Clinical Trial: Use of a Novel Diet (UC DIET) for Treatment of Mild to Moderate Active Pediatric Ulcerative Colitis

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Use of a Novel Diet (UC DIET) Targeting the Microbiota for Treatment of Mild to Moderate Active Pediatric Ulcerative Colitis: An Open Label Pilot Study

Brief Summary: The goal of the study is to evaluate strategies that target the microbiota for the treatment of Ulcerative Colitis , This study will involve a novel diet that the investigators developed , based on the hypothesis that UC involves dysbiosis , underutilzation of certain metabolic pathways and use of pathways that increase risk of inflammation . The investigators have postulated that manipulation of colonic bacterial metabolism with this diet will induce remission in UC without involving additional immune suppression.

Detailed Summary:

Ulcerative colitis is a chronic inflammatory disease primarily involving the colon. It has long been considered to be due to a dysregulated immune response targeting the colon, and involves unknown environmental factors . Recent studies have highlighted several characteristics which may suggest that UC is associated with alterations of the microbiota, defective production of short chain fatty acids and an impaired mucous layer. However at present, no effective therapy targets the microbiota or its interaction with the colonic epithelium. UC in humans is characterized by increased mucosal sulfides and increased sulfate and sulfide reducing bacteria and activation of amino acid metabolism pathways which impair butyrate production, whereas certain dietary patterns in humans and rodent models may induce dysbiosis and favor sulphide reducing bacteria. Further support for targeting the microbiota includes several studies demonstrating that antibiotics might be helpful for severe refractory colitis. Development of treatment strategies that target the microbiota could reduce exposure to immune suppression, and add new therapeutic strategies that do not exist at present.

Though diet has a significant impact on the composition of the microbiota no dietary intervention to date has proven effective for induction of remission. The investigators hypothesized that ulcerative colitis is caused by a series of events involving dysbiosis with sulfate or sulfide reducing bacteria combined with defective production of short chain fatty acids, coupled with a defective mucous layer.


Sponsor: Prof. Arie Levine

Current Primary Outcome: Remission rate, defined as a PUCAI less than 10 at week 6. [ Time Frame: week 6 ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Mean PUCAI week 6 [ Time Frame: week 6 ]
  • Mean Calprotectin at week 6 [ Time Frame: week 6 ]
  • Physicians Global Assessment week 6 [ Time Frame: week 6 ]
  • Remission week 12, defined as a PUCAI less than 10 [ Time Frame: week 12 ]
  • Mean PUCAI week 12 [ Time Frame: week 12 ]


Original Secondary Outcome:

  • Mean PUCAI week 6 [ Time Frame: week 6 ]
  • Mean Calprotectin at week 6 [ Time Frame: week 6 ]
  • Physicians Global Assessment week 6 [ Time Frame: week 6 ]


Information By: Wolfson Medical Center

Dates:
Date Received: January 19, 2015
Date Started: September 2015
Date Completion: April 2017
Last Updated: August 10, 2016
Last Verified: August 2016