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Gastrointestinal DysfunctionNCT05750433

Phage 3Determination of Phage/Probiotic Synergistic Effects on Gastrointestinal Health

A study testing PreforPro+B. subtilis DE111 probiotics and B. subtilis DE111 in people with Gastrointestinal Dysfunction, run by Colorado State University 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 goal of this double blinded clinical trial is to determine whether consumption of the PreforPro product, when co-consumed with Bacillus subtilis DE111 probiotic, synergistically improves bowel regularity, perceived physical symptoms of gastrointestinal distress and other aspects of gastrointestinal health over… Read more about this study

Who is it for?
Ages 18 to 75 yearsHealthy volunteers can take part
Conditions the study is for
Gastrointestinal Dysfunction
What is being tested?
PreforPro+B. subtilis DE111 probiotics and B. subtilis DE111
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
1 siteUnited States
Study dates
1 Oct 2021to 31 Mar 2024
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 18 to 75 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Equal numbers of healthy male and female volunteers between 18-75 years old with BMI scores of 18.5 to 34.9.

Who cannot join

  • Individuals less than 18years of age or greater than 75years of age.
  • If an individual's BMI is outside of 18.5-34.9.
  • History of taking antibiotics and/or probiotics/prebiotics supplementation within 2months of starting antibiotics.
  • If individual is on any medications and dietary supplements that would influence the endpoints of the study, such as statins, metformin, NSAIDs and MAO inhibitors.
  • If individuals with diagnosis with cancer, liver or kidney disease, gastrointestinal diseases and metabolic disorders.
  • Pregnant and breastfeeding women.
  • Additionally inclusion and exclusion in the study will be determined case by case based on self reported alcohol and supplement use.
  • If individual is unable to adhere to study protocol such as consuming capsules for a total 45days, providing stool or blood samples and attending scheduled clinic visits.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Food and Nutrition Clinical Research Lab(FNCRL), Colorado State University

    Fort Collins, Colorado, 80526

Other trials in United States

About this study

Official title: PHAGE 3: Determination of Phage and Probiotic Synergistic Effects on Gastrointestinal Health

The goal of this double blinded clinical trial is to determine whether consumption of the PreforPro product, when co-consumed with Bacillus subtilis DE111 probiotic, synergistically improves bowel regularity, perceived physical symptoms of gastrointestinal distress and other aspects of gastrointestinal health over probiotic use alone. Therefore, the primary goal of this study is to see if PreforPro consumption concurrent with B. subtilis DE111 usage improves probiotic activity. The secondary goal of this study is to assess non-gastrointestinal physiologic parameters to determine whether consumption of PreforPro combined with the probiotic offers any additional health benefits (ie. reduced inflammation, improved gut microbiota profiles) beyond those of consuming a probiotic alone.

Participants will be asked to track daily bowel movements for 7 days prior to beginning capsule consumption and record their diet for a total 3 of days (two weekdays and one weekend day). They will then be asked to consume the provided capsules daily for a period of 45 days. Researchers will compare three parallel arms; (1) PreforPro+B. subtilis DE111 probiotic, (2) B. subtilis DE111 alone, or (3) a maltodextrin placebo to establish their impact on gastrointestinal symptoms and other indicators of health.

Read the detailed description

This is a continuation of previous intervention studies exploring the impacts of a bacteriophage formulation, PreforPro, on gastrointestinal health. The purpose of this study is to determine if the PreforPro product acts synergistically with a spore-based probiotic to influence bowel habits, perceptions of gastrointestinal symptoms, microbiota composition and inflammatory and immune parameters. The proposed study will also explore a longer intervention duration than the previous studies. A secondary outcome will include measuring plasma lipids, as the proposed probiotics (B. subtilis DE111) was shown to improve total and LDL cholesterol levels in our previous study. Bacteriophages may directly influence the microbiota and intestinal environment by selectively infecting host species- in this case E. coli. Additionally, they may have indirect effects as infection of target species can open up ecological niches and/or result in assimilation of released nutrients by other commensal organisms. These phages are generally regarded as safe for human consumption and specifically infecting several strains of E. coli, including enterohemorrhagic strains and Shiga-toxin producing strains. The removal of these E. coli alters the gut environment to allow growth of more favorable bacteria. We have previously shown that PreforPro is both safe and tolerable in a human population and does not broadly disrupt the gut microbiota as would be seen with antibiotic treatment. It did not improve the survival of Bifidobacterium lactis probiotic, but did appear to amplify some of its impacts on perceived functional gastrointestinal health.

A phone screening will be conducted of all interested individuals to evaluate their eligibility. Those meeting the initial eligibility criteria will be scheduled for a clinic visit to obtain informed consent and to confirm eligibility. Consent will be obtained at the Colorado State University Food and Nutrition Clinical Research Lab (FNCRL) by a screening questionnaire and interview/assessment by the clinical coordinator. After securing consent, eligibility will be confirmed by taking anthropometric measures and participants falling within the BMI range will randomly be assigned to 1 of 3 treatment groups: (1) PreforPro+B. subtilis DE111 probiotic, (2) B. subtilis DE111 alone, or (3) maltodextrin placebo.

Visit 1 (baseline): Eligible individuals will be asked to visit the clinic at visit 1 (baseline) to provide consent and confirm eligibility, undergo sample collections (blood and stool) and analysis procedures (weight/height, hip:waist ratio, gastrointestinal symptoms/ quality of life questionnaires) and receive their stool collection container, a stool log and 3-day diet log. Participants will be schedule for their drop off visit, in which they will return to the clinic 7 days after their first visit (Visit 2, Day 0) to return their stool sample, stool log and 3-day diet record. In return, they will be provided with another stool collection kit, their treatment capsules, another stool log and 3-day diet log. At the end of the 45-day treatment period (Visit 3-Final), final blood and stool samples will be collected as well as additional analyses (such as GI questionnaires, stool logs and 3-day diet record). This means that participants will undergo screening (by phone) and make a total of three (3) visits to the clinic during the study (baseline, Day 0, Final). All blood samples will be collected at Colorado State University by trained personnel. Fecal sample collection will be performed by the study participant with collection materials provided by Colorado State University.

Being tested
PreforPro+B. subtilis DE111 probiotics, Placebo, B. subtilis DE111
Keywords
PreforPro, Probiotics, Bacillus subtilis, Prebiotics, Gut health, Gut microbiota, Synergistic effects

What participants receive

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

  • PreforPro+B. subtilis DE111 probioticsDietary supplement

    PreforPro is bacteriophage-based product which was used in combination with Bacillus subtilis probiotics.

  • PlaceboDietary supplement

    Maltodextrin is rice based powder which was used as placebo.

  • B. subtilis DE111Dietary supplement

    Bacillus subtilis probiotics.

Study groups in NCT05750433
Study groupRoleWhat they receive
PreforPro+B. subtilis DE111 probioticsExperimentalPreforPro is a prebiotic which is a bacteriophage-based product. This prebiotic was used in combination with Bacillus subtilis probiotics.
Receives: Dietary Supplement: PreforPro+B. subtilis DE111 probiotics
Placebo(maltodextrin)Placebo comparatorMaltodextrin was used as a placebo.
Receives: Dietary Supplement: Placebo
B. subtilis DE111 aloneActive comparatorBacillus subtilis probiotics was used in this arm alone to compare with the experimental arm.
Receives: Dietary Supplement: B. subtilis DE111

What is being measured

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

  1. Gastrointestinal Health Questionnaire

    Self-assessment of functional measures of gastrointestinal health, including colon and small intestinal pain, gastric function, and gastrointestinal inflammation.

    Measured: Evaluated at Baseline and Final (52 days apart) with questions designed to capture function from the prior 4 weeks.

  2. Bowel Movement Diary

    Daily recording of the number and type (based on Bristol Stool chart) of bowel movements.

    Measured: 52 days

  3. Quality of Life Assessment

    Questionnaire that evaluates the impact of gastrointestinal health on daily activities as well as social and psychological impacts.

    Measured: Evaluated at Baseline and Final (52 days apart)

Secondary outcomes (7)
  1. Gut microbiota changes (beta-diversity)

    16s amplicon sequencing of stool samples will be conducted and analyzed for beta-diversity (differences between samples) using principle coordinate analysis of Bray Curtis distances.

    Measured: 2 samples per person, collected ~7 weeks apart

  2. Gut microbiota changes (alpha diversity)

    16s amplicon sequencing of stool samples will be conducted and analyzed for alpha diversity differences by applying actual and boot-strapped species number estimates, and Shannon and Simpson diversity indices.

    Measured: 2 samples per person, collected ~7 weeks apart

  3. Intestinal inflammation

    Intestinal inflammation will be assessed by levels of fecal calprotectin measured by ELISA

    Measured: 2 samples per person, collected ~7 weeks apart

  4. Intestinal inflammation

    Intestinal inflammation will be assessed by levels of secretory immunoglobin A measured by ELISA

    Measured: 2 samples per person, collected ~7 weeks apart

  5. Systemic inflammation

    Human T-cell associated markers of inflammation in the blood will be measured using a multi-plex Luminex panel for 13 analytes.

    Measured: 2 blood samples per person, collected ~7 weeks apart

  6. Systemic inflammation

    Cultured PBMCs will be stimulated with bacterial LPS and the supernatants will be analyzed for TNF-alpha, Il-6, 1l-10 and IFN-gamma using ELISA.

    Measured: 2 blood samples per person, collected ~7 weeks apart

  7. Lipid panels

    The Piccolo Xpress lipid panel will be used with a 200ul blood sample to measure total cholesterol and other blood lipid parameters.

    Measured: 2 blood samples per person, collected ~7 weeks apart

Timeline

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

  1. First posted1 Mar 2023
  2. Study start1 Oct 2021
  3. Primary completion23 Dec 2022
  4. Study completion31 Mar 2024

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
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05750433
Sponsor's protocol ID
1676
Status last verified
Jun 2024
First submitted
20 Feb 2023
Last updated
27 Jun 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Freedman KE, Hill JL, Wei Y, Vazquez AR, Grubb DS, Trotter RE, Wrigley SD, Johnson SA, Foster MT, Weir TL. Examining the Gastrointestinal and Immunomodulatory Effects of the Novel Probiotic Bacillus subtilis DE111. Int J Mol Sci. 2021 Feb 28;22(5):2453. doi: 10.3390/ijms22052453.

    PubMed 33671071
  • Grubb DS, Wrigley SD, Freedman KE, Wei Y, Vazquez AR, Trotter RE, Wallace TC, Johnson SA, Weir TL. PHAGE-2 Study: Supplemental Bacteriophages Extend Bifidobacterium animalis subsp. lactis BL04 Benefits on Gut Health and Microbiota in Healthy Adults. Nutrients. 2020 Aug 17;12(8):2474. doi: 10.3390/nu12082474.

    PubMed 32824480
  • Trotter RE, Vazquez AR, Grubb DS, Freedman KE, Grabos LE, Jones S, Gentile CL, Melby CL, Johnson SA, Weir TL. Bacillus subtilis DE111 intake may improve blood lipids and endothelial function in healthy adults. Benef Microbes. 2020 Nov 15;11(7):621-630. doi: 10.3920/BM2020.0039. Epub 2020 Nov 9.

    PubMed 33161737
  • Gindin M, Febvre HP, Rao S, Wallace TC, Weir TL. Bacteriophage for Gastrointestinal Health (PHAGE) Study: Evaluating the Safety and Tolerability of Supplemental Bacteriophage Consumption. J Am Coll Nutr. 2019 Jan;38(1):68-75. doi: 10.1080/07315724.2018.1483783. Epub 2018 Aug 29.

    PubMed 30157383
  • Febvre HP, Rao S, Gindin M, Goodwin NDM, Finer E, Vivanco JS, Lu S, Manter DK, Wallace TC, Weir TL. PHAGE Study: Effects of Supplemental Bacteriophage Intake on Inflammation and Gut Microbiota in Healthy Adults. Nutrients. 2019 Mar 20;11(3):666. doi: 10.3390/nu11030666.

    PubMed 30897686

Questions about this trial

What is this clinical trial studying?

A study testing PreforPro+B. subtilis DE111 probiotics and B. subtilis DE111 in people with Gastrointestinal Dysfunction, run by Colorado State University 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 1 inclusion and 8 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 27 Jun 2024. 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?

Gastrointestinal Health Questionnaire (time frame: Evaluated at Baseline and Final (52 days apart) with questions designed to capture function from the prior 4 weeks.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05750433, which also lists 5 linked publications.

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 27 Jun 2024.

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