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回肠结肠局部给予维生素 B₁₂、B₁ 和 C(ColoVit)或格罗宁根抗炎饮食对克罗恩病患者疾病进程和微生物组的影响(VITA-GrAID 研究):一项随机和部分盲法试验的方案

Effects of ileocolonic delivered vitamin B, B and C (ColoVit) or the Groningen anti-inflammatory diet on disease course and microbiome of patients with Crohn's disease (VITA-GrAID study): a protocol for a randomised and partially blinded trial.

机构信息

Department of Gastroenterology and Hepatology, University Medical Centre Groningen, Groningen, The Netherlands

Department of Gastroenterology and Hepatology, University Medical Centre Groningen, Groningen, The Netherlands.

出版信息

BMJ Open. 2023 Mar 14;13(3):e069654. doi: 10.1136/bmjopen-2022-069654.

Abstract

BACKGROUND

Diet plays a pivotal role in the onset and progression of Crohn's disease (CD). Nutritional interventions revealed effects on intestinal inflammation and gut microbial composition. However, data from well-designed and controlled dietary trials are lacking. Therefore, evidence-based dietary recommendations are still unavailable to patients and physicians. Here, we aim to investigate the effects of an evidence-based anti-inflammatory diet, and an ileocolonic-targeted capsule containing vitamin B, B and C (ColoVit) on patients with CD and their healthy household members.

METHODS AND ANALYSIS

In this multicentre, randomised, placebo-controlled, partially blinded nutritional intervention trial, we aim to recruit 255 CD patients with Harvey-Bradshaw Index <8 and a faecal calprotectin (FCal) cut-off of ≥100 µg/g at baseline. Participants will be randomised into two experimental intervention groups and one placebo group. In the experimental groups, participants will either adhere to the Groningen anti-inflammatory diet (GrAID) or ingest an ileocolonic-delivered oral vitamin B/B/C capsule (ColoVit). The study consists of a 12-week controlled interventional phase, which proceeds to a 9-month observational follow-up phase in which patients allocated to the GrAID group will be requested to continue the intervention on their own accord. Household members of participating patients will be asked to participate in the trial as healthy subjects and are allocated to the same group as their peer. The primary study outcome for patients is the change in FCal level from baseline. The primary outcome for household members is the change in gut microbial composition, which is set as secondary outcome for patients.

ETHICS AND DISSEMINATION

The protocol has been approved by the Institutional Review Board of the Stichting Beoordeling Ethiek Biomedisch Onderzoek in Assen, the Netherlands. Written informed consent will be obtained from all participants. Results will be disseminated through peer-reviewed journals and conference presentations.

TRIAL REGISTRATION NUMBER

NCT04913467.

摘要

背景

饮食在克罗恩病(CD)的发病和进展中起着关键作用。营养干预措施显示出对肠道炎症和肠道微生物组成的影响。然而,缺乏精心设计和对照的饮食试验数据。因此,仍然无法为患者和医生提供基于证据的饮食建议。在这里,我们旨在研究一种基于证据的抗炎饮食和一种含有维生素 B、B 和 C 的回肠靶向胶囊(ColoVit)对 CD 患者及其健康家庭成员的影响。

方法和分析

在这项多中心、随机、安慰剂对照、部分盲法营养干预试验中,我们旨在招募 255 名基线 Harvey-Bradshaw 指数<8 和粪便钙卫蛋白(FCal)截断值≥100µg/g 的 CD 患者。参与者将被随机分为两个实验组和一个安慰剂组。在实验组中,参与者将遵循格罗宁根抗炎饮食(GrAID)或服用回肠靶向口服维生素 B/B/C 胶囊(ColoVit)。该研究包括 12 周的对照干预阶段,随后是 9 个月的观察随访阶段,在该阶段,分配给 GrAID 组的患者将被要求自行继续干预。参与患者的家庭成员将被要求作为健康受试者参与试验,并被分配到与他们的同龄人相同的组。患者的主要研究结果是 FCal 水平从基线的变化。家庭成员的主要结果是肠道微生物组成的变化,这是患者的次要结果。

伦理和传播

该方案已获得荷兰 Assen 生物医学研究伦理审查委员会的批准。将从所有参与者处获得书面知情同意。结果将通过同行评议的期刊和会议报告进行传播。

试验注册号

NCT04913467。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e4/10016306/c8b34e807da5/bmjopen-2022-069654f01.jpg

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