Prevention of Clinical Symptoms in Celiac DiseaseNEOCELNCT04034303
Risk Factors for the Development of Celiac Disease in Genetically Predisposed Children
An observational study of Prevention of Clinical Symptoms in Celiac Disease, run by Federico II University at 1 site in Italy.
Trial summary
The study aims to identify risk factors for the development of Celiac Diseases in families with a recognized genetic risk for the presence of a confirmed proband case. Candidate mother will be recruited before a planned pregnancy or within the first 12 weeks of pregnancy. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Prevention of Clinical Symptoms in Celiac Disease
- What is being tested?
- analysis of genetic and epigenetic risk factors
- How many people
- 400 participants
- Where
- 1 siteItaly
- Study dates
- 1 May 2019to 30 Apr 2025
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Study population: Pregnant women from a family with a confirmed CD proband Live newborns from the above mothers
Who may be able to join
- Pregnant women from a family with a confirmed CD proband
Who cannot join
- Women affected by severe chronic disease and cancer Women not able to attend the schedule of visits
- -
Trial locations and contacts
1 site in 1 country.
Italy1 site
University of Naples Azienda Ospedaliera Universitaria
Naples, Campania, 80131
About this study
Official title: Natural History, Risk Factors and Predictive Biomarkers for Celiac Disease: a Prospective Multicenter Study.
The study aims to identify risk factors for the development of Celiac Diseases in families with a recognized genetic risk for the presence of a confirmed proband case. Candidate mother will be recruited before a planned pregnancy or within the first 12 weeks of pregnancy. Familial and environmental risk factors will be evaluated within the couple of parents. Pregnancy will be followed up and appropriate biological samples collected. Delivery will be supervised in order to collect biological samples. Newborns will be controlled from birth up to the 6th year of age. Data about clinical events related to health, life attitudes, nutrition will be collected together with biological samples either in the pregnant mother as well as in the infant.
Read the detailed description
- CD epidemics: Celiac Disease incidence is increasing at unexpected rates in the last two decades in all gluten-consuming populations.
- Remarkable stratified genetic risk: there is a strong genetic component as the main risk to develop disease, as supported by > 85% concordance in monozygotic twins, but genetics cannot change over decades and does not explain the epidemic which has been observed. The presence of double HLA DQ2 in female subjects does increases the risk of disease above that of a mendelian recessive inheritance. Hence the estimation of environmental factors associated to the genetic risk is quite complex and does need a very strict prospective longitudinal study design, since each factor is likely to produce, if ever, a quite small odds ratio .
- Gene expression in the first year of life: we have observed, in our previous cohort studies, that the expression of at least a small set of CD associated candidate genes is substantially different between the children who eventually develop Cd and those who do not, already a 6 months of age, much before any measurable recognition of the gluten antigen, development of antibodies or any clinical sign (ref 3 Galatola).
- Epigenetic changes in small intestinal tissue: in addition of the previously reported gene expression differences, gene methylation and related expression of CD associated candidate genes have been observed in the epithelium and the lamina propria of Cd patients . In addition, microRNA appear to be differently expressed in patients versus controls.
- Early events in the first-second year of life before diagnosis: our groups and others observed that the occurrenceof acute respiratoryinfections in the first and second year of life, at least 12 months before the onset of disease, was associated to increased odds (> x2) of developing CD. It is most likely that viral infections (as the large majority of URTI in children) play a role in the development of food antigen intolerance leading to CD . A role of non-pathogenic viral infections has been also suggestedin the developmentof intolerance to gluten.
- No influence of breast-feeding or gluten introduction: breast feeding does not prevent the incidence of CD in at risk infants: its most likely effect is to delay the onset of clinical symptoms. Similarly, the time and quantity of gluten introduction is not associated to the actual incidence, but is only associated to delayed time effects.
- Possible implication of microbiome: despite the complexity of estimating differences in the composition of microbiome in the infants, it has been suggested that infants who later develop CD might show a fila composition slightly different from their matched controls.
- Being tested
- analysis of genetic and epigenetic risk factors
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
analysis of genetic and epigenetic risk factorsGenetic
analysis of gene, methylation and expression, microbiome
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of Celiac Disease
Number of new cases of infants affected by Celiac Disease in relation to genetic (HLA and non-HLA Associated Genes), Epigenetic (DNA Methylation, Gene Expression, Istone Acetylation of candidate gene) and environmental factors (Maternal factors, Nutrition, Infections)
Measured: 6 years
Secondary outcomes (1)
Analysis of microbiome
Difference in the microbiome composition of the group of infants who eventually develop Celiac Disease versus those who do not develop the disease.
Comparison of Fecal Microbiome of infants at 4, 12 and 24 months subgrouped by outcome.
Measured: 6 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Jul 2019
- Study start1 May 2019
- Primary completion1 May 2022 (estimated)
- Study completion30 Apr 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Prevention of Clinical Symptoms in Celiac DiseaseStudies of the same condition, open and under way.
- More trials run by Federico II UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 400 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Federico II University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Renata Auricchio, Federico II University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04034303
- Sponsor's protocol ID
- NEOCEL2019
- Acronym
- NEOCEL
- Status last verified
- Jul 2019
- First submitted
- 24 Jul 2019
- Last updated
- 2 Aug 2019
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 Aug 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Natural History, Risk Factors and Predictive Biomarkers for Celiac Disease: a Prospective Multicenter Study.
- ClinicalTrials.gov ID
- NCT04034303
- Acronym / sponsor ID
- NEOCEL / NEOCEL2019
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 400 participants (estimated)
- Lead sponsor
- Federico II UniversityUniversity, hospital or other
- Study start
- 1 May 2019 (actual)
- Primary completion
- 1 May 2022 (estimated)
- Study completion
- 30 Apr 2025 (estimated)
- First posted
- 26 Jul 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The study aims to identify risk factors for the development of Celiac Diseases in families with a recognized genetic risk for the presence of a confirmed proband case. Candidate mother will be recruited before a planned pregnancy or within the first 12 weeks of pregnancy. Familial and environmental risk factors will be evaluated within the couple of parents. Pregnancy will be followed up and appropriate biological samples collected. Delivery will be supervised in order to collect biological samples. Newborns will be controlled from birth up to the 6th year of age. Data about clinical events related to health, life attitudes, nutrition will be collected together with biological samples either in the pregnant mother as well as in the infant.
Detailed description
- CD epidemics: Celiac Disease incidence is increasing at unexpected rates in the last two decades in all gluten-consuming populations.
- Remarkable stratified genetic risk: there is a strong genetic component as the main risk to develop disease, as supported by > 85% concordance in monozygotic twins, but genetics cannot change over decades and does not explain the epidemic which has been observed. The presence of double HLA DQ2 in female subjects does increases the risk of disease above that of a mendelian recessive inheritance. Hence the estimation of environmental factors associated to the genetic risk is quite complex and does need a very strict prospective longitudinal study design, since each factor is likely to produce, if ever, a quite small odds ratio .
- Gene expression in the first year of life: we have observed, in our previous cohort studies, that the expression of at least a small set of CD associated candidate genes is substantially different between the children who eventually develop Cd and those who do not, already a 6 months of age, much before any measurable recognition of the gluten antigen, development of antibodies or any clinical sign (ref 3 Galatola).
- Epigenetic changes in small intestinal tissue: in addition of the previously reported gene expression differences, gene methylation and related expression of CD associated candidate genes have been observed in the epithelium and the lamina propria of Cd patients . In addition, microRNA appear to be differently expressed in patients versus controls.
- Early events in the first-second year of life before diagnosis: our groups and others observed that the occurrenceof acute respiratoryinfections in the first and second year of life, at least 12 months before the onset of disease, was associated to increased odds (> x2) of developing CD. It is most likely that viral infections (as the large majority of URTI in children) play a role in the development of food antigen intolerance leading to CD . A role of non-pathogenic viral infections has been also suggestedin the developmentof intolerance to gluten.
- No influence of breast-feeding or gluten introduction: breast feeding does not prevent the incidence of CD in at risk infants: its most likely effect is to delay the onset of clinical symptoms. Similarly, the time and quantity of gluten introduction is not associated to the actual incidence, but is only associated to delayed time effects.
- Possible implication of microbiome: despite the complexity of estimating differences in the composition of microbiome in the infants, it has been suggested that infants who later develop CD might show a fila composition slightly different from their matched controls.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
- Study population
- Pregnant women from a family with a confirmed CD proband Live newborns from the above mothers
Key inclusion criteria (1 listed)
- Pregnant women from a family with a confirmed CD proband
Key exclusion criteria (2 listed)
- Women affected by severe chronic disease and cancer Women not able to attend the schedule of visits
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| analysis of genetic and epigenetic risk factorsanalysis of gene, methylation and expression, microbiome | Genetic | – |
Primary outcome
Incidence of Celiac Disease
Time frame: 6 years
Number of new cases of infants affected by Celiac Disease in relation to genetic (HLA and non-HLA Associated Genes), Epigenetic (DNA Methylation, Gene Expression, Istone Acetylation of candidate gene) and environmental factors (Maternal factors, Nutrition, Infections)
1 secondary outcome
Analysis of microbiome
Time frame: 6 years
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Aug 2019.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Prevention of Clinical Symptoms in Celiac Disease, run by Federico II University at 1 site in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 2 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of Celiac Disease (time frame: 6 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Aug 2019.