A Clinical Study of Mesenchymal Stem Cell Exosomes Nebulizer for the Treatment of ARDS
NCT ID: NCT04602104
Last Updated: 2024-07-22
Study Results
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Basic Information
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COMPLETED
PHASE1/PHASE2
18 participants
INTERVENTIONAL
2020-11-30
2023-01-11
Brief Summary
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Detailed Description
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Exosomes are naturally occurring nanosized vesicles and comprised of natural lipid bilayers with the abundance of adhesive proteins that readily interact with cellular membranes. Studies have confirmed that MSC-Exos can improve most of the pathological changes caused by lung infection, reduce pulmonary edema, reduce protein exudation, reduce alveolar inflammation, and clear bacterial infections. Thus, it brings new hope for the treatment of ARDS.
The purpose of this study is to evaluate allogeneic human mesenchymal stem cell exosomes (hMSC-Exos) in the treatment of acute respiratory distress syndrome (ARDS)
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Phase 1: hMSC-Exos low dose
hMSC-Exos low-dose group
low dose hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (2.0\*10\^8 particles at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Phase 1: hMSC-Exos medium dose
hMSC-Exos medium-dose group
medium dose hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (8.0\*10\^8 particles at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Phase 1: hMSC-Exos high dose
hMSC-Exos high-dose group
high dose hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (16.0\*10\^8 particles at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Phase 2: hMSC-Exos dosage 1
basic treatment+hMSC-Exos (a quarter of MTD/day)
Dosage 1of hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (a quarter of MTD/day at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Phase 2: hMSC-Exos dosage 2
basic treatment+hMSC-Exos (MTD/day)
Dosage 2 of hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (MTD/day at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Phase 2: control group
basic treatment+normal saline
No hMSC-derived exosomes
basic treatment and 7 times aerosol inhalation of normal saline (at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Interventions
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low dose hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (2.0\*10\^8 particles at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
medium dose hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (8.0\*10\^8 particles at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
high dose hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (16.0\*10\^8 particles at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Dosage 1of hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (a quarter of MTD/day at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Dosage 2 of hMSC-Exos
basic treatment and 7 times aerosol inhalation of hMSC-Exos (MTD/day at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
No hMSC-derived exosomes
basic treatment and 7 times aerosol inhalation of normal saline (at Day 1, Day 2, Day 3, Day 4, Day 5, Day 6, Day 7)
Eligibility Criteria
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Inclusion Criteria
2. 18-70 years old, male or female;
3. Definitely diagnosed as acute respiratory distress syndrome (ARDS) (according to the Berlin definition and diagnostic criteria of ARDS);
4. Course of disease \<96 hours after diagnosis;
5. Chest X-ray showed bilateral infiltration with pulmonary edema; no clinical manifestations of left ventricular hypertension, or pulmonary artery wedge pressure (PAOP) ≤18mmHg.
Exclusion Criteria
2. Moderate to severe liver failure (children Pugh score \> 12);
3. Patients with severe chronic respiratory diseases, PaCO2 \> 50mmhg, and need home oxygen therapy;
4. Severe trauma occurred within 14 days before screening;
5. History of malignant tumor (patients with skin basal cell carcinoma in the past can be included);
6. They are undergoing hemodialysis or peritoneal dialysis;
7. The patients who had deep venous thrombosis or pulmonary embolism within 90 days;
8. Acute myocardial infarction occurred within 30 days;
9. Neuromuscular diseases that result in impaired natural ventilation include, but are not limited to, C5 or higher spinal cord injury, amyotrophic lateral sclerosis, Guillain Barre syndrome, and myasthenia gravis;
10. Obesity (BMI \> 28);
11. Lung transplantation;
12. Bone marrow transplantation;
13. Active immunosuppression is defined as receiving immunosuppressive drugs or having a medical condition associated with immunodeficiency. These included: 1) HIV (AIDS or CD4 \< 200 cells / mm3); 2) chemotherapy within 6 weeks before randomization; 3) immunosuppressive therapy, including maintenance glucocorticoid therapy (\> 40) Results: 1) short term systemic steroid therapy (intravenous or oral) for less than 1 week, topical steroid for skin diseases; 4) absolute neutrophil count \< 500 / mm3;
14. Patients undergoing extracorporeal circulation support (ECMO) or high frequency oscillatory ventilation;
15. They were not willing to receive lung protective ventilation (minimum tidal volume 6ml / kg pbw) or liquid management treatment;
16. Have a history of epilepsy, need continuous anticonvulsant therapy, or have received anticonvulsant therapy in the past 3 years;
17. The estimated survival time was less than 30 days;
18. Hepatitis B, hepatitis C, AIDS, syphilis patients;
19. Women of childbearing age are pregnant, lactating or pregnant within one year;
20. Those who could not understand the study protocol;
21. According to the judgment of the researchers, there were other situations in which the patients were not suitable to participate in the study (for example, there were factors to reduce the follow-up compliance, and the patients did not receive relevant supportive treatment, etc.).
18 Years
70 Years
ALL
No
Sponsors
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Shanghai AbelZeta Ltd.
INDUSTRY
Ruijin Hospital
OTHER
Responsible Party
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Locations
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Ruijin Hospital, Medical School of Shanghai Jiaotong University
Shanghai, Shanghai Municipality, China
Countries
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Other Identifiers
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MEXARDS
Identifier Type: -
Identifier Source: org_study_id
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