Intestinal Microbiota Profiling in HAA Patients

Status: Recruiting
Location: See location...
Intervention Type: Other
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

In humans, alcohol-related dysbiosis exists with a decrease in bacteroides. This dysbiosis is responsible for the breakdown of the intestinal barrier by a decrease in the synthesis of protective mucus, and some proteins involved in tight junctions or a decrease in defensin (Reg3b, Reg3g) which promotes bacterial growth and ultimately bacterial translocation. The microbiota of a patient with alcoholic hepatitis is different from that of a patient without alcoholic hepatitis. Acute alcoholic hepatitis has a severe prognosis and corticosteroids are the only first line therapy option, with better survival at 28 days versus placebo. However, mortality remains high at 30% at 3 months, which highlights the importance of seeking intestinal microbiota profile on treatment response. The determination of one or more intestinal microbiota signatures associated with the treatment response Corticosteroids plus FMT or Corticosteroids plus placebo will allow the clinician to have a simple and rapid test obtained in 16S RNA analysis to predict the therapeutic response and potentially the best treatment to adopt and to address medical and medico-economic stakes. The investigators will first characterize the alcohol-induced dysbiosis by a whole microbiota sequencing in the different groups. Specific bacterial species identify by DNA sequencing should be confirmed by qPCR of 16S rDNA to determine a fingerprint of sAH microbiota. Metabolic properties of intestinal microbiota, such as production of short chain fatty acids, will be analyzed by using HPLC. In the sAH group, evolution of intestinal microbiota will be observed by shotgun DNA sequencing between the day 0 and the day 7 of corticosteroids treatment. The analysis of sAH patients' microbiota (day 0) will allow us to obtain a non-responder profile to corticosteroids that can be used as a prognostic marker to use in the clinic. The deliverable is the bacterial fingerprint of the treatment response and its valuation is its use as a predictive tool of the response.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 75
Healthy Volunteers: t
View:

• Patients aged from 18 to 75 years, having :

• Heavy drinker with Maddrey Score ≥ 32 : PT(second)-PT(control)x4.6+Bilirubine (mg/dl)

• Histological confirmed Alcoholic hepatitis

• Personal consent signed to the trial

• No exclusion criteria

Locations
Other Locations
France
CHU Amiens Picardie
RECRUITING
Amiens
Contact Information
Primary
Eric Nguyen-Khac, Pr
nguyen-khac.eric@chu-amiens.fr
0322088851
Time Frame
Start Date: 2023-11-15
Estimated Completion Date: 2028-11
Participants
Target number of participants: 200
Treatments
Experimental: sAH patients
the recruitment of patients with sAH will be carried out from the Hepatogastroenterology Service of the University Hospital of Amiens.
Experimental: Alcohol controls without liver complications
the recruitment of alcohol controls will concern patients followed for alcohol addiction without sAH in the antecedents or evolutionary. It will be carried out by the Hospital of Roye-Montdidier. The total number of controls will be equivalent to the number of sAH patients, matched for age and sex.
Active_comparator: Healthy non-alcoholic witnesses
the general population will be called with a matching on age
Related Therapeutic Areas
Sponsors
Collaborators: CH Montdidier
Leads: Centre Hospitalier Universitaire, Amiens

This content was sourced from clinicaltrials.gov