Use of Wharton Jelly in Diabetic Nephropathy
Primary Purpose
Diabetic Nephropathies
Status
Unknown status
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Wharton Jelly Mesenchymal stem cells
Sponsored by
About this trial
This is an interventional treatment trial for Diabetic Nephropathies focused on measuring Diabetes, nephropathy, Kidney, parenchyma, Wharton Jelly, Mesenchymal stem cells
Eligibility Criteria
Inclusion Criteria:
- Willing and able to provide written informed consent.
- Type 2 diabetes mellitus (DM) for ≥ 3 years.
- Estimated GFR (eGFR) 15-45 ml/min/1.73 m2 by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation on 2 or more consecutive measurements at least 30 days apart within the past 6 months, confirmed by isotope kidney scan.
- Urine protein-to-creatinine ratio (UPCR) ≥ 500 mg/mmol (in spot urine or in 24 hour urine collection) confirmed twice over a period of 6 months.
- Ultrasonographic kidney measurements ≥ 10 cm (for both kidneys).
Exclusion Criteria:
- Patients with uncontrolled hyper or hypo tension; (systolic pressure >160, <100: diastolic pressure < 60, >100) on two different occasions.
- Poor diabetic control: Hemoglobin A1c (HbA1c) > 10%.
- New use of hypoglycemic, antihypertensive and/or lipid lowering agent within the past 6 months.
- Increase in the dose of anti-hypertensive and/or hypoglycemic agent of the previous dose within the past 3 months.
- Current fasting total cholesterol >300 mg/dl.
- Current fasting total triglycerides >400 mg/dl.
- History of any cardiovascular events in the past 6 months.
- Pregnancy or lactating.
- Positive screening test for infectious diseases as per baseline work up.
- History of kidney transplant
- Systemic autoimmune disease.
- Receiving immunosuppressant medications.
- Patients with glomerulonephritis or any non-DM related kidney disease.
- Patients with any coagulation disorder.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Wharton Jelly Mesenchymal stem cells
Arm Description
Intervention: Wharton Jelly Mesenchymal stem cells Site: Renal parenchyma Route of administration: ultrasound guided- intra-parenchymal total of 3 sites in each kidney. Number of doses: 3 doses 2 weeks apart for each kidney. Time interval between each dose: 2 weeks Total volume of cell suspension infused: 3 ml/kidney; each site will receive a 1 ml cell suspension with a total volume of 3 ml in each kidney.
Outcomes
Primary Outcome Measures
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Number, frequency and severity of injection associated adverse events.
The nephrologist will record any adverse event at each follow up visit in addition to evaluation of the overall condition of the patient.
Secondary Outcome Measures
Evaluation of the preliminary efficacy of the injection on kidney's Estimated Glomerular filtration rate
• Any positive changes in the patient's kidney function in terms of Estimated Gomerular filtration rate (mL/min/1.73 m²)
Evaluation of the preliminary efficacy of the injection on kidney's protein to creatinine ratio
Any positive changes in the patient's kidney function in terms of Urine protein to creatinine ratio.
Full Information
NCT ID
NCT03288571
First Posted
August 8, 2017
Last Updated
July 23, 2019
Sponsor
Sophia Al-Adwan
Collaborators
Jordan University of Science and Technology, An-Najah National University
1. Study Identification
Unique Protocol Identification Number
NCT03288571
Brief Title
Use of Wharton Jelly in Diabetic Nephropathy
Official Title
The Safety of Intra-parenchymal Wharton Jelly Mesenchymal Stem Cell Injection in the Treatment of Diabetic Nephropathy
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Unknown status
Study Start Date
November 2019 (Anticipated)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
January 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Sophia Al-Adwan
Collaborators
Jordan University of Science and Technology, An-Najah National University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Wharton Jelly derived Mesenchymal stem cells will be injected in the renal parenchyma of patients with Diabetic Nephropathy
Detailed Description
Mesenchymal stem cells (MSCs) are to be isolated from Umbilical cord Wharton's Jelly obtained after normal full term delivery.
Samples will be tested for any bacterial or fungal growth as well as endotoxin and mycoplasma. The specific markers for MSCs identification will be analyzed by flow cytometry.
Cell suspension will then be injected in the renal parenchyma of patients diagnosed with diabetic nephropathy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Nephropathies
Keywords
Diabetes, nephropathy, Kidney, parenchyma, Wharton Jelly, Mesenchymal stem cells
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Wharton Jelly Mesenchymal stem cells
Arm Type
Experimental
Arm Description
Intervention: Wharton Jelly Mesenchymal stem cells Site: Renal parenchyma Route of administration: ultrasound guided- intra-parenchymal total of 3 sites in each kidney.
Number of doses: 3 doses 2 weeks apart for each kidney. Time interval between each dose: 2 weeks Total volume of cell suspension infused: 3 ml/kidney; each site will receive a 1 ml cell suspension with a total volume of 3 ml in each kidney.
Intervention Type
Biological
Intervention Name(s)
Wharton Jelly Mesenchymal stem cells
Intervention Description
Wharton Jelly Mesenchymal stem cells will be injected in the renal parenchyma
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Description
Number, frequency and severity of injection associated adverse events.
The nephrologist will record any adverse event at each follow up visit in addition to evaluation of the overall condition of the patient.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Evaluation of the preliminary efficacy of the injection on kidney's Estimated Glomerular filtration rate
Description
• Any positive changes in the patient's kidney function in terms of Estimated Gomerular filtration rate (mL/min/1.73 m²)
Time Frame
12 months
Title
Evaluation of the preliminary efficacy of the injection on kidney's protein to creatinine ratio
Description
Any positive changes in the patient's kidney function in terms of Urine protein to creatinine ratio.
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
35 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Willing and able to provide written informed consent.
Type 2 diabetes mellitus (DM) for ≥ 3 years.
Estimated GFR (eGFR) 15-45 ml/min/1.73 m2 by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation on 2 or more consecutive measurements at least 30 days apart within the past 6 months, confirmed by isotope kidney scan.
Urine protein-to-creatinine ratio (UPCR) ≥ 500 mg/mmol (in spot urine or in 24 hour urine collection) confirmed twice over a period of 6 months.
Ultrasonographic kidney measurements ≥ 10 cm (for both kidneys).
Exclusion Criteria:
Patients with uncontrolled hyper or hypo tension; (systolic pressure >160, <100: diastolic pressure < 60, >100) on two different occasions.
Poor diabetic control: Hemoglobin A1c (HbA1c) > 10%.
New use of hypoglycemic, antihypertensive and/or lipid lowering agent within the past 6 months.
Increase in the dose of anti-hypertensive and/or hypoglycemic agent of the previous dose within the past 3 months.
Current fasting total cholesterol >300 mg/dl.
Current fasting total triglycerides >400 mg/dl.
History of any cardiovascular events in the past 6 months.
Pregnancy or lactating.
Positive screening test for infectious diseases as per baseline work up.
History of kidney transplant
Systemic autoimmune disease.
Receiving immunosuppressant medications.
Patients with glomerulonephritis or any non-DM related kidney disease.
Patients with any coagulation disorder.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sofia Adwan, Msc
Phone
00962796175617
Email
sophia.adwan@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Abdalla Awidi, MD
Organizational Affiliation
Cell Therapy Center
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Time Frame
within one month of publication
Learn more about this trial
Use of Wharton Jelly in Diabetic Nephropathy
We'll reach out to this number within 24 hrs