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- Klinische proef NCT02062476
Epigenetic Effects Elicited By Lactobacillus GG In Children With Cow's Milk Allergy
EPIGENETIC EFFECTS ELICITED BY LACTOBACILLUS GG IN CHILDREN WITH COW'S MILK ALLERGY: A POSSIBLE EFFECT OF ATOPIC MARCH
Lactobacillus GG (LGG) is able to exert long lasting effects in children with atopic disorders. We have shown that Nutramigen LGG accelerates tolerance acquisition in infants with cow's milk allergy (CMA). The mechanisms of these effects are still largely undefined. The effect of LGG could be related at least in part by the immunoregulatory role played by LGG. This probiotic can balance the generation of cytokines possibly involved in IgE- or non-IgE-mediated CMA (i.e., IL-4, IL-5, IL-10, IFN-γ , TGF-beta, and TNF-alfa), which can contribute to modulation of inflammatory processes. We have demonstrated that children with IgE-mediated CMA produce significantly higher level of IL-4 and IL-13 in response to cow's milk protein, and that tolerance is associated with a marked reduction of IL-13 production and a concomitant increased frequency of IFN-γ releasing cells.
Epigenetics studies the heritable (and potentially reversible) changes of the genome inherited from one cell generation to the next which alter gene expression but do not involve changes in primary DNA sequences, highlighting the complexity of the inter-relationship between genetics and nutrition. There are three distinct, but closely interacting, epigenetic mechanisms (histone acetylation, DNA methylation, and non-coding microRNAs) that are responsible for modifying the expression of critical genes associated with physiologic and pathologic processes. The profile of epigenetic modifications associated with Th lineage commitment, coupled with the sensitivity of the early developmental period, has led to speculation that factors that disrupt these pathways may increase the risk of allergic diseases. Specifically, effects on DNA methylation and endogenous histone deacetylase inhibitors acting on specific pathways (Th1 and T regulatory cell differentiation) may favour Th2-associated allergic differentiation. MicroRNAs are another structural components of an epigenetic mechanism of post-transcriptional regulation of messenger RNA translation. It has been recently identified a specific Th2-associated miRNA (miR-21) that is critical for the regulation of Th cell polarization.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Verwacht)
Fase
- Fase 2
Contacten en locaties
Studiecontact
- Naam: Roberto Berni Canani, MD, PhD
- Telefoonnummer: 0817462680
Studie Locaties
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Naples, Italië, 80131
- Werving
- University of Naples Federico II
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Contact:
- Roberto Berni Canani
- Telefoonnummer: 0817462680
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Children aged 4 months-4 years with cow's milk allergy
Exclusion Criteria:
- age higher than 4 years,
- concomitant chronic systemic diseases,
- congenital cardiac defects,
- active tuberculosis,
- autoimmune diseases,
- immunodeficiency,
- chronic inflammatory bowel diseases,
- celiac disease,
- cystic fibrosis,
- metabolic diseases,
- malignancy,
- chronic pulmonary diseases,
- malformations of the gastrointestinal tract,
- suspected eosinophilic esophagitis or eosinophilic enterocolitis,
- suspected food-protein-induced enterocolitis syndrome,
- suspected cow's milk protein-induced anaphylaxis.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Treatment with Lactobacillus GG
extensively hydrolyzed casein formula containing LGG
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Geen tussenkomst: Children at diagnosis
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change from baseline to 6 months in tolerance acquisition and epigenetic effects in rtwenty children with cow's milk allergy
Tijdsspanne: Baseline, at least after 6 months of therapy
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The investigators will evaluate in children with CMA if the effect of Lactobacillus GG on tolerance acquisition is mediated at least in part by an epigenetic mechanism.
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Baseline, at least after 6 months of therapy
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Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
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
- 1/14
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Klinische onderzoeken op Koemelkallergie
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Nutricia ResearchActief, niet wervendGroei | Tolerantie | Veiligheid | Onderwerpen die behoefte hebben aan een Human Milk Fortifier (HMF)Nederland, Frankrijk, Duitsland, Verenigd Koninkrijk
Klinische onderzoeken op Lactobacillus GG
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National Institute of Pediatrics, MexicoNekutli S.A. de C.V.VoltooidGezonde voldragen baby'sMexico
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Duke UniversityVoltooidMicrobioomVerenigde Staten
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Tufts Medical CenterBeëindigdVancomycine-resistente enterokokkenkolonisatieVerenigde Staten
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Groningen Research Institute for Asthma and COPDNumico Research Wageningen, the NetherlandsVoltooidAtopische dermatitis | Atopisch eczeem | Infantiel eczeemNederland
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Pablo Román LópezVoltooid
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Shriners Hospitals for ChildrenBeëindigd
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Valio LtdUniversity of Virginia; University of Helsinki; Medcare LtdVoltooid
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Medical University of WarsawOnbekendLuchtweginfecties | Brandend maagzuur | Gastro-intestinale infectiesPolen
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Creighton UniversityVoltooidLongontsteking | Ventilator-geassocieerde longontstekingVerenigde Staten
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Helsinki University Central HospitalFinnish Institute for Health and WelfareVoltooidBovenste luchtweginfectie | Acute middenoorontsteking