Microbiota Intervention to Change the Response of Parkinson's Disease
只有注册用户可以翻译文章
登陆注册
链接已保存到剪贴板
状态招聘中
赞助商
University of California, San Francisco
合作者
Nova Southeastern University
Gateway Institute for Brain Research
临床试验: NCT03575195
BioSeek: NCT03575195
关键词
抽象
The clinical phenotype of Parkinson's disease (PD) is quite variable, as is the response to and side effects from medications. While many patients respond to carbidopa/levodopa early on, motor fluctuations and dyskinesias can become a problem as the condition progresses, causing significant impairment in function and quality of life. The gut microbiome is of increasing interest in PD, potentially contributing to pathophysiology and clinical phenotype. Furthermore, gut bacteria are capable of metabolizing levodopa, which may decrease its ability to reach the central nervous system and could explain the variable effect seen clinically. Altering the population of drug-metabolizing bacteria could improve the clinical symptoms of PD and the benefit seen with medications. The investigators hypothesize that the gut microbiome in people with PD correlates with their phenotypic characteristics, which can be improved with targeting the microbiome through dietary or therapeutic interventions. The investigators propose a two-part clinical trial. First, a cross-sectional analysis will correlate the microbiome profile with (a) the clinical phenotype of PD and (b) medication response. Second, a randomized, controlled trial, will evaluate the effect of microbiome manipulation on clinical phenotype and medication response. The investigators plan to reduce the level of bacteria through antibiotic use, resetting the potentially disadvantageous microbiome population. Outcomes will include changes in clinical symptoms, alterations in the the microbiome, and changes in serum markers of inflammation. This thorough characterization will broaden our understanding of the gut-brain axis significantly in PD in clinically relevant ways that have yet to be explored.
日期
最后验证: | 07/31/2019 |
首次提交: | 06/20/2018 |
提交的预估入学人数: | 06/20/2018 |
首次发布: | 07/01/2018 |
上次提交的更新: | 07/31/2019 |
最近更新发布: | 08/04/2019 |
实际学习开始日期: | 07/14/2019 |
预计主要完成日期: | 08/31/2020 |
预计完成日期: | 11/30/2020 |
状况或疾病
Parkinson Disease
干预/治疗
Drug: Intervention
Other: Placebo
相
相 1/相 2
手臂组
臂 | 干预/治疗 |
---|---|
Experimental: Intervention Rifaximin | Drug: Intervention Rifaximin 550mg orally |
Placebo Comparator: Placebo Matching placebo | Other: Placebo Placebo control |
资格标准
有资格学习的年龄 | 30 Years 至 30 Years |
有资格学习的性别 | All |
接受健康志愿者 | 是 |
标准 | Inclusion Criteria: - Parkinson's disease - Stable on levodopa therapy - Greater than or equal to 2.5 hours of OFF time daily Exclusion Criteria: - Chronic gastrointestinal disease - Recent antibiotic or probiotic therapy - Pregnant - Immunocompromised |
结果
主要结果指标
1. MDS-UPDRS Part III [Two weeks]
The Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a validated scale that quantifies many of the symptoms and signs of Parkinson's disease. Part III in particular focuses on the motor symptoms of Parkinson's disease through a neurologic exam. The exam is often performed when medications are held for 8-12 hours (the "OFF" state) and again when medications are given and providing therapeutic benefit (the "ON" state), and the difference between scores is calculated. The scale goes from a minimum of 0 to a maximum of 132. There is no specific cutoff, but a higher score indicates a higher severity of symptoms. The trial will examine the change in the MDS-UPDRS Part III both OFF and ON medication after the intervention.
2. Percent of OFF time according to home motor diaries [Two weeks]
Patients with Parkinson's disease often have times where levodopa is providing therapeutic benefit and times when it is not. "OFF" time indicates the times of day where levodopa therapy is not providing therapeutic benefit. An outcome of the trial will be the change in medication OFF time that the participant experiences at home, according to motor diaries.