A Clinical Study of Mesenchymal Stem Cell Exosomes Nebulizer for the Treatment of ARDS

NCT ID: NCT04602104

Last Updated: 2024-07-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

18 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-30

Study Completion Date

2023-01-11

Brief Summary

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To evaluate allogeneic human mesenchymal stem cell exosomes (hMSC-Exos) in the treatment of acute respiratory distress syndrome (ARDS)

Detailed Description

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According to the 2012 Berlin diagnostic criteria, there are currently more than 3 million ARDS patients worldwide, accounting for about 10% of patients in the intensive care unit (ICU). In recent years, the incidence of ARDS has increased significantly, which has significantly increased the social and economic burden. The impact of ARDS can even be compared with tumors, AIDS or myocardial infarction. There are the basic clinical treatments, such as using various ventilation methods to improve hypoxia and choosing alternative therapies to improve renal insufficiency. Therefore, there is still a lack of specific treatment measures.

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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Acute Respiratory Distress Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Phase 1: hMSC-Exos low dose

hMSC-Exos low-dose group

Group Type EXPERIMENTAL

low dose hMSC-Exos

Intervention Type BIOLOGICAL

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

Group Type EXPERIMENTAL

medium dose hMSC-Exos

Intervention Type BIOLOGICAL

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

Group Type EXPERIMENTAL

high dose hMSC-Exos

Intervention Type BIOLOGICAL

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)

Group Type EXPERIMENTAL

Dosage 1of hMSC-Exos

Intervention Type BIOLOGICAL

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)

Group Type EXPERIMENTAL

Dosage 2 of hMSC-Exos

Intervention Type BIOLOGICAL

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

Group Type PLACEBO_COMPARATOR

No hMSC-derived exosomes

Intervention Type BIOLOGICAL

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)

Intervention Type BIOLOGICAL

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)

Intervention Type BIOLOGICAL

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)

Intervention Type BIOLOGICAL

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)

Intervention Type BIOLOGICAL

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)

Intervention Type BIOLOGICAL

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)

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

1. The subjects themselves or their family members voluntarily participate in this study and sign the informed consent form;
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

1. Patients with severe allergic constitution;
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.).
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai AbelZeta Ltd.

INDUSTRY

Sponsor Role collaborator

Ruijin Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Ruijin Hospital, Medical School of Shanghai Jiaotong University

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

Other Identifiers

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MEXARDS

Identifier Type: -

Identifier Source: org_study_id

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