This is a randomized controlled trial to explore the efficacy and safety of washed microbiota transplantation (WMT) for diabetic gastroparesis (DGP) patients.
At least 44 subjects who meet all the inclusion criteria but do not meet any exclusion criteria will be enrolled in this study. Data of demographic characteristics, Gastroparesis Cardinal Symptom Index (GCSI), Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM), Gastroparesis Core Symptom Daily Diary (GCS-DD), Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QoL), and clinical outcomes will be collected. After treatment, they will enter the follow-up period for efficacy and safety evaluation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
46
Washed microbiota transplantation refers to the infusion of washed microbiota from healthy donor into patients' gastrointestinal tract. Participants will receive two doses of WMT for DGP.
A carrier fluid with matching volume and consistent appearance to the infusion of washed microbiota.
Department of Microbiota Medicine & Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China
RECRUITINGThe proportion of DGP with symptom relief after the procedure.
Detailed evaluation content of efficacy rate of symptom: Symptom relief is defined as a decrease of at least 50% in the total Gastroparesis Cardinal Symptom Index (GCSI).
Time frame: Four-week post-WMT
The extent of change observed in GCSI of participants;
The GCSI consists of nine items and three subscales to measure symptoms related to gastroparesis. The nausea/vomiting subscale consists of the following three items: nausea, retching, and vomiting. The postprandial fullness/early satiety subscale consists of the following four items: stomach fullness, inability to finish a normal-sized meal, feeling excessively full after meals, and loss of appetite.
Time frame: One-week, Two-week and Eight-week post-WMT
The extent of change observed in Gastroparesis Core Symptom Daily Diary (GCS-DD) of participants;
GCS-DD consists of 13 items for evaluating the core symptom for past 24 hours.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT
The extent of change observed in Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) of participants;
Questionnaire was developed to measure specific symptoms of patients with upper gastrointestinal disorders. It records 20 symptoms (6 subscales) and assesses their severity within the 2 weeks prior to the test. Subscale scores are calculated by averaging across items comprising the subscale; scores vary from 0 (none or absent) to 5 (very severe). The PAGI-SYM subscale scores have good internal consistency and test-retest reliability.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT
The extent of change observed in Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QoL) of participants;
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The PAGI-QoL contains 30 items with five subscales: (1) daily activities (1-10); (2) clothing (11-12); (3) diet/food habits (13-19); (4) relationship (20-22); (5) psychological well-being and distress (23-30). Subscale scores are calculated by averaging the item responses.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT
The extent of change observed in electrogastrogram (EGG) of participants;
The frequency of gastric electric waves will be evaluated by EGG.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT
The extent of change observed in electrogastrogram (EGG) of participants;
The amplitude of gastric electric waves will be evaluated by EGG.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT
The extent of change observed in gastrointestinal ultrasound (GIUS) of participants;
The half gastric emptying time will be evaluated by GIUS.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT
The incidence rate of adverse events;
The number of adverse reactions reported by subjects in the WMT group from the start of treatment to the end of follow-up, divided by the total number of WMT treatments.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT
The changes in gut microbiota composition and metabolites before and after treatment.
The 16s-RNA or meta-analysis of gut microbiota will be used.
Time frame: One-week, Two-week, Four-week and Eight-week post-WMT