Gluten-free diet: After initial fase of habitual diet (6 months), patients will start Gluten-free diet for a period of 12 months
Study summary
Primary sclerosing cholangitis (PSC) is a progressive disease of the biliary tree, which represents one of the most frequent indications for orthotopic liver transplantation (OLTx) in developed countries. There are several lines of evidence that dietary gluten/gliadin displays chronic pro-inflammatory, LPS-like properties. Recent evidence demonstrated the protective effect of gluten- free diet (GFD) in autoimmune diseases like type 1 diabetes, irritable bowel syndrome, non-celiac gluten sensitivity and some neurological disorders. This study is intended to explore therapeutic effect of GFD on PSC and IBD in prospective self-controlled mono-centric intervention study.
Hypothesis: Avoidance of gluten in diet will reduce progression, symptoms and intestinal inflammation in PSC and UC patients.
Eligibility
Sex
ALL
Min age
18 Years
Max age
65 Years
Healthy volunteers
No
Inclusion Criteria (for PSC group):
* Established diagnosis of PSC (based on radiologic features, typical finding on MRCP or ERCP)
* Age 18 - 65 years
* ALP 1,5x higher than ULN
* Signed informed consent
Exclusion Criteria (for PSC group):
* Patients on gluten-free diet
* Patients with coeliac disease or wheat allergy
* Liver transplant recipients
* PSC/AIH overlap syndrome
* Other causes of liver disease
* Radiologic or clinical signs of decompensated liver cirrhosis
* Advanced liver cirrhosis (MELD score ˃ 15)
* Recurrent acute cholangitis or cholangiogenic sepsis in past 3 months
* Use of antibiotics in past 3 months
* History of malignancy
* Pregnant women
* Not signed informed consent
Inclusion criteria (for UC group):
* Ulcerative colitis diagnosed based on clinical, endoscopic and histological findings
* Extension of affected colon \> 15cm
* Mayo score 0-4
* Signed informed consent
Exclusion criteria (for UC group):
* CMV, Clostridium difficile enterocolitis in past 3 months
* Use of antibiotics in past 3 months
* Patients with coeliac disease or wheat allergy
* Patients on gluten-free diet
* Pregnant women
* Not signed informed consent
* Biologic therapy
* Methotrexate
* Prednison \> 10 mg
* Not signed informed consent
Primary outcome measure(s)
Decrease of laboratory markers of cholestasis — 6-12 months Change of alkaline phosphatase \> 25% or normalisation.
Changes of intestinal microbiome composition. — 6-12 months 16S-rRNA sequencing
Trial sites (1)
Facility
City
Region
Status
Institute of clinical and experimental medicine
Prague
Prague
More Institute for Clinical and Experimental Medicine trials in Czechia
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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