- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02751437
Preterm Arginine INTake Study (PAINT)
Effect of Preterm Arginine INTake on Biological Pathways Affecting Immune Function in Infants Requiring Early Parenteral Nutrition
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Title:
Effect of Preterm Arginine INTake on biological pathways affecting immune function in infants requiring early parenteral nutrition (PAINT)
Population: Preterm infants <29 weeks gestation
Number of infants: 12 infants (completing the study) will be recruited over approximately 12 months
Number of sites: One. Infants will be born at Liverpool Women's Hospital (LWH) or transferred to LWH within 48 hours of birth.
Study duration: Informed consent will take place within 72 hours of birth. The first study related blood sample will be taken at this point and will determine arginine status (using blood ammonia and arginine levels) with the last sample taken on postnatal day 10. Other study assessments reflect those routinely performed in preterm infants receiving parenteral nutrition (PN).
Study intervention: All infants will receive standard clinical treatment. The study will involve 4 infants with normal arginine status, and 8 infants with evidence of arginine deficiency. Of these, 4 infants will receive standard PN and the study intervention of an additional arginine infusion of 10mg/kg/hr from day 3 until day 10, the other 8 infants will receive standard PN only.
Primary objective: To determine the alterations in gene expression present in infants <29 weeks gestation (and shown to be arginine deficient on day 3) between day 3 and day 10 in infants receiving additional arginine supplementation. The changes in gene expression will be compared with those seen between day 3 and day 10 in unsupplemented infants, with and without arginine deficiency. The genes of interest are those involved in T-cell function and associated inflammatory pathways.
Secondary objectives:
- To explore other biological pathways i) known to be involved in the pathogenesis of necrotising enterocolitis ii) involved in arginine metabolism iii) that are related to the insulin-IGF-I axis
- To assess whether there is an association between high ammonia levels (as a measure of functional arginine deficiency) and T-cell dysfunction and associated inflammatory pathways.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Liverpool, United Kingdom, L8 7SS
- Liverpool Women's Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Preterm infants born between 23 and 29 completed weeks gestation and admitted to the neonatal unit within 48 hours of birth
Exclusion Criteria:
- Infants who are unlikely to survive the first week after birth.
- Infants with early onset infection (<72 hours)
- Infants known (or suspected to have) a diagnosis of inborn error of metabolism or serious liver dysfunction
- Parents who are unable to give informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: OTHER
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
NO_INTERVENTION: Low Arginine unsupplemented
These infants identified as having low blood arginine levels will receive standard care.
|
|
EXPERIMENTAL: Low Arginine supplemented
These infants identified as having low arginine levels will receive an additional arginine infusion between days 3 and 10 of life.
|
|
NO_INTERVENTION: Normal Arginine
These infants identified as having normal arginine levels will receive standard care.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The pattern of alteration in gene expression between day 3 and day 10 in arginine deficient preterm infants after supplementation with arginine.
Time Frame: Samples on Day 3 and Day 10 of life
|
The changes in gene expression will be compared with those seen in unsupplemented infants, with and without arginine deficiency.
The genes of interest are those involved in T-cell function and associated inflammatory pathways.
|
Samples on Day 3 and Day 10 of life
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The pattern of alteration in gene expression associated with biological pathways known to be associated with NEC.
Time Frame: Day 3 and Day 10 of life
|
Day 3 and Day 10 of life
|
The pattern of alteration in gene expression associated with biological pathways known to be involved in arginine metabolism
Time Frame: Day 3 and Day 10 of life
|
Day 3 and Day 10 of life
|
The pattern of alteration in gene expression associated with biological pathways that are related to the IGF-1-insulin axis
Time Frame: Day 3 and Day 10 of life
|
Day 3 and Day 10 of life
|
To validate if high ammonia levels (as a measure of functional arginine deficiency) are linked with impaired T-cell function and associated inflammatory pathways
Time Frame: Day 3 of life
|
Day 3 of life
|
Collaborators and Investigators
Investigators
- Study Director: Colin Morgan, MBBS BSc MD, Neonatal Unit, Liverpool Women's Hospital, Crown St, Liverpool, L8 7SS
Study record dates
Study Major Dates
Study Start (ACTUAL)
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
- LWH1077
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
Clinical Trials on Preterm Infant Nutrition and Immune Function
-
Selçuk UniversityCompletedMusic | Preterm | Vital Signs | Nutrition Disorder, InfantTurkey
-
Eskisehir Osmangazi UniversityRecruitingPreterm | Feeding; Difficult, Newborn | Nutrition Disorder, InfantTurkey
-
Nationwide Children's HospitalCompleted
-
Brigham and Women's HospitalRecruitingPreterm Birth | Neurodevelopmental Disorders | Breast Milk Expression | Nutrition Disorder, Infant | Brain Development AbnormalityUnited States
-
Duke UniversityNational Institute of Nursing Research (NINR)CompletedPreterm Infant Development | Preterm Infant Health
-
Christiana Care Health ServicesCompletedInfant | Infant, Premature | Infant, Preterm | Infant, LateUnited States
-
NICHD Neonatal Research NetworkEunice Kennedy Shriver National Institute of Child Health and Human Development...CompletedInfant, Newborn | Infant, Moderate PretermUnited States
-
Medical University of GrazCompleted
-
St. Justine's HospitalCompletedParent-Child Relations | Child Development | Preterm Infant | Mothers | Interaction, Mother-InfantCanada
-
NICHD Neonatal Research NetworkEunice Kennedy Shriver National Institute of Child Health and Human Development...CompletedInfant, Newborn | Infant, Moderate PretermUnited States
Clinical Trials on Arginine
-
Emory UniversityNational Center for Complementary and Integrative Health (NCCIH); Children's...RecruitingSickle Cell DiseaseUnited States
-
Emory UniversityNational Center for Complementary and Integrative Health (NCCIH); Children's...CompletedSickle Cell Disease | Vaso-occlusive Pain EpisodeUnited States
-
Instituto de Oncología Ángel H. RoffoCompletedUnresectable Multiple Brain Metastases
-
UCSF Benioff Children's Hospital OaklandCompletedVaso-occlusive Pain EpisodesUnited States
-
Alexandra Hospital, Athens, GreeceUniversity of AthensUnknown
-
Centro Universitario de TonaláWithdrawn
-
Emory UniversityRecruiting
-
University Hospital, Strasbourg, FranceCompletedSkeletal Muscle Ischemia | Severe Lower Limb Ischemia | Mitochondrial DysfunctionFrance
-
Ottawa Hospital Research InstituteCompletedPerioperative Immunonutrition in Colorectal Cancer Patients Undergoing Abdominal Surgery (PERIOP-02)ColoRectal CancerCanada
-
National Neuroscience InstituteSingapore Clinical Research Institute; AegisCN LLCCompletedIntracerebral HemorrhageSingapore