Psoriasis Clinical Trial
— INGUTSKINOfficial title:
Effect of Intestinal Microbiota Modulation Induced by the Chicory Inulin-type β-fructans on Metabolic Parameters and Biomarkers of the Gut-skin Axis in Chronic Skin Inflammation
Verified date | July 2023 |
Source | Polish Academy of Sciences |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
There is increasing evidence of a strong, bidirectional correlation between the gut and the skin, that associates gastrointestinal health with skin homeostasis and allostasis. The dysregulation in the intestinal microbiome-host interplay is connected with the development of many chronic skin inflammations. Plaque psoriasis is a chronic, immune-mediated non-communicable dermatitis affecting approximately 2-3% of the world's population, regardless of gender and age. In most cases (about 70-80%), the skin lesions are mild and do not require systemic treatment. Its etiology is not fully understood, but apart from the genetic predisposition, it is strongly associated with the "gut-skin axis". The rise of the local and systemic immune response in psoriasis is a consequence of systemic inflammation due to intestinal dysbiosis associated with increased intestinal permeability. Thus, gut microbiota modulation should become a research target due to its great potential to impact inflammation, including skin dermatitis, and its manifested consequences. Diet is an underestimated element in psoriasis management, meanwhile, the dietary ingredients support skin health. Among them, prebiotics favorably alters the composition and activity of the intestinal microbes and alleviates inflammation in the intestines. It was hypothesized that restoring the balance of the gut microbiome and the proper functioning of the intestinal barrier in subjects with psoriasis will alleviate the inflammatory symptoms and skin lesions observed in this chronic dermatitis. The goal of this clinical trial is to determine if a diet supplementation with prebiotic (chicory-derived inulin-type β-fructans; ITFs) vs. placebo (maltodextrin) will induce health-related benefits in a mild degree PS, and determine if the identified benefits are evoked by compositional and/or functional shifts of the intestinal bacterial communities. Healthy individuals will constitute a control group (C).
Status | Enrolling by invitation |
Enrollment | 100 |
Est. completion date | February 2027 |
Est. primary completion date | February 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 65 Years |
Eligibility | Inclusion Criteria for PS patients: - mild psoriasis (PASI < 10), - omnivorous diet, - body mass index (BMI) 18 - 30 kg/m2 - general good health - willing to give the written informed consent to participate the study Exclusion Criteria for PS patients: - other chronic or acute inflammatory skin diseases, - gastrointestinal disease, cancer, cardiovascular complications, heart, kidney, and liver failure, - bad or average overall health, - positive tTG antibodies, - currently receive anti-psoriatic systemic and biologic treatment, - received antibiotics within previous month, - use of dietary supplements containing probiotic, prebiotic, and/or symbiotic within previous month, - Pregnancy, lactation |
Country | Name | City | State |
---|---|---|---|
Poland | Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Municipal Hospital Complex, al. Wojska Polskiego 30 | Olsztyn | |
Poland | Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, ul. Tuwima 10 | Olsztyn |
Lead Sponsor | Collaborator |
---|---|
Polish Academy of Sciences | University of Warmia and Mazury, Warsaw University of Life Sciences |
Poland,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Concentration of inflammatory mediators | The concentration of cytokines and chemokines: interferon-?, interleukins: 1ß, 1ra, 2, 4, 5, 6, 7, 8, 9, 10, 12 (p70), 13, 15, 17A, and tumor necrosis factor-a will be analyzed in blood using dedicated assay kit (Bio-Plex Pro Human Cytokine Assay; Bio-Rad) | 24 months | |
Secondary | Assessment of the score of the psoriasis area and severity index (PASI) | The psoriasis area and severity index (PASI) combines the assessment of the severity of and area affected by psoriasis into a single score in the range 0 (no disease) to 72 (maximal disease). | 24 months | |
Secondary | Determination of the body mass index | The body height (in meters) and body weight (in kilograms) will be measeure and will be combined to report body mass index (BMI) in kg/m^2 | 24 months | |
Secondary | Analysis of the concentration of anti-tissue transglutaminase antibodies | The concentration of anti-tissue transglutaminase antibodiesanty-tTG will be determined in blood serum according to standard procedures in the outpatient clinic of the Municipal Hospital in Olsztyn. | 24 months | |
Secondary | Analysis of the body composition | Body composition (percentage of total body fat, water, fat-free mass) will be assessed using a bioelectrical impedance analyser | 24 months | |
Secondary | Analysis of the concentration of C-reactive protein (CRP) | The concentration of the C-reactive protein (CRP) will be analyzed according to standard procedures in the outpatient clinic of the Municipal Hospital in Olsztyn. Serum anty-tTG will be determined to exclude the gluten-related disorders | 24 months | |
Secondary | Assessment of liver functions | The concentration of aspartate aminotransferase and alanine aminotransferase will be analyzed according to standard procedures in the outpatient clinic of the Municipal Hospital in Olsztyn. | 24 months | |
Secondary | Analysis of the concentration of creatinine | The concentration of creatinine will be analyzed in urine according to standard procedures in the outpatient clinic of the Municipal Hospital in Olsztyn. | 24 months | |
Secondary | Determination of carbohydrate metabolism | The concentration of glycated hemoglobin, glucose and insulin will be determined in fasting blood and analyzed according to standard procedures in the outpatient clinic of the Municipal Hospital in Olsztyn. | 24 months | |
Secondary | Determination of lipids metabolism | The concentration of apolipoproteins A and B will be determined in fasting blood and analyzed according to standard procedures in the outpatient clinic of the Municipal Hospital in Olsztyn. | 24 months | |
Secondary | Metabolic rate analysis | The resting energy expenditure will be measured by indirect respirometry with ventilated open-circuit (with canopy system) using Cosmed K5 mobile device, in conditions of thermal comfort, under fasting conditions, and in the supine position. Determining the volume of oxygen and carbon dioxide enables the determination of respiratory quotients and the degree of utilization of fat and carbohydrates in the body. | 24 months | |
Secondary | Assessment of qualitative and quantitative changes in the intestinal microbiota | The hyper-variable regions of the 16S rRNA bacterial gene (V3-V8) will be amplified. Bacterial libraries will be created using a Ligation Sequencing Kit 1D plus either Native Barcoding Expansion or a set of custom barcodes. Final libraries will be sequenced on a GridION X5 sequencer (Oxford Nanopore Technologies, Oxford, UK). High-quality reads will be processed for taxonomic identification by matching the NGS sequences with sequences deposited in the NCBI using a modified uSEARCH algorithm. | 24 months | |
Secondary | Assessment of the metabolic activity of intestinal microbiota | The concentration and profile of short-chain fatty acids (SCFA) will be analyzed using the gas chromatograph with a flame-ionization detector and the autosampler in stool samples collected from patients after nutritional intervention with prebiotic or placebo. | 24 months | |
Secondary | Determination of changes in the expression of genes of inflammatory response in skin | Changes in the expression of genes of inflammatory response will be determined by real-time PCR in skin biopsies collected from patients after nutritional intervention with prebiotic or placebo | 24 months | |
Secondary | Immunohistological skin analysis | The concentration of tumor necrosis factor-a, interleukins 17A, 17F, 12, 23, 8, 22, 35, and interferon-gamma will be determined in lesional and non-lesional skin specimens collected from study participants. | 24 months | |
Secondary | Determination of the concentration of biomarkers of intestinal barrier permeability and integrity | The concentration of the selected intestinal barrier permeability and integrity biomarkers will be analyzed using the ELISA method in the blood (zonulin, iFABP, claudin-3, bacterial LPS) and in stool (calprotectin, ß-defensin-2, a1-Antitrypsin, sIgA) samples. | 24 months | |
Secondary | Determination of the activity of oxidative stress parameters | Superoxide dismutase activity and catalase activity will be analyzed in blood serum | 24 months | |
Secondary | Qualitative characteristics of volatile organic compounds | The profile of volatile organic compounds will be determined by headspace microextraction coupled with gas-chromatography and mass spectrometry in urine and stool samples | 24 months | |
Secondary | Determination of the nutritional status | Nutritional status will be evaluated based on Food Frequency Questionnaire and a 3-days food record | 24 months |
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