Dietary Protein and Monocyte/Macrophage Mammalian Target of Rapamycin (mTOR) Signaling

Sponsor
Washington University School of Medicine (Other)
Overall Status
Active, not recruiting
CT.gov ID
NCT03946774
Collaborator
(none)
20
1
2
38
0.5

Study Details

Study Description

Brief Summary

High protein low carbohydrate diets have become popular in recent years to help facilitate weight loss. It is controversial if these diets are associated with an increased risk of cardiovascular disease.

The investigators propose to administer high and low protein shakes to participants and measure effects on circulating monocytes, immune cells critical to the development of atherosclerosis and cardiovascular disease. In order to study circulating monocytes, blood will be collected from the study participants just prior to drinking the shake, and then 1 and 4 hours after drinking the shake.

In order to assess functional effects on monocytes, investigators will perform a series of assays comparing the results between individuals who drank high protein vs low protein shakes.

Condition or Disease Intervention/Treatment Phase
  • Dietary Supplement: Dietary protein shake
N/A

Detailed Description

Cardiovascular disease remains the leading cause of death globally with obesity as of one of the dominant modifiable risk factors. Obesity is also a precursor to several other cardiovascular risk factors including hypertension, hyperlipidemia, and diabetes. Almost all weight loss efforts utilize dietary modification with high protein/low carbohydrate diets serving as one of the most popular approaches. Despite the metabolic benefits of high dietary protein, recent studies have raised a concerning association with increased risk of atherosclerosis and cardiovascular disease. Although this remains controversial, there is some animal data showing evidence of dietary protein's proatherogenic role. These data are correlative and no mechanistic studies have been undertaken.

The downstream events after protein ingestion involve digestion of the protein into amino acids, increases in blood amino acids, and distribution to target tissues. Mouse models have definitively shown that circulating monocytes and macrophages of arterial blood vessels are particularly sensitive to this amino acid load with robust activation of the mTOR (mammalian target of rapamycin) signaling pathway. This in turn leads to inhibition of essential degradative processes of the macrophage such as autophagy and promotes release of pro-inflammatory cytokines. Thus, macrophage function in vascular beds becomes pathogenic leading to atherogenesis and cardiovascular disease

The translation of these mechanistic studies in animal models to human is the next obvious step in this research. However, no studies have elucidated the mechanisms of monocyte activation and function following administration of high dietary protein in humans. The investigators propose a pilot study to bridge an important gap in translational research which will elucidate the mechanisms by which dietary protein affects human monocyte function and the risk of atherosclerotic plaque formation. Specifically, the investigators will evaluate the acute activation of mTOR signaling and downstream sequelae in circulating monocytes following the administration of protein shakes. This study will address the hypothesis that humans exposed to high dietary protein will have significantly higher post-prandial monocyte mTOR activation with concomitant development of impaired degradative capacity and a proinflammatory state.

An understanding of these mechanisms has broad implications in the evaluation and future therapeutic interventions of cardiovascular disease.

In addition, this can provide a valuable clinical tool for health care providers in educating patients on dietary changes to ameliorate cardiovascular risk.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
20 participants
Allocation:
Non-Randomized
Intervention Model:
Crossover Assignment
Masking:
None (Open Label)
Primary Purpose:
Basic Science
Official Title:
Acute Effects of Dietary Protein on Monocyte/Macrophage mTOR Signaling and Downstream Sequela
Actual Study Start Date :
Oct 1, 2019
Actual Primary Completion Date :
Dec 17, 2020
Anticipated Study Completion Date :
Dec 1, 2022

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: High protein

Subjects getting high protein shake

Dietary Supplement: Dietary protein shake
It is a milk based protein shake. Ingredients include a combination of the following depending on protein content: Boost Plus (a commercial supplement), Unjury (a commercial whey protein isolate), nonfat dry milk powder, Sol Carb (commercial supplement composed of a carbohydrate polymer), canola oil, and water. In order to ensure consistency across all participants each beverage will be prepared in the Clinical Translational Research Unit Metabolic Kitchen under the supervision of a registered dietitian prior to the study participant's visit. Ingredients are individually weighed on a food scale by metabolic kitchen staff to the nearest 0.1 g and then mixed using a magnetic stir plate. Nutritional breakdown of the smoothies (high versus low protein): High protein drink nutrition: 500 kcal per serving, 50% protein, 17% fat, and 36% carbohydrate. Low (standard) protein drink nutrition: 500 kcal per serving, 10% protein, 17% fat, and 73% carbohydrate.

Active Comparator: Low protein

Subjects getting low protein shake

Dietary Supplement: Dietary protein shake
It is a milk based protein shake. Ingredients include a combination of the following depending on protein content: Boost Plus (a commercial supplement), Unjury (a commercial whey protein isolate), nonfat dry milk powder, Sol Carb (commercial supplement composed of a carbohydrate polymer), canola oil, and water. In order to ensure consistency across all participants each beverage will be prepared in the Clinical Translational Research Unit Metabolic Kitchen under the supervision of a registered dietitian prior to the study participant's visit. Ingredients are individually weighed on a food scale by metabolic kitchen staff to the nearest 0.1 g and then mixed using a magnetic stir plate. Nutritional breakdown of the smoothies (high versus low protein): High protein drink nutrition: 500 kcal per serving, 50% protein, 17% fat, and 36% carbohydrate. Low (standard) protein drink nutrition: 500 kcal per serving, 10% protein, 17% fat, and 73% carbohydrate.

Outcome Measures

Primary Outcome Measures

  1. Determination of amino acid levels and mTOR activation in circulating monocytes isolated from subjects ingesting high vs low protein drinks. [0 Hour, 1 Hour, and 3 Hours]

    Changes in amino acid levels and corresponding changes in mTOR activation will be quantified at baseline (time 0 hour prior to ingestion of a protein shake), then at 1 and 3 hours after ingestion of a protein shake.

Secondary Outcome Measures

  1. Determination of changes in autophagy and apoptosis markers in circulating monocytes over time after ingestion of a protein shake [0 Hour, 1 Hour and 3 Hours]

    Blood collected at three different time points (0, 1 and 3 hours) will be used to measure changes in markers of autophagy and apoptosis at baseline (time 0 hour prior to ingestion of a protein shake), then at 1 and 3 hours after ingestion of a protein shake.

  2. Determination of changes in reactive oxygen species in circulating monocytes over time after ingestion of a protein shake. [0 Hour, 1 Hour, and 3 Hours]

    Blood collected at three different time points (0, 1 and 3 hours) will be used to measure changes in levels of reactive oxygen species at baseline (time 0 hour prior to ingestion of a protein shake), then at 1 and 3 hours after ingestion of a protein shake.

  3. Determination of changes in inflammatory markers in circulating monocytes over time after ingestion of a protein shake. [0 Hour, 1 Hour, and 3 Hours]

    Blood collected at three different time points (0, 1 and 3 hours) will be used to measure changes in cytokines at baseline (time 0 hour prior to ingestion of a protein shake), then at 1 and 3 hours after ingestion of a protein shake.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  1. 18+ years of age

  2. Able to drink milk based protein shake

Exclusion Criteria:
  1. Current Pregnancy

  2. Any food allergies

  3. Personal Hx of Diabetes

  4. Personal Hx of Heart Disease

  5. Personal Hx of High blood pressure

  6. Personal Hx of Stroke

  7. Personal Hx of Cancer

  8. Personal Hx of Organ transplant

  9. Taking Rapamycin/Sirolimus

  10. Taking Torisel/Temsirolimus

  11. Taking Afinitor/Everolimus

  12. Taking any statin medication (eg.simvastatin/atorvastatin/rosuvastatin etc)

Contacts and Locations

Locations

Site City State Country Postal Code
1 Washington University Saint Louis Missouri United States 63110

Sponsors and Collaborators

  • Washington University School of Medicine

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Washington University School of Medicine
ClinicalTrials.gov Identifier:
NCT03946774
Other Study ID Numbers:
  • 201808084
First Posted:
May 13, 2019
Last Update Posted:
Mar 31, 2022
Last Verified:
Mar 1, 2022
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 Washington University School of Medicine

Study Results

No Results Posted as of Mar 31, 2022