This study evaluates the effect of antioxidant docosahexaenoic acid (DHA) in patients with cystic fibrosis. Half of participants will receive DHA, while the other half will receive placebo.
Several studies show that patients with cystic fibrosis (CF) usually have, compared to the normal population, low levels of linoleic acid (LA) and docosahexaenoic acid (DHA) and increase in arachidonic acid (AA), which is pro-inflammatory. Normalization or modification of this fatty acid pattern (AP) could reduce chronic inflammation. The aim of this study is to assess the effect of oral supplementation with DHA for one year in pediatric patients (6-18 years) with CF, on inflammatory parameters, AP profile, lung function (spirometry) and number of exacerbations.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
22
Pearls of DHA (BrudyNen)
Pearls manufactured to mimic DHA (BrudyNen).
Parc Tauli Hospital
Sabadell, Barcelona, Spain
Change from Baseline Fatty Acid (FA) profile (percentage) of the erythrocyte membrane at 6 and 12 months
After blood sampling, erythrocytes are separated from the plasma by centrifugation (2500 rpm for 15 min) and stored at -80ºC until analysed. The fatty acids composition are analyzed by gas chromatography. Fatty acid composition (SFA (saturated FA), MUFA (monoinsatured FA), PUFAs N-6 (polyunsaturated FA omega-6) and PUFAS N-3) are mesured as percentage of total fats.
Time frame: baseline, 6 month and 12 month of treatment (end of study)
Change from Baseline Serum interleukins at 12 months
Serum are obtained by centrifugation of blood samples and frozen at -80ºC until testing. Interleukins (IL)-1 β, IL-6, IL-8 and tumor necrosis factor (TNF)-α (pg/ml) are analized in serum by enzyme-linked immunosorbent assay (ELISA kits).
Time frame: baseline and 12 month of treatment (end of study)
Change from baseline pulmonary function at 3,6 ,9 and 12 months
Forced expiratory volume in 1 second (FEV1) , forced vital capacity (FVC) and 25-75% of the forced vital capacity (FEF25-75%) were mesured using spirometry, calibrated daily according to standardized techniques. The results are expressed as the mean value of the percentage of predicted values according to height and sex and litres (L)
Time frame: baseline, 3 months, 6 month, 9 months and 12 month of treatment (end of study)
Number of Pulmonary exacerbation during the study year compared with previous years
The investigators will report the number of pulmonary exacerbations during the previous year and the year of the study. To calculate the number of exacerbations, the medical records of the patients will be reviewed.
Time frame: 12 months prior study, 12 months of the study
Change from baseline fecal calprotectin at the 12 months
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Calprotectin was measured in fecal samples of the participants.
Time frame: Baseline and 12 months
Adverse reactions during the study
Frequency of occurrence of adverse events related to the study treatment: diarrhea, steatorrhea, abdominal pain, nausea, vomiting, gastroesophageal reflux, fishy taste or hemorrhage.
Time frame: baseline, 3, 6 , 9 and 12 month of treatment (end of study)
Change from Baseline Esputum interleukins at 6 and 12 months
Supernatant induced sputum were frozen at -80ºC until testing. Induced sputum Interleukins (IL)-1 β, IL-6, IL-8 and tumor necrosis factor (TNF)-α (pg/ml) were analized by enzyme-linked immunosorbent assay (ELISA kits).
Time frame: baseline and 12 months
Change from baseline differencial cell counts in sputum at 6 and 12 months.
An equal volume of sterile dithiothreitol (DTT), freshly diluted to 10% by the addition of sterile saline, was added to the sputum. This step was performed under a Bio-safety hood using sterile technique. The samples were then incubated in a shaking water bath at 37° C for 5-10 min, and gently mixed using a transfer pipette at 5-min intervals. The weight of the remaining sputum mixture was measured, and a further three times the volume of both DTT and phosphate-buffered saline (Dulbecco's; Gibco BRL, Grand Island, NY) were added. The mixture was incubated once again in the 37° C shaking water bath for another 5-10 min to ensure complete homogenization. Ten microliters of the homogenized sputum samples, mixed with Trypan Blue stain, was used to calculate total cell counts, using a standard hemacytometer. A further 0.25-0.50 ml of both samples was used to prepare cytospin slides for differential cell counts.
Time frame: baseline, 6 months and 12 monts
Change from baseline weight at 3, 6, 9 and 12 months
Weight in kilograms (kg) were measured every 3 months. Subjects dressed only in light underwear and shoeless.
Time frame: Baseline, 3,6,9 and 12 months
Change from baseline height at 3, 6, 9 and 12 months
Height was measured with a standardised statdiometer every 3months
Time frame: Baseline, 3,6,9 and 12 months
Change from baseline body mass index (BMI) at 3, 6, 9 and 12 months
BMI was calculate every 3 months.
Time frame: Baseline, 3,6,9 and 12 months
Change from Baseline FA ratios of the erythrocyte membrane at 6 and 12 months
The next fatty acids (FA) ratios were calculated: Arachidonic acid /eicosapentaenoic acid (ARA/EPA) Arachidonic acid/ docosahexaenoic acid (ARA/DHA) N-3 PUFAS/ALA ( α-linolenic acid) N-6 PUFAS/LA (linoleic acid)
Time frame: baseline, 6 months and 12 months