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Effect of 4 Weeks of Oral Probiotic Desulfovibrio Piger Supplementation on Immunological and Metabolic Parameters in Individuals With Longstanding Type 1 Diabetes (PROSPER)

10. maj 2026 opdateret af: Max Nieuwdorp, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
The goal is to establish the effect of oral probiotic Desulfovibrio piger (D. piger) supplementation on immunological and metabolic parameters in individuals with longstanding type 1 diabetes with residual beta cell function. The investigators will perform a double-blind, randomized, placebo-controlled trial in 2x10 participants to measure effects of D. piger on parameters of systemic and intestinal inflammation and residual beta cell function.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The investigators perform a double-blind, randomized, placebo-controlled trial with two arms (10 participants per arm, total of 20 participants) in adults with longstanding type 1 diabetes with residual beta cell function. The study duration is 6 weeks, with 4 weeks of intervention in which participants will be given D. piger or placebo once daily and 2 weeks of washout period. The main study enpoints include the changes (versus baseline) in parameters of systemic/intestinal inflammation and beta cell function between the placebo and D.piger-treatment arms at the end of treatment (4 weeks). In addition, any long-lasting effects will be determined by assessing the changes in the above described markers after a 2 week washout period (6 weeks).

Secondary endpoints include glucose variability (continuous glucose monitoring, CGM), fecal microbiome composition (including strain engraftment of D. piger, plasma metabolites), immune cell phenotype and frequency and validated questionnaires (gastro-intestinal complaints) at these three timepoints (0,4,6 weeks).

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

20

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Holland
      • Amsterdam, Holland, 1105 AZ
      • Amsterdam, Holland, 1066 EC
        • Rekruttering
        • Diabeter Centrum Amsterdam
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

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Beskrivelse

Inclusion Criteria:

  • Males or females, age >18 years
  • A diagnosis of type 1 diabetes, with duration of more than 5 years, with minimally one of antiGAD65, IA2, ZnT8 autoantibodies present assessed at diagnosis or routine visits at Diabeter Centrum.
  • Evidence of remaining residual beta cell function with detectable UCPCR (more than 0.01 nmol/mmol C-peptide/creatinine ratio) and or fasting plasma C-peptide more than 0.2 mmol/L.
  • BMI 18-30 kg/m2

Exclusion Criteria:

  • Use of antibiotics or proton-pump inhibitors within the last three months before screening or during study period
  • Use of other probiotic supplementation within the last month before screening or during study period
  • A history of cholecystectomy
  • Overt untreated gastrointestinal disease, inflammatory bowel disease or abnormal bowel habits
  • Absence of a large bowel (ie colostomy)
  • Evidence for comprised immunity (HIV infection, chemotherapy, other autoimmune diseases, systemic anti-inflammatory therapy)
  • History of cardiovascular disaeses (CVD) events
  • Hepatic enzymes>2.5 higher than the upper limit of normal range, determined during MARVEL visits/routine visits
  • Kidney failure (eGFR <15ml.min/1.73m2), dialysis, kidney transplantation,
  • Inability or unwillingness to donate feces or urine.
  • Smoking or illicit drug use (e.g. MDMA/amphetamine/cocaine/heroin/GHB) in the past three months or use during the study period.
  • Alcohol abuse (equal or above 21 units per week)
  • Inability or unwillingness to provide informed consent.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Probiotic Desulfovibrio piger
Probiotic bacteria D. piger (10^9 colony forming units (CFU) in 10ml PBS containing 10% glycerol and 10% maltodextrin)
Kosttilskud: Probiotic dietary supplement
Probiotic bacteria D. piger (10^9 colony forming units (CFU) in 10ml PBS containing 10% glycerol and 10% maltodextrin)
Placebo komparator: Placebo
placebo (10ml PBS containing 10% glycerol and 10% maltodextrin)
Kosttilskud: Placebo
Placebo (10ml PBS containing 10% glycerol and 10% maltodextrin)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Parameters of systemic and intestinal inflammation
Tidsramme: From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.

systemic inflammation determined by measuring plasma CRP, and proinflammatory cytokines (IFNgamma, IFN alpha, TNFalpha)

intestinal inflammation assessed by LB, iFABP, zonulin in plasma
From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
Residual beta cell function
Tidsramme: From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
Assessed by C peptide AUC during mixed meal tolerance test and/or post meal urine C-peptide/creatinine ratio levels.
From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Glucose variability
Tidsramme: From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
percentage time in euglycemic range, time above range, time below range and glucose variability measured by continuous glucose monitoring (CGM)
From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
Immune cell phenotypes and frequency
Tidsramme: From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
Immunophenotyping by flow cytometry of PBMC (peripheral blood mononuclear cells) to determine frequency of T cell subsets with activation/exhaustion marker expression
From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
Fecal microbiome composition and strain engraftment
Tidsramme: From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
using 16s rRNA sequencing, primer-specific quantitative PCR for D. piger detection in feces and plasma metabolites
From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
Gastrointestinal Symptom Rating Scale (GSRS)
Tidsramme: From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.
Questionnaire. The minimum and maximum score are 15 and 105 points respectively, and a higher score in the scale reflects more gastro-intestinal complaints.
From start treatment to the end of treatment at 4 weeks and washout at 6 weeks.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Efterforskere

  • Ledende efterforsker: Max Nieuwdorp, Prof. Dr., Amsterdam UMC

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. maj 2026

Primær færdiggørelse (Anslået)

1. maj 2028

Studieafslutning (Anslået)

1. maj 2028

Datoer for studieregistrering

Først indsendt

5. maj 2026

Først indsendt, der opfyldte QC-kriterier

10. maj 2026

Først opslået (Faktiske)

14. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

14. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2025.1139

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