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PTM202 and Modulation of Host Resistance to Diarrheagenic E. Coli (APA12/PANTER)

Primary Purpose

Traveler's Diarrhea

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
E. coli strain E1392-75-2A
PTM202
Sponsored by
NIZO Food Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Traveler's Diarrhea focused on measuring Nutrition, Gastroenteritis, Traveler's diarrhea, E. coli

Eligibility Criteria

18 Years - 55 Years (Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  1. Male;
  2. Age between 18 and 55 years;
  3. BMI ≥18 and ≤27 kg/m2;
  4. Healthy as assessed by the NIZO food research medical questionnaire.
  5. Ability to follow verbal and written instructions;
  6. Availability of internet connection;
  7. Signed informed consent;
  8. Willing to accept disclosure of the financial benefit of participation in the study to the authorities concerned;
  9. Willing to accept use of all encoded data, including publication, and the confidential use and storage of all data for at least 15 years;
  10. Willing to comply with study procedures, including collection of stool samples;
  11. Willingness to abstain from high calcium containing products;
  12. Willingness to abstain from alcoholic beverages three days before, during and for four days after diarrheagenic E. coli challenge;
  13. Willingness to abstain from antibiotics, norit, laxatives, nonsteroidal anti-inflammatory drugs (OTC), opiates, antacids, proton pump inhibitors, and antimotility agents (e.g., loperamide) on the three days before, during and for four days after diarrheagenic E. coli challenge.
  14. Willingness to abstain from probiotics three days before, during and for four days after diarrheagenic E. coli challenge;
  15. Willingness to give up blood donation starting 1 month prior to study start and during the entire study;

Exclusion Criteria:

  1. Any confirmed or suspected immunosuppressive or immunodeficient condition including human immunodeficiency virus infection (HIV);
  2. Disease of the GI tract, liver, bile bladder, kidney, thyroid gland (self-reported);
  3. Diarrheagenic E. coli strain (as used in the study) detected in fecal sample at screening;
  4. Evidence of current excessive alcohol consumption or non-therapeutic drug (ab)use);
  5. High titer serum antibodies against CFA-II diarrheagenic E. coli strain (as used in the study) at screening;
  6. History of microbiologically confirmed ETEC or cholera infection in last 3 years;
  7. Known allergy to the following antibiotics: ciprofloxacin, trimethoprim-sulfamethoxazole, and penicillins;
  8. Known allergy to soy, milk- and/or egg;
  9. Mental status that is incompatible with the proper conduct of the study;
  10. Occupation involving handling of ETEC or Vibrio cholerae currently, or in the past 3 years;
  11. Reported average stool frequency of <1 or >3 per day;
  12. Symptoms consistent with Travelers' Diarrhea concurrent with travel to countries where ETEC infection is endemic (most of the developing world) within 3 years prior to dosing, OR planned travel to endemic countries during the length of the study;
  13. Use of antibiotics, norit, laxatives (up till 6 months prior to inclusion), cholesterol lowering agents, antacids, proton pump inhibitors and immune suppressive agents (up till 3 months prior to inclusion);
  14. Vaccination for or ingestion of ETEC, cholera, or E coli heat labile toxin within 3 years prior to inclusion;
  15. Vegans.

Sites / Locations

  • NIZO

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

PTM202

Arm Description

The placebo will consist of low-lactose isonitrogenous soy product, and will be matched in appearance and flavour to PTM202. After an overnight fast, subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli (strain E1392-75-2A; collection NIZO food research; dose 1E10 CFU (at study day 14).

PTM202 is a dry powder for reconstitution, comprised of a proprietary mixture of dried bovine colostrum and dried whole egg. After an overnight fast, subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli (strain E1392-75-2A; collection NIZO food research; dose 1E10 CFU (at study day 14).

Outcomes

Primary Outcome Measures

Stool consistency
Change in stool consistency score (questionnaire) before and after E. coli challenge
Relative fecal wet weight
Change in relative fecal wet weight (freeze-drying) before and after E. coli challenge

Secondary Outcome Measures

Stool frequency
Change in stool frequency (questionnaire) before and after E. coli challenge
Total fecal wet weight
Change in total fecal wet weight (wet weight measurement) before and after E. coli challenge
Gastro-intestinal symptoms
Change in gastro-intestinal symptoms (questionnaire) before and after E. coli challenge

Full Information

First Posted
September 15, 2017
Last Updated
July 17, 2018
Sponsor
NIZO Food Research
Collaborators
PanTheryx, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03301103
Brief Title
PTM202 and Modulation of Host Resistance to Diarrheagenic E. Coli
Acronym
APA12/PANTER
Official Title
PTM202 and Modulation of Host Resistance to Diarrheagenic Escherichia Coli in a Randomized, Double-blind, Placebo Controlled Study in Healthy Human Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
December 7, 2017 (Actual)
Primary Completion Date
January 23, 2018 (Actual)
Study Completion Date
March 16, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NIZO Food Research
Collaborators
PanTheryx, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The APA12/PANTER study is a parallel 3-weeks intervention study. Subjects will be randomly assigned to one of two treatment groups; placebo or PTM202 (n=36 per group). After an overnight fast, subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli at study day 14. At various time points before and after diarrheagenic E. coli challenge an online diary will be kept to record information on stool consistency, frequency and severity of symptoms and stool samples will be collected to determine total fecal wet weight and percentage of fecal wet weight.
Detailed Description
The APA12/PANTER study is a randomized, double-blind, placebo-controlled, parallel intervention study of 3 weeks in 72 healthy adults. The study will include 2 arms; PTM202 and placebo. Subjects will be instructed to maintain their usual pattern of physical activity and their habitual food intake, but to standardize their dietary calcium intake. After an overnight fast, subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli (strain E1392-75-2A; collection NIZO food research; dose 1E10 CFU (at study day 14). At study day 14, 15 and 16 subjects will receive either placebo or PTM202, a dietary formula containing dried bovine colostrum and dried whole egg. Before and after the diarrheagenic E. coli challenge an online diary will be kept to record information on stool consistency, frequency, severity of symptoms and mediation intake. At various time points before and after diarrheagenic E. coli challenge stool samples will be collected. The main study parameters are Stool consistency (Bristol Stool Scale reported by the subjects in the online diary, and Percentage of fecal wet weight (% determined by freeze-drying). Secondary study parameters are: Stool frequency (Stools per day reported by the subjects in the online diary), Total fecal wet weight (fecal weight in g/day), and the incidence and severity of Gastro-intestinal symptoms (Gastro-intestinal Symptom Rating Scale reported by the subjects in the online diary).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Traveler's Diarrhea
Keywords
Nutrition, Gastroenteritis, Traveler's diarrhea, E. coli

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
The APA12/PANTER study is a randomized, double-blind, placebo-controlled, parallel intervention study of 3 weeks in 72 healthy adults. Subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli (strain E1392-75-2A; collection NIZO food research; dose 1E10 CFU (at study day 14). At study day 14, 15 and 16 subjects will receive either placebo or PTM202, a dietary formula containing dried bovine colostrum and dried whole egg.
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
All researchers of the project team will be kept blind to assignment of treatment, and so will be the study subjects.The placebo will be matched in appearance and flavour to PTM202.
Allocation
Randomized
Enrollment
72 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
The placebo will consist of low-lactose isonitrogenous soy product, and will be matched in appearance and flavour to PTM202. After an overnight fast, subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli (strain E1392-75-2A; collection NIZO food research; dose 1E10 CFU (at study day 14).
Arm Title
PTM202
Arm Type
Experimental
Arm Description
PTM202 is a dry powder for reconstitution, comprised of a proprietary mixture of dried bovine colostrum and dried whole egg. After an overnight fast, subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli (strain E1392-75-2A; collection NIZO food research; dose 1E10 CFU (at study day 14).
Intervention Type
Biological
Intervention Name(s)
E. coli strain E1392-75-2A
Intervention Description
After an overnight fast, subjects will be orally infected with a live, but attenuated, diarrheagenic E. coli (strain E1392-75-2A; collection NIZO food research; dose 1E10 CFU (at study day 14).
Intervention Type
Device
Intervention Name(s)
PTM202
Intervention Description
PTM202 is a dietary formula containing a proprietary mixture of dried bovine colostrum and dried whole egg.
Primary Outcome Measure Information:
Title
Stool consistency
Description
Change in stool consistency score (questionnaire) before and after E. coli challenge
Time Frame
Before challenge (Day 11-13), After challenge (Day 14-18)
Title
Relative fecal wet weight
Description
Change in relative fecal wet weight (freeze-drying) before and after E. coli challenge
Time Frame
Before challenge (Day 11-13), After challenge (Day 14-18)
Secondary Outcome Measure Information:
Title
Stool frequency
Description
Change in stool frequency (questionnaire) before and after E. coli challenge
Time Frame
Before challenge (Day 11-13), After challenge (Day 14-18)
Title
Total fecal wet weight
Description
Change in total fecal wet weight (wet weight measurement) before and after E. coli challenge
Time Frame
Before challenge (Day 11-13), After challenge (Day 14-18)
Title
Gastro-intestinal symptoms
Description
Change in gastro-intestinal symptoms (questionnaire) before and after E. coli challenge
Time Frame
Before challenge (Day 11-13), After challenge (Day 14-18)

10. Eligibility

Sex
Male
Gender Based
Yes
Gender Eligibility Description
Gender identity is self-reported by the subjects through a questionnaire.
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male; Age between 18 and 55 years; BMI ≥18 and ≤27 kg/m2; Healthy as assessed by the NIZO food research medical questionnaire. Ability to follow verbal and written instructions; Availability of internet connection; Signed informed consent; Willing to accept disclosure of the financial benefit of participation in the study to the authorities concerned; Willing to accept use of all encoded data, including publication, and the confidential use and storage of all data for at least 15 years; Willing to comply with study procedures, including collection of stool samples; Willingness to abstain from high calcium containing products; Willingness to abstain from alcoholic beverages three days before, during and for four days after diarrheagenic E. coli challenge; Willingness to abstain from antibiotics, norit, laxatives, nonsteroidal anti-inflammatory drugs (OTC), opiates, antacids, proton pump inhibitors, and antimotility agents (e.g., loperamide) on the three days before, during and for four days after diarrheagenic E. coli challenge. Willingness to abstain from probiotics three days before, during and for four days after diarrheagenic E. coli challenge; Willingness to give up blood donation starting 1 month prior to study start and during the entire study; Exclusion Criteria: Any confirmed or suspected immunosuppressive or immunodeficient condition including human immunodeficiency virus infection (HIV); Disease of the GI tract, liver, bile bladder, kidney, thyroid gland (self-reported); Diarrheagenic E. coli strain (as used in the study) detected in fecal sample at screening; Evidence of current excessive alcohol consumption or non-therapeutic drug (ab)use); High titer serum antibodies against CFA-II diarrheagenic E. coli strain (as used in the study) at screening; History of microbiologically confirmed ETEC or cholera infection in last 3 years; Known allergy to the following antibiotics: ciprofloxacin, trimethoprim-sulfamethoxazole, and penicillins; Known allergy to soy, milk- and/or egg; Mental status that is incompatible with the proper conduct of the study; Occupation involving handling of ETEC or Vibrio cholerae currently, or in the past 3 years; Reported average stool frequency of <1 or >3 per day; Symptoms consistent with Travelers' Diarrhea concurrent with travel to countries where ETEC infection is endemic (most of the developing world) within 3 years prior to dosing, OR planned travel to endemic countries during the length of the study; Use of antibiotics, norit, laxatives (up till 6 months prior to inclusion), cholesterol lowering agents, antacids, proton pump inhibitors and immune suppressive agents (up till 3 months prior to inclusion); Vaccination for or ingestion of ETEC, cholera, or E coli heat labile toxin within 3 years prior to inclusion; Vegans.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Van Schaik
Organizational Affiliation
NIZO Food Research
Official's Role
Study Director
Facility Information:
Facility Name
NIZO
City
Ede
State/Province
Gelderland
ZIP/Postal Code
6718ZB
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No

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PTM202 and Modulation of Host Resistance to Diarrheagenic E. Coli

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