The primary purpose of this randomized, double-blinded, placebo-controlled, crossover clinical trial is to evaluate the efficacy of dietary supplementation with Bifidobacterium infantis NLS super strain among celiac disease patients on a gluten-free who have persistent gastrointestinal symptoms.
Most patients with celiac disease demonstrate substantial clinical improvement during the first few weeks after the onset of the consumption of a gluten-free diet. However, between 30-50% of patients with celiac disease have persistent gastrointestinal symptoms despite consuming a gluten-free diet and presenting negative antibodies. It has recently been reported that celiac disease patients treated with a gluten-free diet that still have persistent symptoms possess different intestinal microbiota patterns than patients without persistent symptoms. Furthermore, a pilot study showed that dietary supplementation with probiotics (Bifidobacterium infantis NLS super strain - Natren LIFESTART®) in untreated celiac disease patients was associated with a significant improvement in symptoms as compared to placebo. Collectively, these findings contribute to the hypothesis that celiac disease patients on a gluten-free diet in whom gastrointestinal symptoms persist may benefit from the supplementation of Bifidobacterium infantis NLS super strain. Participants in this double-blinded crossover trial will be randomized to receive either placebo or Bifidobacterium infantis NLS super strain for 3 weeks, followed by a 2 week washout period, and then followed by 3 weeks of the other of either placebo or probiotic supplementation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
18
2 capsules, 3 times per day, for daily total of 12x10\^9 CFU Bifidobacterium infantis NLS super strain
2 capsules, 3 times per day, containing rice flour, hydroxypropyl and methylcellulose
Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital
Buenos Aires, Argentina
Changes in Gastrointestinal Symptom Rating Scale (GSRS)
Time frame: Baseline, End of Period I (3 weeks), End of Period II (8 weeks)
Changes in Celiac Symptoms Index (CSI)
Time frame: Baseline, End of Period I (3 weeks), End of Period II (8 weeks)
Changes in Quality of Life: SF-36
Time frame: Baseline, End of Period I (3 weeks), End of Period II (8 weeks)
Changes in gut microbiota
16S rRNA Illumina based sequencing
Time frame: Baseline, End of Period I (3 weeks), End of Period II (8 weeks)
Changes in Gluten Immunogenic Peptides (GIP)
Time frame: Baseline, End of Period I (3 weeks), End of Period II (8 weeks)
Changes in serology (IgA tTG & IgA DGP)
Time frame: Baseline, End of Period I (3 weeks), End of Period II (8 weeks)
Changes in anthropometric measurements (BMI)
Time frame: Baseline, End of Period I (3 weeks), End of Period II (8 weeks)
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