Curcumin Therapy to Treat Vascular Dysfunction in Children and Young Adults with ADPKD

 描述（由申请人提供）：虽然常被认为是成人疾病，但ADPKD的并发症开始于儿童时期。虽然ADPKD的标志是多发性肾囊肿的发展和持续生长，导致肾功能的最终丧失，但受影响患者死亡的主要原因是心血管疾病。血管功能障碍（内皮功能障碍和大弹性动脉僵硬）在疾病过程的早期就很明显，并且似乎涉及氧化应激和炎症的增加。在ADPKD成人中预防CVD的治疗选择是有限的，因此儿童期可能是一个关键的治疗窗口。姜黄素是一种安全的天然多酚，存在于印度香料姜黄中，具有激活关键抗氧化剂转录、抑制炎症和减少增殖的独特能力。目的1将使用一项为期1年的随机、安慰剂对照、双盲试验，评估姜黄素（25 mg/kg/天）改善ADPKD儿童和年轻成人（6-22岁）血管功能的疗效。目标2将利用最先进的质谱法确定（在18-22岁的患者亚组中）改善是否与氧化应激和炎症减少相关。第三个探索性目标将使用MRI扫描评估肾脏总体积的变化。这项研究有可能在研究不足的ADPKD儿童和年轻成人人群中建立一种新型、安全且易于提供的治疗动脉功能障碍和可能的肾囊肿的疗法。

 DESCRIPTION (provided by applicant): Although often considered to be a disease of adults, complications of ADPKD begin in childhood. While the hallmark of ADPKD is the development and continued growth of multiple renal cysts that result in ultimate loss of kidney function, the leading cause of death among affected patients is cardiovascular in nature. Vascular dysfunction (endothelial dysfunction and large elastic artery stiffness) is evident very early in te course of the disease and appears to involve increased oxidative stress and inflammation. Treatment options to prevent CVD in adults with ADPKD are limited, thus childhood may represent a key therapeutic window. Curcumin is a safe, naturally occurring polyphenol found in the Indian spice turmeric that has a unique ability to activate transcription of key antioxidants, suppress inflammation, and reduce proliferation. Aim 1 will assess the efficacy of curcumin (25 mg/kg/day) for improving vascular function in children and young adults (6-22 years of age) with ADPKD, using a 1 year randomized, placebo-controlled, double-blind trial. Aim 2 will determine (in a sub-group of patients 18-22 years of age), if improvements are associated with reduced oxidative stress and inflammation, utilizing state of the art mass spectrometry methods. A third exploratory aim will assess changes in total kidney volume using MRI scans. This study has the potential to establish a novel, safe, and easy to deliver therapy for the treatment of arterial dysfunction, and possibly renal cystic disease, in an understudied population of children and young adults with ADPKD.