Necrotizing Enterocolitis Clinical Trial
Official title:
PrePhage - Faecal Bacteriophage Transfer for Enhanced Gastrointestinal Tract Maturation in Preterm Infants - Clinical Trial
PrePhage - Fecal bacteriophage transfer for enhanced gastrointestinal tract maturation in preterm infants This pilot triol has the primary goal of demonstrating the safety of transferring viruses and proteins from healthy term infants to preterm infants born between gestational age (GA) 26 + 0 and 30+6. The long-term goal is to develop a safe and effective treatment to prevent the severe gut disease called necrotizing enterocolitis (NEC). NEC is a common disease in neonatal intensive care units affecting 5-10% of all admitted patients. 15-30% of the affected children die from the disease, and many of the survivors suffer from the effects of extensive gut surgery. While the disease is caused by many different factors, recent research has shown the gut microbiome to be a central factor in the development of NEC. Furthermore, in the recent years special viruses called bacteriophages have shown potential in the treatment of various diseases. By collecting feces from healthy, term infants and filtering it thoroughly, the investigators can provide a treatment that contains practically only viruses, proteins and nutrients. It is our belief that giving the preterm infants a mix of viruses including bacteriophages will prevent NEC. To do this, the investigators will go through 3 stages: 1. Recruiting and following healthy donor infants to study the microbiota and use feces from them to donate in stage 2 and 3 2. Examining the safety of the treatment as well as how it works in preterm piglets STAGE 3 will be performed only if stage 2 shows no serious risks for the infants 3. Testing the treatment in preterm infants. 10 preterm infants will receive the treatment and 10 preterm infants will receive placebo. The investigators expect to see no serious side effects to the treatment. The investigators hope, but do not expect to be able to see a beneficial effect of the treatment. If this pilot trial shows promising results, it will be followed be a larger clinical trial.
Status | Recruiting |
Enrollment | 20 |
Est. completion date | December 31, 2024 |
Est. primary completion date | May 31, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A and older |
Eligibility | Inclusion criteria for participant preterm infants - Preterm infants born between GA 26+0 and 30+6 - Delivery at RH or transferred to RH NICU within 24 hours of delivery - Signed parental consent Exclusion criteria for participant preterm infants - Major congenital anomalies or birth defects - Congenital infection - Extremely SGA infant (weight SD score < -3 SD) - Need for mechanical ventilation or cardiovascular support before first FFT treatment Inclusion criteria for mothers of participants - Women aged 18-45 - Ability to give informed consent Exclusion criteria for participant mothers ? Mothers who have severe infection, defined by need for other treatment to support infection-related comorbidities, besides from antibiotics (e.g. inotropic treatment, iv fluid resuscitation) |
Country | Name | City | State |
---|---|---|---|
Denmark | Rigshospitalet | Copenhagen |
Lead Sponsor | Collaborator |
---|---|
Rigshospitalet, Denmark | Lise Aunsholt, Neonatologist, Clinical Professor |
Denmark,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | No serious adverse events | No increased incidence of sepsis, NEC and death in the treatment group | 14 days | |
Secondary | Feeding tolerance | Using a standardized clinical scoring system, nurses at our NICU will evaluate any negative reactions to enteral feeding. It includes evaluation of aspirate, feces, amount of enteral nutrition administered, objective evaluation of the abdomen, and signs of obstipation | 1 month | |
Secondary | Microbiota Composition | Total genomic DNA will be subjected to deep metagenome sequencing and related to the study outcomes. When extracting faecal DNA as well as viral DNA/RNA, physical fractionation or selective lysis will be employed to ensure host DNA is kept to a minimum. Remaining host DNA material will be removed during bioinformatics filtering and mapping of the shotgun metagenomics data. | 1 month | |
Secondary | Time to full enteral feeding | 1 month | ||
Secondary | Blood pressure | Blood pressure in mmHg | 1 month | |
Secondary | Temperature | Rectal temperature in degrees celsius | 1 month | |
Secondary | Pulse | Pulse measured using samsung monitoring equipment according to standard at our NICU | 1 month | |
Secondary | Length | Length in cm | 1 month | |
Secondary | Weight | Weight in kilograms | 1 month | |
Secondary | Stool characteristics - Amount | Score from 1-4 using Amsterdam stool scale | 1 month | |
Secondary | Stool characteristics - Consistency | Score from 1-6 using diapered infant stool scale | 1 month | |
Secondary | Stool characteristics - Color | Score from 1-6 using Amsterdam Stool Scale | 1 month | |
Secondary | Days of hospitalization | 1 month |
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