NCT Number: NCT06720961
The goal of this study is to find out if there is a direct connection between an imbalance of gut bacteria and the development of scar tissue in the gut by identifying important bacterial proteins found in scarred gut tissue. Our aim is to identify which types of cells and biological processes are affected by these bacterial proteins in people with Crohn's Disease. We will also study how these bacterial proteins cause changes in 3D models of gut fibrosis.
Trial opening soon.
Get Notified18 year–69 year
All sexes
Observational
Milan, Italy, 20132
Alice Frontali
SUB_INVESTIGATOR
Andrea Balla
SUB_INVESTIGATOR
Andrea Galli
SUB_INVESTIGATOR
Andrea Municchi
SUB_INVESTIGATOR
Andrea Vignali
SUB_INVESTIGATOR
Federica Ungaro
SUB_INVESTIGATOR
Federica Ungaro, PhD.
CONTACT
Federico Scarfò
SUB_INVESTIGATOR
Francesco Fiorio
CONTACT
Luca Albarello
SUB_INVESTIGATOR
Pierpaolo Sileri
SUB_INVESTIGATOR
Silvio Danese
PRINCIPAL_INVESTIGATOR
Stefania Vetrano
SUB_INVESTIGATOR
More than 50% of CD patients develop a penetrating disease or stenosis due to fibrostenosis, which in most cases requires surgery, as no effective therapies have yet been found. The disease leads to both structural and functional alterations of the intestinal mucosa. Although the functional alteration of the mucosa is mainly caused by the continuous tissue damage that occurs during the chronic inflammation associated with CD, recent studies have suggested that the fibrosis associated with CD may be driven by triggering factors independent of inflammation, such as dysbiosis of the microbiota. Our proposal aims to establish the causal link between gut dysbiosis and fibrosis by studying the role of key bacterial proteins present in fibrotic gut tissue.
This project will ultimately offer new molecular targets for the development of possible tailor-made antifibrotic treatments, with likely benefits for healthcare, as it will facilitate the management of severe CD, avoiding surgery and reducing SSN costs.
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Specimens of CD patients and non-IBD related patients will be collected during the surgery performed for clinical practice, without other risks for the patients, since we will use only leftover material after pathologist analysis. All of the collected surgical samples will be used for this project and, for this reason, they will not be conserved after the research period. Any residual samples will be destroyed.
One week before the surgery to remove the stricture, fecal samples from CD patients belonging to B1, B2, B3 groups will be collected. They will be used for the exploratory objective. All of the collected fecal samples will be used for this project and, for this reason, they will not be conserved after the research period. Any residual samples will be destroyed.
Time frame: Experiments and analysis: 11th to 36th month
Control subjects' and CD-derived surgical specimens will be processed to obtain a cell suspension, that will be frozen and stored for the subsequent cell sorting. Frozen CD and healthy cell suspensions will be then thawed and undergo FACS for specific cell markers (CD31 for endothelial cells, EpCam for epithelial cells, CD90 for fibroblasts, CD45 for leukocytes, including CD4 and CD8 for T cells, CD20 for B cells, CD14 and CD163 for macrophages (MΦ), CD11b and c for dendritic cells (DCs). Single-cell populations will undergo library preparation and will be analyzed by ribo-minus RNAseq at 30M reads of depth.
Metatranscriptomics for profiling the microbial composition, as well as the transcriptomics to determine both the differential gene expression (DGE) and the Gene Set Enrichment Analysis (GSEA), will be performed.
Time frame: Experiments and analysis: 11th to 36th month
We will isolate and sequence RNA of specific cellular subtypes from the phenotype B1, B2, and B3 of fibrotic CD tissues and healthy non-IBD tissues.
We will profile the microbial composition by Metatranscriptomics as well as we will determine both the differential gene expression (DGE) and the Gene Set Enrichment Analysis (GSEA) through transcriptomics.
Moreover, to identify the cellular type(s) where bacterial proteins will be expected to exert the most prominent pro-fibrotic effects, we will set up the transwell-based experimental platform by plating epithelial cells (organoids) and/or endothelial cells, and/or fibroblasts in the upper chamber of the transwell, while lamina propria mononuclear cells (LPMCs) will be plated in the lower chamber
Time frame: Experiments on in-vivo models: 13th to 24th month
To evaluate the efficacy of nanomedicine therapy in inhibiting the deleterious processes induced by bacterial factors by exploiting in vivo models that recapitulate CD-associated fibrosis.
We will evaluate the pro-fibrotic potential of specific bacterial factors during experimental intestinal fibrosis, testing a possible treatment through the liposome-mediated inhibition of bacterial factor-induced mechanisms. For this. purpose, fecal samples collected from patients will be handled and processed for analysis in our Lab and will then be shipped to UO2 for in vivo studies
Contact information is provided by the study sponsor or research team.
Federica Ungaro, PhD.
CONTACT
Silvio Danese, PhD.-MD
CONTACT
IRCCS San Raffaele
Other
Unveiling the Microbial Impact on Intestinal Fibrosis and the Associated Immune Microenvironment: New Insights for the Pathogenesis and Treatment of Crohn's Disease-associated Complications
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