NCT01574209

Brief Summary

It is well known that the intestinal barrier is altered in celiac disease (CD), an autoimmune disease that develops in genetically predisposed subjects exposed to ingestion of wheat gliadin and of related prolamines of barley and rye. More recently, defective epithelial barrier has been implicated in the pathogenesis of other conditions such as irritable bowel syndrome (IBS). At present IBS is still considered a functional condition although low-grade inflammation has been associated with its manifestation, particularly that following infection. Different substances have been implicated in the (dis)regulation of intestinal barrier, among them zonulin seems to play a key role. Other gastrointestinal peptides are GPL-2, Ghrelin, and Epidermal growth factor (EGF). In order to shed light on the hormonal regulation of intestinal barrier function in celiac patients before undergoing a gluten free diet and possible differences with those of IBS patients, in the present study the investigators will apply the non-invasive lactulose/mannitol permeability test toward the evaluation of intestinal damage. The pattern of intestinal permeability and the GI peptides concentration will be compared in celiac patients, IBS patients and healthy controls.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
70

participants targeted

Target at P25-P50 for all trials

Timeline
Completed

Started Apr 2012

Shorter than P25 for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 28, 2012

Completed
4 days until next milestone

Study Start

First participant enrolled

April 1, 2012

Completed
9 days until next milestone

First Posted

Study publicly available on registry

April 10, 2012

Completed
5 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2012

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2012

Completed
Last Updated

November 9, 2012

Status Verified

November 1, 2012

Enrollment Period

5 months

First QC Date

March 28, 2012

Last Update Submit

November 8, 2012

Conditions

Celiac DiseaseIrritable Bowel Syndrome

Keywords

Celiac diseaseIBSIntestinal barrierIntestinal permeabilityGI peptides

Outcome Measures

Primary Outcomes (1)

  • Plasma concentrations of GI peptides (Zonulin, GLP-2, Ghrelin and EGF)

    within one month after the enrollment

Secondary Outcomes (1)

  • Intestinal permeability

    within one month after the enrollment

Study Arms (3)

Celiac Disease

Patients suffering from coeliac diseases confirmed by small intestinal biopsy

IBS patients

Patients suffering from irritable bowel syndrome (IBS) according to Rome III criteria

Healthy subjects

Healthy subjects as control group

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Outpatients recruited in IRCCS "S. de Bellis"

You may qualify if:

  • Diagnosis of CD was based on the detection of IgA antiendomysial and IgA antitissue transglutaminase antibodies in serum
  • Diagnosis must be confirmed by a small intestinal biopsy obtained at the time of gastrointestinal endoscopy.
  • All patients must show Marsh 3 grade villous atrophy at the time of the diagnosis.
  • Subjects suffering from irritable bowel syndrome according to the Rome III criteria.
  • Availability of at least one GI imaging study during the last five years (colonoscopy, sigmoidoscopy, abdominal ultrasound, barium enema)

You may not qualify if:

  • None were taking anti-inflammatory drugs (including mast cell stabilisers, histamine antagonists, anticholinergics, anti-diarrhoea medication, probiotics, immunosuppressants and steroids)
  • Presence of organic syndrome, including food allergy, atopy and severe clinical depression or anxiety.
  • Abnormal laboratory data or thyroid function

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

National Institute of Digestive Diseases IRCCS "S. de Bellis"

Castellana Grotte, Bari, 70013, Italy

Location

Related Publications (7)

  • Fasano A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol Rev. 2011 Jan;91(1):151-75. doi: 10.1152/physrev.00003.2008.

    PMID: 21248165BACKGROUND

  • Cani PD, Possemiers S, Van de Wiele T, Guiot Y, Everard A, Rottier O, Geurts L, Naslain D, Neyrinck A, Lambert DM, Muccioli GG, Delzenne NM. Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut. 2009 Aug;58(8):1091-103. doi: 10.1136/gut.2008.165886. Epub 2009 Feb 24.

    PMID: 19240062BACKGROUND

  • Gecse K, Roka R, Sera T, Rosztoczy A, Annahazi A, Izbeki F, Nagy F, Molnar T, Szepes Z, Pavics L, Bueno L, Wittmann T. Leaky gut in patients with diarrhea-predominant irritable bowel syndrome and inactive ulcerative colitis. Digestion. 2012;85(1):40-6. doi: 10.1159/000333083. Epub 2011 Dec 14.

    PMID: 22179430BACKGROUND

  • Menard S, Lebreton C, Schumann M, Matysiak-Budnik T, Dugave C, Bouhnik Y, Malamut G, Cellier C, Allez M, Crenn P, Schulzke JD, Cerf-Bensussan N, Heyman M. Paracellular versus transcellular intestinal permeability to gliadin peptides in active celiac disease. Am J Pathol. 2012 Feb;180(2):608-15. doi: 10.1016/j.ajpath.2011.10.019. Epub 2011 Nov 24.

    PMID: 22119716BACKGROUND

  • Malandrino N, Capristo E, Farnetti S, Leggio L, Abenavoli L, Addolorato G, Gasbarrini G. Metabolic and nutritional features in adult celiac patients. Dig Dis. 2008;26(2):128-33. doi: 10.1159/000116770. Epub 2008 Apr 21.

    PMID: 18431062BACKGROUND

  • Linsalata M, Riezzo G, D'Attoma B, Clemente C, Orlando A, Russo F. Noninvasive biomarkers of gut barrier function identify two subtypes of patients suffering from diarrhoea predominant-IBS: a case-control study. BMC Gastroenterol. 2018 Nov 6;18(1):167. doi: 10.1186/s12876-018-0888-6.

    PMID: 30400824DERIVED

  • Russo F, Chimienti G, Clemente C, D'Attoma B, Linsalata M, Orlando A, De Carne M, Cariola F, Semeraro FP, Pepe G, Riezzo G. Adipokine profile in celiac patients: differences in comparison with patients suffering from diarrhea-predominant IBS and healthy subjects. Scand J Gastroenterol. 2013 Dec;48(12):1377-85. doi: 10.3109/00365521.2013.845907. Epub 2013 Oct 28.

    PMID: 24164320DERIVED

MeSH Terms

Conditions

Celiac DiseaseIrritable Bowel Syndrome

Condition Hierarchy (Ancestors)

Malabsorption SyndromesIntestinal DiseasesGastrointestinal DiseasesDigestive System DiseasesMetabolic DiseasesNutritional and Metabolic DiseasesColonic Diseases, FunctionalColonic Diseases

Study Officials

  • Giuseppe Riezzo, MD

    National Institute of Digestive Diseases IRCCS "S. de Bellis"

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Director of Experimental Pathophysiology Laboratory

Study Record Dates

First Submitted

March 28, 2012

First Posted

April 10, 2012

Study Start

April 1, 2012

Primary Completion

September 1, 2012

Study Completion

October 1, 2012

Last Updated

November 9, 2012

Record last verified: 2012-11

Locations

IT(1)