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COVID-19
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Depression is very common and poses a huge disease burden. About 20% of the US population suffers from depression at least once in their lifetime. Inflammations that are hidden inside our body as a result of aging, obesity, chronic diseases, or certain treatments (e.g., interferon for hepatitis C) appear to cause depressive symptoms and even clinical depression. Individuals with such inflammations are more likely to suffer from depression and are less likely to respond to currently available antidepressant medications. This study will test theophylline, a medication currently used for asthma treatment, as a new way to mitigate depressive symptoms in response to such inflammations. This study begins with a 90-minute screening session to determine whether participants are eligible to join the main study. Those who meet the eligibility criteria will then join the main study, which will consist of taking theophylline or methylcellulose (i.e., oral placebo) for 2 weeks at home and an 8-hour session at the UCLA Medical Center. Approximately 20 healthy adults will be recruited for participation in the study. During the course of the study, participants will take theophylline or methylcellulose for 2 weeks at home and then will be injected either lipopolysaccharide (LPS) or saline (i.e., intravenous placebo) at the UCLA Medical Center. LPS is a bacterial substance that can initiate chemical reactions that are similar to those seen in individuals with mild sickness symptoms, such as a slight increase in body temperature, muscle aches, or tiredness. It is a safe way of investigating the body's response to inflammation and how these changes may alter cognitive, emotional, or neural function. It has been given thousands of times to healthy volunteers - both younger and older adults - without any serious side effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PO theophylline & IV LPS | Experimental | Oral (PO) theophylline 400 mg/day for 2 weeks followed by a single intravenous (IV) bolus of lipopolysaccharide (LPS) 0.8 ng/kg of body weight |
|
| PO placebo & IV LPS | Experimental | PO methylcellulose (placebo) daily for 2 weeks followed by a single intravenous (IV) bolus of lipopolysaccharide (LPS) 0.8 ng/kg of body weight |
|
| PO theophylline & IV placebo | Experimental | PO theophylline 400 mg/day for 2 weeks followed by a single IV bolus of 0.9% saline |
|
| PO placebo & IV placebo | Placebo Comparator | PO methylcellulose (placebo) daily for 2 weeks followed by a single IV bolus of 0.9% saline |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Theophylline ER | Drug | Capsules of theophylline ER |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in depressed mood from baseline | Short Form of the Profile of Mood States (POMS-SF) Depression Subscale with higher scores indicating more severe depressed mood (range 0-32) | At baseline and then at 1, 1.5, 2, 3, 4, 5, and 6 hours after LPS (or saline) administration |
| Measure | Description | Time Frame |
|---|---|---|
| Change in tension/anxiety from baseline | Short Form of the Profile of Mood States (POMS-SF) Tension Subscale with higher scores indicating more severe tension/anxiety (range 0-24) | At baseline and then at 1, 1.5, 2, 3, 4, 5, and 6 hours after LPS (or saline) administration |
| Change in depressive symptoms from baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Subjective Sensitivity to Social Rejection | Cyberball Social Exclusion Task | 2 hours after LPS (or saline) administration |
| Negative Bias in Facial Emotion Recognition | Emotional Face Recognition Task |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCLA Cousins Center for Psychoneuroimmunology | Los Angeles | California | 90095 | United States |
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| ID | Term |
|---|---|
| D003863 | Depression |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D008070 | Lipopolysaccharides |
| ID | Term |
|---|---|
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D011135 | Polysaccharides, Bacterial |
| D011134 | Polysaccharides |
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| PO placebo | Other | Capsules of methylcellulose |
|
| Lipopolysaccharide (LPS) | Biological | Purified bacterial wall component as an inflammatory challenge |
|
| IV placebo | Other | Normal (0.9%) saline |
|
Montgomery-Asberg Depression Rating Scale (MADRS): a clinician-rated questionnaire of depressive symptoms with scores ranging from 0 to 60, with higher scores indicating more severe depressive symptoms |
| At baseline and then at 2, 4, and 6 hours after LPS (or saline) administration |
| Change in feelings of social disconnection from baseline | Feelings of Social Disconnection Scale: a self-report questionnaire of feelings of social disconnection with scores ranging from 0 to 28, with higher scores indicating more severe feelings of social disconnection | At baseline and then at 2, 4, and 6 hours after LPS (or saline) administration |
| Change in fatigue from baseline | Short Form of the Profile of Mood States (POMS-SF) Fatigue Subscale with higher scores indicating more severe fatigue (range 0-20) | At baseline and then at 1, 1.5, 2, 3, 4, 5, and 6 hours after LPS (or saline) administration |
| Change in confusion from baseline | Short Form of the Profile of Mood States (POMS) Confusion Subscale with higher scores indicating more severe confusion (range 0-20) | At baseline and then at 1, 1.5, 2, 3, 4, 5, and 6 hours after LPS (or saline) administration |
| Change in verbal memory from baseline | Verbal memory measured using computerized tests from CNS Vital Signs™ | At baseline and then 3 hours after LPS (or saline) administration |
| Change in visual memory from baseline | Visual memory measured using computerized tests from CNS Vital Signs™ | At baseline and then 3 hours after LPS (or saline) administration |
| Change in executive function from baseline | Executive function measured using computerized tests from CNS Vital Signs™ | At baseline and then 3 hours after LPS (or saline) administration |
| Change in attention from baseline | Attention measured using computerized tests from CNS Vital Signs™ | At baseline and then 3 hours after LPS (or saline) administration |
| 2 hours after LPS (or saline) administration |
| Reward | Reward Learning Task | 2 hours after LPS (or saline) administration |
| Change in proinflammatory cytokines from baseline | Plasma proinflammatory cytokines (interleukin-1 receptor antagonist, interleukin-6, tumor necrosis factor-α, and soluble tumor necrosis factor receptor) | At baseline and then at 1, 1.5, 2, 3, 4, 5, and 6 hours after LPS (or saline) administration |
| Change in kynurenine Metabolites from baseline | Plasma tryptophan, kynurenine, quinolinic acid, and kynurenic acid | At baseline and then at 1, 1.5, 2, 3, 4, 5, and 6 hours after LPS (or saline) administration |
| Change in gene expression from baseline | Genome-wide transcriptional profiling with focus on the percentage increase from baseline to 30 minutes after LPS (or saline) administration in activities of transcription factors related to immune activation, sympathetic activation, and glucocorticoid insensitivity: respectively, nuclear factor kappa-B (NF-kB), cAMP response element-binding protein (CREB), and glucocorticoid receptor (GR). | At baseline and 30 minutes after LPS (or saline) administration |
| D008055 |
| Lipids |
| D000942 | Antigens, Bacterial |
| D000941 | Antigens |
| D001685 | Biological Factors |
| D004731 | Endotoxins |
| D001427 | Bacterial Toxins |
| D014118 | Toxins, Biological |