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NCT Number: NCT06860295

"Immunoregulation in Atherosclerosis: A Single-Cell RNA Sequencing Study"

Atherosclerosis is the leading cause of acute cardiovascular events, such as myocardial infarction and stroke, and is a significant risk factor for cardiovascular mortality. The detailed understanding of the immune mechanisms and cellular transformations involved in the pathogenesis of atherosclerosis is still limited, and the use of single-cell RNA sequencing (scRNAseq) has revealed new cellular functions and subpopulations associated with disease progression. This study aims to identify cellular subpopulations, molecular pathways, and changes in gene expression related to the development of atherosclerosis in human coronary arteries. Using scRNAseq, the study seeks to characterize the transcriptomic landscape of cells present in atherosclerotic plaques and identify molecular signatures that reveal individual predispositions to specific phenotypes, such as disease susceptibility and response to therapies. The research will be conducted at the Albert Einstein Israeli Hospital in São Paulo and will involve samples from coronary arteries and atherosclerotic plaques of the explanted hearts of patients who have undergone heart transplants as well as from discarded material of coronary artery bypass graft surgery (CABG). With an estimated sample size of 20-30 plaques, the data obtained will allow for a detailed analysis of the molecular mechanisms involved in atherosclerosis, contributing to the development of specific therapeutic targets.

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Key information

Conditions

Atherosclerosis of Coronary Artery Arterial Occlusive Diseases Arteriosclerosis Atherosclerosis Cardiovascular Diseases Coronary Artery Disease Coronary Disease Heart Diseases Myocardial Ischemia Vascular Diseases

Age range

45 year–75 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Hospital Israelita Albert Einstein

São Paulo, 05652-900, Brazil

About this study

This is a prospective observational study that will be conducted with samples of coronary arteries and atherosclerotic plaques from the explanted hearts of patients with ischemic cardiomyopathy who have undergone heart transplants as well as from discarded material of coronary artery bypass graft surgery . The atherosclerotic plaque samples will be retrieved from the coronary arteries during the transplant surgery or the CABG procedure and transported to the laboratory within 2 hours. The selected arteries will be dissected and microscopically evaluated, and the samples will be fixed in formalin, embedded in paraffin, and stained for histological analysis. The tissue will be enzymatically dissociated to obtain individual cells, which will then be filtered and assessed for cell viability. The cells will undergo single-cell RNA sequencing (scRNAseq) with the aim of analyzing around 5,000-10,000 cells per sample. The sample size will be 20-30 plaques, with the goal of capturing the main cellular populations and performing a robust analysis.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients diagnosed with ischemic cardiomyopathy due to advanced atherosclerosis, undergoing heart transplantation;
  • Patients with coronary artery disease submitted to coronary artery bypass graft surgery (CABG)."
  • Aged between 40 and 75 years;
  • Signed informed consent form.

Exclusion criteria

  • Patients with systemic inflammatory or autoimmune diseases;
  • History of cancer within the last 5 years or active malignancy;
  • Recent use (within the last 6 months) of immunosuppressive therapy.

Treatment and study plan

Single Cell RNA Sequencing

Diagnostic Test

Reprocessing

Data normalization, dimensionality reduction, and clustering will be performed using the Seurat package (based on R).

Cell types will be identified based on canonical marker gene expression. Cell Subpopulation Identification

Clusters will be annotated based on signatures of known cell types (e.g., endothelial cells, smooth muscle cells, macrophages, etc.).

Differential gene expression analysis will be conducted to identify disease-associated genes.

Pathway and Function Enrichment

Gene Set Enrichment Analysis (GSEA) and pathway analyses (e.g., KEGG, Reactome) will be carried out to investigate the biological processes and pathways driving atherosclerosis.

Quality Control

Sequencing reads will be assessed for quality using FASTQC, and low-quality reads will be filtered out.

The Cell Ranger software (10x Genomics) will be used to align reads to the human genome and quantify gene expression at the single-cell level.

Primary outcomes

  1. Concentration of Specific Cells Clusters And Macrophage / Linfocite Subpopulations : Create a high-resolution single-cell atlas of atherosclerotic plaques.

    Time frame: Through study completion, an average of 1 year and a half.

    Determine the concentration of cellular clusters with specific inflammatory subpopulations determination to Create a high-resolution single-cell atlas of atherosclerotic plaques, revealing cell-specific transcriptional changes associated with the disease. The findings could identify new therapeutic targets for intervention in atherosclerosis and enhance the understanding of its molecular pathogenesis.

Secondary outcomes

  1. Concentration of interleukins and cellular subtypes by citometer flow to Identification of molecular signatures in atherosclerosis

    Time frame: Through study completion, an average of 1 year and a half .

    The secondary objective is to identify molecular signatures that reveal individual predispositions to specific phenotypes, such as susceptibility to atherosclerosis, response to therapies, and other health characteristics, establishing the foundation for precision medicine and population health studies in Brazil by determining specific concentrations of pro and anti-inflammatory molecules and cell types.

Study contacts

Contact information is provided by the study sponsor or research team.

Carlos Vicente Serrano, PhD

CONTACT

[email protected]

+55 (11) 2151-5408

Sponsors and collaborators

Lead sponsor

Hospital Israelita Albert Einstein

Other

Registry information

Official study title

The Architectural Immunoregulation in Atherosclerotic Disease: A Single-Cell RNA Sequencing and Spatial Biology Approach

Important dates

Study start
2025
Primary completion
2026
Study completion
2027
First posted
Mar 6, 2025
Registry last updated
Jun 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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