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Gastrointestinal InjuryNCT04111263

Gut-microbiota Targeted Nutritional Intervention for Gut Barrier Integrity at High Altitude

A study testing FP, High altitude and Sea level in people with Gastrointestinal Injury and Acute Mountain Sickness, run by United States Army Research Institute of Environmental Medicine at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this randomized, crossover clinical trial is to determine the efficacy of a gut microbiota-targeted nutritional intervention containing a blend of fermentable fibers and polyphenols (FP) for mitigating increases in GI permeability, and decrements in immune function and neuropsychologic performance following… Read more about this study

Who is it for?
Ages 17 to 39 yearsHealthy volunteers can take part
What is being tested?
FP, High altitude and Sea level
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
33 participants
Where
1 siteUnited States
Study dates
6 Oct 2019to 5 Nov 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 17 to 39 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Men and women aged 18 - 39 years (active duty personnel who are 17 yr of age will also be allowed to participate)
  • In good health
  • Physically active
  • For active duty, passed most recent body composition assessment; for civilians, body mass index (BMI) ≤ 30.0 kg/m2.
  • Self-reports having a bowel movement at least as frequently as every-other-day
  • Self-reports normal vision (with or without glasses) and hearing

Who cannot join

  • Born at altitudes greater than 2,100 m (~7,000 feet)
  • Living in areas that are more than 1,200 m (~4,000 feet), or have traveled to areas that are more than 1,200 m for five days or more within the last 2 mo
  • Pregnant, expecting to become pregnant during study, or breastfeeding
  • Any of the following medical conditions:
  • Musculoskeletal injuries that compromise exercise capability
  • Metabolic or cardiovascular abnormalities (e.g., kidney disease, diabetes, cardiovascular disease, etc.)
Show all 30Show fewer
  • Suspected or known strictures, fistulas, or physiological/mechanical GI obstruction
  • Evidence of apnea or other sleeping disorders
  • Evidence of prior high altitude pulmonary or cerebral edema diagnosis
  • Disease of the GI tract including, but not limited to diverticulitis, inflammatory bowel disease, peptic ulcer disease, Crohn's disease, ulcerative colitis
  • Anemia or Sickle Cell Anemia/Trait
  • Alcoholism or other substance abuse issues
  • History of gastric bezoar
  • Swallowing disorders; severe dysphagia to food or pills
  • Implanted or portable electro-mechanical medical devices
  • Allergy to skin adhesive
  • Past GI surgery
  • Colonoscopy within 3 months of study participation
  • Taking prescription medications other than a contraceptive (unless approved by Medical Office and study PI)
  • Regular use of over-the-counter medications (including antacids, laxatives, stool softeners, and anti-diarrheals) unless approved by Medical Office and study PI
  • Any use of antibiotics, except topical antibiotics, within 3 months of study participation
  • Not willing to refrain from using non-steroidal anti-inflammatory medications (NSAIDs) or antihistamine during the study
  • Not willing to stop consumption of prebiotic- or probiotic-containing supplements (e.g.,VSL#3, PRO-15, etc.), or other dietary supplements at least 2 weeks before and throughout study participation
  • Not willing to stop consumption of probiotic-containing foods (e.g., yogurt, etc.) during study participation.
  • Not willing to refrain from smoking any nicotine product (includes e-cigarettes), vaping, and chewing tobacco during controlled-diet periods.
  • Not willing to abstain from caffeine and alcohol during controlled-diet periods.
  • Allergies, intolerances, unwillingness or inability to eat provided foods and beverages
  • Following vegetarian/vegan diet
  • Unable to regularly sleep for 7-10 hr/night
  • Any previous blood donation, within 8 weeks of the first blood draw of the study, of a volume that when combined with the amount of blood to be collected during the study would exceed 550 mL

Trial locations and contacts

1 site in 1 country.

United States1 site
  • USARIEM

    Natick, Massachusetts, 01760

Other trials in United States

About this study

Official title: Efficacy of a Gut-microbiota Targeted Nutritional Intervention for Promoting Gut Barrier Integrity During Short-term Exposure to Hypobaric Hypoxia.

The aim of this randomized, crossover clinical trial is to determine the efficacy of a gut microbiota-targeted nutritional intervention containing a blend of fermentable fibers and polyphenols (FP) for mitigating increases in GI permeability, and decrements in immune function and neuropsychologic performance following rapid ascent to simulated high altitude. Fifteen healthy young adults will participate in each of three study phases that include a 14-day supplementation period in which participants will consume 1 of 2 supplement bars: placebo (PL, will be consumed during 2 phases) and FP supplementation (will be consumed during one phase only). During the final 2-d of each phase, participants will live in a hypobaric chamber under sea level or high altitude conditions.

Read the detailed description

The collection of microbes inhabiting the human gastrointestinal (GI) tract, known as the gut microbiota, is increasingly recognized as a mediator of GI, immunologic, and neuropsychologic responses to various environmental and physiologic stressors. The hypobaric hypoxia characteristic of high altitude environments is a stressor that has recently been associated with increased GI permeability, and which has been shown to cause decrements in immune, neuropsychological and physical function. To what extent modulation of the human gut microbiota can mitigate these responses during high altitude exposure is undetermined. The aim of this randomized, crossover clinical trial is to determine the efficacy of a gut microbiota-targeted nutritional intervention containing a blend of fermentable fibers and polyphenols (FP) for mitigating increases in GI permeability, and decrements in immune function and neuropsychologic performance following rapid ascent to simulated high altitude. Fifteen healthy young adults will participate in each of three study phases in random order. Each phase will include a 14-day supplementation period in which participants will consume 1 of 2 supplement bars: placebo (PL, will be consumed during 2 phases) and FP supplementation (will be consumed during one phase only). During the final 2-d of each phase, participants will live in a hypobaric chamber. During one phase the chamber environment will mimic low-altitude conditions (SHAM). During two phases the chamber environment will mimic the barometric pressure at Pike's Peak CO (460 mmHg; HA).

Being tested
FP, Placebo, High altitude, Sea level
Keywords
Microbiome, Intestinal permeability, Cognition, Immune, Fiber, Military, Altitude, Polyphenol
Medical subject headings
Altitude Sickness

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FPDietary supplement

    Fiber and polyphenol blend

  • PlaceboDietary supplement

    Matched placebo

  • High altitudeOther

    Simulated high altitude in altitude chamber using hypobaric hypoxia

  • Sea levelOther

    Sea level environment in altitude chamber

Study groups in NCT04111263
Study groupRoleWhat they receive
PL+SHAMSham comparatorPlacebo intervention + sea level exposure
Receives: Dietary Supplement: Placebo; Other: Sea level
PL+HAPlacebo comparatorPlacebo intervention + high altitude exposure
Receives: Dietary Supplement: Placebo; Other: High altitude
FP+HAExperimentalFiber and polyphenol supplementation + high altitude exposure
Receives: Dietary Supplement: FP; Other: High altitude

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Difference in intestinal permeability

    Intestinal permeability measured by the ratio of the urinary excretion of sucralose and erythrirol

    Measured: Study days 20, 40 and 60

Secondary outcomes (47)
  1. Difference in lipopolysaccharide binding protein concentrations

    Fasting serum lipopolysaccharide binding protein concentration

    Measured: Study days 20, 21, 41, 42, 62, 63

  2. Difference in zonulin concentrations

    Fasting serum zonulin concentration

    Measured: Study days 20, 21, 41, 42, 62, 63

  3. Difference in glucagon-like peptide-2 concentrations

    Fasting serum glucagon-like peptide-2 concentration

    Measured: Study days 20, 21, 41, 42, 62, 63

  4. Difference in intestinal fatty acid binding protein concentrations

    Fasting and post-exercise serum intestinal fatty acid binding protein concentration

    Measured: Study days 20, 21, 41, 42, 62, 63

  5. Difference in claudin-3 concentrations

    Fasting and post-exercise serum claudin-3 concentration

    Measured: Study days 20, 21, 41, 42, 62, 63

  6. Difference in S100B concentrations

    Fasting and post-exercise serum S100B concentration

    Measured: Study days 20, 21, 41, 42, 62, 63

  7. Difference in systemic inflammation

    Fasting serum interleukin (IL) IL-6, IL-8, IL-10, IL-17, IL-1β, IL-1ra, tumor necrosis factor-α, interferon-γ concentrations

    Measured: Study days 20, 21, 41, 42, 62, 63

  8. Difference in intestinal inflammation

    Fecal calprotectin concentration

    Measured: Study days 6, 18, 21, 23, 27, 39, 42, 44, 48, 60, 63, 65

  9. Difference in glucose concentrations

    Fasting and post-exercise serum glucose concentrations

    Measured: Study days 20, 21, 41, 42, 62, 63

  10. Difference in insulin concentrations

    Fasting and post-exercise serum insulin concentrations

    Measured: Study days 20, 21, 41, 42, 62, 63

  11. Difference in lactate concentrations

    Fasting and post-exercise serum lactate concentrations

    Measured: Study days 20, 21, 41, 42, 62, 63

  12. Difference in glycerol concentrations

    Fasting and post-exercise serum glycerol concentrations

    Measured: Study days 20, 21, 41, 42, 62, 63

  13. Difference in cortisol concentrations

    Fasting and post-exercise serum cortisol concentrations

    Measured: Study days 20, 21, 41, 42, 62, 63

  14. Difference in bone specific alkaline phosphatase concentrations

    Fasting serum bone specific alkaline phosphatase concentration

    Measured: Study days 20, 41, 62

  15. Difference in carboxy-terminal collagen crosslinks concentrations

    Fasting serum carboxy-terminal collagen crosslinks concentration

    Measured: Study days 20, 41, 62

  16. Difference in tartrate resistant acid phosphatase concentrations

    Fasting serum tartrate resistant acid phosphatase concentration

    Measured: Study days 20, 41, 62

  17. Difference in procollagen type 1 N-terminal propeptide concentrations

    Fasting serum procollagen type 1 N-terminal propeptide concentration

    Measured: Study days 20, 41, 62

  18. Difference in osteocalcin concentrations

    Fasting serum osteocalcin concentration

    Measured: Study days 20, 41, 62

  19. Difference in secretory immunoglobulin A concentrations

    Secretory immunoglobulin A concentrations in tear fluid and saliva

    Measured: Study days 20, 21, 41, 42, 62, 63

  20. Difference in immune cell phenotypes

    Immune cell phenotype by flow cytometry

    Measured: Study days 21, 42, 63

  21. Difference in T-cell simulated cytokine production

    T-cell simulated cytokine production by cell culture and flow cytometry

    Measured: Study days 21, 42, 63

  22. Difference in natural killer-cell cytotoxicity

    Natural killer-cell cytotoxicity by cell culture and flow cytometry

    Measured: Study days 21, 42, 63

  23. Difference in development of acute mountain sickness

    Environmental Symptoms Questionnaire-short form. Acute Mountain Sickness will be measured multiple times daily using the Lake Louise scoring system wherein higher scores indicate more severe symptoms. AMS severity cutoffs will use mild (0.7-1.53), moderate (1.53-2.63), severe >=2.63

    Measured: Study days 20, 21, 41, 42, 62, 63

  24. Difference in gastrointestinal symptoms; quality of life

    Gastrointestinal symptoms measure by modified version of the gastrointestinal quality of life index wherein lower scores indicate more severe symptoms.

    Measured: Study weeks 0, 1, 2, 3, 4, 5, 6, 7, 8, 9

  25. Difference in gastrointestinal symptoms; irritable bowel syndrome

    Gastrointestinal symptoms measure by modified version of the irritable bowel syndrome symptom severity scale score wherein higher scores indicate more severe symptoms. Scored on scale of 0-500; symptom severity scored as mild (75-174), moderate (175-300), severe (>300).

    Measured: Study weeks 0, 1, 2, 3, 4, 5, 6, 7, 8, 9

  26. Difference in appetite

    Hunger, fullness, desire to eat, and prospective consumption measured by 100 mm visual analog scale. Scored from 0-100 with higher scores indicating greater sensation.

    Measured: Study weeks 0, 1, 2, 3, 4, 5, 6, 7, 8, 9

  27. Difference in changes in mood state

    Measured by Profile of Mood States Questionnaire; a 65-item inventory of self-reported mood states which factor into six mood sub-scales (tension/anxiety (0-36), depression/dejection (0-60), anger/hostility (0-48), vigor/activity (0-32), fatigue/inertia (0-28), confusion/bewilderment (0-28), and total mood disturbance (0-200) wherein higher scores indicate greater mood state.

    Measured: Study days 20, 21, 41, 42, 62, 63

  28. Difference in changes in feeling

    Measured by Feeling Scale; a one-item inventory measuring the extent to which participants feel pleasant or unpleasant. Higher scores indicate more unpleasant feeling. Scored from -5 (very bad) to 5 (very good)

    Measured: Study days 20, 21, 41, 42, 62, 63

  29. Difference in changes arousal

    Measured by Felt Arousal Scale; a one-item inventory measuring the extent to which participants feel aroused. Higher scores indicate greater arousal (low=1 to high =6).

    Measured: Study days 20, 21, 41, 42, 62, 63

  30. Difference in willingness to take risks

    Measured by Evaluation of Risks Questionnaire; a 24-item questionnaire providing scores on five scales: self-control, danger seeking, energy, impulsivity, and invincibility.

    Measured: Study days 20, 21, 41, 42, 62, 63

  31. Difference in risk taking behavior

    Measured by Balloon Analogue Risk Task

    Measured: Study days 7, 20, 21, 41, 42, 62, 63

  32. Difference in resting metabolic rate

    Resting metabolic rate measured by indirect calorimetry

    Measured: Study days 7, 21, 42, 63

  33. Difference in physical activity energy expenditure

    Energy expenditure measured by indirect calorimetry during 60-minute steady state exercise

    Measured: Study days 20, 21, 41, 42, 62, 63

  34. Difference in gastrointestinal transit time

    Gastric, small intestine and large intestine transit time measured by SmartPill

    Measured: Study days 20, 41, 62

  35. Difference in gastrointestinal pH

    Gastric, small intestine and large intestine pH measured by SmartPill

    Measured: Study days 20, 41, 62

  36. Difference in changes in working memory

    Measured by N-Back task before, during and after exercise

    Measured: Study days 20, 21, 41, 42, 62, 63

  37. Difference in changes in spatial working memory

    Measured by emotional Interference task before, during and after exercise

    Measured: Study days 20, 21, 41, 42, 62, 63

  38. Difference in changes in spatial memory

    Measured by Matching to Sample test in the morning and afternoon

    Measured: Study days 20, 21, 41, 42, 62, 63

  39. Difference in change in reaction time

    Measured by reaction time task before, during and after exercise

    Measured: Study days 20, 21, 41, 42, 62, 63

  40. Difference in change in response inhibition

    Measured by Go/No-Go task before, during and after exercise

    Measured: Study days 20, 21, 41, 42, 62, 63

  41. Difference in vigilance

    Measured by scanning visual vigilance task

    Measured: Study days 20, 21, 23, 41, 42, 44, 62, 63, 65

  42. Difference in simple visual reaction time

    Measured by psychomotor vigilance test

    Measured: Study days 20, 21, 23, 41, 42, 44, 62, 63, 65

  43. Difference in language-based logical reasoning

    Measured by grammatical Reasoning task

    Measured: Study days 20, 21, 23, 41, 42, 44, 62, 63, 65

  44. Difference in ambulatory vigilance

    Measured by wrist-worn vigilance monitor

    Measured: 48-hours/day during study weeks 0, 2, 3, 5, 6, 8, 9

  45. Difference in fecal short chain fatty acids

    Fecal short chain fatty acid concentrations

    Measured: Study days 6, 18, 21, 23, 27, 39, 42, 44, 48, 60, 63, 65

  46. Difference in gut microbiota composition

    Fecal bacterial community diversity and relative abundance measured by 16S rRNA gene sequencing

    Measured: Study days 6, 18, 21, 23, 27, 39, 42, 44, 48, 60, 63, 65

  47. Differences in microRNA concentrations

    Fasting and post-exercise circulating and exosomal microRNA

    Measured: Study days 20, 21, 41, 42, 62, 63

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Oct 2019
  2. Study start6 Oct 2019
  3. Primary completion5 Nov 2022
  4. Study completion5 Nov 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Crossover
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
33 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04111263
Sponsor's protocol ID
19-02-HC
Other IDs
M-10783
Status last verified
Dec 2022
First submitted
2 Jul 2019
Last updated
23 Dec 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing FP, High altitude and Sea level in people with Gastrointestinal Injury and Acute Mountain Sickness, run by United States Army Research Institute of Environmental Medicine at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference in intestinal permeability (time frame: Study days 20, 40 and 60). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Dec 2022.

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