Tuberculosis Clinical Trial
Official title:
Pilot Phase I Clinical Trial, Double-blind, Randomized, Placebo Controlled and Masked to Evaluate the Tolerability and Immunogenicity of Nyaditum Resae ® Probiotic Administered to Pediatric Population in Contact With Tuberculosis With or Without Latent Tuberculosis Infection
This is a doble-blind, masked, compared with placebo clinical trial in pediatric population
in contact with tuberculosis with or without tuberculosis infection. This trial aims to study
the effect of the probiotic Nyaditum resae® at the level of specific Treg memory cells eight
weeks after the first administration, and the global tolerability of the treatment.
Nyaditum resae® is a preparation in the form of capsules containing heat-killed environmental
mycobacteria Mycobacterium manresensis. The overall objective of the study is the effect of
Nyaditum resae® on immunity, which could reduce the risk of developing active tuberculosis.
The incidence of tuberculosis is still a problem of the first magnitude. Every year 1.5
million people die; there are 10 million cases of illness and 100 million new infected. The
growing problem of multi-resistance is to be added, remaining so prevalent: 700,000 patients,
a figure that increases annually with 100,000 people. Prevention of tuberculosis is currently
very difficult because it is a disease caused by a bacillus (Mycobacterium tuberculosis) that
is transmitted by air: No risk factor for becoming infected has been identified and there is
still no prophylactic vaccine that prevents from infection. One of the most characteristic
aspects of tuberculosis is that the majority (90-95 %) of people without immunity alterations
do not develop the disease after being infected. As for people who do develop the disease, it
is still not known why they develop it.
A group of researchers from the Institut Germans Trias i Pujol recently discovered a
mechanism that explains this trend. In short, what happens is that certain people create a
too strong inflammatory response against tuberculosis bacillus, which ends up creating
massive destruction of the tissue that is around the bacillus and brings the characteristic
lesion of tuberculosis: tuberculous cavity.
This group of researchers was devising ways to "reeducate" the immune system against the
bacillus not make it aggressive. And they did it using two instruments. The first one, an
environmental mycobacteria, namely a bacillus of the family of mycobacteria tuberculosis,
that usually lives in the water we drink, so that at a greater or lesser extent we already
have it in our intestinal flora. The second, inducing a tolerant response, like we do when we
eat food. To induce a tolerant response, low and repeated doses of the product make the
immune system of the digestive duct "used to" their presence. Thus, when it becomes to find
the product, the immune system reacts in a very light and balanced manner, avoiding excessive
inflammatory responses. The clearest example is the fact that our immune system "is used" to
feed proteins and generates no rejection answers found in the intestinal mucosa.
Hence comes the probiotic Nyaditum resae®, a preparation in the form of capsules, containing
a heat-killed Mycobacterium manresensis and thus can generate a cross-immunity with the
tuberculosis bacillus. By giving low and repeated dose to generate a tolerant response, which
happens when there is an infection by Mycobacterium tuberculosis, so that a balanced immune
response is triggered able to reduce the risk of developing active tuberculosis.
Tolerability of Nyaditum resae® has been studied in adults. Next step is to asses its
behavior in pediatric population, since is a particularly vulnerable population in countries
where there is a high incidence of this disease.
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