Potential Use of Autologous and Allogeneic Mesenchymal Stem Cells in Patients With Multiple System Atrophy
试验速览
- 阶段
- 不适用
- 入组人数
- 15
- 试验地点
- 1
- 主要终点
- Changes of structures improvement of the eyes from Baseline to 1,3,6,9 and 12 months after second implantation
研究概览
简要总结
The prevalence of Multiple System Atrophy (MSA) is reported to be between 3.4 - 4.9 cases per 100,000 population. The estimated average incidence is 0.6 - 0.7 cases per 100,000 people per year. Many patients are not diagnosed properly during their lifetime because of the difficulty in differentiating MSA from other disorders. Approximately 29 - 33% of patients with isolated late onset cerebellar ataxia and 8 - 10% of patients with parkinsonism will develop MSA.
There are currently no therapies that can cure or stop the progression of the disease. The current pharmacological therapy is only to relieve symptoms. Mesenchymal stem cells (MSC) are considered an efficient source of cells for therapy, because they can be safely harvested and transplanted to donors or patients, have low immunogenicity, and have broad therapeutic potential. Results from preliminary preclinical and clinical trials indicate the potential of MSC-based treatment in meeting several key aspects of neurodegeneration. Stem cell-based therapy for neurodegenerative diseases aims to stop clinical damage by regenerating and by providing local support for damaged tissue, in addition after transplantation, MSCs have been shown to be capable of penetrating the lesion area and thus have great potential use as a means of administering therapeutic agents.
The subjects of this study were patients who experienced possible MSA based on the consensus clinical criteria for MSA. There will be three treatment groups with a total sample of 5 subjects each.
Group 1 will receives MSC-Adipose Autologous with doses 2x50 million cells intratechally.
Group 2 will receives MSC-Umbilical Cord Allogeneic with doses 2x 50 million cells intratechally.
Group 3 will receives MSC-Umbilical Cord Allogeneic with doses 2x50 million cells intratechally and 2x10cc secretome MSC from Adipose Intravenously.
Clinical improvement will be evaluated using the UMSARS scale, PET-Scans, MRI, DaTScan, IGF-1, BDNF, Sympathetic skin respons (SSR), EMG, Composite Autonomic Severity Score (CASS), High definition-Optical coherence tomography (HD-OCT), ERG, VEP, Log MAR chart, Ishihara test and side adverse effect on MSC.
This study is divided into six timeframes : Before an implantation, First Month after second implantation, Third month after secondary implantation, Sixth month after second implantation, Ninth month after second implantation and Twelve month after second implantation. The differences between the test variables are then used as an indicator to assess clinical improvement within the subjects.
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
- Single (Participant)
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients developed MSA based on clinical examination and consensus MSA criteria.
- •Patients diagnosed with MSA for less than 4 years.
- •Patients with an anticipated survival of at least 3 years in the opinion of the examiner.
- •Patients with MOCa and Mini Mental State Examination (MMSE) values of more than
- •For Adipose Autologous-MSC group subjects were not experiencing active infection, which was confirmed by screening for HbSAg, Anti HCV, Syphilis, HIV, CMV, Rubella, and Toxoplasma.
- •Subjects are willing to participate in research and fill out an informed consent form.
- •Do not have autoimmune disorder, or undergoes management disorders and / or other diseases related to MSA
- •Subjects are willing to participate in research and fill out an informed consent form.
排除标准
- •Suffer from systemic autoimmune diseases (systemetic lupus erythomatosus, Addison's disease, Crohn's disease, arthritis management), immunodeficiency (SIDA), or blood clotting disorders or management of malignant diseases (diseases associated with MSA)
- •Undergo immunosuppressive therapy, anticoagulants or corticosteroids.
- •Patients with malignant neoplasms and close family history of neoplasms.
- •already had history of spinal surgery, have paralysis or have spinal diseases.
- •Patients with a history of electroconvulsive therapy.
- •Patients with a history of brain surgery for Parkinson's disease.
- •Patients with systemic or local infections located close to the injection site.
- •Undergo immunosuppressive therapy, anticoagulants or corticosteroids.
- •The patient was not willing to take part in the study and did not fill out informed consent.
研究组 & 干预措施
Autologous Adipose MSC Group
This group will receive the implantation of autologous mesenchymal stem cell origin of adipose tissue with a dose of 2 x 50 million cells given with a distance of 1 month
干预措施: Autologous Adipose Mesenchymal Stem Cell Implantation (Biological)
Allogeneic Umbilical Cord MSC Group
This group will receive intrathecal implantation of allogeneic mesenchymal stem cells from the umbilical cord with a dose of 2 x 50 million cells given a distance of 1 month.
干预措施: Allogeneic Umbilical Cord Mesenchymal Stem Cell Implantation (Biological)
Allogeneic Umbilical Cord MSC and Adipose Secretome Group
This group will receive intrathecal implantation of allogeneic mesenchymal stem cells from the umbilical cord as much as 2 x 50 million followed by 2 x 10cc mesenchymal stem cell secretions from adipose tissue intravenously given at a distance of 1 month.
干预措施: Allogeneic Umbilical Cord Mesenchymal Stem Cell and Adipose Secretome Implantation (Biological)
结局指标
主要结局
Changes of structures improvement of the eyes from Baseline to 1,3,6,9 and 12 months after second implantation
时间窗: Pre-implantation, 1st Month, 3rd Months, 6th Months , 9th, 12th Months After Second Implantation
an increase in the thickness of the Retinal Nerve Fiber Layer(RNFL) checked from the High Definition-Optical Coherence Tomography examination(HD-OCT)
Changes of Clinical Evaluation from Baseline to 1,3,6,9 and 12 months after second implantation
时间窗: Pre-implantation, 1st Month, 3rd Months, 6th Months , 9th, 12th Months After Second Implantation
Subjects will be evaluated by Neurological test
Changes of the eyesight from Baseline to 1,3,6,9 and 12 months after second implantation
时间窗: Pre-implantation, 1st Month, 3rd Months, 6th Months , 9th, 12th Months After Second Implantation
improvement of eyesight will be checked using LogMar Test
Imaging Evaluation from Baseline to 1,3,6,9 and 12 months after second implantation
时间窗: Pre-implantation, 1st Month, 3rd Months, 6th Months , 9th, 12th Months After Second Implantation
The Brain will be checked to see Changes of MRI to see increased FDG Uptake
次要结局
未报告次要终点
研究者
Ismail Hadisoebroto Dilogo
Principal Investigator
Indonesia University
