| ID | Type | Description | Link |
|---|---|---|---|
| R01HD095158-02 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Texas Higher Education Coordinating Board | OTHER_GOV |
| Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | NIH |
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This protocol is a blinded randomized controlled study of the effects of BB-12 with LGG at different doses in 70 healthy children with autism spectrum disorders at lower and higher doses over an 56-day period and a 28- day observation period. The study is being conducted in order to assess safety and tolerability of the probiotic (BB-12 with LGG) at 2 different doses of BB-12 with LGG. Identifying effects on behaviors in healthy children with ASD using SRS-2 and ABC, GI symptoms using GI symptom severity index, and relevant biomarkers of inflammation, microbiota, and metabolites. Primary testing and procedures will be conducted at the University of Texas Health Science Center at Houston and Memorial Hermann.
Biomarker identification includes Integrative analysis of plasma metabolome and stool microbiota will be conducted with the collaboration of Dr. Ruth Ann Luna and Dr. Jim Versalovic at Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology & Microbiology of Baylor College of Medicine.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| BB-12 with LGG (Lower Dose) | Active Comparator | BB-12 with LGG (Multistrain probiotic; lower dose): 1 billion CFUs |
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| Placebo | Placebo Comparator | Maltodextrin |
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| BB-12 with LGG (Higher Dose) | Active Comparator | BB-12 with LGG (Multistrain probiotic: higher dose): 10 billion CFUs |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BB-12 with LGG (Higher Dose) | Drug | BB-12 with LGG - Higher Dose (10 billion CFUs) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Effects of BB-12+LGG at different doses on adverse events (safety) | Adverse events (Safety) will be measured by case report form (survey) that are related to BB-12 with LGG (health-promoting bacteria) or placebo treatment. The symptom grade will detail the severity of adverse events. | 84 days |
| Measure | Description | Time Frame |
|---|---|---|
| Effects of BB-12+LGG at different doses on irritability and maladaptive behaviors with Aberrant Behavior Checklist (ABC) | Psychological/Behavioral change in irritability and related maladaptive behaviors associated with ASD will be measured by the Aberrant Behavior Checklist (ABC)-2 pre and post treatment | Days 1, 21, 56 and 84 |
| Measure | Description | Time Frame |
|---|---|---|
| Effects of BB-12+LGG at different doses on GI symptoms as measured by GI Symptom Severity Index | GI symptoms will be measured by the GI Severity Index. | Days 1, 21, 56 and 84 |
| Effects of BB-12+LGG at different doses on gut inflammation (S1009A) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| J Marc RHoads, MD | The University of Texas Health Science Center, Houston | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UTHealth | Houston | Texas | 77030 | United States |
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After psychological screening, the subjects will be randomize children to one of 3 groups. The total number of subject to be enrolled will be 70 healthy children with confirmed ASD status, randomizing each child to placebo (maltodextrin), low daily dose (1 billion cfu's), and higher daily dose (10 billion cfu's) of BB-12+LGG once daily at 1:2:2 ratio. Data will be combined with 30 patients obtained from two funding sources: Texas (THECB) and U.T. pilot project. The data will be combined and an identical design of the placebo and 1 billion cfu dose arms.
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The head statistician and study pharmacist will be aware of randomization scheme. The investigators will use an adaptive minimization program for randomization that balances the 3 study arms with respect to distributions of sex and age (4-10 vs. 11-16 y.o.). Patients will be randomized to placebo, 1 billion CFU, and 10 billion CFU study arms at a ratio of 1:2:2. (Currently marketed over-the-counter probiotics typically contain 0.1-50 billion CFUs per dose.) The performance of our covariate adaptive randomization algorithm will be verified through simulation studies before implementation.
| Placebo | Drug | Maltodextrin |
|
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| BB-12 with LGG (Lower Dose) | Drug | BB-12 with LGG - Lower Dose (1 billion CFUs) |
|
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| Effects of BB-12+LGG at different doses on irritability and maladaptive behaviors measured with the Social Responsiveness Scale-2 |
Psychological/Behavioral change in irritability and related maladaptive behaviors associated with ASD will be measured by the and the Social Responsiveness Scale-2 (SRS-2) pre and post treatment. |
| Days 1, 21, 56 and 84 |
Plasma S100A9 will indicate GI and systemic levels of inflammation. S100A9 is a damage-associated molecular pattern molecule (DAMP) released by granulocytes, which is reportedly elevated 2-fold in plasma of children with ASD.
| Days 1, 56 and 84 |
| Effects of BB-12+LGG at different doses on gut inflammation (Fecal Calprotectin) | Biological change in fecal calprotectin levels. FC is a highly accurate fecal marker of inflammation. | Days 1, 56 and 84 |
| Effects of BB-12+LGG at different doses on gut inflammation (Plasma Zonulin) | Plasma zonulin, a marker for intestinal permeability ("leaky gut"), which is often associated with inflammation. | Days 1, 56 and 84 |
| Effects of BB-12+LGG at different doses on gut inflammation (IL-8) | IL-8 can be an indicator of gut inflammation; it released from the intestinal epithelial cells during inflammation. | Days 1, 56 and 84 |
| Effects of BB-12+LGG at different doses on fecal microbial community | Using 16S rDNA analysis, this will determine microbial alpha and beta diversity and distribution of the major taxa before and after probiotic treatment. | Days 1, 56 and 84 |
| Effects of BB-12+LGG at different doses on metabolites | This will determine levels of metabolic markers which are reported to be abnormal in autism: fecal amino acids, ammonia, short chain fatty acids (SCFA), and phenols. | Days 1, 56 and 84 |
| ID | Term |
|---|---|
| D000067877 | Autism Spectrum Disorder |
| D003248 | Constipation |
| D003967 | Diarrhea |
| ID | Term |
|---|---|
| D002659 | Child Development Disorders, Pervasive |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D019936 | Probiotics |
| C008315 | maltodextrin |
| ID | Term |
|---|---|
| D019587 | Dietary Supplements |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
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