Mechanism of Isolevuglandin-Protein Adduct Formation in Persistent Immune Activation in Long COVID POTS
Vanderbilt University Medical Center
Summary
Long COVID is defined by a range of symptoms affecting multiple organs that persist for more than three months following an acute SARS-CoV-2 infection. Approximately 7% of individuals who recover from SARS-Cov-2 infection develop Long COVID. Long COVID Postural Orthostatic Tachycardia Syndrome (LCPOTS) symptoms include fatigue, exercise intolerance, orthostatic intolerance, syncope, and heightened orthostatic tachycardia. Research has found that decreased parasympathetic activity in LCPOTS increases the production of highly immunogenic neoantigens Isolevuglandins (IsoLG-adducts). IsoLG-adducts induce formation of circulating monocyte/T cell complexes(doublets) leading to the persistent and unresolved immune response that continues after the initial infection. The purpose of the this research, is to study the effects of 2-hydroxybenzylamine (2-HOBA), an Iso-LG-adduct scavenger, its effects in immune markers and compare it with Placebo
Description
Background: Decreased parasympathetic activity is present in LCPOTS; this system is an important modulator of NAPDH oxidase activity because the activation of NADPH oxidase in monocytes promotes superoxide (reactive oxygen species -ROS) production.Oxidative stress occurs when ROS are generated in excess of normal antioxidants. Oxidative stress occurs when reactive oxygen species (ROS) are generated in excess of normal antioxidantsOxidative stress occurs when reactive oxygen species (ROS) are generated in excess of normal antioxidants that can cause harm by having adverse effects on T cell fun…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: All participants should meet diagnostic criteria for Long COVID and POTS and as outlined below: Long COVID (LC) is defined by a range of symptoms affecting multiple organs that persist for more than three months following an acute SARS-CoV-2 infection. POTS: the presence of chronic symptoms lasting more than 3 months, along with orthostatic tachycardia (a HR increase over 30 bpm upon standing or exceeding 120 bpm without orthostatic hypotension) within 10 minutes upon standing or 75-degree head up tilt. For patients aged 18 and 21, an increase of more than 40 bpm or a s…
Interventions
- DrugTo Measure levels of circulating monocyte/ T cell doublets at Baseline
To determine the levels of circulating monocyte/ T cell doublets on all the LCPOTS subjects
- DrugTo measure levels of circulating monocyte/ T cell doublets after 28 days of 2 HOBA treatment
Subjects will be randomized 1:1 to 2-HOBA or matching placebo. The levels of circulating monocyte/ T cell doublets (immune burden) after 28 days of 2 HOBA treatment
- DrugTo measure levels of circulating monocyte/ T cell doublets after 28 days of Placebo treatment
The levels of circulating monocyte/ T cell doublets (immune burden) after 28 days of 2 HOBA treatment and compare it to the placebo arms
- Diagnostic TestTo Measure Splanchnic venous capacitance after 28 days of Treatment with 2HOBA
We will Measure changes in Splanchnic venous capacitance after 28 days of Treatment with 2HOBA and compare it with baseline during 30 Mins head up tilt . All the LCPOTS subjects will be randomized 1:1 to 2-HOBA or matching placebo
Location
- Cyndya ShibaoNashville, Tennessee