Autologous Adipose-Derived Mesenchymal Stem Cells for Chronic Traumatic Brain Injury
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 入组人数
- 51
- 试验地点
- 4
- 主要终点
- Absolute Neutrophils
研究概览
简要总结
The global objective of this study is to establish the safety and investigate the potential treatment effect of an intravenous infusion of HB-adMSCs (Hope Biosciences adipose-derived mesenchymal stem cells) on brain structure, neurocognitive/functional outcomes, and neuroinflammation after traumatic brain injury.
详细描述
This study is a prospective, randomized, double-blind, placebo-controlled Phase 2a study of three infusions of autologous HB-adMSCs (Hope Biosciences adipose-derived mesenchymal stem cells) (2 x 10^8 total cells per dose) administered over a 6 week period with 14 day intervals between infusions. Subjects will be monitored and assessed for infusion related toxicity for at least 1 hour after the infusion and by telephone 24hr. after each infusion. Safety assessments will be conducted at the study follow-up clinic visits 6 and 12 months, and 2 years (telephone call) after the last HB-adMSC (Hope Biosciences adipose-derived mesenchymal stem cells) infusion, or more frequently if infusion related adverse events are suspected.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 55 Years(Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults between 18 and 55 years of age.
- •Documented functional neurological damage to the central nervous system from blunt force head trauma unlikely to improve with present standard of care approaches.
- •A Glasgow Outcome Scale-Extended (GOS-E) score > 2 and ≤
- •Onset or diagnosis of the injury or disease process greater than 6 months and ≤ 20 years.
- •Ability to obtain consent from the subject or their legally authorized representative (LAR).
- •Ability to verbally communicate in English or Spanish (required for validated neurocognitive outcome testing).
排除标准
- •Known history of:
- •intellectual deficiency or uncontrolled psychiatric conditions likely to invalidate our ability to assess changes in cognition or behavior, or at the discretion of the PI,
- •recently treated infection,
- •renal disease or altered renal function (screening eGFR < 60 mL/min/1.73m2),
- •hepatic disease or altered liver function (screening SGPT > 150 U/L or T. Bilirubin >1.3 mg/dL),
- •immunosuppression (screening WBC < 3, 000 cells/ml),
- •Positive infectious disease tests including HIV, Hep. B, Hep. C., and Syphilis,
- •chemical or ETOH dependency that in the opinion of the investigator would preclude enrollment/participation in the study,
- •acute or chronic lung disease requiring significant medication/oxygen supplementation,
- •bleeding disorders, thrombocytopenia, including immune-mediated heparin-induced thrombocytopenia,
- •known sensitivity to heparin, Lovenox, and pork products,
- •individuals with mechanical prosthetic heart valves,
- •individuals who have received a stem cell treatment, gene or cellular therapy.
- •Normal brain CT/MRI exam.
- •Planned epidural or spinal anesthesia, or undergoing spinal puncture, complete spinal cord injury.
- •Diagnosed with a genetic or metabolic disorder related to the neurologic condition.
- •Other acute or chronic medical conditions that, in the opinion of the investigator, may increase the risks associated with study participation.
- •For women of childbearing potential, a positive pregnancy test at the screening visit or, for both women and men, unwillingness to comply with acceptable methods of birth control during the study.
- •Concurrent participation in interventional drug or device study.
- •Inability to undergo the diagnostic tests (PET/DT-MRI) or unwilling/unable to cooperate with the diagnostic tests and outcome assessments.
- •Metal implants including baclofen pumps that would preclude DT-MRI.
- •Unwilling or unable to return for the follow-up study visits.
- •Uncorrectable vision impairment that will prevent completion of neurocognitive tests require visual processing.
研究组 & 干预措施
Treatment
Autologous Adipose Derived Mesenchymal Stem Cells
干预措施: Autologous HB-adMSCs (Biological)
Placebo
Normal Saline
干预措施: Normal Saline (Drug)
结局指标
主要结局
Absolute Neutrophils
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of absolute neutrophils in blood (x 10\^3/uL)
Eosinophils
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of eosinophils in blood (%)
Basophils
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of basophils in blood (%)
Absolute lymphocytes
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of absolute lymphocytes in blood (x 10\^3/uL)
Absolute monocytes
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of absolute monocytes in blood (x 10\^3/uL)
Absolute eosinophils
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of absolute eosinophils in blood (x 10\^3/uL)
Mean corpuscular volume
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of mean corpuscular volume (MCV) in blood (fL)
Glucose
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of level of glucose in the blood (mg/dL)
Calcium
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of level of calcium in the blood (mg/dL) clinical lab evaluation of level of calcium in the blood (mg/dL) clinical lab evaluation of level of calcium in the blood (mg/dL)
Albumin
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of level of albumin in the blood (g/dL)
Total Protein
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of total protein in the blood (g/dL)
Sodium
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of total sodium in the blood (mmol/L)
Total Bilirubin
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of total bilirubin in blood (mg/dL)
White blood cell
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of white blood cells (WBC) in blood (x 10\^3/uL)
Total carbon dioxide
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of total carbon dioxide in the blood (mmol/L)
Potassium
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of potassium in the blood (mmol/L)
Chloride
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical lab evaluation of chloride in the blood (mmol/L)
BUN (blood urea nitrogen)
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of blood urea nitrogen (BUN) (mg/dL)
Creatinine
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of creatinine in blood (mg/dL
Alkaline phosphatase
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of alkaline phosphatase (ALP) in blood (IU/L)
Alanine aminotransferase
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of alanine aminotransferase (ALT) in blood (IU/L)
Aspartate aminotransferase
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of aspartate aminotransferase (AST) in blood (IU/L)
Red blood cell
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of red blood cells (RBC) in blood (x 10\^6/uL)
Hemoglobin
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of hemoglobin in blood (g/dL)
Hematocrit
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of hematocrit in blood (%)
Mean corpuscular hemoglobin
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of mean corpuscular hemoglobin (MCH) in blood (pg)
Mean corpuscular hemoglobin concentration
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of mean corpuscular hemoglobin concentration (MCHC) in blood (g/dL)
Red cell distribution width
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of red cell distribution width (RDW) in blood (%)
Neutrophils
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of neutrophils in blood (%)
Lymphocytes
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of lymphocytes in blood (%)
Monocytes
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of monocytes in blood (%)
Absolute basophils
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of absolute basophils in blood (x 10\^3/uL)
Immature Granulocytes
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of immature granulocytes in blood (%)
Absolute Immature Granulocytes
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of absolute immature granulocytes in blood (x 10\^3/uL)
Platelets
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of platelets in blood (x 10\^3/uL)
Prothrombin Time
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of time for blood to coagulate (seconds)
INR (international normalized ratio)
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of international normalized ratio of blood coagulation (no unit)
Urine Pregnancy (if applicable)
时间窗: Week 0 (Infusion 1), change from week 0 (Infusion 1) at week 2 (Infusion 2), change from week 0 (Infusion 1) at week 4 (Infusion 3), change from week 0 (Infusion 1) at 6 months post-infusion, change from week 0 (Infusion 1) at 1 year post-infusion
clinical evaluation of human chorionic gonadotropin (hCG) in urine (positive/negative)
次要结局
- Whole brain MRI (Magnetic resonance imaging)(Baseline, change from baseline at 6 months post-infusion)
- PET/DT-MRI (positron emission tomography/Diffusion tensor-Magnetic resonance imaging)(Baseline, change from baseline at 6 months post-infusion)
- Glasgow Outcome Scale - Extended(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- Disability Rating Scale(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- Behavior Rating of Executive Functions-Adult(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- TBI (Traumatic Brain Injury) Quality of Life Questionnaires(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- Brief Symptom Inventory 18(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- NIH Toolbox - Pattern Comparison Processing Speed Test(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- NIH Toolbox - Dimensional Change Card Sort Test(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- NIH Toolbox - Picture Vocabulary Test(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- NIH Toolbox - List Sorting Working Memory Test(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- NIH Toolbox - Flanker Inhibitory Control and Attention Test(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- NIH Toolbox - 9-hole Pegboard Dexterity Test(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- Rey Auditory Verbal Learning Test(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- Verbal Fluency(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- Interleukin 10(Baseline imaging (visit #2), change from baseline at 6 months post-infusion, change from baseline 1 year post-infusion)
- Wechsler Adult Intelligence Scale - IV: Processing Speed Index(Baseline, change from baseline at 6 months post-infusion, change from baseline at 1 year post-infusion)
- Plasma cytokines(Baseline imaging (visit #2), change from baseline at 6 months post-infusion, change from baseline 1 year post-infusion)
- Interleukin 1-alpha(Baseline imaging (visit #2), change from baseline at 6 months post-infusion, change from baseline 1 year post-infusion)
- Interleukin 4(Baseline imaging (visit #2), change from baseline at 6 months post-infusion, change from baseline 1 year post-infusion)
- Tumor necrosis factor alpha(Baseline imaging (visit #2), change from baseline at 6 months post-infusion, change from baseline 1 year post-infusion)
- Interleukin 6(Baseline imaging (visit #2), change from baseline at 6 months post-infusion, change from baseline 1 year post-infusion)
- Albumin(Baseline imaging (visit #2), change from baseline at 6 months post-infusion, change from baseline 1 year post-infusion)
