This study will determine whether an experimental medicine, STA-5326 mesylate, is safe to use in patients with common variable immunodeficiency (CVID) who have inflammation of the gut. It will also determine if patients who take this drug show improvement in their symptoms, decrease in inflammatory chemicals in the gut, changes in their immune cells, and improvement in how their gut is functioning to absorb food.
Patients between 18 and 75 years of age with CVID and chronic diarrhea or involuntary weight loss of more than 5 percent of their past body weight over the past 12 months may be eligible for this study. Candidates are screened with a review of their medical records, a medical history and physical examination, blood, urine and stool tests, chest x-rays and skin test for exposure to tuberculosis, and a hydrogen breath test. For the latter, breath samples are collected before and every 20 minutes (for 2 hours) after the subject drinks a sugar solution. This test determines the digestive effects of bacteria in the upper intestine. Samples are collected by having the subject blow into a balloon.
Participants undergo the following tests and procedures:
Immune System and Gastrointestinal Evaluation
48-hour stool fat collection (measures the amount of undigested fat in the stool): Subjects keep a diary of what they eat for a 48-hour period. At the beginning of the 48 hours they take two dye capsules and then take another two capsules 48 hours later. They collect a stool sample when they pass the second set of capsules in their bowel movement. An additional 24-hour stool collection is tested for loss of protein in the stool.
D-xylose absorption test (measures the ability of the gut to absorb nutrients): Subjects drink a solution of d-xylose (a sugar substitute). Blood samples are collected before and 1 hour after drinking the solution.
Upper endoscopy: A thin flexible lighted tube is advanced through the mouth to evaluate the esophagus, stomach and beginning of the small intestine.
Lower endoscopy: A thin flexible lighted tube is advanced through the rectum to evaluate the colon.
Treatment Period (Study days 1 to 57)
Physical examination - study days 1, 8, 15, 29, 43 and 57
Blood samples to test the levels of STA-5326 in the blood. On study days 1 and 57, samples are collected before the medication dose and 1, 2, 4, 6 and 8 hours after the dose; on day 29, one sample is collected before the medication dose.
Blood samples for routine safety testing - study days 1, 8, 15, 29, 43 and 57
Medication history - study days 1, 8, 15, 29, 43 and 57
Interview about pain, discomfort, and well being - study days 1, 8, 15, 29, 43 and 57
Pregnancy test for women who can become pregnant - study days 15, 43, and 57
D-xylose absorption test - study days 29 and 57
Electrocardiogram - study days 29 and 57
Urine test - study days 29 and 57
Blood test for research on immune cells - study day 57
Repeat endoscopies and studies of gut function (24- and 48-hour stool collections)
Follow-up period (Day 85 and day 113)
-Physical examination, blood tests, medication history, questions about pain, discomfort and well being