Centre de recherche du CHUS
Sherbrooke, Quebec, J1H 5N4, Canada
NCT Number: NCT04823442
Could sympathomimetics and sympatholytics drugs safe for the management of Type 2 Diabetes (T2D)? Based on recent evidence, we propose that pharmacological stimulation of Beta-3 adrenergic receptor (ADBR3) at higher doses of Mirabegron may be required to elicit changes in glycemia, but should be combined with Beta-1 adrenergic receptor (ADRB1) antagonists to suppress the unwanted effects on the cardiovascular system.
Together, several results establish a previously unappreciated cross-talk between Gs-coupled ADRB1 and ADRB3 in adipose tissue for the control of glucose homeostasis. Moreover, these data suggest that antagonizing ADRB1 may be a good way to significantly lower the dose of ADRB3 agonist required for glucose control.
Therefore, we believe that there are therapeutic opportunities in targeting adrenergic receptors for the treatment of T2D at least in young/middle aged people.
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Notify Me18 year–35 year
Male
Interventional
Not applicable
Sherbrooke, Quebec, J1H 5N4, Canada
In brief, participants will take part in 2 metabolic studies (A and B) performed in random order and at an interval of 7 to 14 days. Each metabolic study will last 8.5 hours with a baseline period of 2.5 hours. Participants will ingest either 200 mg of the ADRB3 agonist mirabegron (Myrbetriq, Astellas Pharma Canada) alone (study A) or in combination with 10 mg of bisoprolol, an ADRB1-antagonist (study B), at time 0.
The radioactive PET tracers (PET: positron emission tomography) used in this study are the [11C]-acetate and [18F]-FDG to estimate BAT oxidative metabolism and glucose metabolism, respectively. The perfusion of [6,6 D2]-glucose, [1,1,2,3,3-2H]-glycerol and [U-13C]-palmitate stable isotopes will also be performed in this study from time -150 min. to +300 min to examine the systemic appearance rate of glucose, glycerol and fatty acids, respectively. These studies will be almost identical (same perfusion of stable and radioactive tracers, same number of PET acquisitions) except for the drug which will be administered orally at time 0.
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Mirabegron: a single dose of 200 mg mirabegron (4 tablets of 50 mg)
Other names: Myrbetriq
a single dose of 10 mg (2 tablets of 5 mg)
Other names: Apo Bisoprolol
Time frame: 30 minutes before and 210 minutes after drug administration
Measured with 11C-acetate using dynamic PET/CT acquisition.
Time frame: 240 minutes after drug administration
Assessed using i.v. injection of 18FDG with sequential dynamic PET/CT scanning
Time frame: 300 minutes after drug administration
Assessed using i.v. injection of 18FDG with static PET/CT scanning
Time frame: 150 minutes before and mean of time 180, 240 and 300 minutes after drug administration (steady state).
Systemic appearance rate of glycerol and fatty acid determined by perfusion of [1,1,2,3,3-2H]-glycerol, [U-13C]-palmitate tracers. and concentration of total NEFA, triglycerides, palmitate, oleate, linoleate, glycerol.
Time frame: 150 minutes before and mean of time 180, 240 and 300 minutes after drug administration (steady state).
Systemic appearance rate of glucose determined by perfusion of [6,6 D2]-glucose
Time frame: 150 minutes before and mean of time 210 and 270 minutes after drug administration (steady state).
VO2 and VCO2 will be measured by indirect calorimetry to calculate carbohydrate and fatty acid oxidation rates.
Time frame: baseline and 300 minutes after drug administration
Estimated by quantifying changes in tissue radiodensity with CT.
Time frame: 150 minutes before and mean of time 180, 240 and 300 minutes after drug administration (steady state).
measured with ELISA and Milliplex.
Université de Sherbrooke
Other
Sympathomimetics and Sympatholytics in Type 2 Diabetes: Teaching Old Drugs New Tricks
Acronym: GB9
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