Influence of NEP inhibition on vascular leak and inflammation

  • Research type

    Research Study

  • Full title

    Assessment of the effect of neutral endopeptidase inhibition on vascular leak and leukocyte accumulation in a human cantharidin blister model

  • IRAS ID

    288749

  • Contact name

    Adrian Hobbs

  • Contact email

    a.j.hobbs@qmul.ac.uk

  • Sponsor organisation

    Queen Mary, University of London

  • Duration of Study in the UK

    2 years, 2 months, 1 days

  • Research summary

    Acute Respiratory Distress Syndrome is a severe type of lung injury that affects 10% of patients admitted to Intensive Care Units worldwide, with an unacceptably high mortality of up to 48% in those with the most severe form of the condition. It is a complex and poorly understood syndrome that results in progressive failure of the lungs. Crucially, the inflamed lungs allow fluid to leak from the circulation into the airspace, so that patients' lungs fill with fluid - "drowning from the inside". As this condition progresses, the patient typically requires increasing amounts of oxygen and eventually, support from a ventilator. To date, there are no effective treatments for ARDS that can limit, stop or repair this process.

    This research study is aiming to look at a naturally occurring substance produced by blood vessels, C-type natriuretic peptide (CNP). We have evidence suggesting that CNP plays a role in maintaining the barrier provided by blood vessels that stops fluid leaking out into tissues. This is based on various studies done on CNP by our research group that have established its widespread role in maintaining cells that line blood vessels and play a vital role in lungs' barrier function: the endothelium.

    CNP is broken down in part by an enzyme called Neutral endopeptidase and therefore, drugs that inhibit this enzyme would result in increased CNP concentration and activity. If CNP does in fact strengthen the lungs' endothelial barrier, then this class of drug may benefit patients with ARDS. The aim of this experimental medicine study is to assess the effect of using the licensed NEP inhibitor Racecadotril,, in a well-established, safe model of inflammation-induced skin blisters in healthy human volunteers to determine primarily whether the fluid accumulation i.e. leak, in these blisters is reduced by treatment with this drug.

  • REC name

    London - South East Research Ethics Committee

  • REC reference

    22/LO/0496

  • Date of REC Opinion

    22 Aug 2022

  • REC opinion

    Further Information Favourable Opinion