Genetic Determinism of Epithelial Barrier Defects in Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) Clinical Trial

— PROTIBS  

Official title:

Genetic Determinism of Epithelial Barrier Defects Induced by Increase in Proteases Activity in Irritable Bowel Syndrome

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT02841878
• Other study ID #: 14-PP-20
• Status: Withdrawn
• Phase: N/A
• First received: August 24, 2015
• Last updated: February 15, 2018
• Start date: September 2016
• Est. completion date: September 2018

Study information

• Verified date: February 2018
• Source: Centre Hospitalier Universitaire de Nice
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Irritable bowel syndrome (IBS) profoundly affects the quality of life. Mucosal micro-inflammation, epithelial permeability disorder and proteases activity increase have been demonstrated in the patients' gastrointestinal tract. Protease activity increase could be subjected to a genetic determinism (decrease in proteases inhibitors genes expression). Objectives: 1/ To study relations between proteases activity (in stool and colonic biopsies supernatants), proteases inhibitors genes expression and mucosal cellular infiltrate (IBS patients and healthy subjects). 2/ Establishing a correlation between proteases activity, mucosal micro-inflammation and symptoms. 3/ To evaluate proteases inhibitors therapeutic potential. Expected results: 1/ Decreased expression of proteases inhibitors genes in subjects with IBS. 2/ Correlation of symptoms with proteases activity intensity. 3/ Demonstration of restorative potential of proteases inhibitors.

Description:

Irritable bowel syndrome (IBS) is the first reason for consultation in gastroenterology and his prevalence reach 5% of the general population. IBS is characterized by abdominal discomfort, diarrhea or constipation and decreased quality of life.

Recent facts on IBS pathophysiology show association between mucosal immunity activation (mast cells and their proteases) and epithelial permeability disorder. Permeability disorder can be reproduced by application of colonic biopsies cultures supernatants on in-vitro cell cultures. In parallel, tight junctions proteins mRNA (ZO-1, Occludin) decrease is observed ex-vivo in biopsies and in-vitro.

Gut bacterial proteases (cystein and serin proteases) may also play a role. In human, proteases activity is correlated with IBS symptoms severity. Proteases activity increase (cystein and serin proteases) is poorly understood, and this increase could be subjected to a genetic determinism (decrease in proteases inhibitors genes expression - Serpin A1/E1).

Objectives: 1/ To study relations between proteases activity (in stool and colonic biopsies supernatants), proteases inhibitors genes expression and mucosal cellular infiltrate (IBS patients and healthy subjects). 2/ Establishing a correlation between proteases activity, mucosal micro-inflammation and symptoms. 3/ To evaluate proteases inhibitors therapeutic potential.

Method: Subjects will be recruited in gastroenterology consultation. IBS patients will answer to Rome III criteria. Patients coming for screening colonoscopy will be defined as healthy subjects.

Colonic biopsies will be sent in real time to the research laboratory (EA 6302) for supernatants collecting, mRNA expression studies (Serpins, ZO-1, occludin, cytokines), proteases activity / permeability measurements and proteases inhibitors reversibility tests. Histologic study will also be performed.

Expected results: 1/ Decreased expression of proteases inhibitors genes in subjects with IBS. 2/ Correlation of symptoms with proteases activity intensity. 3/ Demonstration of restorative potential of proteases inhibitors.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: September 2018
• Est. primary completion date: September 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

• Patient with irritable bowel syndrome (IBS), defined by Rome III criteria (patient group)

• Patients coming for screening colonoscopy (control group)

Patients exclusion criteria :

• Active inflammatory bowel disease

• Infectious bowel disease or other cause that could explain digestive symptoms

Healthy subjects inclusion criteria :

• Patients coming for screening colonoscopy without inflammatory bowel disease or IBS

Related Conditions & MeSH terms

• Irritable Bowel Syndrome
• Irritable Bowel Syndrome (IBS)
• Syndrome

Intervention

Genetic:
• Analysis on colorectal biopsy

Locations

Country	Name	City	State
France	Department of gastroenterology, Hopital Archet 2	Nice

Sponsors (1)

Lead Sponsor	Collaborator
Centre Hospitalier Universitaire de Nice

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Clinical criteria	Abdominal Pain : Francis scoring	at the medical visit
Primary	Clinical criteria	Transit disorders : Rome III criteria questionnaire	at day one
Primary	Clinical criteria	Quality of life alteration (questionnaires)	at day one
Secondary	Experimental criteria	Proteases activity (cystein and serin proteases); Tight junctions genes expression Cytokines genes expression (TNFalpha, interleukines) Cellularity on histologic sections	at day one
Secondary	Experimental criteria	Proteases inhibitors genes expression (Serpins A1 / E1)	at day one
Secondary	Experimental criteria	Colonic biopsies permeability	at day one