Ziegler, A.-G. ; Arnolds, S. ; Koelln, A. ; Achenbach, P. ; Berner, R.* ; Bonifacio, E.* ; Casteels, K.* ; Elding Larsson, H.* ; Gündert, M. ; Hasford, J.* ; Kordonouri, O.* ; Lundgren, M.* ; Oltarzewski, M.* ; Pekalski, M.L.* ; Pfirrmann, M.* ; Snape, M.D.* ; Szypowska, A.* ; Todd, J.A.*
Supplementation with Bifidobacterium longum subspecies infantis EVC001 for mitigation of type 1 diabetes autoimmunity: the GPPAD-SINT1A randomised controlled trial protocol.
BMJ Open 11:e052449 (2021)
INTRODUCTION: The Global Platform for the Prevention of Autoimmune Diabetes-SINT1A Study is designed as a randomised, placebo-controlled, double-blind, multicentre, multinational, primary prevention study aiming to assess whether daily administration of Bifidobacterium infantis from age 7 days to 6 weeks until age 12 months to children with elevated genetic risk for type 1 diabetes reduces the cumulative incidence of beta-cell autoantibodies in childhood. METHODS AND ANALYSIS: Infants aged 7 days to 6 weeks from Germany, Poland, Belgium, UK and Sweden are eligible for study participation if they have a >10.0% expected risk for developing multiple beta-cell autoantibodies by age 6 years as determined by genetic risk score or family history and HLA genotype. Infants are randomised 1:1 to daily administration of B. infantis EVC001 or placebo until age 12 months and followed for a maximum of 5.5 years thereafter. The primary outcome is the development of persistent confirmed multiple beta-cell autoantibodies. Secondary outcomes are (1) Any persistent confirmed beta-cell autoantibody, defined as at least one confirmed autoantibody in two consecutive samples, including insulin autoantibodies, glutamic acid decarboxylase, islet tyrosine phosphatase 2 or zinc transporter 8, (2) Diabetes, (3) Transglutaminase autoantibodies associated with coeliac disease, (4) Respiratory infection rate in first year of life during supplementation and (5) Safety. Exploratory outcomes include allergy, antibody response to vaccines, alterations of the gut microbiome or blood metabolome, stool pH and calprotectin. ETHICS AND DISSEMINATION: The study was approved by the local ethical committees of the Technical University Munich, Medical Faculty, the Technische Universität Dresden, the Medizinische Hochschule Hannover, the Medical University of Warsaw, EC Research UZ Leuven and the Swedish ethical review authority. The results will be disseminated through peer-reviewed journals and conference presentations and will be openly shared after completion of the study. TRIAL REGISTRATION NUMBER: NCT04769037.
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Publication type
Article: Journal article
Document type
Scientific Article
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Keywords
Diabetes & Endocrinology ; Epidemiology ; General Diabetes ; Immunology ; Paediatrics; Beta-cell Autoimmunity; Gut Microbiome; Risk; Children; Autoantibodies; Progression; Childhood
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Language
english
Publication Year
2021
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2021
ISSN (print) / ISBN
2044-6055
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2044-6055
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Volume: 11,
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Article Number: e052449
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BMJ Publishing Group
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British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
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Peer reviewed
POF-Topic(s)
30201 - Metabolic Health
Research field(s)
Helmholtz Diabetes Center
PSP Element(s)
G-502100-001
Grants
Deutsches Zentrum fur Diabetesforschung DZD
BMBF
Helmholtz Zentrum Munchen, Germany
Leona M. and Harry B. Helmsley Charitable Trust
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Erfassungsdatum
2021-12-20