An interventional study of Ascorbic Acid in Glucocorticoids Deficiency, sponsored by Hadassah Medical Organization. Status unknown at 1 site in Israel. Open to participants aged 1 Year and older. Per ClinicalTrials.gov, last updated 2016-07-20.
Sponsored by Hadassah Medical Organization · Not applicable, Interventional, and Treatment
Nicotinamide nucleotide transhydrogenase (NNT) mutations cause glucocorticoid and mineralocorticoid deficiencies through decreased detoxification of reactive oxygen species (ROS) in adrenocortical cells.
Ascorbic acid is well known by its high antioxidant activity due to the neutralization of free radicals and other reactive oxygen species.
Preliminary results of NNT_p.G200S homozygous fibroblasts' treatment with 10 micro molar L-ascorbic acid shows significant improvement in mitochondrial morphology and in ROS content.
The aim of this study is to figure out if ascorbic acid treatment improves the phenotype of NNT patients by reducing ROS in their adrenocortical cells and preventing their apoptosis.
Most cases of familial glucocorticoid and mineralocorticoid deficiency are caused by mutations interrupting steroidogenesis such as 21- hydroxylase deficiency. Recently, nicotinamide nucleotide transhydrogenase (NNT) mutations were found to cause isolated glucocorticoid deficiency or combined mineralocorticoid and glucocorticoid deficiency through decreased detoxification of reactive oxygen species (ROS) in adrenocortical cells.
NNT mutation in mice causes also glucose intolerance. Ascorbic acid is an essential water-soluble vitamin with excellent reducing properties, well known by its high antioxidant activity due to the neutralization of free radicals and other reactive oxygen species. This vitamin acts as the first line of defense during oxidative stress in the human body.
Ascorbic acid treatment for variant disease (e.g. - cancer, type 2 diabetes, anxiety, depression, asthma and cardiovascular diseases) have been meticulously studies with no major adverse effects.
In a previous study, the investigators demonstrated a higher ROS levels, a lower ATP content and a change in mitochondrial morphology in NNT_p.G200S homozygous fibroblasts compared with control fibroblasts.
Preliminary results of NNT_p.G200S homozygous fibroblasts' treatment with 10 micro molar L-ascorbic acid shows significant improvement in mitochondrial morphology and in ROS content.
The aim of this study is to figure out if ascorbic acid treatment improves the phenotype of NNT patients by reducing ROS in their adrenocortical cells and preventing their apoptosis.
During the study NNT_p.G200S homozygous patients (no.-3) will be hospitalised for ACTH and OGTT tests and start ascorbic acid treatment at a doses of 75-80% of the upper limit of allowance according to IOM. ACTH and OGTT will be repeated 6 months later to assess improvement in glucocorticoids production and insulin resistance.
Hadassah Medical Organization is the lead sponsor of 659 studies on the registry; 54 are open to participants now.
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Inclusion Criteria:
Ascorbic acid administration at a doses of 75-80% of the upper limit of allowance according to IOM
Also known as: Vitamin C
glucocorticoids secretion in response to ACTH test
Time frame: 1 year
basal ACTH levels
Time frame: 1 year
insulin and glucose levels in OGTT
Time frame: 1 year
Plan to share: No
This study is status unknown, as verified in Jun 2016. You cannot join it, but the record below documents what was studied.
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Hadassah Medical Organization