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临床试验/NCT05544396
NCT05544396进行中(未招募)不适用

Study on the Probiotics Regulating miRNA in H. Pylori-induced Wnt/β-catenin Gastric Carcinogenesis.

National Cheng-Kung University Hospital2 个研究点 分布在 1 个国家目标入组 100 人开始时间: 2024年3月20日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
进行中(未招募)
入组人数
100
试验地点
2
主要终点
The IM regression rate one year after H. pylori eradication

研究概览

简要总结

Background. H. pylori has recognized as a type 1 carcinogen for gastric adenocarcinoma. Although H. pylori eradication promises to reduce the risk of gastric cancer, the regression rate of intestinal metaplasia (IM) after eradication is unsatisfactory. Therefore, to find the mechanism of IM persistent and a new strategy to improve IM regression are critical for reducing gastric cancer development. The canonical Wnt/beta-catenin signaling pathway upregulating cyclooxygenase-2 (COX-2) transcriptional activity involves gastric carcinogenesis after H. pylori infection. Investigators have established an in vitro model that H. pylori induces a cagA-dependent nuclear COX-2 expression in both GES-1 and AGS cells. MicroRNAs (miRNAs) are a class of widespread non-coding RNAs and have been shown to involve in the gastric carcinogenesis. Among these gastric cancer-related miRNA candidates, some were reported to interact with Wnt/β-catenin pathway. Clinically, H. pylori eradication plus celecoxib therapy results in about one-third cases being IM regression, which correlated to the nuclear β-catenin and COX-2 expression before treatment. Based on the probiotics ingestion can ameliorate H. pylori-induced inflammatory pathways, investigators hypothesis that H. pylori eradication with probiotics supplement may promote IM regression through regulating certain miRNAs and Wnt/β-catenin signaling. The aims of this 3-year grant will

  1. to establish the H. pylori induces the Wnt/beta-catenin and COX-2 signaling pathway in vitro.
  2. to investigate the effects and mechanisms of L. acidophilus and B. latis on H. pylori-induced Wnt/beta-catenin oncogenesis pathway.
  3. to study whether probiotics ingestion promote IM regression or ameliorate IM progression in H. pylori-infected patients after successful eradication therapy.

Materials and Methods. A H. pylori (HP238) isolate strain, GES-1, and AGS cells will be used for in vitro study. The protein levels of cell tests will measured by western blot. The differences of miRNAs expression between monk, cells infected with H. pylori, and cells pretreated with probiotics than infected by H. pylori will be analyzed by next generation sequencing method. H. pylori-infected patients with IM will be randomly allocated to receive probiotics or controls, the 2nd endoscopy will be arranged at the 12th month to evaluate the IM status.

Anticipated results. This study will to establish the H. pylori-induced Wnt/beta-catenin oncogenesis pathway in vitro. Furthermore, the effect and mechanism of probiotics inhibit the H. pylori-induced Wnt/beta-catenin signaling will be clarified. Finally, investigators will provide an evidence for the probiotics ingestion promote the rate of IM regression in patients after H. pylori eradication.

详细描述

What are already know

  1. H. pylori-induced Wnt/beta-catenin cascades leads to gastric carcinogenesis.
  2. Nuclear beta-catenin and COX-2 expression correlated to the IM regression rate in human after H. pylori eradication.
  3. Administration of selective COX-2 inhibitos, celecoxib, results in partial IM regression in patients with long-term IM persistence after H. pylori eradication
  4. Certain miRNAs involve in gastric oncogenesis by targeting Wnt/beta-catenin signaling pathway.

What will be add

  1. The Wnt/beta-catenin oncogenesis induction is different between primary (GES-1), and cancer (AGS) gastric cells after H. pylori infection.
  2. Probiotics ameliorate or prevent H. pylori-induced gastric Wnt/beta-catenin/COX2 carcinogenesis signaling through regulating miRNAs.
  3. Probiotics administration improves regression rate in patients with CAG and IM after H. pylori successful eradication.

Diagram of clinical trial to evaluate probiotics ingestion improves H. pylori-related intestinal metaplasia (IM) in patients after eradication therapy

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
20 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • 20 years of age or older
  • Have undergone gastroscopy
  • First discovered H.pylori infection and intestinal metaplasia

排除标准

  • Massive bleeding is life-threatening
  • Gastric cancer
  • Previous treatment for H.pylori
  • Long-term use of non-steroidal anti-inflammatory drugs (eg, aspirin), and hydrogen ion pump inhibitors.

研究组 & 干预措施

probiotic group

Experimental

Routine eradicate treatment H. pylori, and probiotics (2 packs per day) for 6 months.

干预措施: probiotic (Other)

control group

Placebo Comparator

Only routine eradicate treatment H. pylori.

干预措施: probiotic (Other)

结局指标

主要结局

The IM regression rate one year after H. pylori eradication

时间窗: Eligible participants allocated to treat or non-treat groups. The panendoscopy was performed one year later.

H. pylori-infected participants (n=100) with IM received successful H. pylori eradication. Group I (n=50) given oral probiotics 1 pack bid for 6 months, Group II did not treat. The 2nd panendoscopy followed at one year later to evaluate IM status using Updated Sydney System Score.

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Yao-Jong Yang

professor

National Cheng-Kung University Hospital

研究点 (2)

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