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CompletedNCT03274648Updated Jan 28, 2020

Dietary Interventions and Butyrate Production in Behçet's Patients

An interventional study of Oral butyrate and Vegetarian diet in Behcet Syndrome, sponsored by Azienda Ospedaliero-Universitaria Careggi. Completed at 1 site in Italy. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2020-01-28.

Sponsored by Azienda Ospedaliero-Universitaria Careggi · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
17
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

A dietary intervention trial will be performed on patients affected by Behçet's syndrome. Three different diets will be compared, analyzing their effects on the gut microbiota composition, on endogenous butyrate production and on the general symptoms in Behçet's patients.

Read the detailed description

A dietary intervention trial will be conducted with the use of three different diets in order to compare the effects of these diets on the gut microbiota composition, on endogenous butyrate production and on the general symptoms in Behçet's patients.

The study will be a randomized, open trial designed to test whether a vegetarian diet or an habitual diet supplemented with oral butyrate would benefit the butyrate production, the gut microbiota composition and the general symptoms of Behçet's patients, compared with the habitual diet.

The study will involve 30 subjects with Behçet syndrome. Patients will be randomly assigned to follow a 3-months isocaloric dietary profile with either:

  • vegetarian diet containing inulin and resistant starch-rich foods, including no meat and fish, but containing eggs and dairy products
  • habitual diet supplemented with 2.4g/day of oral butyrate
  • habitual diet without supplementation At the baseline visit, subjects will be educated about the aims and methods of the clinical trial and will sign their informed consent form.

Anthropometric measurements, body composition, and blood and stool sampling will be obtained from each participant at the beginning and at the end of the intervention period. All subjects will be examined between 07.00 and 09.30 hours after a 12 h fasting period.

The following parameters will be analyzed both at the beginning and at the end of the intervention period:

  • Complete blood count
  • Lipid variables - total cholesterol, low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), triglycerides
  • Glycemic profile - glucose, insulin, glycated hemoglobin (HbA1C), HOMA index
  • Liver function tests - aspartate aminotransferase (AST), alanine transaminase (ALT), gammaglutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, prealbumin
  • Kidney function tests - serum creatinine, urea, uric acid
  • Mineral profile - sodium, potassium, magnesium, calcium
  • Iron metabolism - iron, ferritin
  • Vitamin profile - vitamin B12, folic acid, vitamin D
  • Thyroid function - TSH
  • Inflammatory markers - erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, serum amyloid A (SAA)
  • Serology for celiac disease - IgA, anti-transglutaminase antibodies (IgA), anti endomysium antibodies (IgA)
  • Circulating levels of inflammatory cytokines
  • Oxidative stress markers
  • Gut microbiota composition
  • Butyrate production

At the beginning and at the end of the intervention period, participants will be asked to complete a questionnaire, which will assess Behçet's symptoms frequency and severity. In addition, participants will be contacted by phone to complete a 24-hours recall in order to test the adherence to diets they have been assigned to.

02

Conditions studied

  • Behcet Syndrome

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03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • All patients affected by Behçet's disease

Exclusion criteria

Exclusion Criteria:

  • Pregnancy or breastfeeding
  • Presence of diabetes mellitus
  • Presence of other immune-mediated diseases
  • Presence or history of cancer in the last 5 years
  • Presence of infectious diseases in the last 3 months
  • No antibiotic therapy in the last 3 months
  • No vegetarian or vegan diet
  • No intake of pro- or pre-biotics in the last 3 months
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
17 participants (actual)

Study arms

  • Experimental
    vegetarian diet

    vegetarian diet containing inulin and resistant starch-rich foods, including no meat and fish, but containing eggs and dairy products

    Dietary Supplement: Vegetarian diet

  • Experimental
    Habitual diet + oral butyrate

    habitual diet supplemented with 2.4g/day of oral butyrate

    Dietary Supplement: Oral butyrate

  • Active comparator
    Habitual diet

    habitual diet without supplementation

    Dietary Supplement: Habitual diet

Interventions

  • Dietary supplementOral butyrate

    Patients follow the habitual diet supplemented with 2.4g/day of oral butyrate

  • Dietary supplementVegetarian diet

    Patients follow a vegetarian diet containing inulin and resistant starch-rich foods, including no meat and fish, but containing eggs and dairy products

  • Dietary supplementHabitual diet

    Patients follow the habitual diet

05

What researchers measure

Primary outcomes

  1. Evaluation of gut microbiota composition

    Time frame: 0-3 months

  2. Evaluation of butyrate production

    For the extraction of SCFAs (and butyrate in particular) the method described in Schnorr et al. will be follow" \[Schnorr SL, Candela M, Rampelli S, Centanni M, Consolandi C, Basaglia G,et al. Gut microbiome of the Hadza hunter-gatherers. Nat Commun 2014;5:3654\]

    Time frame: 0-3 months

  3. Complete blood count

    composite score

    Time frame: 0-3 months

  4. Lipid variables

    composite score taking into account the levels of: total cholesterol, low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), triglycerides

    Time frame: 0-3 months

  5. Glycemic profile

    composite score taking into account the levels of : glucose, insulin, glycated hemoglobin (HbA1C), HOMA index

    Time frame: 0-3 months

  6. Vitamin profile

    composite score, taking into account the levels of: vitamin B12, folic acid, vitamin D

    Time frame: 0-3 months

  7. Liver function tests

    composite score taking into account the levels of: aspartate aminotransferase (AST), alanine transaminase (ALT), gammaglutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, prealbumin

    Time frame: 0-3 months

  8. Kidney function tests

    composite score taking into account the levels of : serum creatinine, urea, uric acid

    Time frame: 0-3 months

  9. Mineral profile

    composite score taking into account the levels of: sodium, potassium, magnesium, calcium

    Time frame: 0-3 months

  10. Iron metabolism

    composite score taking into account the levels of: iron, ferritin

    Time frame: 0-3 months

  11. Thyroid function

    measurement of TSH levels

    Time frame: 0-3 months

  12. Inflammatory markers

    composite score taking into account the levels of: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, serum amyloid A (SAA)

    Time frame: 0-3 months

  13. Serology for celiac disease

    composite score taking into account the levels of: IgA, anti-transglutaminase antibodies (IgA), anti endomysium antibodies (IgA)

    Time frame: 0-3 months

  14. Circulating levels of inflammatory cytokines

    composite score

    Time frame: 0-3 months

  15. Oxidative stress markers

    composite score

    Time frame: 0-3 months

Secondary outcomes

  1. Evaluation Behçet's symptoms frequency and severity

    Participants are asked to complete a questionnaire, which will assess Behçet's symptoms frequency and severity.

    Time frame: 0-3 months

06

Study locations

1 site
  • AOU Careggi
    Florence, 50134, Italy
07

References and documents

Publications

  • Skef W, Hamilton MJ, Arayssi T. Gastrointestinal Behcet's disease: a review. World J Gastroenterol. 2015 Apr 7;21(13):3801-12. doi: 10.3748/wjg.v21.i13.3801. PubMed 25852265 ↗
  • Consolandi C, Turroni S, Emmi G, Severgnini M, Fiori J, Peano C, Biagi E, Grassi A, Rampelli S, Silvestri E, Centanni M, Cianchi F, Gotti R, Emmi L, Brigidi P, Bizzaro N, De Bellis G, Prisco D, Candela M, D'Elios MM. Behcet's syndrome patients exhibit specific microbiome signature. Autoimmun Rev. 2015 Apr;14(4):269-76. doi: 10.1016/j.autrev.2014.11.009. Epub 2014 Nov 27. PubMed 25435420 ↗
  • Wong JM. Gut microbiota and cardiometabolic outcomes: influence of dietary patterns and their associated components. Am J Clin Nutr. 2014 Jul;100 Suppl 1:369S-77S. doi: 10.3945/ajcn.113.071639. Epub 2014 Jun 4. PubMed 24898225 ↗

Individual participant data

Plan to share: No — IPD will not be shared

08

Registry details

Key details

Study ID
NCT03274648
Lead sponsor
Azienda Ospedaliero-Universitaria Careggi
Responsible party
GIACOMO EMMI (Principal Investigator, Azienda Ospedaliero-Universitaria Careggi) — Principal investigator
First posted
Sep 7, 2017
Start date
Sep 27, 2017
Primary completion
May 1, 2019
Completion
Jul 5, 2019
Last update
Jan 28, 2020

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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