Biological Modulation of Bacterial QSSMs, Innate and Adaptive Immunity by Antibiotics, Probiotics and Prebiotics in Healthy Individuals
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Purpose
It has recently been discovered that bacteria are able to communicate using specialised molecules known as Quorum Sensing Signalling Molecules (QSSMs). An accumulation of QSSMs in their surrounding environment allow for the bacteria to quantify the size of colonies. At specific colony sizes the concentration of QSSMs reaches a critical threshold leading to the activation of genes that cause an infection. It is by this mechanism that bacteria within a colony coordinate behaviour to activate infectivity when colony sizes are large enough to withstand defensive measures from the host's immune system. A disruption of quorum sensing may reduce the severity of infection and this has led to the development of inhibitors of quorum sensing as a new strategy in antibacterial therapy.
QSSMs are also thought to facilitate infection by other mechanisms and are able to influence the number and function of a specific type of immune cell known as an 'antigen presenting cell'. These cells are pivotal in allowing the immune system to recognise components of bacteria as foreign and thereby mount the appropriate response. It was found that large numbers of these types of cells underwent programmed cell death (cell suicide) in the presence of QSSMs compared to when QSSMs were absent. This mirrors the situation in blood sampled from patients with severe infections where there is a greater proportion of cell deaths among antigen presenting cells than other types of immune cell.
This study aims to establish in healthy volunteers, the mechanisms by which QSSMs affect immune cells and facilitate the spread of infection. Antibiotic administration in humans can alter the environment of the intestine and can lead to an overgrowth of harmful bacteria to potentially cause an infection. Probiotics supplements can prevent bacterial overgrowth and potentially reduce infective complications. The mechanism, which we aim to clarify, may involve changes in both the production of QSSMs and the function of immune cells.
Hypothesis
- Antibiotic use alters gut flora, leading to the appearance in the systemic circulation of bacterial QSSMs and changes in immune function of the host.
- Probiotics and/or prebiotics have beneficial effects by preserving the normal resident gut flora, thereby, modulating bacterial QSSMs and preserving the immune function of the host.
Aims
The aims of our study are 2 fold:
- Firstly, to study the effect of orally administered antibiotic on QSSMs (in faeces and blood) and on innate and adaptive immunity in healthy humans.
- Secondly, to study the effect of orally administered combinations of prebiotic, probiotic and antibiotic on QSSMs (in faeces and blood) and on innate and adaptive immunity in healthy humans.
| Condition | Intervention | Phase |
|---|---|---|
|
Quorum Sensing Prebiotics Probiotics Sepsis |
Dietary Supplement: Bifidobacterium longum BB536 Dietary Supplement: Active hexose correlated compound (AHCC) Dietary Supplement: Bifidobacterium longum BB536 and Active hexose correlated compound (AHCC) Dietary Supplement: Corn starch placebo capsule Drug: Azithromycin |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Factorial Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Basic Science |
| Official Title: | Biological Modulation of Bacterial QSSMs, Innate and Adaptive Immunity by Antibiotics, Probiotics and Prebiotics in Healthy Individuals |
- Serum QSSM level [ Time Frame: 14 days ] [ Designated as safety issue: No ]
- T cell Th1/Th2 ratio [ Time Frame: 14 days ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 40 |
| Study Start Date: | October 2009 |
| Study Completion Date: | May 2011 |
| Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Placebo/Probiotic |
Dietary Supplement: Bifidobacterium longum BB536
2 capsules od
Drug: Azithromycin
250mg od
|
| Active Comparator: Placebo/Prebiotic |
Dietary Supplement: Active hexose correlated compound (AHCC)
One capsule tds
Drug: Azithromycin
250mg od
|
| Active Comparator: Prebiotic/Probiotic |
Dietary Supplement: Bifidobacterium longum BB536 and Active hexose correlated compound (AHCC)
One capsule tds (prebiotic) and two capsules od (probiotic)
Drug: Azithromycin
250mg od
|
| Placebo Comparator: Placebo/Placebo |
Dietary Supplement: Corn starch placebo capsule
One capsule tds and two capsules od
Drug: Azithromycin
250mg od
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Male volunteers
- Age 18-55 years
- Willing to participate and able to give informed consent
- Alcohol abstinence during study
Exclusion Criteria:
- Smokers/substance abusers
- Individuals with diabetes mellitus
- Oral/Intravenous steroids
- Allergy to azithromycin
- Individuals already taking regular medications/probiotics/nutritional supplements
- Individuals with chronic disease or currently under investigation
- Individuals with ≤3 bowel movements/week
- Individuals with ≥2 bowel movements/day
Contacts and Locations| United Kingdom | |
| University of Nottingham | |
| Nottingham, Nottinghamshire, United Kingdom, NG7 2UH | |
| Principal Investigator: | Abeed Chowdhury, MB ChB BSc MRCS | University of Nottingham |
| Study Director: | Dileep Lobo, MBBS DM FRCS | University of Nottingham |
More Information
No publications provided
| Responsible Party: | Dileep Lobob, University of Nottingham |
| ClinicalTrials.gov Identifier: | NCT01201577 History of Changes |
| Other Study ID Numbers: | 09GA014 |
| Study First Received: | September 13, 2010 |
| Last Updated: | May 31, 2011 |
| Health Authority: | United Kingdom: National Institute for Health Research |
Keywords provided by University of Nottingham:
|
Quorum sensing Prebiotics Probiotics Sepsis |
Additional relevant MeSH terms:
|
Sepsis Infection Systemic Inflammatory Response Syndrome Inflammation Pathologic Processes Anti-Bacterial Agents Azithromycin Sulfalene |
Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Anti-Infective Agents, Urinary Renal Agents Antimalarials Antiprotozoal Agents Antiparasitic Agents |
ClinicalTrials.gov processed this record on May 22, 2013