Mode of Action of Butyrate in the Human Colon
Primary Purpose
Irritable Bowel Syndrome (IBS), Healthy
Status
Completed
Phase
Not Applicable
Locations
Sweden
Study Type
Interventional
Intervention
Sodium butyrate bolus
Sponsored by
About this trial
This is an interventional basic science trial for Irritable Bowel Syndrome (IBS)
Eligibility Criteria
Inclusion Criteria:
- signed informed consent
- Fulfilled Rome IV diagnostic criteria for IBS (for IBS participants)
Exclusion Criteria:
- known gastrointestinal diseases
- previous complicated gastrointestinal surgery (including e.g. appendectomy or cholecystectomy)
- pregnancy or breast-feeding
- use of antibiotics within the last 12 weeks before the colonoscopy procedure
- regular consumption of probiotics within the last 4 weeks before the colonoscopy procedure
- use of laxatives or anti-diarrhoeals within the last 4 weeks before the colonoscopy procedure
- use of serotonin selective re-uptake inhibitors (SSRI) or serotonin nor-epinephrine re-uptake inhibitors (SNRI) with the last 12 weeks before the colonoscopy procedure
- alcohol or drug abuse
- latex allergy
- any other clinically significant disease/condition which in the investigator's opinion could interfere with the results of the study.
Sites / Locations
- University Hospital Örebro
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Irritable Bowel Syndrome (IBS) participants
Healthy participants
Arm Description
100 mM sodium butyrate solution containing indigo carmine as a dye agent will be administered to subjects in this arm.
100 mM sodium butyrate solution containing indigo carmine as a dye agent will be administered to subjects in this arm.
Outcomes
Primary Outcome Measures
Colonic permeability ex vivo in Ussing chambers
Difference in the translocation of FITC-labeled dextran and horseradish peroxidase between the study arms before and after exposure to the butyrate bolus
Secondary Outcome Measures
Butyrate uptake ex vivo in Ussing chambers
Difference in the uptake of C14-labelled butyrate between the study arms before and after exposure to the butyrate bolus
Regulation of gene expression
Difference in the genome-wide transcriptional response to an increase of butyrate in the descending colon between the study arms before and after exposure to the butyrate bolus
Concentrations of blood glucagon like peptide-1 (GLP-1)
Difference in blood levels of GLP-1 between the study arms before and after exposure to the butyrate bolus
Concentrations of blood glucagon like peptide-2 (GLP-2)
Difference in blood levels of GLP-2 between the study arms before and after exposure to the butyrate bolus
Concentrations of blood peptide YY (PYY)
Difference in blood levels of PYY between the study arms before and after exposure to the butyrate bolus
Concentrations of blood gastric inhibitory polypeptide (GIP)
Difference in blood levels of GIP between the study arms before and after exposure to the butyrate bolus
Concentrations of blood insulin
Difference in blood levels of insulin between the study arms before and after exposure to the butyrate bolus
Concentrations of blood glucagon
Difference in blood levels of glucagon between the study arms before and after exposure to the butyrate bolus
Concentrations of blood leptin
Difference in blood levels of leptin between the study arms before and after exposure to the butyrate bolus
Concentrations of blood glucose
Difference in blood levels of glucose between the study arms before and after exposure to the butyrate bolus
Concentrations of blood serotonin
Difference in blood levels of serotonin between the study arms before and after exposure to the butyrate bolus
Concentrations of blood metabolites in the gluconeogenic pathway
Difference in blood levels of metabolites in the gluconeogenic pathway between the study arms before and after exposure to the butyrate bolus
Concentrations of blood butyrate
Difference in blood levels of butyrate between the study arms before and after exposure to the butyrate bolus
Full Information
NCT ID
NCT05249023
First Posted
March 23, 2021
Last Updated
February 10, 2022
Sponsor
Örebro University, Sweden
1. Study Identification
Unique Protocol Identification Number
NCT05249023
Brief Title
Mode of Action of Butyrate in the Human Colon
Official Title
Mode of Action of Butyrate in the Human Colon
Study Type
Interventional
2. Study Status
Record Verification Date
February 2022
Overall Recruitment Status
Completed
Study Start Date
April 11, 2018 (Actual)
Primary Completion Date
February 19, 2021 (Actual)
Study Completion Date
February 19, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Örebro University, Sweden
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Butyrate has recently gained attention as an important microbial compound in human colon health. Several diseases, including Irritable Bowel Syndrome (IBS), have been linked with a loss of butyrate in the colon resulting in the hypothesis that butyrate is important for disease resistance. However, despite a plethora of preclinical evidence about butyrate's role in colon health, data from human studies are insufficient, largely due to the lack of available tools for colon-specific butyrate delivery and sampling. This project will elucidate butyrate's mode of action in the human colon and its implications for gut functioning in IBS and healthy participants by employing a unique in vivo human setting. Specifically, the regulatory capacity of butyrate on intestinal barrier function and the transcriptional host responses that are associated with an increase of butyrate in the colon will be determined. Moreover, butyrate's role as a signalling molecule for gut hormones and serotonin release will be studied.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Irritable Bowel Syndrome (IBS), Healthy
7. Study Design
Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
37 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Irritable Bowel Syndrome (IBS) participants
Arm Type
Experimental
Arm Description
100 mM sodium butyrate solution containing indigo carmine as a dye agent will be administered to subjects in this arm.
Arm Title
Healthy participants
Arm Type
Experimental
Arm Description
100 mM sodium butyrate solution containing indigo carmine as a dye agent will be administered to subjects in this arm.
Intervention Type
Other
Intervention Name(s)
Sodium butyrate bolus
Intervention Description
On the test day participants suffering from IBS and healthy participants will undergo a distal colonoscopy procedure for the collection of mucosal biopsy specimens pre- and post-administration of a sodium butyrate solution (100 mM) at a selected area in the descending colon. Biopsies will be obtained from the colon pre- and 90 min post-administration of the intervention solution. Blood samples will be collected before and at six time-points after the intervention solution administration.
Primary Outcome Measure Information:
Title
Colonic permeability ex vivo in Ussing chambers
Description
Difference in the translocation of FITC-labeled dextran and horseradish peroxidase between the study arms before and after exposure to the butyrate bolus
Time Frame
Mucosal biopsies collected pre- and 90 min post-administration of the butyrate solution
Secondary Outcome Measure Information:
Title
Butyrate uptake ex vivo in Ussing chambers
Description
Difference in the uptake of C14-labelled butyrate between the study arms before and after exposure to the butyrate bolus
Time Frame
Mucosal biopsies collected pre- and 90 min post-administration of the butyrate solution
Title
Regulation of gene expression
Description
Difference in the genome-wide transcriptional response to an increase of butyrate in the descending colon between the study arms before and after exposure to the butyrate bolus
Time Frame
Mucosal biopsies collected pre- and 90 min post-administration of the butyrate solution
Title
Concentrations of blood glucagon like peptide-1 (GLP-1)
Description
Difference in blood levels of GLP-1 between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood glucagon like peptide-2 (GLP-2)
Description
Difference in blood levels of GLP-2 between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood peptide YY (PYY)
Description
Difference in blood levels of PYY between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood gastric inhibitory polypeptide (GIP)
Description
Difference in blood levels of GIP between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood insulin
Description
Difference in blood levels of insulin between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood glucagon
Description
Difference in blood levels of glucagon between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood leptin
Description
Difference in blood levels of leptin between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood glucose
Description
Difference in blood levels of glucose between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood serotonin
Description
Difference in blood levels of serotonin between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood metabolites in the gluconeogenic pathway
Description
Difference in blood levels of metabolites in the gluconeogenic pathway between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Title
Concentrations of blood butyrate
Description
Difference in blood levels of butyrate between the study arms before and after exposure to the butyrate bolus
Time Frame
Blood samples collected before (0 min) and at six timepoints after the butyrate solution administration (5, 15, 30, 45, 60 and 90 min).
Other Pre-specified Outcome Measures:
Title
Gastrointestinal symptoms measured by Gastrointestinal Symptom Rating Scale-IBS
Description
Difference in the frequency and severity of gastrointestinal symptoms between the study arms before and after the exposure to the butyrate bolus (13 items that measure the severity of IBS symptoms in five clusters (pain, bloating, constipation, diarrhea, and early satiety).
Time Frame
1 week
Title
Food habits measured by an electronic food frequency questionnaire Mealq
Description
Survey of participants food habits prior the exposure to the butyrate bolus.
Time Frame
1 week
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
signed informed consent
Fulfilled Rome IV diagnostic criteria for IBS (for IBS participants)
Exclusion Criteria:
known gastrointestinal diseases
previous complicated gastrointestinal surgery (including e.g. appendectomy or cholecystectomy)
pregnancy or breast-feeding
use of antibiotics within the last 12 weeks before the colonoscopy procedure
regular consumption of probiotics within the last 4 weeks before the colonoscopy procedure
use of laxatives or anti-diarrhoeals within the last 4 weeks before the colonoscopy procedure
use of serotonin selective re-uptake inhibitors (SSRI) or serotonin nor-epinephrine re-uptake inhibitors (SNRI) with the last 12 weeks before the colonoscopy procedure
alcohol or drug abuse
latex allergy
any other clinically significant disease/condition which in the investigator's opinion could interfere with the results of the study.
Facility Information:
Facility Name
University Hospital Örebro
City
Örebro
State/Province
Örebro County
ZIP/Postal Code
70185
Country
Sweden
12. IPD Sharing Statement
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Mode of Action of Butyrate in the Human Colon
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