30 Participants Needed

Compound 21 for Preeclampsia

KS
Overseen ByKelsey Schwartz
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores why women who experienced preeclampsia during pregnancy might face higher risks of heart disease later. Researchers examine how the body's tiny blood vessels function in these women and whether activating certain receptors with Compound 21 (an Angiotensin II Type 2 Receptor Agonist) can restore normal function. The study focuses on women 12 weeks to 5 years post-pregnancy, comparing those who had preeclampsia to those who did not. Women who had preeclampsia but not other conditions like hypertension or diabetes before pregnancy might be suitable for this study. As an Early Phase 1 trial, this research aims to understand how the treatment works in people, offering participants a chance to contribute to groundbreaking insights.

Will I have to stop taking my current medications?

If you are currently taking antihypertensive or cholesterol-lowering medications, you cannot participate in this trial. The protocol does not specify about other medications, so it's best to discuss with the trial team.

Is there any evidence suggesting that Compound 21 is likely to be safe for humans?

Research has shown that Compound 21 has potential based on earlier studies. It activates the angiotensin type 2 receptor, which can protect blood vessels. In animal studies, this compound improved blood flow and reduced high blood pressure.

This trial remains in the early stages, so detailed safety information for humans is limited. However, some studies suggest that the compound is generally well-tolerated. These early results are promising, but more research is needed to fully understand its safety and effects in humans.12345

Why do researchers think this study treatment might be promising for preeclampsia?

Unlike the standard treatments for preeclampsia, which typically focus on managing symptoms like high blood pressure with medications such as antihypertensives, Compound 21 works differently by targeting the microvasculature. Researchers are excited about this treatment because it involves delivering Compound 21 directly to the skin's tiny blood vessels using a technique called intradermal microdialysis. This approach not only offers a novel mechanism by potentially improving blood vessel function, but also allows for localized treatment, reducing the risk of systemic side effects. This innovative method could pave the way for more effective and safer management of preeclampsia.

What evidence suggests that Compound 21 might be an effective treatment for preeclampsia?

Research has shown that Compound 21, administered to participants in this trial, might address issues related to preeclampsia. Compound 21 improves blood flow and relaxes blood vessels by targeting specific areas that regulate blood pressure and inflammation. Dysfunction in these areas has been linked to preeclampsia. Additionally, Compound 21 may reduce inflammation, offering extra protection. This raises hope that Compound 21 could aid in managing long-term heart and blood vessel issues associated with preeclampsia.12367

Who Is on the Research Team?

AR

Anna Reid-Stanhewicz, PhD

Principal Investigator

University of Iowa

Are You a Good Fit for This Trial?

This trial is for women aged 18-45 who experienced preeclampsia between 12 weeks and 5 years ago. It's also open to those who had healthy pregnancies. Participants should not be currently pregnant, planning pregnancy, have a history of hypertension or metabolic disease before pregnancy, use tobacco, or take certain medications like antihypertensives or statins.

Inclusion Criteria

Women who had preeclampsia and women who did not have preeclampsia
I gave birth between 12 weeks and 5 years ago.

Exclusion Criteria

Known allergy to study drugs
Current tobacco use
Body mass index less than 18.5 kg/m2
See 7 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo intradermal microdialysis for the local delivery of compound 21 and L-NAME to the cutaneous microvasculature

1 hour
1 visit (in-person)

Follow-up

Participants are monitored for changes in microvascular blood flow response and angiotensin receptor expression

4 weeks
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Compound 21
Trial Overview The study tests Compound 21 on the microvascular function in the skin of women post-preeclampsia. Researchers are investigating if activating angiotensin II receptors can repair blood vessel damage caused by preeclampsia and reduce future cardiovascular disease risk.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: assessment of microvascular functionExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Anna Stanhewicz, PhD

Lead Sponsor

Trials
12
Recruited
460+

Published Research Related to This Trial

Preeclampsia is primarily caused by systemic maternal vascular dysfunction due to oxidative stress and excessive anti-angiogenic factors from a dysfunctional placenta, leading to hypertension and other complications during pregnancy.
Currently, the only definitive treatment for preeclampsia is the delivery of the placenta, often resulting in preterm birth, highlighting the urgent need for new therapies that specifically target the underlying vascular dysfunction.
Targeting the vascular dysfunction: Potential treatments for preeclampsia.Marshall, SA., Cox, AG., Parry, LJ., et al.[2019]
A study involving 168 women (84 with early-onset preeclampsia and 84 controls) found that certain genetic variations in the angiotensin II receptor genes (AT1R and AT2R) are associated with a higher risk of developing early-onset preeclampsia, particularly in those with three mutant receptor combinations.
The presence of these genetic variants could help predict susceptibility to early-onset preeclampsia and may guide future research on targeted treatments for hypertensive disorders in pregnancy.
Association of maternal angiotensin II type 1 and type 2 receptor combination genotypes with susceptibility to early-onset preeclampsia.Satra, M., Samara, M., Alatsathianos, G., et al.[2022]
Activation of AT2 receptors (AT2Rs) by Compound 21 (C-21) in rats significantly increased urinary sodium excretion by 10-fold, demonstrating its efficacy in promoting natriuresis without affecting renal blood flow.
C-21 not only induced natriuresis but also lowered blood pressure in a model of hypertension, suggesting that targeting AT2Rs could be a promising strategy for treating conditions related to fluid retention and high blood pressure.
AT₂ receptor activation induces natriuresis and lowers blood pressure.Kemp, BA., Howell, NL., Gildea, JJ., et al.[2021]

Citations

Activation of angiotensin type 2 receptor attenuates ...Administration of AT 2 R agonist C21 to T dams abolished the hypertensive response, improved UA blood flow, and reversed the exaggerated vasoconstriction to ...
Reduced AT2R Signaling Contributes to Endothelial ...Reductions in AT 2 R-mediated dilation contribute to attenuated or impaired endothelial function in women who had a pregnancy complicated by preeclampsia.
Compound 21 for PreeclampsiaCompound 21 is unique because it targets GPCRs (G protein-coupled receptors), which are promising candidates for treating preeclampsia, unlike other treatments ...
Stimulation of Angiotensin II Receptor Subtype 2 Reduces ...We investigated the effect of AT2R on the pathogenesis of PE using a mouse model and recently developed AT2R agonist (compound 21 [C21]).
Role of Inflammation and the Angiotensin Type 2 Receptor ...A recent study using the AT2R agonist compound 21 showed that the AT2R reduces stimulation of a proinflammatory cytokine, interleukin-6, by inhibiting the ...
Stimulation of Angiotensin II Receptor Subtype 2 Reduces ...A recently developed AT2R agonist (compound 21 [C21]) [33] has been shown to activate AT2R, resulting in protective effects for the lungs, ...
Sensitivity of Angiotensin II Type II Receptors in Women ...The purpose of this study is to examine the microvascular differences in women who have had preeclampsia following activation of protective angiotensin ...
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