Does Ultraviolet Irradiation Reduce Platelet Reactivity and Improve Coronary Microvascular Function in Man?
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Purpose
Endothelium derived nitric oxide (NO) regulates vascular tone and blood pressure in man. NO also inhibits platelet aggregation and mediates a variety of beneficial anti-inflammatory and repair mechanisms. NO may also be a mediator in the release of the endogenous fibrinolytic factor, tissue-plasminogen activating factor (t-PA) from the endothelium.1 Via these actions it plays a very important role in protection of the vasculature from atherothrombosis and clinical sequelae such as myocardial infarction and stroke.
Visible and ultraviolet (UV) light relax vascular smooth muscles by producing NO in a phenomenon known as photorelaxation.2 The investigators have demonstrated significant stores of pre-formed, bound NO and other nitrosospecies in human skin, which are rapidly released upon exposure to UVA.3 The investigators have demonstrated recently that serum nitrite and nitroso-species are increased after standing in a UVA phototherapy cabinet and that local UVA exposure is associated with increased forearm arterial blood flow that is independent of skin temperature. The investigators have also demonstrated a fall in mean arterial blood pressure in subjects exposed UVA.
Cardiovascular morbidity and the prevalence of hypertension vary with latitude. The investigators hypothesise that some of this geographical variation may be explained by a diminished sunlight/UVA exposure with attendant negative effects upon NO bio-availability.4 To further examine the potential beneficial effects of UVA exposure we will examine the effects of whole-body UVA upon platelet activation and upon myocardial/coronary arterial flow reserve. The investigators will correlate these measures with systemic nitrate, nitrite and nitroso-species content in healthy volunteers.
HYPOTHESES
- UVA irradiation enhances coronary flow reserve in healthy volunteers.
- UVA irradiation suppresses platelet activation in healthy volunteers.
- UVA irradiation enhances the release of endogenous fibrinolytic factors in healthy volunteers.
| Condition | Intervention |
|---|---|
|
Hypertension |
Radiation: UVA Radiation |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Basic Science |
| Official Title: | Does Ultraviolet Irradiation Reduce Platelet Reactivity and Improve Coronary Microvascular Function in Man? |
- Coronary Flow Reserve [ Time Frame: 0, 20, 40 and 60 mins ] [ Designated as safety issue: No ]Change in coronary flow assessed pre and post UVA radiation versus control
- Platelet Activation [ Time Frame: 0, 20, 40 and 60 mins ] [ Designated as safety issue: No ]Platelet activation assessed using platelet monocyte activity
- Endogenous Fibrinolysis [ Time Frame: 0, 20, 40 and 60 minutes ] [ Designated as safety issue: No ]Assessed using flow cytometry
| Enrollment: | 12 |
| Study Start Date: | March 2012 |
| Study Completion Date: | August 2012 |
| Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Sham Comparator: Sham UVA
sham exposure will be provided by covering the UVA lamps with space blanket.
|
Radiation: UVA Radiation
UVA radiation exposure for 20 minutes
|
|
Experimental: UVA Radiation
Patients will be exposed to UVA radiation for 20 minutes
|
Radiation: UVA Radiation
UVA radiation exposure for 20 minutes
|
Eligibility| Ages Eligible for Study: | 18 Years to 45 Years |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Healthy male volunteers aged between 18-45 years (inclusive).
Exclusion Criteria:
- Inability to provide informed consent
- Co-existent systemic disease (including any history of asthma, reactive airways disease or hypertension)
- Contraindication to UVA treatment
- Any history of cardiac conduction abnormality (including bundle branch block or atrial fibrillation)
- Smoker
- Current intake of aspirin, other non-steroid anti-inflammatory medications or any regular medication.
- Recent infective/inflammatory condition
- Echocardiographic evidence of left ventricular hypertrophy (left ventricular septal diameter >1.2 cm in diastole), systolic dysfunction or significant valvular stenosis or regurgitation.
Contacts and Locations| United Kingdom | |
| University of Edinburgh | |
| Edinburgh, Lothian, United Kingdom, Eh16 4SA | |
| Principal Investigator: | Ninian Lang, MbChB | University of Edinburgh |
More Information
No publications provided
| Responsible Party: | University of Edinburgh |
| ClinicalTrials.gov Identifier: | NCT01785511 History of Changes |
| Other Study ID Numbers: | UVA Study |
| Study First Received: | June 20, 2012 |
| Last Updated: | February 19, 2013 |
| Health Authority: | United Kingdom: National Research Ethics Committee |
Keywords provided by University of Edinburgh:
|
hypertension UV radiation coronary flow reserve nitric oxide |
Additional relevant MeSH terms:
|
Hypertension Vascular Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on May 22, 2013