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Defining Normal Citrulline Levels as a Diagnostic Tool for Screening of Gastrointestinal Disease in Premature Infants
Since the first description of citrulline as a potential marker for intestinal function in 1998, its use has been investigated in a variety of disease processes including Short Bowel Syndrome, Celiac disease, chemotherapy and radiation induced intestinal injury, infections producing intestinal cytopathic effects like Adenovirus, and predicting rejection in intestinal transplantation. The use of citrulline levels as a diagnostic tool to predict gastrointestinal disease in the premature population has not been properly addressed.
The introduction of enteral nutrition in the premature infant is a process of trial and error, knowing that the immaturity of the gastrointestinal system may lead to frequent episodes of feeding intolerance. This is augmented by the fear of the development of necrotizing enterocolitis (NEC) once feeds are commenced. NEC is a condition characterized by disruption of the intestinal epithelial barrier, a pathogenic process shared with some of the conditions mentioned above for which citrulline has proven clinically useful.
A normal pattern of citrulline production has not been established in the premature population. Previous studies have shown decreased levels of glutamine and arginine in premature infants up to 10 days prior to the development of necrotizing enterocolitis. Glutamine and arginine are two amino acids closely involved in the synthesis and catabolism of citrulline.
The investigators therefore hypothesize that defining a normal pattern of citrulline production in the premature population may prove to be a clinically useful diagnostic tool to screen for gastrointestinal disease.
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Werkelijk)
Contacten en locaties
Studie Locaties
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Florida
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Miami, Florida, Verenigde Staten, 33136
- Holtz Children's Hospital- University of Miami/Jackson Memorial Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion Criteria:
1. Premature infants with gestational age between <32 weeks regardless of birth weight
Exclusion Criteria:
- Inborn errors of metabolism
- Need for exchange transfusion
- Multiple congenital anomalies
- Renal failure (defined as urine output <1ml/k/h >24h, creatinine >1.8, or diagnosis of "non-oliguric renal failure" as determined by Pediatric nephrology)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
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Gestational age < 32 weeks
Premature infants with gestational age between <32 weeks regardless of birth weight
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Citrulline samples will be collected at the time of other lab work twice a week from enrollment until 40 weeks postconceptional age and once a week until 44 weeks postconceptional age (1 month corrected age) OR discharge from NICU(whichever is soonest).
In subgroup developing NEC, citrulline samples will be collected twice a week from enrollment until discharge from NICU or death.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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The primary outcome is to establish the normal pattern of citrulline concentration in the premature population, infants born <32 weeks gestation, which represents normal maturity of the intestinal glutamine pathway.
Tijdsspanne: From birth to one month corrected age (Gestational age 44 weeks) or discharge from neonatal intensive care unit (NICU)
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Levels of citrulline concentration in premature infants
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From birth to one month corrected age (Gestational age 44 weeks) or discharge from neonatal intensive care unit (NICU)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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A secondary outcome, in the subgroup of infants who develop necrotizing enterocolitis, will be to evaluate the pattern of citrulline concentration prior to its development.
Tijdsspanne: From birth until discharge from NICU
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levels of citrulline concentration in prematureinfants with NEC
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From birth until discharge from NICU
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Studie directeur: Jennifer Garcia, MD, University of Miami, Dept of Pediatrics, Division of GI, Hepatology and Nutrition
- Hoofdonderzoeker: Teresa Del Moral, MD, University of Miami, Dept of Pediatrics, Division of Neonatology
- Studie stoel: John Thompson, MD, The Children's Hospital at Montefiore
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 20081180
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .
Klinische onderzoeken op Necrotiserende enterocolitis
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University Hospitals of Derby and Burton NHS Foundation...University of NottinghamWervingNecrotiserende enterocolitis NeonataalVerenigd Koninkrijk
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Gorm GreisenVoltooidComplicaties | NEC - Necrotiserende enterocolitisDenemarken
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Mednax Center for Research, Education, Quality...Phoenix Children's Hospital; Banner University Medical CenterVoltooidVolledige ouderlijke voeding | Necrotiserende enterocolitis bij pasgeborenenVerenigde Staten
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Azienda Ospedaliero, Universitaria PisanaVoltooid
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Dr. Behcet Uz Children's HospitalOnbekendNecrotiserende enterocolitis bij pasgeborenenKalkoen
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Medical University of WarsawNog niet aan het wervenNecrotiserende enterocolitisPolen
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The University of Hong KongWervingNecrotiserende enterocolitisHongkong
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Ain Shams UniversityVoltooid
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Marmara UniversityOnbekendNecrotiserende enterocolitisKalkoen
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Maastricht University Medical CenterOnbekend
Klinische onderzoeken op Citrulline samples
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Ain Shams UniversityNog niet aan het wervenPost COVID-19-conditie