMed)

Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, Carnethon MR, Dai S, de Simone G, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Greenlund KJ, Hailpern SM, Heit JA, Ho PM, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, McDermott MM, Meigs JB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Rosamond WD, Sorlie PD, Stafford RS, Turan TN, Turner MB, Wong ND, Wylie-Rosett J; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation. 2011 Feb 1;123(4):e18-e209. doi: 10.1161/CIR.0b013e3182009701. Epub 2010 Dec 15.

Reference Type BACKGROUND
PMID: 21160056 (View on PubMed)

Boakye AA, Zhang D, Guo L, Zheng Y, Hoetker D, Zhao J, Posa DK, Ng CK, Zheng H, Kumar A, Kumar V, Wempe MF, Bhatnagar A, Conklin DJ, Baba SP. Carnosine Supplementation Enhances Post Ischemic Hind Limb Revascularization. Front Physiol. 2019 Jul 2;10:751. doi: 10.3389/fphys.2019.00751. eCollection 2019.

Reference Type BACKGROUND
PMID: 31312142 (View on PubMed)

Schon M, Just I, Krumpolec P, Blazicek P, Valkovic L, Aldini G, Tsai CL, De Courten B, Krssak M, Ukropcova B, Ukropec J. Supplementation-induced change in muscle carnosine is paralleled by changes in muscle metabolism, protein glycation and reactive carbonyl species sequestering. Physiol Res. 2023 Mar 8;72(1):87-97. doi: 10.33549/physiolres.934911. Epub 2022 Dec 22.

Reference Type BACKGROUND
PMID: 36545878 (View on PubMed)

Caruso J, Charles J, Unruh K, Giebel R, Learmonth L, Potter W. Ergogenic effects of beta-alanine and carnosine: proposed future research to quantify their efficacy. Nutrients. 2012 Jul;4(7):585-601. doi: 10.3390/nu4070585. Epub 2012 Jun 26.

Reference Type BACKGROUND
PMID: 22852051 (View on PubMed)

Harris RC, Stellingwerff T. Effect of beta-alanine supplementation on high-intensity exercise performance. Nestle Nutr Inst Workshop Ser. 2013;76:61-71. doi: 10.1159/000350258. Epub 2013 Jul 25.

Reference Type BACKGROUND
PMID: 23899755 (View on PubMed)

Hipkiss AR. Energy metabolism, proteotoxic stress and age-related dysfunction - protection by carnosine. Mol Aspects Med. 2011 Aug;32(4-6):267-78. doi: 10.1016/j.mam.2011.10.004. Epub 2011 Oct 15.

Reference Type BACKGROUND
PMID: 22020113 (View on PubMed)

Teufel M, Saudek V, Ledig JP, Bernhardt A, Boularand S, Carreau A, Cairns NJ, Carter C, Cowley DJ, Duverger D, Ganzhorn AJ, Guenet C, Heintzelmann B, Laucher V, Sauvage C, Smirnova T. Sequence identification and characterization of human carnosinase and a closely related non-specific dipeptidase. J Biol Chem. 2003 Feb 21;278(8):6521-31. doi: 10.1074/jbc.M209764200. Epub 2002 Dec 6.

Reference Type BACKGROUND
PMID: 12473676 (View on PubMed)

Drozak J, Veiga-da-Cunha M, Vertommen D, Stroobant V, Van Schaftingen E. Molecular identification of carnosine synthase as ATP-grasp domain-containing protein 1 (ATPGD1). J Biol Chem. 2010 Mar 26;285(13):9346-9356. doi: 10.1074/jbc.M109.095505. Epub 2010 Jan 22.

Reference Type BACKGROUND
PMID: 20097752 (View on PubMed)

Lombardi C, Carubelli V, Lazzarini V, Vizzardi E, Bordonali T, Ciccarese C, Castrini AI, Dei Cas A, Nodari S, Metra M. Effects of oral administration of orodispersible levo-carnosine on quality of life and exercise performance in patients with chronic heart failure. Nutrition. 2015 Jan;31(1):72-8. doi: 10.1016/j.nut.2014.04.021. Epub 2014 May 10.

Reference Type BACKGROUND
PMID: 25287762 (View on PubMed)

Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res. 2015 Apr 24;116(9):1509-26. doi: 10.1161/CIRCRESAHA.116.303849.

Reference Type BACKGROUND
PMID: 25908725 (View on PubMed)

Annex BH. Therapeutic angiogenesis for critical limb ischaemia. Nat Rev Cardiol. 2013 Jul;10(7):387-96. doi: 10.1038/nrcardio.2013.70. Epub 2013 May 14.

Reference Type BACKGROUND
PMID: 23670612 (View on PubMed)

Other Identifiers

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R01HL163419

Identifier Type: NIH

Identifier Source: secondary_id

View Link

24.0309

Identifier Type: -

Identifier Source: org_study_id

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