Safety and Effect of L. Reuteri on Biomarkers of Inflammation in Healthy Infants With Colic
Biological: Lactobacillus reuteri
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Safety and Effect of L. Reuteri on Biomarkers of Inflammation in Healthy Infants With Colic|
- 45 healthy infants with colic will receive LR (health-promoting bacteria) or placebo measuring any changes in their health status. [ Time Frame: 92 days ] [ Designated as safety issue: Yes ]
- Physical Examination of infants will be performed to evaluate any adverse effects of LR.
- Electrolyte testing at baseline will evaluate for any inborn error of fluid and electrolyte balance and at end of treatment will evaluate for any adverse impact of LR in the subjects.
- Determine effect of L. reuteri in 45 infants with colic on gastrointestinal inflammation as assessed by fecal calprotectin. [ Time Frame: 1, 42 & 92 days ] [ Designated as safety issue: No ]To examine for evidence of anti-inflammatory effects in the normal intestine, we will test fecal samples from all infants for calprotectin level.
- Measuring the change in crying times (Barr Diary) in 45 healthy infants with colic during the administration of L reuteri. [ Time Frame: 92 days ] [ Designated as safety issue: No ]Clinical scoring of crying and fussing will be evaluated using the Barr diary which will show crying patterns.
- Determine effects of L. reuteri in 45 healthy infants with colic measuring the immunologic responses with plasma cytokines and circulating regulatory T-cells. [ Time Frame: 1& 42 days ] [ Designated as safety issue: No ]
- A panel of inflammatory biomarkers will be examined which includes Th1 cytokines (TNFα, IL-1β); a Th2 cytokine (IL-10), a cytokine which regulates maturation of Tregs (IL-2), a cytokine receptor (OPG), a marker of intestinal barrier function (TIMP-1) and a marker for autoimmunity (TWEAK). Biomarkers will be assessed by MSD human multiplex cytokine assays or R&D Human ELISA kit.
- We will determine if LR treatment affects the frequency of Tregs in PBMCs in normal babies with colic.
- Determine effect of L. reuteri on gastrointestinal inflammation as assessed by fecal microbiota in 45 healthy infants with colic. [ Time Frame: 1, 42 & 92 days ] [ Designated as safety issue: No ]A stool sample will be collected and analyzed to determine the effect on overall microbiota produced by the ingestion of LR.
|Study Start Date:||September 2013|
|Estimated Study Completion Date:||September 2016|
|Estimated Primary Completion Date:||September 2016 (Final data collection date for primary outcome measure)|
Active Comparator: Lactobacillus reuteri
The first arm of the cohort will include 30 patients on LR (5x10^8 cfu's orally once daily.)
Biological: Lactobacillus reuteri
Lactobacillus reuteri oil drops are a natural product containing Lactobacillus reuteri (LR), which has traditionally been used for the establishment of a well-functioning gastrointestinal (GI) microbiota and prevention and treatment of mild diarrhea associated with GI-tract infections, travel or antibiotic treatment.
The drug is a clear liquid when suspended in sunflower oil. The drug will be administered orally, 0.2cc once daily.
Placebo Comparator: Sunflower Oil
The second arm includes 15 subjects on placebo (sunflower oil.)
Placebo is sunflower oil (vehicle for LR). The placebo will be administered the same way as drug listed above.
This study will evaluate the safety and tolerability of Lactobacillus reuteri in healthy infants with colic. Patients will be randomized to receive either L. reuteri at one dose orally for a total of 42 doses. The doses will be 5x108 (5 drops) during a satisfactory assessment of safety and tolerability. The time on study treatment is 6 months, and the target sample size is 45 healthy infants.
Secondly, the investigators aim to gather evidence supporting hypothesis of safety and tolerability of Lactobacillus reuteri by administering a physical examination and testing of complete blood count, liver tests, and serum electrolytes over a forty-two day period.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01849991
|United States, Texas|
|University of Texas Health Science Center at Houston|
|Houston, Texas, United States, 77030|
|Principal Investigator:||J. Marc Rhoads, M.D.||The University of Texas Health Science Center, Houston|