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The Effect of Combinatorial Nutritional Supplementation on Immune Function in Healthy Older Adults

Primary Purpose

Vitamin D Deficiency

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Redoxon VI
placebo
Sponsored by
Oregon State University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Vitamin D Deficiency focused on measuring innate immunity, elderly adults, multivitamin supplement, vitamin D, vitamin C, zinc

Eligibility Criteria

55 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Serum vitamin D level 25-50 nmol/L (10-20 ng/ml), inclusive
  • Willing to limit intake of salmon, herring and sardines to one 4-ounce serving per week for 3 weeks prior to and throughout the study.
  • Willing to limit intake of oysters, shellfish, liver, beef, lamb and poultry dark meat to one 4-ounce serving per week for 3 weeks prior to and throughout the study.
  • Willing to limit intake of citrus fruits and citrus fruit juices to 2 servings per day during the study for 3 weeks prior to and throughout the study.
  • Willing to stop taking multivitamins, supplements containing zinc, vitamins C and D, and food/beverage products supplemented with zinc and vitamins C and D for 3 weeks prior to and throughout the study.

Exclusion Criteria:

  • Usual dietary intake of zinc >15 mg/day (as determined in Telephone Screening Script)
  • Tobacco use, including e-cigarettes, or smoking of any substance (e.g. cannabis) in the past three months or plans to smoke during the study.
  • Have undergone a surgical procedure within the past two months or expect a surgical procedure in the next four months.
  • Regularly consume more than two alcoholic drinks a day.
  • Have participated in another clinical study within the past two months.
  • Undergoing UV therapy (e.g. treatment for skin conditions such as psoriasis) or UV tanning.
  • Have a significant acute or chronic illness such as cardiovascular disease, kidney or liver disease, diabetes, thyroid or parathyroid disorder, history of cancer less than five years.
  • Have had bariatric surgery (e.g. gastric bypass, gastric banding, sleeve gastrectomy, etc.), other gastrointestinal procedure (e.g. cholecystectomy) or disorders (e.g. Crohn's disease, celiac disease, ulcerative colitis)
  • Stage II hypertension (either systolic blood pressure > 159 mm Hg or diastolic blood pressure > 99 mm Hg)
  • BMI < 18.5 or > 29.9
  • Diagnosis of hypervitaminosis A, hypervitaminosis D, or hypercalcemia
  • Have received an organ or tissue transplant
  • Have eczema, atopic dermatitis, or psoriasis
  • Have or have had allergy to medications or foods, seasonal allergies or allergic asthma after age 18 (childhood asthma/allergies not exclusionary)
  • Diagnosis of an autoimmune disorder (e.g. lupus, rheumatoid arthritis, multiple sclerosis, etc.) or HIV positive status.
  • Currently taking or using any of the following medications:

    • Topical medications containing retinoids
    • Desferioxamine
    • Disulfiram
    • Warfarin
    • Vitamin D analogs
    • Vitamin A analogs
    • Cholestyramine
    • Orlistat
    • Mineral oil (oral intake)
    • Thiazide diuretics
    • Calcium channel blockers
    • Phenobarbital or phenytoin or other anticonvulsants
    • Estrogen replacement therapy
    • Leukotriene receptor antagonists
    • Immunosuppressant/anti-rejection drugs
    • Oral corticosteroids

Sites / Locations

  • Oregon State University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Redoxon VI

Placebo

Arm Description

2 film coated tablets Redoxon VI oral intake daily for 12 weeks

2 film coated tablets placebo oral intake daily for 12 weeks

Outcomes

Primary Outcome Measures

S. aureus clearance from whole blood
Determine the clearance of S. aureus by whole blood from individuals before and after treatment with Redoxon VI or placebo using a whole blood killing functional assay

Secondary Outcome Measures

Determine phagocytic activity of neutrophils by measuring uptake of fluorescently labeled Escherichia coli using flow cytometry
Determine phagocytic activity of neutrophils before and after treatment. The investigators will measure phagocytic activity by quantifying the uptake of pHrodoTM Red-labeled Escherichia coli (LifeTechnologies, Carlsbad, CA) by fluorescence activated cell sorting (FACS). The amount of bacteria taken-up by the neutrophils will be determined by mean fluorescence of all cells.
Total ROS generation by neutrophils
Determine total ROS generation by neutrophils before and after treatment.
Number of neutrophils, monocytes and lymphocytes
Determine the number of circulating neutrophils, monocytes and lymphocytes in blood of individuals before and after treatment.
hCAP18 levels in neutrophils, monocytes and serum
Determine hCAP18 levels in neutrophils, monocytes and sera from individuals before and after treatment.
Serum levels of inflammatory cytokines
Determine levels of inflammatory cytokines in sera from individuals before and after treatment.

Full Information

First Posted
August 11, 2016
Last Updated
November 29, 2022
Sponsor
Oregon State University
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1. Study Identification

Unique Protocol Identification Number
NCT02876315
Brief Title
The Effect of Combinatorial Nutritional Supplementation on Immune Function in Healthy Older Adults
Official Title
The Effect of Combinatorial Nutritional Supplementation on Immune Function in Healthy Older Adults
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Completed
Study Start Date
December 2016 (Actual)
Primary Completion Date
January 2019 (Actual)
Study Completion Date
December 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Oregon State University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Many older adults do not get enough zinc, vitamin C and vitamin D, and this can be related to decreased ability to fight infection. The purpose of this research study is to determine if taking a multivitamin/mineral supplement every day for 12 weeks will increase the ability of immune cells in blood to kill bacteria.
Detailed Description
Vitamins C and D and the mineral zinc are each considered immune modulating micronutrients, but their specific effects on the immune system, especially when used in combination, is relatively unknown. Deficiency in each of these micronutrients is frequently observed in aging adults and may contribute to age-related declines in immune status. Based on prior published studies, the investigators hypothesize that supplementation of older adults with a combination of vitamin C, vitamin D, and zinc will increase the innate ability of neutrophils to kill invading bacteria through a variety of mechanisms, including increased phagocytosis, antimicrobial peptide expression and changes in reactive oxygen species (ROS) production. Therefore, this study is designed to investigate the effects of Redoxon VI, a supplement consisting of a combination of vitamin C, vitamin D, and zinc on functional markers of the immune system of healthy, older adults when compared to a matched placebo. To accomplish this, the investigators will recruit 40 healthy adults between the ages of 60 and 75 and randomize them to either Redoxon VI or an identical, inactive placebo control supplement to be taken twice a day for 12 weeks. Since neutrophil-mediated killing is a crucial defense against Staphylococcus aureus infection that declines with age, it will serve as a primary outcome in this study. Using blood collected from individuals before and after supplementation, the investigators will measure the ability of neutrophils to clear S. aureus cells, and compare the killing activity in those individuals receiving the vitamin and mineral supplement to those receiving the placebo. The investigators will confirm these changes in immune cell function by also measuring phagocytic activity in neutrophils, as well as their ability to produce ROS. As secondary measures of immune function, the investigators will also determine circulating levels of neutrophils, monocytes and lymphocytes, measure cathelicidin antimicrobial peptide (also known as hCAP18/LL-37) levels, and determine changes in circulating levels of inflammatory cytokines. Based on previous studies, the investigators expect that any increase in functional immune status will correspond to changes in vitamins C, D and zinc status in these individuals. The investigators expect the results from this study to provide the foundation for future studies investigating combinations of supplements on immune function and more extensive studies using these micronutrients to restore declines in immune function observed in older adults.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Vitamin D Deficiency
Keywords
innate immunity, elderly adults, multivitamin supplement, vitamin D, vitamin C, zinc

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
42 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Redoxon VI
Arm Type
Experimental
Arm Description
2 film coated tablets Redoxon VI oral intake daily for 12 weeks
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
2 film coated tablets placebo oral intake daily for 12 weeks
Intervention Type
Dietary Supplement
Intervention Name(s)
Redoxon VI
Other Intervention Name(s)
Redoxon Vita Immune
Intervention Description
Each tablet contains: Vitamin C (500mg) Vitamin A (1167IU) Vitamin B6 (3.3mg) Vitamin B12 4.8µg) Vitamin D (200IU) Vitamin E (22.5mg) Folic Acid (200µg) Zinc (5mg) Selenium (55µg) Copper (450µg) Iron (2.5mg) Other ingredients: Microcrystalline cellulose, magnesium stearate, hydroxypropylmethylcellulose, hydroxypropylcellulose hypromellose, titanium dioxide, microcrystalline cellulose, iron oxide yellow, sodium croscarmellose, and talc
Intervention Type
Dietary Supplement
Intervention Name(s)
placebo
Intervention Description
Ingredients: Microcrystalline cellulose, magnesium stearate, hydroxypropylmethylcellulose, hydroxypropylcellulose hypromellose, titanium dioxide, microcrystalline cellulose, iron oxide yellow, sodium croscarmellose, and talc
Primary Outcome Measure Information:
Title
S. aureus clearance from whole blood
Description
Determine the clearance of S. aureus by whole blood from individuals before and after treatment with Redoxon VI or placebo using a whole blood killing functional assay
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Determine phagocytic activity of neutrophils by measuring uptake of fluorescently labeled Escherichia coli using flow cytometry
Description
Determine phagocytic activity of neutrophils before and after treatment. The investigators will measure phagocytic activity by quantifying the uptake of pHrodoTM Red-labeled Escherichia coli (LifeTechnologies, Carlsbad, CA) by fluorescence activated cell sorting (FACS). The amount of bacteria taken-up by the neutrophils will be determined by mean fluorescence of all cells.
Time Frame
12 weeks
Title
Total ROS generation by neutrophils
Description
Determine total ROS generation by neutrophils before and after treatment.
Time Frame
12 weeks
Title
Number of neutrophils, monocytes and lymphocytes
Description
Determine the number of circulating neutrophils, monocytes and lymphocytes in blood of individuals before and after treatment.
Time Frame
12 weeks
Title
hCAP18 levels in neutrophils, monocytes and serum
Description
Determine hCAP18 levels in neutrophils, monocytes and sera from individuals before and after treatment.
Time Frame
12 weeks
Title
Serum levels of inflammatory cytokines
Description
Determine levels of inflammatory cytokines in sera from individuals before and after treatment.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Serum vitamin D level 25-50 nmol/L (10-20 ng/ml), inclusive Willing to limit intake of salmon, herring and sardines to one 4-ounce serving per week for 3 weeks prior to and throughout the study. Willing to limit intake of oysters, shellfish, liver, beef, lamb and poultry dark meat to one 4-ounce serving per week for 3 weeks prior to and throughout the study. Willing to limit intake of citrus fruits and citrus fruit juices to 2 servings per day during the study for 3 weeks prior to and throughout the study. Willing to stop taking multivitamins, supplements containing zinc, vitamins C and D, and food/beverage products supplemented with zinc and vitamins C and D for 3 weeks prior to and throughout the study. Exclusion Criteria: Usual dietary intake of zinc >15 mg/day (as determined in Telephone Screening Script) Tobacco use, including e-cigarettes, or smoking of any substance (e.g. cannabis) in the past three months or plans to smoke during the study. Have undergone a surgical procedure within the past two months or expect a surgical procedure in the next four months. Regularly consume more than two alcoholic drinks a day. Have participated in another clinical study within the past two months. Undergoing UV therapy (e.g. treatment for skin conditions such as psoriasis) or UV tanning. Have a significant acute or chronic illness such as cardiovascular disease, kidney or liver disease, diabetes, thyroid or parathyroid disorder, history of cancer less than five years. Have had bariatric surgery (e.g. gastric bypass, gastric banding, sleeve gastrectomy, etc.), other gastrointestinal procedure (e.g. cholecystectomy) or disorders (e.g. Crohn's disease, celiac disease, ulcerative colitis) Stage II hypertension (either systolic blood pressure > 159 mm Hg or diastolic blood pressure > 99 mm Hg) BMI < 18.5 or > 29.9 Diagnosis of hypervitaminosis A, hypervitaminosis D, or hypercalcemia Have received an organ or tissue transplant Have eczema, atopic dermatitis, or psoriasis Have or have had allergy to medications or foods, seasonal allergies or allergic asthma after age 18 (childhood asthma/allergies not exclusionary) Diagnosis of an autoimmune disorder (e.g. lupus, rheumatoid arthritis, multiple sclerosis, etc.) or HIV positive status. Currently taking or using any of the following medications: Topical medications containing retinoids Desferioxamine Disulfiram Warfarin Vitamin D analogs Vitamin A analogs Cholestyramine Orlistat Mineral oil (oral intake) Thiazide diuretics Calcium channel blockers Phenobarbital or phenytoin or other anticonvulsants Estrogen replacement therapy Leukotriene receptor antagonists Immunosuppressant/anti-rejection drugs Oral corticosteroids
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adrian F Gombart, PhD
Organizational Affiliation
Principal Investigator
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oregon State University
City
Corvallis
State/Province
Oregon
ZIP/Postal Code
97331
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32823974
Citation
Fantacone ML, Lowry MB, Uesugi SL, Michels AJ, Choi J, Leonard SW, Gombart SK, Gombart JS, Bobe G, Gombart AF. The Effect of a Multivitamin and Mineral Supplement on Immune Function in Healthy Older Adults: A Double-Blind, Randomized, Controlled Trial. Nutrients. 2020 Aug 14;12(8):2447. doi: 10.3390/nu12082447.
Results Reference
derived

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The Effect of Combinatorial Nutritional Supplementation on Immune Function in Healthy Older Adults

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