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Effect of Acute and Sub-acute Administration of Gluten on Extra-intestinal and Gastrointestinal Symptoms in Patients With Non-coeliac Gluten Sensitivity

Not Applicable
Conditions
NCGS
Gluten
Interventions
Other: Placebo
Other: Gluten
Registration Number
NCT03798249
Lead Sponsor
Universitaire Ziekenhuizen KU Leuven
Brief Summary

The investigators will investigate the effects of acute and sub-acute administration of gluten on mood, intestinal permeability, gastrointestinal symptoms, gut microbiota and cortisol levels in NCGS patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Non-coeliac gluten sensitivity patients

    • Previous symptoms of IBS fulfilling Rome III criteria that self reportedly improved with a gluten-free diet
    • Symptoms currently well controlled on a gluten-free diet
    • Adherence to the gluten-free diet for at least 6 weeks prior to recruitment
    • Coeliac disease excluded (either by absence of the HLA-DQ2 and HLA-DQ8 haplotype or by a normal duodenal biopsy (Marsh 0) performed at endoscopy while on a gluten-containing diet in individuals expressing the HLA-DQ2 or HLA-DQ8 haplotype)
    • IgA anti-tissue-transglutaminase or IgG anti-deaminated gliadin peptide positive
  • Body Mass Index (BMI) of 20 - 25 kg/m2

  • Stable body weight for at least 3 months prior to the start of the study

Exclusion Criteria
  • Medical

    • Coeliac disease
    • Abdominal or thoracic surgery. Exception: appendectomy
    • Gastrointestinal, endocrine or neurological diseases
    • Cardiovascular, respiratory, renal or urinary diseases
    • Hypertension
    • Food or drug allergies
  • Psychiatric disorders

    • Eating disorders
    • Depressive disorders
    • Anxiety disorders
    • Psychotic disorders
  • Restraint or emotional eating

  • Medication on a regular basis, exception: oral contraception

  • History of cannabis use or any other drug of abuse for at least 12 months prior to the study

  • Alcohol abuse (more than 21 units of alcohol for men, more than 14 units for woman per week)

  • Pregnant or breastfeeding women

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPatients will receive acutely 16 g of whey protein and 2 glutenfree muffins, twice a day, during 5 days
GlutenGlutenPatients will receive acutely 16 g of gluten and 2 muffins glutenfree with 8 g of gluten, twice a day, during 5 days
Primary Outcome Measures
NameTimeMethod
The effect of gluten acutely and sub-acutely on extraintestinal symptoms in NCGS patients measured on the Positive and Negative Affect ScheduleAt the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 20), after test visit 3 (at day 35), after test visit 4 (at day 40)

Change from baseline. Scores can be 'very slightly or not at all', 'a little', 'moderately', 'quite a bit', 'extremely'

The effect of gluten acutely and sub-acutely on extraintestinal symptoms in NCGS patients measured on the Profile of Mood StateAt the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 20), after test visit 3 (at day 35), after test visit 4 (at day 40)

Scores are measured on the Visual Analogue Scale. Change from baseline. The scale is ranged 0 - 10, in which 0 no occurrence of the symptom and 10 a lot occurrence of the symptom. Measured at day 0, day 15, day 21, day 36 and day 41.

Secondary Outcome Measures
NameTimeMethod
The effect of gluten acutely and sub-acutely on gastrointestinal symptoms in NCGS patients measured on the visual analogue scale for gastrointestinal symptomsAt the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 20), after test visit 3 (at day 35), after test visit 4 (at day 40)

With '0' no complaints and '10' a lot of complaints (change from baseline). Measured on the Visual Analogue Scale. Measured at day 0, day 15, day 21, day 36 and day 41.

Effect of acute and sub-acute gluten administration on intestinal permeability (lactulose mannitol ratio)At the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 21), after test visit 3 (at day 36), after test visit 4 (at day 41)

Change in intestinal permeability after gluten administration. In the urine we can measure the ratio lactulose/mannitol. This can be measured using High Performance Liquid Chromatography at day 0, day 15, day 21, day 36 and day 41.

Effect of acute and sub-acute gluten administration on Lipopolysaccharide-Binding Protein levels in bloodsampleDuring test visit 0 (day 0), test visit 2 (at day 21), after test visit 4 (at day 41)

Change in lipopolysaccharide-binding protein levels measured at day 0, day 21 and day 41

Effect of acute and sub-acute gluten administration on high sensitive reactive protein levels in bloodsampleDuring test visit 0 (day 0), test visit 2 (at day 21), after test visit 4 (at day 41)

Change in high sensitive reactive protein levels measured at day 0, day 21 and day 41

Effect of acute and sub-acute gluten administration on lipopolysaccharide levels in bloodsampleDuring test visit 0 (day 0), test visit 2 (at day 21), after test visit 4 (at day 41)

Change in lipopolysaccharide levels measured at day 0, day 21 and day 41

Effect of acute and sub-acute gluten administration on gut microbiota compositionAfter test visit 0 (day 0), day 13 and day 14, after test visit 1 (day 15), day 16, 17, 18, 19 and 20, two days before test visit 3 (day 34 and 35), day 36, 37, 38, 39, 40

Change in gut microbiota composition (compared to day 0) with focus on: Bifidobacterium, Lactobacillus, Enterobacteriaceae, E. coli (stool samples)

Effect of acute and sub-acute gluten administration on cortisol awakening responseDay before test visit 1 (day 14), test visit 1 (day 15), test visit 2 (day 21), day before test visit 3 (day 35), test visit 3 (day 36) and test visit 4 (day 41)

Change in cortisol levels between gluten and placebo administration (saliva samples). Measured using an ELISA assay.

Trial Locations

Locations (2)

TARGID

🇧🇪

Leuven, Vlaams-Brabant, Belgium

Jan Tack

🇧🇪

Leuven, Belgium

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