Cystic Fibrosis Clinical Trial
Official title:
To Investigate Whether Choline Supplementation in Children With CF Will Correct Biochemical Markers of Choline Deficiency and Improve Plasma Indices of Methylation Capacity and Redox Status and Result in Decreased Pro-inflammatory Cytokines
Cystic Fibrosis (CF) is a complex disease with a wide range of clinical problems. Despite
enzyme replacement therapy, children with cystic fibrosis (CF) may still have problems
absorbing some nutrients. Detailed studies of the nutrient status of children with CF and
have found low amounts of choline, an essential dietary nutrient, and altered levels of some
amino acids in almost all patients. Choline is an essential dietary nutrient that is
important in many important body functions, which include proving a source of methyl groups,
the structure of cell membranes and in acetylcholine. Most choline is present in our diets
in a fat known as phosphatidylcholine. Research studies have shown that children with cystic
fibrosis do not absorb fat, including phosphatidylcholine very well. In previous studies, we
showed that choline provided as a dietary supplement for 2 weeks improved choline status in
children with cystic fibrosis.
The purpose of this research is to find out if choline supplements over a longer duration of
6 months will improve and maintain normal choline status in children with CF.
This is a prospective study involving 34 children attending an outpatient clinic for
children with CF. After enrollment, subjects will be followed for 9 months with each child
serving as their own control in a repeated measures design.
Chart data, height, weight, pulmonary function, dietary intake and a venous blood and urine
sample will be collected at enrollment then every 3 months for 9 months. Choline
supplementation will be from enrollment for 6 months, with follow up at 3 months post
supplementation. To avoid additional hospital visits and blood draws, and to co-ordinate
with pulmonary function, hematology, clinical chemistry tests as part of clinical care, each
subject will be seen at routine scheduled clinic appointments, which are every 3 months.
The objectives are to
1. determine if supplementation with choline for 6 months corrects biochemical markers of
choline deficiency and improves indices of reduced methylation capacity (including
methionine, SAM, SAM/SAH) and redox status (GSH/GSSG) based on measures of blood and
urine
2. determine whether or not choline supplementation decreases plasma pro-inflammatory
mediators
3. determine if choline supplementation improves the low n-6 and n-3 fatty acids levels in
children with CF,
4. explore if choline supplementation has the potential to have clinical relevance in
reducing recurrent inflammation, and improve pulmonary function and/or reduce liver
disease.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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