Treatment Strategy to Enhance Nrf2 Signaling in Older Adults

Sponsor
Northern Arizona University (Other)
Overall Status
Not yet recruiting
CT.gov ID
NCT04848792
Collaborator
Villanova University (Other)
30
1
2
27
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Study Details

Study Description

Brief Summary

Exercise is the cornerstone of disease prevention and often an important component of treatment. However, the efficacy of an exercise stimulus is reduced with aging. This study will investigate whether adding a treatment with phytonutrients found in cruciferous vegetables can improve the exercise response in older individuals.

Condition or Disease Intervention/Treatment Phase
  • Dietary Supplement: Sulforaphane
  • Dietary Supplement: Placebo capsules
N/A

Detailed Description

Redox balance plays a key role in the age-associated increased risk for diseases. One reason for the lower resistance to oxidative stress with age is a gradual shift in the redox state toward a more oxidized cellular environment resulting in disruption of cell signaling. Nuclear erythroid factor 2-related factor 2 (Nrf2) is the master regulator of antioxidant defenses. Nrf2 drives expression of a host of genes involved in cytoprotection and antioxidant defenses. The Traustadottir lab was the first to demonstrate Nrf2 activation in response to acute exercise in humans, and in agreement with animal data, found an age-related impairment in exercise-induced Nrf2 signaling. This underscores an important problem related to aging, namely that older individuals are less sensitive to an exercise stimulus compared to younger cohorts. The focus of the proposed study is to try to solve this problem by amplifying the signal and mitigating the "exercise desensitization" exhibited by older individuals to restore redox balance. This study will test the hypothesis that combining acute exercise with sulforaphane will improve Nrf2 activation and downstream signaling in older adults compared to either alone. Sulforaphane is a phytonutrient found in high concentrations in cruciferous vegetables and a potent Nrf2 activator. The hypothesis will be tested using two different approaches; the first experiment will use an in vivo-ex vivo approach, where peripheral blood mononuclear cells (PBMCs) collected from older men and women (≥60y, n=30) pre- and post-acute exercise (in vivo) will be cultured and stimulated with SFN (ex vivo). This allows for a greater experimental control of the SFN stimulus. The second experiment will test the clinical translation applying the sulforaphane stimulus in vivo through an oral supplementation of sulforaphane in the form of whole broccoli sprout material, prior to acute exercise, in the same individuals. This second experiment will be a randomized placebo-controlled cross-over design. For all trials Nrf2 signaling will be measured by Nrf2 activation through an ARE binding assay, nuclear to whole cell ratio of Nrf2 protein, and Nrf2-dependent gene expression (HO-1, GCLC, NQO1, GR). Potential sex differences will be investigated. The insights gained from this study are whether combining simple interventions in the category of healthy lifestyle and preventive medicine can improve the adaptive response to exercise in older individuals. This could have an enormous impact by improving the health and well-being of older Americans.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
30 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Intervention Model Description:
HumansHumans
Masking:
Double (Participant, Investigator)
Masking Description:
The design of this experiment will be a randomized, double-blind, placebo-controlled, cross-over design, where each subject will serve as their own control. Randomization of order of trials (supplement/placebo) will be performed by a person that is otherwise not part of study personnel, and study personnel and subjects will be blinded to the order. The person doing the randomizing will keep a record of the order using study ID, and researchers will be unblinded upon completion of data collection.
Primary Purpose:
Supportive Care
Official Title:
Treatment Strategy to Enhance Nrf2 Signaling in Older Adults: Combining Acute Exercise With the Phytochemical Sulforaphane
Anticipated Study Start Date :
Apr 1, 2022
Anticipated Primary Completion Date :
Jun 30, 2024
Anticipated Study Completion Date :
Jun 30, 2024

Arms and Interventions

Arm Intervention/Treatment
Experimental: SFN supplement

The oral sulforaphane supplement is a myrosinase-active whole broccoli sprout material (EnduraCell Bioactive, Cell-Logic, Queensland, AU) containing 14 mg SFN per capsule. Three capsules will be consumed 90 min prior to the start of the acute exercise trial. The dose of 3 capsules is equivalent to approximately 220 µmol of SFN, which is comparable to that of other studies using broccoli sprout extracts and the recommended single dose.

Dietary Supplement: Sulforaphane
Myrosinase-active whole broccoli sprout material
Other Names:
  • EnduraCell Bioactive
  • Dietary Supplement: Placebo capsules
    Placebo capsules

    Placebo Comparator: Placebo

    Placebo capsules provided by Cell-Logic.

    Dietary Supplement: Sulforaphane
    Myrosinase-active whole broccoli sprout material
    Other Names:
  • EnduraCell Bioactive
  • Dietary Supplement: Placebo capsules
    Placebo capsules

    Outcome Measures

    Primary Outcome Measures

    1. Nrf2 activation in response to acute exercise [Comparing trials separated by one week (supplement vs. placebo)]

      Nrf2/ARE Binding Assay

    Secondary Outcome Measures

    1. NQO1 gene expression in response to acute exercise [Comparing trials separated by one week (supplement vs. placebo)]

      NQO1 mRNA measured with RT-qPCR

    2. HO-1 gene expression in response to acute exercise [Comparing trials separated by one week (supplement vs. placebo)]

      HO-1 mRNA measured with RT-qPCR

    3. Glutathione reductase (GR) gene expression in response to acute exercise [Comparing trials separated by one week (supplement vs. placebo)]

      GR mRNA measured with RT-qPCR

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    60 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:
    • Men and women, 60 years and older

    • Competent to independently give informed consent

    • Successful completion of screening

    • Maximal oxygen consumption below the 60th percentile based on gender:

    • Women: ≤ 21.2 mL/kg/min

    • Men: ≤ 30.5 mL/kg/min

    Exclusion Criteria:
    • Estrogen supplementation (in any form) within the previous 6 months

    • Any medication that could affect outcome measures such as statins, blood pressure medications, or anti-depressives

    • Use of anti-oxidant supplements, in excess of standard multi-vitamins (1 tablet/day) and/or any supplements known to target Nrf2 including resveratrol, Protandim, and sulforaphane

    • Current smoker

    • Body Mass Index (BMI) greater than 33 kg/m2 (Class I Obesity)

    • Any chronic illness that could affect outcome measures, including diabetes, liver or renal disease, or cancer (other than skin cancer)

    • History of a myocardial infarction within the last 6 months, clinically significant aortic stenosis, use of cardiac defibrillator, or uncontrolled angina

    • Clinically significant arrhythmia on a resting EKG or significant EKG changes during the baseline VO2 max test

    • Any other condition that would contraindicate maximal exercise testing, including elevated blood pressure at rest (systolic BP >150 or diastolic BP >90 mm Hg on at least 2 measurements, at least 10 minutes apart) or musculoskeletal problems

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Northern Arizona University Flagstaff Arizona United States 86011

    Sponsors and Collaborators

    • Northern Arizona University
    • Villanova University

    Investigators

    None specified.

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Northern Arizona University
    ClinicalTrials.gov Identifier:
    NCT04848792
    Other Study ID Numbers:
    • 1551363
    First Posted:
    Apr 19, 2021
    Last Update Posted:
    Oct 1, 2021
    Last Verified:
    Sep 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by Northern Arizona University
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Oct 1, 2021