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CTRI Number  CTRI/2024/12/078304 [Registered on: 18/12/2024] Trial Registered Prospectively
Last Modified On: 13/11/2025
Post Graduate Thesis  No 
Type of Trial  Observational 
Type of Study   Cross Sectional Study 
Study Design  Other 
Public Title of Study   B-vitamin production by human gut microbes 
Scientific Title of Study   The absorption of gut-microbe-produced-B-vitamins-in humans by oral administration of 13C cellulose 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Pratibha Dwarkanath 
Designation  Associate Professor 
Affiliation  St. John’s Research Institute 
Address  Division of Nutrition,St. John’s Research Institute, Opp BDA Complex, Koramangala, Bangalore; 560034, Karnataka, India

Bangalore
KARNATAKA
560034
India 
Phone  9880714118  
Fax    
Email  pratibha@sjri.res.in  
 
Details of Contact Person
Scientific Query
 
Name  Pratibha Dwarkanath 
Designation  Associate Professor 
Affiliation  St. John’s Research Institute 
Address  Division of Nutrition,St. John’s Research Institute, Opp BDA Complex, Koramangala, Bangalore; 560034, Karnataka, India


KARNATAKA
560034
India 
Phone  9880714118  
Fax    
Email  pratibha@sjri.res.in  
 
Details of Contact Person
Public Query
 
Name  Shalini Gajanan Hegde 
Designation  Associate Professor 
Affiliation  St. John’s Medical College 
Address  Department of Pediatric Surgery,St. John’s Medical College, Bangalore; 560034, Karnataka, India

Bangalore
KARNATAKA
560034
India 
Phone  9914208942  
Fax    
Email  shal.hegde@gmail.com  
 
Source of Monetary or Material Support  
St. Johns medical college hospital 
 
Primary Sponsor  
Name  St Johns Medical College Bangalore 
Address  3rd floor Department Of Physiology, St. John’s Medical College, Bangalore  
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Pratibha Dwarkanath  St John’s Medical College Hospital  Division of nutrition , 3rd floor, St. John’s Medical College Hospital
Bangalore
KARNATAKA 
9880714118

pratibha@sjri.res.in 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
St. John’s Medical College Hospital   Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Healthy Human Volunteers  Apparently healthy adults of both sexes 
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  NIL  NIL 
Intervention  NIL  NIL 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  45.00 Year(s)
Gender  Both 
Details  Apparently healthy adults of both sexes 
 
ExclusionCriteria 
Details  1. Subjects who are on B12 supplements.
2. Antibiotic use in the last 3 months.
3. Diarrhea in the last 3 months.
4. on special/fad diets.
5 History of gastrointestinal surgery ( bowel resection, gastrectomy, vagotomy, ileostomy,
bariatric, colostomy)
6. Uncontrolled co-morbidities like diabetes hypertension and cardiovascular disease, or this
with history of allergic or hypersensitive reaction, were excluded from the study.
7. Clinical suspicion of any of the vitamin B deficiencies
 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
To determine whether colonic microbiota can synthesize vitamins for human host absorption by providing 13C labeled cellulose as substrate  The study is over a course of 72 hours with sampling at baseline, 24, 30, 36, 42, 48, 60, 72 hours. Sampling before 24 hours may be done after analysis of pilot data. 
 
Secondary Outcome  
Outcome  TimePoints 
To determine whether colonic microbiota can synthesize vitamins for human host absorption by providing 13C labeled cellulose as substrate to evaluate the association of measured microbial B12 levels in human blood with B12 status to identify specific bacterial strains in the microbe which are capable of measured vitamin production  The study is over a course of 72 hours with sampling at baseline, 24, 30, 36, 42, 48, 60, 72 hours. Sampling before 24 hours may be done after analysis pilot data. 
 
Target Sample Size
Modification(s)  
Total Sample Size="15"
Sample Size from India="15" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   29/12/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="2"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

Indians in general are thought to have monotonous and predominantly cereal-based vegetarian diets with very little milk intake. In consequence, their intake of micronutrients, particularly the B vitamins, is low. Taking B12 as an example, the prevalence of its deficiency should be extraordinarily high, considering that the median daily population intake is only 1.2 µg/day1 compared to the stated average requirement (AR) of 2 µg/day.2 Yet, a recent national survey of 1-19y Indian children found just ~20-30% to be biochemically deficient, with no observed clinical manifestations. This has been replicated in a recent DBT-funded national survey of Indian adolescents and adults in 8 states, where <30% of the population were found to be deficient.4

A possible explanation of this apparent paradox is that in vivo intestinal microbial nutrient synthesis contributes to human micronutrient homeostasis. If this were indeed true – two important criteria need to be met. i) Is the human gut microbiome capable of producing B vitamins and nutrients ii) can these nutrients be adequately absorbed from the colon, where maximal synthesis may be expected to take place

Objective: To determine whether colonic microbiota can synthesize vitamins for human host absorption by providing 13C labelled cellulose as substrate

Methodology: Subject will report to the 3rd floor division of nutrition at 7 am. Sociodemographic details and relevant medical history will be documented. The bodyweight will be measured to the nearest 0.01 kg using calibrated digital weighing scale (Goldtech, AE038, New Delhi, India). Height will be measured using Seca stadiometer to the nearest 0.1 cm. All measurements will be in triplicates and mean of 3 readings will be considered. In the preceding week before the study, the subject will be instructed not to make any drastic changes in his/her diet.Baseline blood sample (8 ml) will be collected in a fasting state. 0.5 g – 4g of U- 13C Cellulose (U-10508, 97% purity, Isolife, Netherlands) will be administered as a suspension in 100 ml water or within a sandwich of white bread and butter. The subject will be allowed to eat his/her regular diet and resume regular activity after dose administration and report again after 24 hours and subsequently as per blood sampling protocol

 

Serial blood samples will be processed for respective vitamin measurements on a high-resolution analytical platform consisting of a Vanquish Flex Binary UHPLC coupled to a mass spectrometer (Q Exactive, LC-HRAM-MS; Thermo Scientific) with a heated electrospray ionization (HESI-II) probe. Separation of the metabolites will be achieved by using a Hypersil Gold aQ column (100 × 2.1 × 1.9 μm; Thermo Scientific) in a reverse-phase gradient. The pooled samples will also be injected periodically throughout the runs for QC check.

The Q Exactive mass spectrometer will be operated under electrospray ionization (HESI-II) positive and negative polarity mode in full scan (m/z 67–1000) and resolution set to 70,000 (FWHM) at m/z 200, with automatic gain control (AGC) target of 1×106 ions and a maximum ion injection time (IT) of 100 ms. Data-dependent MS/MS profiles will be acquired on a “Top5” data-dependent mode using the following parameters: resolution 35,000; AGC 1×105 ions; maximum IT 50 ms; 1.0 amu isolation window; combined NCE 25%, 35% and 50% and dynamic exclusion time set at 10s; Spectrum data type, Centroid.

Compound Discoverer (CD) will be used to detect the labelled features and isotope incorporation analysis. The stable isotope labelling layout, using an unlabelled reference sample, detects unknown compounds above a specified minimum intensity threshold, determines their elemental composition and identity, and then determines the labelled counterparts (isotopologues) of these compounds in the samples marked as labelled. The output provides the Isotopologues Distribution Chart, Trend Chart, and Metabolic pathways associated with the labelled features including the relative exchange rate (RER) for each compound to identify features with 13C incorporation. Each sampling time point will be manually evaluated for potential isotopic shift of upto m+n isotopomers for 13C incorporation based on the precursor labelling and their metabolites.

 Fecal samples will be obtained at baseline to characterize the gut microbiota for B vitamin production capacity and identify specific strains associated with the measured plasma appearance of different B vitamins. Fecal samples will also be obtained at end of study  for untargeted metabolomics of the fecal sample

 

 

 

 
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