Clinical Trial Details
— Status: Enrolling by invitation
Administrative data
| NCT number |
NCT04759729 |
| Other study ID # |
MMA29012021 |
| Secondary ID |
|
| Status |
Enrolling by invitation |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
December 1, 2020 |
| Est. completion date |
March 31, 2021 |
Study information
| Verified date |
January 2021 |
| Source |
Medical University of Gdansk |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
The probiotics supplementation seems to be safety way to optimize the intestinal microbiota
composition and thus modulate the immune system and reduce oxidative stress. Moreover it may
enhance muscle protein synthesis, mitochondrial biogenesis and function, as well as muscle
glycogen storage. Probiotics intake via reduce inflammatory markers and reactive oxygen
species production may attenuate macromolecules damage and have some beneficial effect on
aerobic and anaerobic performance. The combined probiotics and vitamin D supplementation may
enhance this effect. The synergistic intestinal microbiota and vitamin D interaction towards
muscle protein synthesis and mitochondrial function improvement may be manifested by mTOR and
FOXO signaling influence on oxidative stress as well as immunological functions modulation.
In the study investigators will assess if multistrain probiotic mixture in conjunction with
vitamin D may have beneficial effect on sport performance among trained male mixed-martial
arts athletes. The study protocol is designed as a randomized double-blind placebo-controlled
clinical trial. Researchers are going to evaluate changes in the gut, including microbiome
composition and epithelial permeability; differences in the blood parameters as well as
direct influence on sport performance, expressed by anaerobic and aerobic fitness capacity.
Researchers will provide an evidences, having both theoretical as well as practical aspect.
Description:
The study is designed as a randomized double-blind placebo-controlled clinical trial with
4-week probiotics and vitamin D intervention period. The study is conducted between December
2020 and March 2021, at the Medical University of Gdańsk, Department of Bioenergetics and
Physiology of Exercise (Gdańsk, Poland) . Researchers will enrol 25 trained, male
mixed-martial arts athletes. Enrolled athletes will be randomly assigned to receive probiotic
(PRO) or matching placebo (PL) in a 1:1 ratio, using Excel random number generator, following
the rule of the random and blindness.
The study product is a vitamin D ,,Juvit d3" and probiotic mixture ,,Sanprobi Active &
Sport", containing 2,5 x 109 CFU/g per capsule (≥500 million CFU in one capsule) of five
strains of lactic acid bacteria (Bifidobacterium lactis W51, Lactobacillus brevis W63,
Lactobacillus acidophilus W22, Bifidobacterium bifidum W23 and Lactococcus lactis W5); maize
starch, maltodextrin, plant proteins and hydroxypropyl ethylcellulose tablets' coating.
Identical-looking placebo capsules containing 40 mg of maltodextrin and plants proteins will
be used for cartel. Each pack of probiotic or placebo contain 40 capsules. All athletes will
receive a bottle of Juvit d3 as well as three identical-looking packings of probiotics or
placebo, depending on the random allocation, at the baseline visit. Participants will be
informed to take 4 capsules with meals and 3500 iu of vitamin d daily.
At baseline visit, all subjects will receive the study product as well as diary of
supplements and dietary intake and training diary. Both PRE and POST visit will be splitted
in two days in order to reliable and appropriate performance of all procedures. The time
window between these splitted visit is 3-5 days. Participants will report to the Medical
University of Gdańsk at the beginning (PRE) and the end (POST) of the 4-week intervention
period. During both visits athletes will complete an assessment of body composition, food
frequency questionnaire (FFQ), cardio-respiratory fitness evaluation and will provide fecal
samples. Furthermore, the blood samples will be drawn before and after sport tests, to assess
selected markers of inflammatory as well as muscle damage state and lactate utilization
level. The last one blood collection will be perform after 24 hours of anaerobic sport test.
Participant will be instructed to continue their training programme. Athletes will be
obligated to perform at least 5 endurance workouts per week to keep the competitive character
of the study.
The body composition analysis will be evaluated to detect potential changes within body fat
mass and fat free mass. The level of each tissue will be compared to intestinal bacteria
content. Investigators will try to explain if gut microbiome composition may affect body
composition and which bacterial phyla are responsible for possible for this potential
changes. This target will be obtain through multi-frequency bioelectrical impedance analysis
(BIA).
Aerobic fitness capacity will be assess through bicycle ergometer ER900 Jaeger using the
wasserman protocol. The test will be preceded by a 5-minute warm-up with a load of 100 W,
followed by a 5-minute rest. The test will start at a load of 125 W and a frequency of 60 ± 5
RPM / min, the load will be increased every 1 minutes by 25 W. The test will be conducted
until the maximum individual exercise load is reached, i.e. the inability to continue the
exercise while maintaining the specified frequency or lack of increase oxygen uptake. During
examination investigators will monitor the amount of oxygen uptake and carbon dioxide
exhaled, minute lung ventilation as well as heart rate. The aerobic test will be conducted
3-5 days before anaerobic assessment as part of PRE and POST visits.
Anaerobic fitness assessment will be obtained by the Wingate Anaerobic Test (WAnT) using
cycloergometer MCE_v_5.1. Before the examination, the saddle will be individually adjusted,
then the athletes will perform a 5-minute warm-up at 50 W load and a frequency of 60 RPM /
min, with two 10-second accelerations in 3 and 4 minutes. After the warm-up, there will be a
3-minute rest. The load will be adjusted individually and will amount to 7.5% of the
athlete's body weight. At the "start" command, the athlete will performing a 30-second sprint
in a sitting position, trying to achieve peak power as quickly as possible and maintain it
throughout the duration of the effort. After the test, there will be an active 2-minute
break. The test will be carried out 3 times. The WAnT assesses the maximum, minimum and
average power, time to reach maximum power and relative power drop.
The blood samples will be collected during Wingate tests at the two points time: PRE and POST
intervention, at the same conditions. Blood samples from the arm vein will be drawn by a
specialist nurse into two appropriate standardized tubes containing respectively K2EDTA and
clotting activator. Each time up to 4 ml of blood will be collected. Blood samples will be
taken indirectly before the start of exercise tests, 30 minutes after the end of the tests
and 24 hours after the end of the tests. The blood will then be centrifuged at 3000 x g to
separate serum and plasma. The material will be placed into separately labeled
microcentrifuge tubes and stored at -80 ° C for later determinations. All analysis will be
performed at the end of the study at Medical University in Gdańsk.
The collected venous blood samples will be subjected to analysis at the Medical University of
Gdańsk. Researchers will assess the level of serum pro-inflammatory cytokines (IL-6 and
TNF-α) as well as anti-inflammatory cytokines (L-2 and IL-15) using a commercially available
enzyme-linked immunosorbent assay (ELISA) kits. To evaluate the plasma level of muscle damage
investigators will determinate the activity of creatine kinase (CK) through kinetic method,
using the commercially available kit.
Capillary blood samples will be taken each time, Wingate tests are performed, by a
specialized nurse, in an amount of 100 µL, into a sterile graduated microcapillary. The
measurements will be performed on fingertip capillary blood. The blood will then be
transferred to a micro-centrifuge tube containing 500 µl 0.6 mol perchloric acid, centrifuged
and stored at -20 degrees C until the determination is carried out. Capillary blood will be
collected before exercise testing and in 2-3, 15, 30 and 60 minutes after test. Collected
capillary blood samples will undergo analysis at the Medical University of Gdańsk. The
purpose of the analysis will be to determine the level of lactate in the samples taken.
Determination of lactate level will be performed using colorimetric kinetic method, based on
reaction speed.
The subjects will provide a fecal sample indirectly before and after the intervention period.
The material will be collected by participants into a special standardized container. A stool
sample will be taken twice: before testing, and in the end of the intervention. Stool samples
will be immediately frozen and stored at -80 degrees Celsius, then in the same conditions
transported to the assessment by independent laboratory. Collected fecal samples will be
subjected to quantitative and qualitative content of the intestinal microbiota with using the
new generation sequencing method. Selected hypervariable regions of the 16SrRNA gene will be
analyzed. The composition of the microbiome will be characterized primarily by alpha and beta
diversity. Diversity of microbial communities in one sample (alpha) will be measured using
several indicators, such as Chao1, ACE, Shannon and inverted Simpson. All indicators will be
calculated on the basis of raw NGS data (without any pre-processing, e.g. removal of rare
species) and compared between the test and control group using a standard statistical test
depending on the distribution of variables. Diversity of microbial communities between
samples (beta) will be measured using the difference indicator (Bray-Curtis) and distance
metrics (UniFrac weighted - a phylogenesis-based metric). Similarity indicators will be
calculated for all sample pairs and stored in dissimilarity matrices. Bray-Curtis will
perform permutation multivariate analysis of variance (PERMANOVA) and weighted UniFrac
difference matrices to assess differences at the group level. Beta diversity analysis will be
preceded by supervised and unattended pre-processing of data, such as the removal of rare
species and transformation of numbers using the median sequencing depth as a scaling factor.
Collected fecal samples will be analyzed in the context of the presence of intestinal
permeability parameters such as calprotectin, zonulin and IFABP as well as bacterial
metabolism products such as short chain fatty acids (SCFA).
All obtained data will be analysed using the statistic program Statistica 13. To statistical
analysis will be included only full data, from subjects who complete all intervention period
as well as all study procedures. Data will be previously checked for normality using
Shapiro-Wilk W-test. In the case of data' abnormal distributed, their natural logarithms will
be used. Researchers will usual descriptive statistics for background information as well as
to examine the trends in the analysed parameters with mean values of 95% confidence interval.
Depending on the normality of the underlying data, parametric or non-parametric tests will be
carried out. The statistical significance is set at p < 0.05.
