- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05576038
Tryptophan for Impaired AhR Signaling in Celiac Disease (TIARSCeD)
Restoration of Impaired Microbiota-mediated Aryl Hydrocarbon Receptor Signaling in Celiac Disease by Oral Tryptophan Supplementation: an Exploratory, Pilot Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Gaston H Rueda, MD
- Phone Number: 21875 905 521-2100
- Email: ruedag@mcmaster.ca
Study Contact Backup
- Name: Utkarshini N Kirtikar, MSc
- Phone Number: 21875 905 521-2100
- Email: kirtikau@mcmaster.ca
Study Locations
-
-
Ontario
-
Hamilton, Ontario, Canada, L8N3Z5
- Recruiting
- McMaster University
-
Contact:
- David Armstrong
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria:
- 18 and 75 years of age
- Celiac disease (CeD) diagnosis: Individuals with histological and serological evidence of CeD serology (positive biopsy and anti-tTG IgA)
- Persistent CeD related symptoms (>40 on the Celiac Symptom Index) despite >1 year of a gluten free diet (GFD)
Exclusion criteria:
- Acid anti-secretory and antacid medications
- Antibiotics, antibacterial agents or probiotics, currently, or within the last 8 weeks
- Current organic gastrointestinal or other autoimmune diseases, such as inflammatory bowel disease or diabetes mellitus (type 1)
- Lactose and/or fructose intolerance
- History of bariatric surgery, fundoplication or gastrectomy (partial or complete)
- Connective tissue disease
- Concurrent organic GI pathology other than benign polyps, haemorrhoids, lipomas, Helicobacter pylori infection, diverticulosis and melanosis coli
- Chronic treatment with high dose opioids
- Alcohol or drug abuse
- Concurrent systemic disease and/or laboratory abnormalities considered by investigators to be a risk or that could interfere with data collection
- Allergy or sensitivity to any component of the study medication or placebo
- Use of lithium and monoamine oxidase inhibitors (MAOIs)
- Participation in another dietary treatment study within the last 4 weeks
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: L-Tryptophan
L-tryptophan* supplements (Tryptan, Valeant Canada LP): each treatment capsule contains 500 mg of L-Tryptophan; talc and magnesium stearate. Study participants will be instructed to take 2 x 500 mg capsules (1000 mg) every 8 hrs, three times a day. (total daily dose: 3000 mg) for a total of 3 weeks. Instructions will be printed on the label of the pill container. |
L-tryptophan is an essential amino acid responsible for activating the aryl hydrocarbon receptor (AhR).
Dietary tryptophan is metabolized by the gut microbiota producing several 'indoles' such as (indole-3-aldehyde (IAld), indole-3-acetic acid (IAA), indole-3 propionic acid (IPA), indole-3-acetaldehyde (IAAld), indole-3-lactic acid (ILA) and indole-acrylic acid) and tryptamine, which are ligands for the AhR, a nuclear transcription factor involved in activating target genes responsible for maintaining gut integrity.
Prior literature suggests that patients with active celiac disease have a lower functional capacity to produce these AhR ligands, which further impairs the AhR pathway.
Hence, the aim of this study is to assess the effects of tryptophan supplementation in patients with celiac disease, non-responsive to a GFD for more than 1 year compared with the effects of an inactive, placebo comparator, L-leucine.
|
Placebo Comparator: Freedom SimpleCap Powder
500 mg of SimpleCap Powder. Study participants will be instructed to take 2 x 500 mg capsules (1000 mg) every 8 hrs, three times a day. (total daily dose: 3000 mg) for a total of 3 weeks. Instructions will be printed on the label of the pill container. |
Freedom SimpleCap Powder is a high functionality capsule and tablet excipient composite comprised of filler, glidant, disintegrant and lubricant (ingredients include: Microcrystalline Cellulose, Silicon Dioxide Colloidal, Sodium Starch Glycolate, Sodium Stearyl Fumarate).
This capsule is dye, lactose and gluten free and will not interfere with the AhR pathway.
Freedom SimpleCap Powder makes oral capsule formulation convenient, quick and simple Thus, this SimpleCap Powder will be an appropriate placebo comparator for this study.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measurement of Celiac Symptom Index (CSI)
Time Frame: 3 weeks
|
Change in CSI score; a 7-point decrease in CSI score indicates meaningful improvement.
|
3 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life questionnaire (PAGI-QoL).
Time Frame: 3 weeks
|
Change in PAGI-QoL score from baseline to week 3; an increase in score indicates an improvement in quality of life.
PAGI-QoL score ranges from 0 to 5, 0 being the lowest and 5 being the highest.
|
3 weeks
|
Hospital Anxiety and Depression Scale (HADS)
Time Frame: 3 weeks
|
Change in the anxiety and depression scores for the HADS from baseline to week 3; a decrease in the scores indicate decreases in anxiety and depression respectively.
The anxiety and depression scales score separately, each ranging from 0 to 21, 0 being the lowest and 21 being the highest.
|
3 weeks
|
Gastrointestinal Symptoms Rating Scale (GSRS)
Time Frame: 3 weeks
|
Change in GSRS score from baseline to week 3. Score ranges from 1-7; decrease in score indicates improvement.
|
3 weeks
|
Intestinal indole production in the duodenum
Time Frame: 3 weeks
|
Change in duodenal indole production from baseline to week 3
|
3 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Duodenal mucosal villus-crypt ratio (VCR)
Time Frame: 3 weeks
|
Change in the duodenal mucosal VCR from baseline to week 3; an increase in the mucosal VCR ratio indicates decreased mucosal injury
|
3 weeks
|
Aryl hydrocarbon Receptor (AhR) activation in the duodenum
Time Frame: 3 weeks
|
Change in duodenal mucosal AhR activation from baseline to week 3
|
3 weeks
|
Tissue transglutaminase IgA (tTG) titres
Time Frame: 3 weeks
|
Change in tTG titers from baseline to week 3; a decrease in tTG titres is associated with decreased gluten exposure and, hence, with decreased celiac disease activity
|
3 weeks
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- 14582
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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