- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03150927
Clinical Study of Novel Probiotic Microbial Composite™ to Treat Undernourished Young Children
A Clinical Study to Determine the Effects of a Novel Probiotic Microbial Composite™ on Improving Digestive Health and Key Growth Parameters in Undernourished Young Children
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The Probiotic Microbial Composite™ is a multifaceted technology that encompasses three key areas, namely, prebiotics, probiotics and post-biotics. The first component, prebiotics, involve non-digestible food ingredients, typically oligosaccharides which act by beneficially affecting the host by stimulating growth, activity, or in fact both of specific intestinal bacteria.
The probiotic component refers to the augmentation or addition of bacteria to enhance and support the various beneficial bacteria that are inherent to the gastrointestinal tract. The bio-fermented Microbiotic Composite™ is a consortium of bacteria which can play a significant physiological role as a probiotic. This theory, termed the microbial consortium theory suggests that rather than a cumulative effect by the bacteria, there is in fact combinatorial affect by the use of several species.
The final component post-biotics, in general, mimic the beneficial health promoting effects of probiotics whilst avoiding the risk of taking live micro-organisms within the gastrointestinal tract, especially in populations such as infants and the elderly in whom the intestinal barriers, as well as, innate immune defenses can be impaired. The term typically encompasses a vast plethora of byproducts, know as metabolites, produced and secreted by the bacteria in response to their environment.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Karnataka
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Mysore, Karnataka, India, 570 001
- Mysore Medical College and Research Institute
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
The Randomized Clinical Trial (RCT) will typically involve 250 subjects randomized into two arms based on age and sex.
Following a positive outcome in the RCT (following 6 months), we envisage converting the study to an observational based study (case-study) based on ethical principles where the placebo arm of the study would be administered the test product. Each subject will be assessed for a total of two years.
Inclusion criteria:
- Inpatient setting: Children with age of 3 years to 12 years with acute diarrhea
- Outpatient setting: healthy children aged 3 years to 12 years
Exclusion criteria:
- Subjects taking any kind of prescription medication.
- Subjects taking any dietary supplements (2-week washout is permitted).
- Subjects taking any antibiotics (must have discontinued antibiotic use 12-weeks prior to beginning study). An allowance will be made to existing subjects already taking part in the study. This confounder will however have to be noted by the primary investigators.
Individual has a condition the Investigator believes would interfere with his or her ability to provide informed consent, comply with the study protocol, which might confound the interpretation of the study results or put the person at undue risk.
- Including subjects who are bed or wheelchair-bound
- Including subjects who have any physical disability which could interfere with their ability to perform the functional performance measures included in this protocol.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Probiotic Microbial Composite
Probiotic Microbial Composite is a safe, 100% natural material containing all Generally Recognized as Safe (GRAS) Probiotics, combined with FDA approved food grade excipient materials.
The probiotics contained within are also all 100% natural and non-Genetically Modified Organisms (non-GMO).
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125mg (or 250 mg) of BiOWiSH Probiotic Microbial Composite™ is to be dosed once daily.
Product will be supplied in capsule form to be administered orally.
Each subject will be given a 15-day supply (30 capsules) to take with them after their initial visit.
Capsules will be administered every 15 days by primary investigators at follow up visits.
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Placebo Comparator: Placebo
Placebo is a mixture of inactive ingredients found in Probiotic Microbial Composite.
These ingredients are FDA approved food grade materials, 100% natural and palatable.
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125mg (or 250 mg) of Placebo is to be dosed once daily.
Product will be supplied in capsule form to be administered orally.
Each subject will be given a 15-day supply (30 capsules) to take with them after their initial visit.
Capsules will be administered every 15 days by primary investigators at follow up visits.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Acute diarrhea in children ages 3 years to 12 years
Time Frame: 24 weeks
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Subjects will be assessed as to severity of diarrhea using a standardized measure of diarrheal severity in pediatrics
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24 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Serial assessment of healthy children aged 3 years to 12 years
Time Frame: 2 years
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Subjects will be followed by serial assessment of mid-arm circumference measured in centimeters.
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2 years
|
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Serial assessment of healthy children aged 3 years to 12 years
Time Frame: 2 years
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Subjects will be followed by serial assessment of head circumference measured in centimeters.
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2 years
|
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Height of healthy children aged 3 years to 12 years
Time Frame: 2 years
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Subjects will be followed by serial assessment of height in centimeters
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2 years
|
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Weight of healthy children aged 3 years to 12 years
Time Frame: 2 years
|
Subjects will be followed by serial assessment of weight in kilograms
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2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Mudassir A Khan, Ph.D., Department of Community Medicine/Public Health Mysore Medical College & Research Institute
- Principal Investigator: Amit Kapur, MBBS, Prince of Wales Hospital
- Principal Investigator: Richard S Carpenter, PhD, Biowish Technologies, Inc.
Publications and helpful links
General Publications
- D'Souza AL, Rajkumar C, Cooke J, Bulpitt CJ. Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. BMJ. 2002 Jun 8;324(7350):1361. doi: 10.1136/bmj.324.7350.1361.
- Cremonini F, Di Caro S, Nista EC, Bartolozzi F, Capelli G, Gasbarrini G, Gasbarrini A. Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2002 Aug;16(8):1461-7. doi: 10.1046/j.1365-2036.2002.01318.x.
- van Nood E, Vrieze A, Nieuwdorp M, Fuentes S, Zoetendal EG, de Vos WM, Visser CE, Kuijper EJ, Bartelsman JF, Tijssen JG, Speelman P, Dijkgraaf MG, Keller JJ. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013 Jan 31;368(5):407-15. doi: 10.1056/NEJMoa1205037. Epub 2013 Jan 16.
- Allen SJ, Okoko B, Martinez E, Gregorio G, Dans LF. Probiotics for treating infectious diarrhoea. Cochrane Database Syst Rev. 2004;(2):CD003048. doi: 10.1002/14651858.CD003048.pub2.
- Asuzu MC. A comparative study of the commonly used nutritional assessment tools for primary health care. East Afr Med J. 1991 Nov;68(11):913-22.
- Bhutta ZA, Das JK. Interventions to address maternal and childhood undernutrition: current evidence. Nestle Nutr Inst Workshop Ser. 2014;78:59-69. doi: 10.1159/000354941. Epub 2014 Jan 27.
- Canani RB, Cirillo P, Terrin G, Cesarano L, Spagnuolo MI, De Vincenzo A, Albano F, Passariello A, De Marco G, Manguso F, Guarino A. Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations. BMJ. 2007 Aug 18;335(7615):340. doi: 10.1136/bmj.39272.581736.55. Epub 2007 Aug 9.
- Depeint F, Tzortzis G, Vulevic J, I'anson K, Gibson GR. Prebiotic evaluation of a novel galactooligosaccharide mixture produced by the enzymatic activity of Bifidobacterium bifidum NCIMB 41171, in healthy humans: a randomized, double-blind, crossover, placebo-controlled intervention study. Am J Clin Nutr. 2008 Mar;87(3):785-91. doi: 10.1093/ajcn/87.3.785.
- Fang SB, Lee HC, Hu JJ, Hou SY, Liu HL, Fang HW. Dose-dependent effect of Lactobacillus rhamnosus on quantitative reduction of faecal rotavirus shedding in children. J Trop Pediatr. 2009 Oct;55(5):297-301. doi: 10.1093/tropej/fmp001. Epub 2009 Feb 8.
- Grosse SD, Roy K. Long-term economic effect of early childhood nutrition. Lancet. 2008 Feb 2;371(9610):365-6. doi: 10.1016/S0140-6736(08)60180-4. No abstract available.
- Guarino A, Canani RB, Spagnuolo MI, Albano F, Di Benedetto L. Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea. J Pediatr Gastroenterol Nutr. 1997 Nov;25(5):516-9. doi: 10.1097/00005176-199711000-00005.
- Gueimonde M, Sakata S, Kalliomaki M, Isolauri E, Benno Y, Salminen S. Effect of maternal consumption of lactobacillus GG on transfer and establishment of fecal bifidobacterial microbiota in neonates. J Pediatr Gastroenterol Nutr. 2006 Feb;42(2):166-70. doi: 10.1097/01.mpg.0000189346.25172.fd.
- Hoddinott J, Maluccio JA, Behrman JR, Flores R, Martorell R. Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults. Lancet. 2008 Feb 2;371(9610):411-6. doi: 10.1016/S0140-6736(08)60205-6.
- Hooper LV, Midtvedt T, Gordon JI. How host-microbial interactions shape the nutrient environment of the mammalian intestine. Annu Rev Nutr. 2002;22:283-307. doi: 10.1146/annurev.nutr.22.011602.092259. Epub 2002 Apr 4.
- Johnston BC, Supina AL, Ospina M, Vohra S. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004827. doi: 10.1002/14651858.CD004827.pub2.
- Kalliomaki M, Salminen S, Poussa T, Isolauri E. Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial. J Allergy Clin Immunol. 2007 Apr;119(4):1019-21. doi: 10.1016/j.jaci.2006.12.608. Epub 2007 Feb 7. No abstract available.
- Kosek M, Bern C, Guerrant RL. The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000. Bull World Health Organ. 2003;81(3):197-204. Epub 2003 May 16.
- Laparra JM, Sanz Y. Comparison of in vitro models to study bacterial adhesion to the intestinal epithelium. Lett Appl Microbiol. 2009 Dec;49(6):695-701. doi: 10.1111/j.1472-765X.2009.02729.x. Epub 2009 Aug 25.
- Laparra JM, Sanz Y. Interactions of gut microbiota with functional food components and nutraceuticals. Pharmacol Res. 2010 Mar;61(3):219-25. doi: 10.1016/j.phrs.2009.11.001. Epub 2009 Nov 13.
- Lefkovitz AL, Zarowitz BJ. It's a microscopic world after all: prebiotics, probiotics, and synbiotics. Geriatr Nurs. 2013 Jul-Aug;34(4):323-5. doi: 10.1016/j.gerinurse.2013.06.007. No abstract available.
- Marteau P, Shanahan F. Basic aspects and pharmacology of probiotics: an overview of pharmacokinetics, mechanisms of action and side-effects. Best Pract Res Clin Gastroenterol. 2003 Oct;17(5):725-40. doi: 10.1016/s1521-6918(03)00055-6.
- Mountzouris KC, McCartney AL, Gibson GR. Intestinal microflora of human infants and current trends for its nutritional modulation. Br J Nutr. 2002 May;87(5):405-20. doi: 10.1079/BJNBJN2002563.
- Owen GM. The new National Center for Health Statistics growth charts. South Med J. 1978 Mar;71(3):296-7. doi: 10.1097/00007611-197803000-00027. No abstract available.
- Patel RM, Denning PW. Therapeutic use of prebiotics, probiotics, and postbiotics to prevent necrotizing enterocolitis: what is the current evidence? Clin Perinatol. 2013 Mar;40(1):11-25. doi: 10.1016/j.clp.2012.12.002. Epub 2013 Jan 17.
- Pedone CA, Arnaud CC, Postaire ER, Bouley CF, Reinert P. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract. 2000 Nov;54(9):568-71.
- Pedone CA, Bernabeu AO, Postaire ER, Bouley CF, Reinert P. The effect of supplementation with milk fermented by Lactobacillus casei (strain DN-114 001) on acute diarrhoea in children attending day care centres. Int J Clin Pract. 1999 Apr-May;53(3):179-84.
- Ruemmele FM, Bier D, Marteau P, Rechkemmer G, Bourdet-Sicard R, Walker WA, Goulet O. Clinical evidence for immunomodulatory effects of probiotic bacteria. J Pediatr Gastroenterol Nutr. 2009 Feb;48(2):126-41. doi: 10.1097/MPG.0b013e31817d80ca.
- Saavedra JM, Bauman NA, Oung I, Perman JA, Yolken RH. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet. 1994 Oct 15;344(8929):1046-9. doi: 10.1016/s0140-6736(94)91708-6.
- Sanz Y, De Palma G. Gut microbiota and probiotics in modulation of epithelium and gut-associated lymphoid tissue function. Int Rev Immunol. 2009;28(6):397-413. doi: 10.3109/08830180903215613.
- Schoeman SE, Hendricks MK, Hattingh SP, Benade AJ, Laubscher JA, Dhansay MA. The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa. Public Health Nutr. 2006 Dec;9(8):1007-12. doi: 10.1017/s1368980006009864.
- Schwiertz A, Gruhl B, Lobnitz M, Michel P, Radke M, Blaut M. Development of the intestinal bacterial composition in hospitalized preterm infants in comparison with breast-fed, full-term infants. Pediatr Res. 2003 Sep;54(3):393-9. doi: 10.1203/01.PDR.0000078274.74607.7A. Epub 2003 Jun 4.
- Shanahan F. Probiotics: a perspective on problems and pitfalls. Scand J Gastroenterol Suppl. 2003;(237):34-6. doi: 10.1080/00855910310001476.
- Szajewska H, Mrukowicz J. Meta-analysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2005 Sep 1;22(5):365-72. doi: 10.1111/j.1365-2036.2005.02624.x.
- Szajewska H, Ruszczynski M, Radzikowski A. Probiotics in the prevention of antibiotic-associated diarrhea in children: a meta-analysis of randomized controlled trials. J Pediatr. 2006 Sep;149(3):367-372. doi: 10.1016/j.jpeds.2006.04.053.
- Szajewska H, Skorka A, Dylag M. Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther. 2007 Feb 1;25(3):257-64. doi: 10.1111/j.1365-2036.2006.03202.x. Erratum In: Aliment Pharmacol Ther. 2009 Apr;29(7):800.
- Tlaskalova-Hogenova H, Stepankova R, Hudcovic T, Tuckova L, Cukrowska B, Lodinova-Zadnikova R, Kozakova H, Rossmann P, Bartova J, Sokol D, Funda DP, Borovska D, Rehakova Z, Sinkora J, Hofman J, Drastich P, Kokesova A. Commensal bacteria (normal microflora), mucosal immunity and chronic inflammatory and autoimmune diseases. Immunol Lett. 2004 May 15;93(2-3):97-108. doi: 10.1016/j.imlet.2004.02.005.
- Tsilingiri K, Rescigno M. Postbiotics: what else? Benef Microbes. 2013 Mar 1;4(1):101-7. doi: 10.3920/BM2012.0046.
- Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics. 2005 Jan;115(1):5-9. doi: 10.1542/peds.2004-1815.
- Wingreen NS, Levin SA. Cooperation among microorganisms. PLoS Biol. 2006 Sep;4(9):e299. doi: 10.1371/journal.pbio.0040299.
- Zoetendal EG, Rajilic-Stojanovic M, de Vos WM. High-throughput diversity and functionality analysis of the gastrointestinal tract microbiota. Gut. 2008 Nov;57(11):1605-15. doi: 10.1136/gut.2007.133603.
- Borody TJ, Peattie D, Kapur A. Could fecal microbiota transplantation cure all Clostridium difficile infections? Future Microbiol. 2014;9(1):1-3. doi: 10.2217/fmb.13.146. No abstract available.
- Cunliffe NA, Kilgore PE, Bresee JS, Steele AD, Luo N, Hart CA, Glass RI. Epidemiology of rotavirus diarrhoea in Africa: a review to assess the need for rotavirus immunization. Bull World Health Organ. 1998;76(5):525-37.
- Dabek M, McCrae SI, Stevens VJ, Duncan SH, Louis P. Distribution of beta-glucosidase and beta-glucuronidase activity and of beta-glucuronidase gene gus in human colonic bacteria. FEMS Microbiol Ecol. 2008 Dec;66(3):487-95. doi: 10.1111/j.1574-6941.2008.00520.x. Epub 2008 Jun 4.
- Dubey AP, Rajeshwari K, Chakravarty A, Famularo G. Use of VSL[sharp]3 in the treatment of rotavirus diarrhea in children: preliminary results. J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 1:S126-9. doi: 10.1097/MCG.0b013e31816fc2f6.
- Gronlund MM, Lehtonen OP, Eerola E, Kero P. Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr. 1999 Jan;28(1):19-25. doi: 10.1097/00005176-199901000-00007.
- Hapfelmeier S, Lawson MA, Slack E, Kirundi JK, Stoel M, Heikenwalder M, Cahenzli J, Velykoredko Y, Balmer ML, Endt K, Geuking MB, Curtiss R 3rd, McCoy KD, Macpherson AJ. Reversible microbial colonization of germ-free mice reveals the dynamics of IgA immune responses. Science. 2010 Jun 25;328(5986):1705-9. doi: 10.1126/science.1188454.
- International Conference on Primary Health Care. Declaration of Alma-Ata. WHO Chron. 1978 Nov;32(11):428-30. No abstract available.
- Johnson CL, Versalovic J. The human microbiome and its potential importance to pediatrics. Pediatrics. 2012 May;129(5):950-60. doi: 10.1542/peds.2011-2736. Epub 2012 Apr 2.
- Kawamoto S, Tran TH, Maruya M, Suzuki K, Doi Y, Tsutsui Y, Kato LM, Fagarasan S. The inhibitory receptor PD-1 regulates IgA selection and bacterial composition in the gut. Science. 2012 Apr 27;336(6080):485-9. doi: 10.1126/science.1217718.
- Rautava S, Arvilommi H, Isolauri E. Specific probiotics in enhancing maturation of IgA responses in formula-fed infants. Pediatr Res. 2006 Aug;60(2):221-4. doi: 10.1203/01.pdr.0000228317.72933.db.
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BWT-20150720-001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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