The Correlation Between the Enzyme Paraoxigenase 1 (PON1) to Carotid Artery Atheromatous Plaque

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01440036
Recruitment Status : Unknown
Verified December 2011 by yehudit.hackmon, Ziv Hospital.
Recruitment status was:  Recruiting
First Posted : September 23, 2011
Last Update Posted : December 16, 2011
Information provided by (Responsible Party):
yehudit.hackmon, Ziv Hospital

Brief Summary:
The objective of the research, is to examine the hypothesis, that the enzyme paraoxygenase 1 ( PON1) can influence carotid artery's atherosclerotic plaque content and stability, and its relation to plasma's enzyme concentration.

Condition or disease Intervention/treatment
Carotid Artery Stenosis Procedure: Carotid endarterectomy

Detailed Description:

Atherosclerosis is a major risk factor for morbidity and mortality in the western world. It is characterized by the accumulation of fat (cholesterol) in the arterial wall, creation of the atheromatous plagues and the creation of arterial stenosis and occlusion. The cellular content of theses plaques include: fibroblasts, endothelial cells, smooth muscle cells, macrophages, and lipids: phospholipids, cholesterol, oxysterols and fatty acids. Lipids penetration from the blood stream collaborates different proteins, including the anti-atherogenic enzyme - paraoxygenase 1 - PON1. This enzyme has many ani-atherogenic activities, e.g. Protection from oxygenation and increase of cholesterol efflux from macrophages by HDL. Although the enzyme has a verity of substrates and known anti-atherogenous function, its mechanism is still vogue. The enzymes accumulation rate is the function of the advancement of the fatty strike towards advanced lesion. There is evidence that the presence accumulation and activity of the PON1 within the plaque, is a defense mechanism against atherosclerosis development. The assumption to be proved is that PON1 can control plaque's content and influence its atherogenous factors. Furthermore, we will try to identify these factors that the PON1 acts on. Beside plaque's content and PON1's influence on them, we would like to investigate the phenotype of haptoglobin in the subjects that the plaques were removed from. It is known that diabetics that have the genotype haptoglobin 2-2, characterized by increased risk for oxygenation stress and cardiovascular events (up to 5 times). We would like to examine if there is a correlation between plaque's content, PON1's ability to disassemble oxygenized factors within the plaque, and the phenotype to haptoglobin.

Methods: The plaque source will be from carotid endarterectomy, in the vascular unit. This procedure is a routine operation for patients suffering from carotid artery stenosis, based on clinical decisions. The plaques will be transported to a lipid laboratory soon after they will be harvested, will be frozen in liquid nitrogen and processed into powder. This material will be the origin for the proteins we try to extract. Patient's blood samples (that is drawn routinely for the operation) will be the source for the characterization of the haptoglobin's genotype.

It is critical to emphasize that routinely, the plaques are waste products, and only 5 cc of additional blood is withdrawn from the patients for research purposes.

Study Type : Observational
Estimated Enrollment : 100 participants
Observational Model: Case Control
Time Perspective: Prospective
Official Title: The Correlation Between the Enzyme Paraoxigenase 1 (PON1) to Carotid Artery Atheromatous Plaque
Study Start Date : October 2011
Estimated Primary Completion Date : October 2012
Estimated Study Completion Date : October 2014

Group/Cohort Intervention/treatment
Carotid endarterectomy
Patients that have the common indication for the treatment of carotid artery stenosis by surgery - CEA (carotid endarterectomy), symptomatic and asymptomatic patients.
Procedure: Carotid endarterectomy
The removal of atherosclerotic plaque from the carotid artery, by surgery

Biospecimen Retention:   Samples Without DNA
Atherosclerotic plaque from carotid arteries Blood sample (5cc)

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients undergoing CEA

Inclusion Criteria:

  • Patients undergoing CEA

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01440036

Contact: Tal Salamon, MD 972-50-8434185
Contact: Dallit Manheim, MD 972-50-6265752

Ziv Medical Center Recruiting
Safed, Israel
Contact: Tal Salamon, MD    972-50-8434185   
Contact: Dallit Manheim, MD    972-50-6265752   
Sponsors and Collaborators
Ziv Hospital

Responsible Party: yehudit.hackmon, Principal Investigator, Ziv Hospital Identifier: NCT01440036     History of Changes
Other Study ID Numbers: 0032-11-ZIV
First Posted: September 23, 2011    Key Record Dates
Last Update Posted: December 16, 2011
Last Verified: December 2011

Keywords provided by yehudit.hackmon, Ziv Hospital:
carotid artery
Atherosclerotic plaque
paraoxygenase 1 PON1
Patients undergoing carotid artery endarterectomy CEA for carotid artery stenosis

Additional relevant MeSH terms:
Carotid Stenosis
Plaque, Atherosclerotic
Carotid Artery Diseases
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Arterial Occlusive Diseases
Vascular Diseases
Cardiovascular Diseases
Pathological Conditions, Anatomical