- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT05858437
Indvirkning af propionsyre på regulatorisk T-cellefunktion hos børn med CKD (Pro-Kids)
Indvirkning af propionsyre på regulatorisk T-cellefunktion hos børn med kronisk nyresygdom
Pro-Kids is a multi-center, double-blind, randomized and placebo-controlled intervention study in children with chronic kidney disease. The investigators address the effect of a dietary food supplementation of propionic acid on the immune system and the function of the intestinal barrier in CKD patients treated with hemodialysis.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Chronic inflammation is a major risk factor of cardiovascular disease progression in CKD, irrespective of confounding comorbidities. Based on current knowledge, microbially-derived metabolites such as short chain fatty acids (SCFA) play an important role in the regulation of chronic inflammatory processes in CKD patients. Children with CKD are known to have reduced serum levels of the SCFA propionic acid (PA), as a consequence of both gut microbial dysbiosis and reduced fiber intake. In animal and human studies the impact of PA on function and abundance of regulatory T cells (Treg) has been demonstrated. Consequently, the investigators aim to normalize the PA serum levels by oral PA food supplementation in hemodialysis patients in order to mitigate chronic inflammation.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
- Navn: Johannes Holle, Dr. med.
- Telefonnummer: 004930450516012
- E-mail: johannes-benjamin.holle@charite.de
Undersøgelse Kontakt Backup
- Navn: Nicola Wilck, Dr. med.
- Telefonnummer: 004930450516012
- E-mail: nicola.wilck@charite.de
Studiesteder
-
-
State of Berlin
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Berlin, State of Berlin, Tyskland, 13353
- Rekruttering
- Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité-Universitätsmedizin Berlin
-
Kontakt:
- Johannes Holle, MD
-
Kontakt:
- Dominik Müller, MD
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Body weight: > 30kg
- CKD G5 treated with hemodialysis
- Continuous hemodialysis treatment for > 3 months
- Clinical stable condition
- Manifestation of CKD within childhood (<18 years)
Exclusion Criteria:
- Disease or dysfunctions, which disqualifies the patient
- Incapacity of contract or any other circumstances, which prohibit the patient or his legal guardians from understanding setup, meaning and entity of the study
- Acute infections
- Immunosuppressive therapy within the last 12 weeks before the start of the study
- Pre-/pro- or postbiotic or antibiotic therapy within the last 4 weeks before the start of the study
- Planned or unplanned hospitalization within in last 4 weeks before the start of the study or during study
- Malignant diseases
- Pregnancy
- chronic gastrointestinal or hepatic diseases (for example chronic inflammatory bowel disease
- alcohol- or drug abuse
- parallel participation on other interventional trials
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Grundvidenskab
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: PA Intervention
The group which receives the PA as a dietary food supplement. A single capsule contains 500mg of sodiumpropionate, which is taken twice daily for 28 days. |
The patients will be randomized to PA or placebo intervention (2:1 randomization). After the intervention of 28 days, we conduct an open-label study phase, where all patients are offered a dietary supplement of PA for overall 12 weeks (8 additional weeks for the intervention group and 12 weeks for the placebo group). By doing so we are giving every patient the opportunity to take PA and benefit from the possible positive impact on immunsystem and intestinal barrier function. |
|
Placebo komparator: Placebo Intervention
The control-group receives a placebo instead of propionate. The placebo contains maltodextrin and the same amount of sodium chloride as compared to the PA intervention. The placebo is taken twice per day for 28 days. |
The patients will be randomized to PA or placebo intervention (2:1 randomization). After the intervention of 28 days, we conduct an open-label study phase, where all patients are offered a dietary supplement of PA for overall 12 weeks (8 additional weeks for the intervention group and 12 weeks for the placebo group). By doing so we are giving every patient the opportunity to take PA and benefit from the possible positive impact on immunsystem and intestinal barrier function. |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in count of regulatory T-cells from baseline to week 4
Tidsramme: Baseline visit (week 0) in comparison to week 4
|
Analysis of Treg counts in whole blood (absolute quantification) and peripheral blood mononuclear cells (PBMC; relative quantification) by flow cytometry. |
Baseline visit (week 0) in comparison to week 4
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Propionic acid serum levels and targeted metabolomics
Tidsramme: Baseline visit (week 0); Week 2; Week 4; Week 12
|
Analysis of PA serum levels and other microbially-derived metabolites by GC-MS and LC-MS |
Baseline visit (week 0); Week 2; Week 4; Week 12
|
|
Immune cell phenotyping of peripheral blood mononuclear cells (PBMC)
Tidsramme: Baseline visit (week 0); Week 2; Week 4; Week 12
|
Patients PBMC will be thawed and immune cells we be analyzed using multicolor flow cytometry and mass cytometry. By using a broad range of different antibodies combined in several panels the investigators will analyse distinct T cell subtypes including markers of activation, but also other immune cells (including B cells, dendritic cells, monocytes, natural killer cells). Data will reported in relation to parent populations (e.g. T heller cells in % of T cells). |
Baseline visit (week 0); Week 2; Week 4; Week 12
|
|
T regulatory cell (Treg) suppression assay
Tidsramme: Baseline visit (week 0); Week 4
|
The suppressive capacity of patients Treg will be analyzed by co-cultivation with conventional, stimulated T cells (Tconv) in different proportions (Treg:Tconv). The proliferation of Tconv will be reported. |
Baseline visit (week 0); Week 4
|
|
Single cell RNA sequencing of immune cells
Tidsramme: Baseline visit (week 0); Week 4
|
Analysis of the transcriptome of immune cells using cellular indexing of transcriptomes and epitopes (CITEseq) |
Baseline visit (week 0); Week 4
|
|
Intestinal barrier function
Tidsramme: Baseline visit (week 0); Week 2; Week 4; Week 12
|
Analysis of biomarkers for intestinal barrier function, such as sCD14, zonulin-1 and LPS |
Baseline visit (week 0); Week 2; Week 4; Week 12
|
|
Taxonomy of the fecal microbiome
Tidsramme: Baseline visit (week 0); Week 4
|
The taxonomy of the fecal microbiome will be anayzed using 16S RNA amplicon sequencing. |
Baseline visit (week 0); Week 4
|
|
Cardiovascular Phenotyping
Tidsramme: Baseline visit (week 0); Week 2; Week 4; Week 12
|
Analysis of heart rate over time. |
Baseline visit (week 0); Week 2; Week 4; Week 12
|
|
Cardiovascular Phenotyping
Tidsramme: Baseline visit (week 0); Week 2; Week 4; Week 12
|
Analysis of blood pressure over time. |
Baseline visit (week 0); Week 2; Week 4; Week 12
|
|
Cholesterol levels
Tidsramme: Baseline visit (week 0); Week 2; Week 4; Week 12
|
Cholesterol levels will be assessed using standard clinical lab values. |
Baseline visit (week 0); Week 2; Week 4; Week 12
|
Samarbejdspartnere og efterforskere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Patologiske processer
- Mandlige urogenitale sygdomme
- Nyresygdomme
- Urologiske sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Kronisk sygdom
- Sygdomsegenskaber
- Nyreinsufficiens
- Patologiske tilstande, tegn og symptomer
- Nyreinsufficiens, kronisk
- Natriumpropionat
Andre undersøgelses-id-numre
- EA2/195/22
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