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Effekten av propionsyra på reglerande T-cellsfunktion hos barn med kronisk njursjukdom (Pro-Kids)

3 november 2026 uppdaterad av: Johannes Benjamin Holle, Charite University, Berlin, Germany

Propionsyras inverkan på reglerande T-cellsfunktion hos barn med kronisk njursjukdom

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.

Studieöversikt

Status

Rekrytering

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

16

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

    • State of Berlin
      • Berlin, State of Berlin, Tyskland, 13353
        • Rekrytering
        • Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité-Universitätsmedizin Berlin
        • Kontakt:
          • Johannes Holle, MD
        • Kontakt:
          • Dominik Müller, MD

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

12 år till 20 år (Barn, Vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Grundläggande vetenskap
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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-jämförare: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in count of regulatory T-cells from baseline to week 4
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Propionic acid serum levels and targeted metabolomics
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

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Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

15 januari 2024

Primärt slutförande (Faktisk)

8 juli 2026

Avslutad studie (Beräknad)

1 mars 2027

Studieregistreringsdatum

Först inskickad

25 april 2023

Först inskickad som uppfyllde QC-kriterierna

4 maj 2023

Första postat (Faktisk)

15 maj 2023

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

4 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

3 november 2026

Senast verifierad

1 oktober 2026

Mer information

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