- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02164877
Effect of Soluble Dietary Fiber on Bacterial Translocation in Crohn's Disease
A Randomized, Controlled Study of Soluble Dietary Fiber on Bacterial Translocation in Adults Patients With Crohn's Disease
Study Overview
Detailed Description
Bacterial translocation (BT) is a proposed mechanism of CD. Microorganisms can be cultured from 18-48% of draining mesenteric lymph nodes from CD patients. A breakdown in barrier function in "late stage" CD has been observed in patients requiring surgery. In addition, it was found that BT influences the response to biological therapy and clinical relapse in CD. Therefore, reducing BT may be of therapeutic importance in treatment for CD.
The role of soluble dietary fiber in Crohn's disease (CD) is still inconclusive. Population based studies have shown that long-term intake of dietary fiber is associated with lower risk of CD. However, meta-analysis did not show benefit in inducing or maintaining remission. In addition, the possible mechanism of dietary fiber on CD is still unclear.
The rationale relates to the beneficial effects of fiber may be due to the production of the fiber metabolites short-chain fatty acids (SCFAs), particularly butyrate. Dietary substrates may modify the commensal microbiota or their metabolites or enhance epithelial barrier function. Recently, it was found that dietary fiber metabolites SCFA is regulatory of mucosal regulatory T cells. The current study is to examine the impact of dietary fiber on bacterial translocation,intestinal luminal microbiology, and mucosal immunology in CD patients.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Jiangsu
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Nanjing, Jiangsu, China, 210002
- Department of Generay Surgery, Jinling hosptal, Medical School of Nanjing University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients aged >=17 years with diagnosis of CD for at least 3 months defined by histology or radiology
- ileocolonic non-penetrating disease
- Moderate active CD with CDAI 250-450
- CRP level over normal range
- Stable CD therapy with a total steroid dose not exceeding 10mg prednisolone or equivalent for 4 weeks
Exclusion Criteria:
- Infection with enteric pathogen
- Usage of probiotics, antibiotics, or prebiotics within the last month
- Change in dose of oral steroids or 5-ASA within the last 4 weeks or AZA or MTX in the last 3 months
- Dose of steroids exceeds 10 mg prednisolone per day or equivalent
- Infusion of IFX or any alternative biological therapy within the last 3 months
- Use of rectal 5-ASA or steroids within the last 2 weeks.
- Imminent need for surgery or presence of severe disease (CDAI >450)
- Pregnancy or lactation
- Short bowel syndrome or subtotal/total colectomy
- Pure anal disease and previous proctocolectomy
- Significant hepatic, renal, endocrine, respiratory, neurological or cardiovascular disease as determined by the principal investigator
- History of cancer with a disease-free state of less than two years
- Patients with penetrating disease or small bowel lesion only.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: pectin
Patients allocated to experiment group will receive standard enteral nutrition formula(Fresubin) supplemented with 15g pectin each day for 4 weeks.
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Patients allocated to experiment group will receive 15g pectin each day
Other Names:
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Placebo Comparator: control
Patients allocated to control group will receive standard enteral nutrition formula(Fresubin) for 4 weeks
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Patients allocated to experiment group will receive 15g pectin each day
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
bacteria translocation in MLN, mesenteric fat and peripheral blood
Time Frame: 4 weeks after treatment
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Bacterial translocation to mesenteric lymph nodes (MLN),mesenteric fat and peripheral blood during laparotomy before surgical mobilization, as determined by DGGE.
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4 weeks after treatment
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
change of fecal bacteriology
Time Frame: baseline, week 4
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fecal microbiology before and 4 weeks after pectin treatment, as determined by DGGE
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baseline, week 4
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change of fecal SCFA
Time Frame: baseline, week 4
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fecal short chain fatty acid (SCFA) levels before and 4 weeks after treatment, as determined by HPLC.
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baseline, week 4
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clinical response
Time Frame: up to 4 weeks after treatment
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the percentage of patients achieving a clinical response (fall in CDAI of >=70 points) at week 4.
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up to 4 weeks after treatment
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change of mucosal Treg numbers
Time Frame: baseline, week 4
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mucosal Treg(FoxP3+CD4+)cell number before and after treatment,as determined by immunofluorescence
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baseline, week 4
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adverse events
Time Frame: up to 4 weeks after treatment
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gastrointestinal symptoms(borborygmi,flatulence,abdominal pain,diarrhea etc)
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up to 4 weeks after treatment
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jianfeng Gong, MD, Department of general surgery,Jinling hospital
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pectin-2014
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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