Connective Tissue Diseases Clinical Trial
Official title:
Effect of Synbiotic Supplementation on Interleukin 17 (IL-17) Level, Regulatory T-cells, Gut Permeability and Microbiota in Patient With Connective Tissue Disease
This is a double blind randomized placebo controlled trial to determine the effect of synbiotic to FOXP3 regulatory T cells, IL-17, gut permeability and gut microbiota in patients with connective tissue disease. Synbiotic can increase FOXP3 regulatory T cells, decrease IL-17 and improve gut permeability and gut microbiota in patients with connective tissue disease.
Study showed gut microbiota has a role in the pathogenesis of autoimmune diseases. Gut
microbiota which can increase gut permeability affect the antigen presentation to the immune
system. Synbiotic supplementation is expected to improve immune system, gut permeability, and
gut microbiota in patients with connective tissue disease.
The subjects who fulfill inclusion criteria, willing to participate and sign informed consent
will be randomized into two groups: the group receiving synbiotic containing probiotic
(Lactobacillus helveticus R0052 60%, Bifidobacterium infantis R0033 20%, dan Bifidobacterium
bifidum R0071 20%) and 80 mg fructooligosaccharide (group I, n=23) and the group receiving
placebo (group II, n=23). Both groups receive intervention for two months. Patients continue
to receive their immunosuppressive drugs (corticosteroids, hydroxychloroquine, mycophenolate
mofetil, azathioprine, or cyclosporine).
Percentage of FOXP3 Regulatory T-cells, serum IL-17, zonulin, high sensitivity C-reactive
protein, and gut microbiota are evaluated at the beginning and at the end of the study. FOXP3
regulatory T-cell is evaluated by flowcytometry. Serum IL-17 and zonulin are measured by
ELISA. Gut microbiota is evaluated using 16s ribosomal RNA gene next generation sequencing.
The DNA from the stool is isolated by DNA stool mini kit (QIAamp).
The results are presented in mean ± standard deviation, median (IQR 25-75%) and n (%). The
Kolmogorov-Smirnov test is used to determine the normality of the data, assuming the
normality of the data is fulfilled if p> 0.05. Bivariate analysis uses paired T test if the
data has normal distribution. If the distribution is not normal, Wilcoxon test will be used.
Differences are said to be significant when the value of p <0.05.
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