아토피 피부염에 대한 치료 효과
건강한 지원자와 아토피 피부염 환자의 마이크로바이옴에 대한 치료 효과
Background:
- Atopic dermatitis, or eczema, is a chronic skin disorder. Patients sometimes have infections with S. aureus bacteria. Researchers want to study how eczema treatments affect the number and the type of bacteria on the skin.
Objectives:
- To study the effect of eczema treatments on skin bacteria.
Eligibility:
- Individuals between 2 and 25 years of age who have moderate to severe atopic dermatitis.
- Healthy volunteers between 18 and 40 years of age with no history of eczema.
Design:
- Participants will be screened with a physical exam and medical history. Research samples will be collected. Skin biopsies may also be performed.
- All participants will be assigned to one of several study groups.
- Healthy volunteers must not have taken antibiotics in the year before the start of the study.
- All participants will have regular study visits during their 1-year participation. More research samples will be collected at these visits.
- Healthy volunteers may be asked to come in for a one-time follow up after the 1 year mark.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
상세 설명
BACKGROUND:
- The use of antibiotics has revolutionized medicine, yet the impact of antimicrobials on the human microbiome is incompletely understood.
- Antimicrobial treatments, including topical and systemic antibiotics, are highly effective and are frequently used to manage disease flares of atopic dermatitis (AD). Concomitant use of dilute bleach baths reduces the clinical severity of AD in patients with clinical signs of bacterial skin infections.
- The longitudinal impact of various antimicrobials on the human microbiome, particularly in skin, has not been systematically investigated.
- Our recent study demonstrated that antibiotic-resistant bacteria can be observed after antibiotic exposure; however, multi-year persistence has not been evaluated
OBJECTIVES:
Primary:
- To characterize microbiome alterations in healthy adult volunteers and patients with AD after antimicrobial treatments.
ELIGIBILITY:
- All subjects must be co-enrolled in NIH protocol 08-HG-0059
- (Cohorts 1 [NO FURTHER ACCRUAL], 2 [INACTIVE], 4 [NO FURTHER ACCRUAL], 5 [INACTIVE]) Healthy volunteers aged 18 to 50 years with no history of AD.
- (Cohort 1 [NO FURTHER ACCRUAL], 2 [INACTIVE], 4 [NO FURTHER ACCRUAL] and 5 [INACTIVE]) No prior use of systemic antibiotics in preceding 12 months.
- (Cohort 3 [INACTIVE]) Subjects 2-50 years with atopic dermatitis with symptoms of active bacterial infection.
- (Cohort 3 [INACTIVE]) Objective SCORAD (SCORing Atopic Dermatitis) score of >= 15 indicating moderate-to-severe disease.
- (Cohort 6) Individuals previously enrolled in Cohorts 1 [NO FURTHER ACCRUAL] and 4 [NO FURTHER ACCRUAL].
DESIGN:
- A prospective, interventional, longitudinal study examining changes in microbiome resulting from randomized, placebo-controlled, investigator-blinded antimicrobial treatments.
- Subjects in Cohort 1 [NO FURTHER ACCRUAL] will be randomized to take one of 4 open label antibiotic regimens.
- Subjects from Cohort 2 [INACTIVE] randomized to one of four possible blinded treatment combinations of study baths and antibiotics.
- Subjects in Cohort 3 [INACTIVE] will be randomized to a cephalexin regimen with or without study baths.
- Subjects in Cohorts 4 [NO FURTHER ACCRUAL] and 5 [INACTIVE] will receive one of two open label antibiotic regimens.
- All subjects will undergo longitudinal microbiome sampling.
- Subjects who completed on-protocol antibiotic regimen in Cohorts 1 [NO FURTHER ACCRUAL] and 4 [NO FURTHER ACCRUAL] may be recruited >1 year after completion of Cohorts 1 and 4 to undergo an optional single visit for microbiome sampling as Cohort 6.
- AD patients [INACTIVE] will undergo clinical assessment to determine responses of skin infections to treatment.
연구 유형
연구 유형
등록 (추정된)
등록
단계
단계
- 2 단계
연락처 및 위치
연구 연락처
연구 연락처
- 이름: Heidi H Kong, M.D.
- 전화번호: (301) 827-2460
- 이메일: NIAMSderm@nih.gov
연구 장소
-
-
Maryland
-
Bethesda, Maryland, 미국, 20892
- 모병
- National Institutes of Health Clinical Center
-
연락하다:
- NIH Clinical Center Office of Patient Recruitment (OPR)
- 전화번호: TTY dial 711 800-411-1222
- 이메일: ccopr@nih.gov
-
-
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
- INCLUSION CRITERIA:
Cohorts 1 [NO FURTHER ACCRUAL], 2 [INACTIVE], 4 [NO FURTHER ACCRUAL] and 5 [INACTIVE]: Healthy Volunteers
- Males and females aged 18-50 years at time of initial protocol sampling
- Subjects must participate fully and be willing to comply with the procedures of the protocol
- Subjects must be co-enrolled in NIH protocol 08-HG-0059
- Ability of subject to understand and provide written informed consent
- Access to bathing facilities (Cohort 2 [INACTIVE])
- Ability to swallow capsules or tablets
Cohort 3 [INACTIVE]: Atopic Dermatitis Patients
- Subjects must be aged 2-50 years
- Subjects must be co-enrolled in NIH protocol 08-HG-0059
- Subjects must have a diagnosis of atopic dermatitis on the basis of the criteria defined by UK Working Party s Diagnostic Criteria for Atopic Dermatitis
- Subjects must have a primary care provider
- Subjects must have an Objective SCORAD (SCORing Atopic Dermatitis) of greater than or equal to 15 indicating AD severity of moderate to severe
- Prior to initiation of randomized treatment, subjects must have signs of bacterial skin infections (skin weeping, crusting, and/or pustules)
- Access to bathing facilities
- All subjects and/or their Legally Authorized Representative (LAR) must have the ability and agree to participate fully and comply with
the procedures of the protocol and provide informed consent. Pediatric patients will be included in age appropriate discussions and
age appropriate assent will be obtained in accordance with NIH guidelines.
-Ability of subject to understand and provide written informed consent
Cohort 6: Healthy Volunteers
- Subjects previously enrolled in Cohorts 1 [NO FURTHER ACCRUAL] and 4 [INACTIVE] who completed on-protocol antibiotic regimen
- Subjects must participate fully and be willing to comply with the procedures of the protocol
- Ability of subject to understand and provide written informed consent
EXCLUSION CRITERIA:
Cohorts 1 [NO FURTHER ACCRUAL] and 2 [INACTIVE]: Healthy Volunteers
- Does not meet inclusion criteria
- Any female with symptoms and/or serum hormone levels consistent with perimenopause or menopause
- Use of systemic antibiotics in 12 months preceding baseline sampling
- Use of swimming pools, hot tubs, or whirlpools in 7 days preceding baseline sampling
- Use of topical or oral complementary/alternative medicine (CAM) agents within 4 weeks of initiation of treatment
- Known allergic reaction to sulfa, beta-lactam, or tetracycline class drugs; or lidocaine or epinephrine
- Family history of toxic epidermal necrolysis
- Known allergy or sensitivity to sodium hypochlorite (NaOCl)
- History of AD or asthma
- Inability to comply with the requirements of the protocol
- Pregnant or lactating
- Subjects with a primary or acquired immunodeficiency, including HIV seropositiviy
- Any chronic past or present medical illness, including chronic skin diseases like psoriasis
- Subjects receiving or planning to receive an IND agent, ultraviolet light therapy, monoclonal antibodies, or systemic immunosuppressants
- Subjects who provide direct healthcare or reside in healthcare facilities or in non-hospital settings such as, assisted living facilities, homeless shelters, jails and prisons as well as subjects with frequent exposure to laboratory animals
Cohort 3 [INACTIVE]: Atopic Dermatitis Patients
- Does not meet inclusion criteria
- Any female with symptoms and/or serum hormone levels consistent with perimenopause or menopause
- Known allergic reaction to beta-lactam class drugs, lidocaine, or epinephrine
- Family history of toxic epidermal necrolysis
- Known allergic reaction to sodium hypochlorite (NaOCl)
- Use of systemic antibiotics within 8 weeks, or topical antibiotics on intended sampling sites within 3 weeks, prior to baseline sampling
- Use of topical corticosteroids on all intended sampling sites within 7 days, prior to baseline sampling
- Use of topical or oral CAM agents within 4 weeks of initiation of treatment
- Subjects with known primary or acquired immunodeficiency
- Subjects with unstable or uncontrolled medical conditions that could require hospitalization during the initial month of the study or who have been hospitalized for treatment of these conditions in the one month prior to baseline sampling
- Subjects receiving or planning to receive an IND agent, ultraviolet light therapy, monoclonal antibodies, or systemic immunosuppressants within 7 days or 5 half-lives (whichever is the longer time period) of initiating treatment on this protocol
- Subjects who are currently receiving or have received chemotherapy or radiation for treatment of malignancies within the previous 6 months
- Pregnancy or lactating
Cohorts 4 [NO FURTHER ACCRUAL] and 5 [INACTIVE]: Healthy Volunteers
- Does not meet inclusion criteria
- Any female with symptoms and/or serum hormone levels consistent with perimenopause or menopause
- Use of systemic antibiotics in 12 months preceding baseline sampling
- Use of swimming pools, hot tubs, or whirlpools in 7 days preceding baseline sampling
- Use of topical or oral complementary/alternative medicine (CAM) agents within 4 weeks of initiation of treatment
- (Cohort 4 [NO FURTHER ACCRUAL]) Known allergic reaction to sulfa class drugs; or lidocaine or epinephrine
- (Cohort 5 [INACTIVE]) Known allergic reaction to tetracycline class drugs; or lidocaine or epinephrine
- Family history of toxic epidermal necrolysis
- History of AD or asthma
- Inability to comply with the requirements of the protocol
- Pregnant or lactating
- Subjects with a primary or acquired immunodeficiency, including HIV seropositivity
- Any chronic past or present medical illness, including chronic skin diseases like psoriasis
- Subjects receiving or planning to receive an IND agent, ultraviolet light therapy, monoclonal antibodies, or systemic immunosuppressants
- Subjects who provide direct healthcare or reside in healthcare facilities or in non-hospital settings such as assisted living facilities, homeless shelters, jails and prisons as well as subjects with frequent exposure to laboratory animals
Cohort 6: Healthy Volunteers
- Does not meet inclusion criteria
- Use of swimming pools, hot tubs, or whirlpools in 7 days preceding sampling
- Use of topical or oral CAM agents within 1 week or 4 weeks, respectively, prior to sampling
- Pregnant or lactating females in all cohorts are excluded from participating due to the potential effects of the above listed antimicrobials on the developing human fetus or nursing infant; listed in Sections 11.1 through 11.5. Females of childbearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately. Lactating mothers will discontinue breastfeeding prior to study enrollment.
- Smokers and subjects who use smokeless tobacco products are excluded in all cohorts due to tobacco s unknown impact on human oral mucosa and microflora.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
|
활성 비교기: 1A/Cephalexin
Cephalexin + Placebo bleach |
500 mg orally every 8 hours for 14 days |
|
활성 비교기: 1B/TMP/SMX
TMP/SMZ DS 800 /160 orally every 12 hours for 14 days |
800/160 orally every 12 hours for 14 days |
|
활성 비교기: 1C/Doxycycline 100
Doxycycline 100 mg orally every 12 hours for 56 days |
500 mg orally every 8 hours for 14 days 6 % dilute bleach |
|
활성 비교기: 1D/Doxycycline 20
Doxycycline 20 mg orally every 12 hours for 56 days |
20 mg orally every 12 hours for 56 days or 100 mg orally every 12 hours for 56 days |
|
활성 비교기: 2A/Cephalexin + Dilute bleach
Systemic antibiotics (Cephalexin) + dilute bleach study bath liquid |
500 mg orally every 8 hours for 14 days 6 % dilute bleach |
|
위약 비교기: 2B/Cephalexin + Placebo bleach
Systemic antibiotics (Cephalexin) + placebo study bath liquid |
500 mg orally every 8 hours for 14 days Three times a week for 14 days |
|
위약 비교기: 2C/Placebo capsules + Dilute bleach
Placebo capsules + dilute bleach study bath liquid |
6 % dilute bleach Capsule orally every 8 hours daily for 14 days |
|
위약 비교기: 2D/Placebo capsules + Placebo bleach
Placebo capsules + placebo study bath liquid |
Three times a week for 14 days Capsule orally every 8 hours daily for 14 days |
|
활성 비교기: 3A/Cephalexin + Dilute bleach
Systemic antibiotics (Cephalexin) + dilute bleach study bath liquid |
500 mg orally every 8 hours for 14 days 6 % dilute bleach |
|
위약 비교기: 3B/Cephalexin + Placebo bleach
Systemic antibiotics (Cephalexin) + placebo study bath liquid |
500 mg orally every 8 hours for 14 days Three times a week for 14 days |
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Characterize microbiome alterations
기간: 2 weeks
|
Difference in Shannon Diversity Indices (SDI) from baseline to day 14. |
2 weeks
|
2차 결과 측정
2차 결과 측정
결과 측정 |
기간 |
|---|---|
|
건강한 성인 지원자로부터 샘플을 채취하여 인간 미생물의 게놈 분석을 평가하고 개선합니다.
기간: 연구 기간 내내
|
연구 기간 내내
|
|
다양한 항균제가 인간 미생물군집을 어떻게 변화시킬 수 있는지 조사합니다.
기간: 연구 기간 내내
|
연구 기간 내내
|
공동 작업자 및 조사자
스폰서
스폰서
수사관
수사관
- 수석 연구원: Heidi H Kong, M.D., National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정된)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- 유전병, 선천적
- 면역계 질환
- 과민성, 즉시
- 과민증
- 피부질환, 습진
- 선천성, 유전성, 신생아 질환 및 이상
- 피부 및 결합 조직 질환
- 피부염, 아토피
- 피부염
- 습진
- 피부병
- 피부 질환, 유전
- 황 화합물
- 유기 화학 물질
- 이종 사이 클릭 화합물, 1- 링
- 이종 사이 클릭 화합물
- 이종 사이 클릭 화합물, 2- 링
- 이종 사이 클릭 화합물, 융합 링
- 탄화수소
- 탄화수소, 순환
- 다 환식 방향족 탄화수소
- 탄화수소, 방향족
- 다 환식 화합물
- 아미드
- 아닐린 화합물
- 아민
- 무기 화학 물질
- 염소 화합물
- 피리 미딘
- 벤젠 유도체
- 나프 타센
- 산화물
- 산소 화합물
- 테트라 사이클린
- 베타-락탐
- 락탐
- 세 팔로 스포린
- 티아 지인
- 벤젠 설포 아미드
- 설폰 아미드
- 설파 닐라 미드
- 설폰
- 차아 염소산
- 나트륨 화합물
- 독시사이클린
- 세팔렉신
- 트리메토프림
- 설파메톡사졸
- 차아염소산나트륨
기타 연구 ID 번호
기타 연구 ID 번호
- 120159
- 12-AR-0159
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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