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CompletedNCT03418428DiGMAUpdated Jan 2, 2020

Intestinal Microbiome After Gastrectomy

An observational study in Gastric Cancer, sponsored by Vilnius University. Completed at 1 site in Lithuania. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-01-02.

Sponsored by Vilnius University · Observational

Study type
Observational
Model
Case-control
Time perspective
Cross-sectional
Enrollment
34
Ages
18 Years and older
Sex
All
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Study summary

The gastric barrier plays a major role in the maintanance of the distal intestinal microbiome composition. It has been shown before that the use of gastric acid suppression medication, such as proton pump inhibitors, are associated with distinctive alterations of the intestinal microbiome. Foremost, the invasion of predominantly oral bacteria, like Veillonella and Streptococcus species, were a resurring finding in previous reports.

Gastric cancer treatment includes the total or subtotal resection of the stomach which can influence the gastric acid production. However, the influence by alterations in gastric milieu after this treatment on the composition of the intestinal microbiome is not well studied.

Therefore, the intestinal microbiome of patients after total or subtotal gastrectomy and its influence on intestinal inflammation and gut permeability will be studied.

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Conditions studied

  • Gastric Cancer

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Test group: Patients with a history of gastric cancer surgery, without the current use of PPI and no recurrence of gastric cancer and a minimum of 12 months since the last adjuvant treatment Control group 1: Patients with a history of endoscopic resection of gastric cancer, without the current use of PPI and no recurrence of gastric cancer Control group2: Healthy volunteers recruited from relatives of study participants (Test group and Control group 1), without the current use of PPI Control group 3: Patients with a history of long-term PPI usage (6 months) without a history of gastric cancer

Inclusion criteria

  • age 18 years and above
  • history of radical removal of gastric cancer (Test group and Control group 1) or PPI (Control group 3)
  • informed consent

Exclusion criteria

Exclusion Criteria:

  • chemotherapy or radiotherapy 12 months prior to inclusion
  • gastric stump cancer
  • usage of antibiotics, pro- pre or synbiotics, H2-blocker 1 month prior to inclusion
  • PPI use (except for Control group 3) 1 month prior to inclusion
  • history of radical removal of gastric cancer (Control group 2-3)
  • history of gastrointestinal tract resections (other than gastric)
  • recurrence of gastric cancer
  • current non-gastric malignancies
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Study design

Observational model
Case-control
Time perspective
Cross-sectional
Enrollment
34 participants (actual)
Patient registry
No

Groups and cohorts

  • Test group

    Patients who underwent total or subtotal gastrectomy for the treatment of gastric cancer

  • Control group 1

    Patients who underwent endoscopic mucosal resection/submucosal dissection for the treatment of gastric cancer

  • Control group 2

    In-house relatives of Test group and Control group 1 participants

  • Control group 3

    Patients with long-term history of proton pump inhibitor usage

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What researchers measure

Primary outcomes

  1. Intestinal microbiome composition

    Significant differences in the beta-diversity of the intestinal microbiome between Test group and Control groups

    Time frame: 5 years after surgery

Secondary outcomes

  1. Intestinal microbiome composition (II)

    Significant differences in the alpha-diversity of the intestinal microbiome between Test group and Control groups

    Time frame: 5 years after surgery

  2. Fecal calprotectin

    Significant differences in intestinal inflammation measured by fecal calprotectin between Test group and Control groups

    Time frame: 5 years after surgery

  3. Fecal zonulin

    Significant differences in intestinal permeability measured by fecal zonulin between Test group and Control groups

    Time frame: 5 years after surgery

  4. Serum LPS

    Significant differences in serum LPS between Test group and Control groups

    Time frame: 5 years after surgery

  5. Serum sCD14

    Significant differences in serum sCD14 between Test group and Control groups

    Time frame: 5 years after surgery

  6. Serum LBP

    Significant differences in serum LBP between Test group and Control groups

    Time frame: 5 years after surgery

  7. Serum sCD163

    Significant differences in serum sCD163 between Test group and Control groups

    Time frame: 5 years after surgery

  8. Serum sMR

    Significant differences in serum sMR between Test group and Control groups

    Time frame: 5 years after surgery

  9. Serum CRP

    Significant differences in serum CRP between Test group and Control groups

    Time frame: 5 years after surgery

  10. Serum DAO

    Significant differences in serum DAO between Test group and Control groups

    Time frame: 5 years after surgery

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Study locations

1 site
  • National Cancer Institute
    Vilnius, Lithuania
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References and documents

Publications

  • Horvath A, Bausys A, Sabaliauskaite R, Stratilatovas E, Jarmalaite S, Schuetz B, Stiegler P, Bausys R, Stadlbauer V, Strupas K. Distal Gastrectomy with Billroth II Reconstruction is Associated with Oralization of Gut Microbiome and Intestinal Inflammation: A Proof-of-Concept Study. Ann Surg Oncol. 2021 Feb;28(2):1198-1208. doi: 10.1245/s10434-020-08678-1. Epub 2020 Jun 5. PubMed 32504369 ↗

Individual participant data

Plan to share: Undecided — The use of sequence data repositories is planed

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Registry details

Key details

Study ID
NCT03418428
Lead sponsor
Vilnius University
Collaborators
Medical University of Graz, National Cancer Institute (NCI)
Responsible party
Rimantas Bausys (Medical Doctor, Vilnius University) — Principal investigator
First posted
Feb 1, 2018
Start date
Apr 1, 2018
Primary completion
Jun 30, 2019
Completion
Dec 1, 2019
Last update
Jan 2, 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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This study is completed, as verified in Dec 2019. You cannot join it, but the record below documents what was studied.

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