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Autologous Bronchial Basal Cells Transplantation for Treatment of Bronchiectasis

Phase 1
Conditions
Bronchiectasis
Interventions
Biological: Bronchial basal cells
Registration Number
NCT02722642
Lead Sponsor
Regend Therapeutics
Brief Summary

Bronchiectasis is a result of chronic inflammation compounded by an inability to clear mucoid secretions. Inflammation results in progressive destruction of the normal lung architecture, in particular the elastic fibers of bronchi. Currently there is no effective drug for bronchiectasis. This study intends to carry out an open, single-center, non-randomized, self control phase I/II clinical trial. During the treatment, bronchial basal cells (BCCs) will be isolated from patients' own bronchi by bronchoscopic brushing and expanded in vitro. Cultured cells will be injected directly into the lesion by fiberoptic bronchoscopy after lavage. After six-month observation, the investigators will evaluate the safety and effectiveness of the treatment by measuring the key indicator-- the CT imaging of dilated bronchi as well as four secondary indicators including the pulmonary function, laboratory factor level, incidence of acute exacerbation and the patients' self-evaluation.

Detailed Description

Bronchiectasis is a term for irreversible lung damage resulting from recurrent episodes of infection and inflammation. Bronchial basal cells (BCCs) have been proven with stem cell activity to regenerate bronchi and repair lung damage. In this single-center, non-randomized, self control phase I/II clinical trial, patients' own BCCs will be grown in laboratory before injected to the damaged part of lung tissue. Transplanted BCCs have the potential to replenish the bronchial epithelium and reconstruct respiratory architecture.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Subjects diagnosed as bronchiectasis.
  • Subjects with at least 6 lung segments affected.
  • Subjects with stable condition for more than 2 weeks.
  • Subjects can tolerate bronchoscopy.
  • Subjects signed informed consent.
Exclusion Criteria
  • Women of childbearing age at the stage of pregnancy or lactation, or those without taking effective contraceptive measures.
  • Subjects with syphilis or HIV positive antibody.
  • Subjects with any malignancy.
  • Subjects suffering from any of the following pulmonary diseases: active tuberculosis, pulmonary embolism, pneumothorax, multiple huge bullae, uncontrolled asthma, acute exacerbation of chronic bronchitis or extremely severe COPD.
  • Subjects suffering from other serious diseases, such as diabetes, myocardial infarction, unstable angina, cirrhosis, and acute glomerulonephritis.
  • Subjects with leukopenia (WBC less than 4x10^9 / L) or agranulocytosis (WBC less than 1.5x10^9 / L or neutrophils less than 0.5x10^9 / L) caused by any reason.
  • Subjects with severe renal impairment, serum creatinine> 1.5 times the upper limit of normal.
  • Subjects with liver disease or liver damage: ALT, AST, total bilirubin> 2 times the upper limit of normal.
  • Subjects with a history of mental illness or suicide risk, with a history of epilepsy or other central nervous system disorders.
  • Subjects with severe arrhythmias (such as ventricular tachycardia, frequent superventricular tachycardia, atrial fibrillation, and atrial flutter, etc.) or cardiac degree II or above conduction abnormalities displayed via 12-lead ECG.
  • Subjects with a history of alcohol or illicit drug abuse.
  • Subjects accepted by any other clinical trials within 3 months before the enrollment.
  • Subjects with poor compliance, difficult to complete the study.
  • Any other conditions that might increase the risk of subjects or interfere with the clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Bronchial basal cellsBronchial basal cellsPatients will receive 10\^6 (1 million)/Kg/person cells of clinical grade bronchial basal cells (BBCs) injected via fiberoptic bronchoscopy after fully lavage of the localized lesions.
Primary Outcome Measures
NameTimeMethod
CT imaging of dilated bronchi3 day - 6 months

CT image of dilated bronchi will be analyzed.Clinical indicators include the spread of dilation, extent of dilation and the thickness of bronchi wall.

Secondary Outcome Measures
NameTimeMethod
blood gas level(PH)3 day - 6 months
patients' self-evaluation3 day - 6 months

The self-efficacy evaluation can also be classified into four levels: effective, improved, stable and invalid.

MRC chronic dyspnea scale3 day - 6 months
St. George's Respiratory Questionnaire (SGRQ) scale3 day - 6 months
incidence of acute exacerbation3 day-6 months
inflammation indicators3 day - 6 months

TNF-α,IL1-β,PDGF,MMP9,TIMP1,CRP, PCT

blood gas level(HCO3)3 day - 6 months
blood gas level(PaCO2)3 day - 6 months
pulmonary function test (FEV1)3 day - 6 months

Forced expiratory volume in one second, FEV1

fibrotic factor level3 day - 6 months

TGF-β, Hydroxyproline

pulmonary function test (DLco)3 day - 6 months

Diffusing capacity of CO

pulmonary function test (FVC)3 day - 6 months

forced vital capacity

pulmonary function test (MMEF)3 day - 6 months

maximal midexpiratory flow curve

blood gas level(PaO2)3 day - 6 months
6-minute walk distance test3 day - 6 months
pulmonary function test (MVV)3 day - 6 months

maximal voluntary ventilation

Trial Locations

Locations (1)

First Affiliated Hospital of the Third Military University, PLA (Southwest Hospital)

🇨🇳

Chongqing, Chongqing, China

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