Crohn's Disease - Inflammation and Microbial Proteolytic Activity

NCT ID: NCT06503081

Last Updated: 2025-08-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-12-01

Study Completion Date

2025-02-20

Brief Summary

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This study postulates that altered microbiota associated with areas of mucosal inflammation in CD, can be characterized by an increased proteolytic profile. This is clinically important as it may be possible to modulate the proteolytic activity of the CD-associated bacteria by using other bacteria that produce protease inhibitors, such as serpins.

Detailed Description

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Crohn's disease (CD), characterized by discontinuous intestinal injury and inflammation, has been associated with changes in the luminal microbiota and impaired barrier function. Previously, the investigators have shown that in patients with CD, the mucosa-associated microbiota is altered. Additionally, it has been shown that in patients with active CD, areas of intestinal injury are associated with impaired barrier function, but the mechanisms remain unclear. Increased host proteolytic activity has been reported in both CD and ulcerative colitis (UC). The microbiota is an important source of proteases with potential inflammatory and barrier disrupting capacity. Indeed, preliminary data indicate that in UC patients the gut microbiota contributes to proteolytic imbalance. It is unknown whether this is also the case in CD. Specifically, this study postulates that the altered microbiota associated with areas of mucosal inflammation in CD, is characterized by an increased proteolytic profile. This is clinically important as it may be possible to modulate the proteolytic activity of the CD-associated bacteria by using other bacteria that produce protease inhibitors such as serpins.

In this prospective observational study, patients booked for routine white light colonoscopy under the care of the Division of Gastroenterology, Hamilton Health Sciences at the McMaster University Medical Centre and Juravinski Hospital Endoscopy Units will be invited to participate. Patients previously diagnosed with Crohn's disease who have a clinical indication for undergoing a standard white light colonoscopy, as determined by the gastroenterologist, will be invited to participate; biopsy samples and mucosal brushings will be taken from inflamed and non-inflamed areas in the ileum or colon.

Conditions

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Crohn's Disease of Both Small and Large Intestine

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Crohn's disease

Patients previously diagnosed with Crohn's disease who have a clinical indication for undergoing a standard white light colonoscopy, as determined by their gastroenterologist, will be invited to participate. Patients undergoing colonoscopy for other indications (for example, for the investigation of possible malignancy, polyps, gastrointestinal bleeding or diarrhea, without colonic inflammation), will not be included in this study.

Colonoscopy

Intervention Type PROCEDURE

Colonoscopy with video recording and biopsy collection

Interventions

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Colonoscopy

Colonoscopy with video recording and biopsy collection

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Be aged between 18 - 70 years old
* Have a confirmed diagnosis of Crohn's disease
* Have a clinical indication for standard, white light colonoscopy to assess disease activity and extent

Exclusion Criteria

* Inability to provide written informed consent
* Presence of serious life-threatening co-morbidities
* Evidence of toxic megacolon, jaundice, cirrhosis, renal dysfunction, acute GI bleeding
* History of difficult colonoscopy, strictures or extensive diverticulosis
* Antibiotics in the last month
* Probiotics in the last week
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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McMaster University

OTHER

Sponsor Role lead

Responsible Party

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David Armstrong

Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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McMaster University

Hamilton, Ontario, Canada

Site Status

Countries

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Canada

References

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Xavier RJ, Podolsky DK. Unravelling the pathogenesis of inflammatory bowel disease. Nature. 2007 Jul 26;448(7152):427-34. doi: 10.1038/nature06005.

Reference Type BACKGROUND
PMID: 17653185 (View on PubMed)

Bouma G, Strober W. The immunological and genetic basis of inflammatory bowel disease. Nat Rev Immunol. 2003 Jul;3(7):521-33. doi: 10.1038/nri1132.

Reference Type BACKGROUND
PMID: 12876555 (View on PubMed)

Libertucci J, Dutta U, Kaur S, Jury J, Rossi L, Fontes ME, Shajib MS, Khan WI, Surette MG, Verdu EF, Armstrong D. Inflammation-related differences in mucosa-associated microbiota and intestinal barrier function in colonic Crohn's disease. Am J Physiol Gastrointest Liver Physiol. 2018 Sep 1;315(3):G420-G431. doi: 10.1152/ajpgi.00411.2017. Epub 2018 May 31.

Reference Type BACKGROUND
PMID: 29848021 (View on PubMed)

Denadai-Souza A, Bonnart C, Tapias NS, Marcellin M, Gilmore B, Alric L, Bonnet D, Burlet-Schiltz O, Hollenberg MD, Vergnolle N, Deraison C. Functional Proteomic Profiling of Secreted Serine Proteases in Health and Inflammatory Bowel Disease. Sci Rep. 2018 May 18;8(1):7834. doi: 10.1038/s41598-018-26282-y.

Reference Type BACKGROUND
PMID: 29777136 (View on PubMed)

Vergnolle N. Protease inhibition as new therapeutic strategy for GI diseases. Gut. 2016 Jul;65(7):1215-24. doi: 10.1136/gutjnl-2015-309147. Epub 2016 Apr 12.

Reference Type BACKGROUND
PMID: 27196587 (View on PubMed)

Motta JP, Magne L, Descamps D, Rolland C, Squarzoni-Dale C, Rousset P, Martin L, Cenac N, Balloy V, Huerre M, Frohlich LF, Jenne D, Wartelle J, Belaaouaj A, Mas E, Vinel JP, Alric L, Chignard M, Vergnolle N, Sallenave JM. Modifying the protease, antiprotease pattern by elafin overexpression protects mice from colitis. Gastroenterology. 2011 Apr;140(4):1272-82. doi: 10.1053/j.gastro.2010.12.050. Epub 2011 Jan 1.

Reference Type BACKGROUND
PMID: 21199654 (View on PubMed)

Caminero A, McCarville JL, Galipeau HJ, Deraison C, Bernier SP, Constante M, Rolland C, Meisel M, Murray JA, Yu XB, Alaedini A, Coombes BK, Bercik P, Southward CM, Ruf W, Jabri B, Chirdo FG, Casqueiro J, Surette MG, Vergnolle N, Verdu EF. Duodenal bacterial proteolytic activity determines sensitivity to dietary antigen through protease-activated receptor-2. Nat Commun. 2019 Mar 13;10(1):1198. doi: 10.1038/s41467-019-09037-9.

Reference Type BACKGROUND
PMID: 30867416 (View on PubMed)

Other Identifiers

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HiREB-7789

Identifier Type: -

Identifier Source: org_study_id

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