An Early Phase 1 interventional study of 18 F-FP-DTBZ and PET Scanning in Healthy Volunteers and Diabetes Mellitus, Type 1, sponsored by Columbia University. Completed at 1 site in United States. Open to participants aged 18 Years to 70 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-23.
Sponsored by Columbia University · Early Phase 1, Interventional, and Basic science
Type 1 diabetes mellitus (T1DM) develops when there is impaired insulin production due to loss of insulin producing cells (beta cells). The amount of insulin that can be produced is imperfectly correlated with beta cell mass (BCM). The development of a reliable method to noninvasively quantify the total amount of insulin producing beta cells would be of great benefit by providing an important endpoint for the development of new treatments of diabetes. The investigators have previously identified a specific marker on islet cells called vesicular monoamine transporter 2 (VMAT2) that the investigators now propose to use in positron emission tomography (PET) scanning to determine islet beta cell mass. The PET radiopharmaceutical 18 F-fluoropropyl(FP)-dihydrotetrabenazine(DTBZ) has been used previously in human subjects without adverse effects. It has shown promise in differentiating type 1 diabetes and non-diabetes. The investigators now hypothesize that repeat PET scans will be reproducible in the same subject. Subjects with normal BCM will be recruited from among normal weight non-diabetic people with plasma insulin levels within the normal range. Subjects with predicted reduced BCM will be recruited from among patients with T1DM who have low or non-measurable insulin levels. Two PET scan measurements will be taken in each subject and the amount of VMAT2 in the pancreas will be and compared for reproducible findings. Biochemical testing will also be performed and compared to PET scans as a potential indirect marker of beta cell mass.
Diabetes results when the insulin secretory capacity of the beta cell population is lost or severely compromised.Plasma insulin levels have been used as a surrogate marker of beta cell mass (BCM) but insulin levels often do not correlate well. A "gold standard of measurement" to obtain BCM would be of great value. The aim of the proposed study is to evaluate an islet imaging technique using PET scanning to directly measure BCM and thus provide valuable information for monitoring disease progress and response to therapy in people with diabetes and in people at high risk for diabetes. Type 1 diabetes (T1DM) occurs when the beta cells are selectively destroyed by a T cell mediated autoimmune process. People at high risk for developing T1DM, such as first degree relatives of patients with T1DM, can sometimes be identified before the disease develops by measuring autoantibodies to beta cells, however this test is neither sensitive nor specific. Little is known about the natural history of BCM, turnover and cell lifetime, or the course of inflammation in diabetes. This is principally because the pancreas is a highly heterogeneous organ that is difficult to biopsy without significant complications, and BCM only comprises 1 to 2% of the total volume. Accurate assessment of BCM in human diabetes is limited to autopsy studies, which usually suffer from inadequate clinical information; thus, the development of non-invasive means of BCM measurement could be important for interventional therapies of T1DM, islet regeneration/stem cell therapy and islet transplantation.
3,614 studies on the registry are indexed under Diabetes Mellitus, Type 1; 586 are open to participants now.
This study's enrollment of 23 is below the median of 40 across 2,718 interventional studies indexed under Diabetes Mellitus, Type 1.
Browse Diabetes Mellitus, Type 1 studies →Columbia University is the lead sponsor of 1,135 studies on the registry; 195 are open to participants now.
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Patients with type 1 diabetes may be enrolled if they meet all of the following criteria:
Healthy volunteers may be enrolled if they meeting all of the following criteria:
Exclusion Criteria:
Potential participants must not have any of the following exclusion criteria:
Are women of childbearing potential not refraining from sexual activity or not using adequate contraception.
Women must not be pregnant (negative serum human chorionic gonadotropin (hCG) at the time of screen) or breastfeeding at screening, and must agree to take appropriate steps not to become pregnant during for 30 days following the clinical trial
Pancreatic 18 F-FP-DTBZ uptake will be measured with PET scanning in healthy controls: subjects with predicted normal BCM (healthy, normal weight, non-diabetic individuals who have stimulated insulin and c-peptide levels within the normal range).
Drug: 18 F-FP-DTBZ · Radiation: PET Scanning
Pancreatic 18 F-FP-DTBZ uptake will be measured with PET scanning in patients with longstanding T1D: subjects with predicted reduced beta cell mass (subjects with established T1DM who have low or no measurable stimulated insulin and c-peptide levels).
Drug: 18 F-FP-DTBZ · Radiation: PET Scanning
The drug, no carrier added \[18 F\]-FP-DTBZ, is formulated in 5% (v/v) ethanol in 0.9% sterile saline solution to produce \[18 F\]-FP-DTBZ for injection. Subjects will receive a single i.v. administration of no more than 7.6 millicuries (mCi) of \[18 F\]-FP-DTBZ for injection immediately prior to imaging. The specific activity at time of injection will less than 1.0 mCi/microgram and thus for a 7.6 mCi dose the maximal mass dose will be less than 10 microgram.
Individuals will be imaged continuously (i.e. dynamically) for 2 hours.
Also known as: Positron Emission Tomography
Mean VMAT2 Functional Binding Capacity in the β Cells to 18 F-FP-DTBZ
The VMAT2 functional binding capacity in the body and tail of the pancreas is calculated as BPND (VMAT2 binding potential) × PET ROI (region-of-interest) Volume. BPND is unitless, and ROI unit is mL. Higher values of the VMAT functional binding capacity indicates greater β cell mass.
Time frame: Up to 2 months from enrollment
Potential subjects with diabetes were recruited at the Naomi Berri Diabetes Center. The physician ascertained from the patient that he/she is willing to discuss the study with the research team before the investigators approach the patient. Non-diabetic subjects were either be referred by their physicians, by word of mouth, or by flyer.
| Milestone | Healthy Controls | Patients With T1D |
|---|---|---|
| Started | 15 | 8 |
| Completed | 14 | 8 |
| Not completed | 1 | 0 |
| Withdrew: Withdrawal by subject | 1 | 0 |
The VMAT2 functional binding capacity in the body and tail of the pancreas is calculated as BPND (VMAT2 binding potential) × PET ROI (region-of-interest) Volume. BPND is unitless, and ROI unit is mL. Higher values of the VMAT functional binding capacity indicates greater β cell mass.
| unitless | Study Controls | Longstanding T1D |
|---|---|---|
| Mean VMAT2 Functional Binding Capacity in the β Cells to 18 F-FP-DTBZ | 103 ± 12 | 38 ± 5 |
Collected over Throughout study period, up to 2 months. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Study Controls | 0/14 (0%) | 0/14 (0%) | 0/14 (0%) |
| Longstanding T1D | 0/8 (0%) | 0/8 (0%) | 0/8 (0%) |
| Age, Categorical(Participants) | Healthy Controls | Patients With T1D | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 14 | 8 | 22 |
| >=65 years | 0 | 0 | 0 |
| Sex: Female, Male(Participants) | Healthy Controls | Patients With T1D | Total |
|---|---|---|---|
| Female | 5 | 4 | 9 |
| Male | 9 | 4 | 13 |
| Ethnicity (NIH/OMB)(Participants) | Healthy Controls | Patients With T1D | Total |
|---|---|---|---|
| Hispanic or Latino | 0 | 0 | 0 |
| Not Hispanic or Latino | 0 | 0 | 0 |
| Unknown or Not Reported | 14 | 8 | 22 |
This study is completed, as verified in Jul 2024. You cannot join it, but the record below documents what was studied.
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