DNA Methylation and Vascular Function

• ClinicalTrials.gov Identifier: NCT03527420
• Recruitment Status: Recruiting
• First Posted: May 17, 2018
• Last Update Posted: June 10, 2021
• Sponsor: University of Illinois at Chicago
• Collaborator: National Heart, Lung, and Blood Institute (NHLBI)
• Information provided by (Responsible Party): Abeer M. Mohamed, University of Illinois at Chicago

Study Description

Brief Summary:

The main objective is to examine DNA hypomethylation as an underlying mechanism for the increased production of inflammatory cytokines and the impaired vascular function in obese individuals and as a potential target for nonpharmacological preventive/therapeutic interventions such as aerobic exercise.

Condition or disease	Intervention/treatment	Phase
Obesity; Vascular Dysfunction	Other: Exercise training	Not Applicable

Detailed Description:

The long-term goal of this study is to identify valid targets and strategies for the prevention and treatment of obesity-related cardiovascular disease. Obesity is characterized by a large accumulation of fat tissues that secrete numerous inflammatory mediators (called adipocytokines), generating a systemic inflammatory state. These adipocytokines induce vascular dysfunction which is the initial step towards developing cardiovascular disease. Obesity is affected by environmental factors such as diet and physical activity. These factors induce epigenetic changes, which are changes that affect gene expression without altering the DNA sequence. One of these epigenetic modifications is the reduction in DNA methylation (referred to as hypomethylation) resulting in subsequent increases in gene expression. Preliminary data of the current study showed that the extracted DNA from fat tissues of obese subjects is hypomethylated compared to non-obese controls. DNA hypomethylation correlated significantly with higher expression of adipocytokines and impaired vasodilation in obese subjects. Therefore, the main hypothesis in this study is that the increase in adipocytokine expression in obese adults is mediated by DNA hypomethylation and that DNA hypomethylation is a promising target to prevent obesity-associated inflammation and vascular dysfunction. The flexible modifiable nature of DNA methylation makes it a perfect target for lifestyle interventions such as physical activity and weight loss. Thus, the investigators propose that aerobic exercise training and weight loss following Bariatric surgery will reverse DNA hypomethylation and improve vascular function in obese subjects. This hypothesis will be tested by (1) Investigating abnormal DNA methylation patterns of adipocytokines in fat tissues from obese adults between the age of 18 and 50 compared to non-obese subjects; (2) Test the effectiveness of 12-week aerobic exercise training on reversing DNA hypomethylation and improving vascular function in obese adults; and (3) Examine the effectiveness of weight loss surgery on DNA methylation and vascular function. The proposed studies will improve the understanding of the epigenetic underpinning of obesity-related vascular dysfunction, identify novel therapeutic targets for improving vascular function in obese adults, and provide an evidence for the positive effects of aerobic exercise training and weight loss on the prevention and treatment of obesity-associated cardiovascular disease. These studies will have a positive impact on improving the prevention and therapeutic management of obesity-related cardiovascular morbidities that affect millions of people worldwide.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 80 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Prevention
• Official Title: DNA Methylation and Vascular Function in Obesity: Role of Exercise and Weight Loss
• Actual Study Start Date: October 11, 2019
• Estimated Primary Completion Date: June 30, 2022
• Estimated Study Completion Date: August 31, 2022

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: Exercising; 12 weeks of aerobic exercise training	Other: Exercise training; Twelve weeks of aerobic exercise training
No Intervention: Non-exercising; standard of care

Outcome Measures

Primary Outcome Measures :

1. DNA methylation status of adipocytokines in obese individuals [ Time Frame: Month 24-30 ]
   DNA methylation of 20 preselected adipocytokines using "Amplicon sequencing-based methylation profiling" will be measured in fat tissue collected from obese individuals who are scheduled for bariatric surgery before and after 12 weeks of aerobic exercise training.

Secondary Outcome Measures :

1. Vascular health biomarkers in obese individuals before and after exercise training [ Time Frame: Month 24-30 ]
   Serum or plasma levels (pg/ml) of biomarkers of vascular function such as endothelin-1, cyclic guanosine monophosphate (cGMP), and endothelial cell adhesion molecules (soluble intracellular adhesion molecules, soluble vascular cell adhesion molecules, soluble platelet and endothelial cell adhesion molecules, soluble E-selectin, and soluble P-selectin).
2. Flow induced dilation [ Time Frame: Month 1-20 ]
   Measuring reactivity of brachial artery and isolated arterioles from adipose tissues

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 50 Years (Adult)
• Sexes Eligible for Study: All
• Gender Based Eligibility: Yes
• Gender Eligibility Description: Gender identity
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• BMI ≥ 35 kg/m2
• Between ages 18-50 years
• Not pregnant
• Approved for a bariatric surgery

Exclusion Criteria:

• To avoid confounding from other inflammatory conditions individuals with current cancer, heart, kidney or liver disease, gallbladder disease or acute or chronic inflammatory diseases (including rheumatoid arthritis, lupus and other autoimmune diseases and genetic diseases) will be excluded
• Pregnant women will be excluded, as they will not be eligible for bariatric surgery
• Current smokers
• Currently abusing alcohol or drugs

Contacts and Locations

Contacts

Contact: Abeer Mohamed, MD, PhD; 3127539998; amahmo4@uic.edu

Locations

United States, Illinois

University of Illinois at Chicago; Recruiting

Chicago, Illinois, United States, 60612

Contact: Abeer M Mohamed, MD, PhD 312-355-8099 amahmo4@uic.edu

Sponsors and Collaborators

University of Illinois at Chicago

National Heart, Lung, and Blood Institute (NHLBI)

Investigators

• Principal Investigator: Abeer Mohamed, MD, PhD; University of Illinois at Chicago

More Information

• Responsible Party: Abeer M. Mohamed, Postdoctoral Research Associate, University of Illinois at Chicago
• ClinicalTrials.gov Identifier: NCT03527420
• Other Study ID Numbers: 2017-1125; 1K99HL140049-01 ( U.S. NIH Grant/Contract )
• First Posted: May 17, 2018
• Last Update Posted: June 10, 2021
• Last Verified: June 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Yes
• Plan Description: All data obtained will be shared with the public openly via publication in the most rigorous, visible and appropriate scientific journals possible. Data will be published as soon as it is reasonable to do so (i.e., sufficient data generated to warrant a suitable paper). Supplemental data for each published paper will be made available in one location on the laboratory webpage of the applicant and her mentor. The applicant and other investigators are open to collaboration with outside groups as well when there is mutual interest in this approach. In accordance to the NIH public access requirement (Section 218), we will submit to the National Library of Medicine's PubMed Central an electronic version of our final peer-reviewed manuscripts upon acceptance for publication to be made public no later than 12 months after the official date of publication. We will make every effort to keep findings of this research project widely available and accessible to the research community.
• Supporting Materials: Statistical Analysis Plan (SAP); Clinical Study Report (CSR)
• Time Frame: Month 30-36

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Abeer M. Mohamed, University of Illinois at Chicago:

Obesity; DNA methylation; Exercise; Weight loss; Bariatric; Macrovascular; Microvascular; Epigenetics; Adipose tissue; Adipocytokines; Inflammation; Cardiovascular

Additional relevant MeSH terms:

Obesity; Overnutrition; Nutrition Disorders; Overweight; Body Weight