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Umbilical Cord Mesenchymal Stem Cells Therapy for Diabetic Nephropathy

Primary Purpose

Mesenchymal Stem Cells, Diabetic Nephropathy

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
Human umbilical cord mesenchymal stem cells
Sponsored by
Yan'an Affiliated Hospital of Kunming Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mesenchymal Stem Cells focused on measuring Human umbilical cord mesenchymal stem cells, Diabetic nephropathy

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Enrollment criteria:

  • Adult patients (age 18-60 years) who met the WHO 1999 diagnostic criteria for type 2 diabetes, regardless of gender;
  • Concomitant proteinuria ,3500 mg/day≥24h urinary protein excretion ≥500 mg/day, and uncontrolled disease course;
  • Pathological examination of puncture biopsy resulting in diagnosis of type IIa, IIb, III, or IV diabetic nephropathy. (In 2010, an international expert group led by Bruijn of Leiden University in the Netherlands published a pathological classification system for diabetic nephropathy);
  • eGFR between 30 ml/min/1.732 m2 and 60 ml/min/1.732 m2;
  • Diabetes treatment according to guidelines and norms before the umbilical cord mesenchymal stem cell therapy;
  • If there is a possibility of pregnancy in female, must be negative pregnancy test, not in lactation, and confirm that is receiving the method of contraception recognized by the researchers, and agree to maintain the method of contraception throughout the study. Sexually active male patients must agree to the use of an appropriate contraceptive method for birth control from the first administration of the study treatment until 24 weeks after the last administration.
  • participate in all visits, examinations, and treatments as required by the experimental protocol.

Exclusion criteria:

  • Patients with kidney biopsy diagnosis of type I diabetic nephropathy or a diagnosis of another glomerular disease;
  • Patients with abnormal renal function (serum creatinine ≥ the upper limit of normal);
  • Patients with HbA1c ≥10%;
  • Patients with active liver disease or abnormal liver function test results (ALT or AST ≥2 times the upper limit of normal);
  • Patients with blood leukocyte count <3.0 × 109/L, hemoglobin <90 g/L, platelet count <100 × 109/L, or those who have other hematologic diseases (severe anemia, idiopathic thrombocytopenic purpura, splenomegaly, coagulation dysfunction, etc.);
  • Patients with serious and unstable cardiovascular or cerebrovascular diseases (unstable angina pectoris, coronary artery disease, cerebrovascular disease, transient ischemic attack, congestive heart failure, etc.), acute and difficult to control the disease, after treatment has not been effectively controlled severe hypertension (blood pressure >160/100 mm Hg), or organ transplantation;
  • Patients with increased use of hypotensive drugs in the past 3 months;
  • Patients with uncontrolled infection;
  • Patients with tumors or abnormal tumor marker levels;
  • Patients with blood-borne diseases (i.e., HIV, syphilis, hepatitis B, and hepatitis C);
  • Pregnancy, the potential for pregnancy, or lactation;
  • Patients receiving immunosuppressive therapy;
  • Patients with a history of allergy, especially patients allergic to human blood albumin;
  • Patients with mental illness affecting their voluntarism, ability to make decisions, and ability to communicate;
  • A history of alcoholism or known drug addiction in the last 2 years;
  • Participation in another clinical trial within the last 3 months;
  • Patients judged inappropriate for this study by the physicians.

Sites / Locations

  • Yan'an Hospital of Kunming CityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Human umbilical cord mesenchymal stem cells

Arm Description

Human umbilical cord mesenchymal stem cells were given to each diabetic nephropathy subject once a month, peripheral intravenous injection, a total of three times

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent and Treatment-Chronic Adverse Events of human umbilical cord mesenchymal stem cells for diabetic nephropathy patient
The patient's discomfort and clinical symptoms during the study were recorded, as well as the related laboratory test indicators and physical examination abnormalities of the subjects during the study.Describe the association with umbilical cord mesenchymal stem cell therapy and calculate the incidence of treatment-related acute and chronic adverse events.

Secondary Outcome Measures

Changes in eGFR before and after treatment; Changes in 24h urine protein quantification before and after treatment
Main evaluation index of curative effect:percentage changes in estimated glomerular filtration rate (eGFR), urinary albumin creatinine ratio, and 24-hour urinary protein quantification from baseline to 60 weeks of treatment. Other efficacy indicators included fasting blood glucose, blood glucose 2 hours after breakfast, HbA1c, blood and urine routine, liver and renal function, blood lipid, blood electrolyte, and daily insulin dosage.

Full Information

First Posted
September 16, 2019
Last Updated
April 19, 2021
Sponsor
Yan'an Affiliated Hospital of Kunming Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT04125329
Brief Title
Umbilical Cord Mesenchymal Stem Cells Therapy for Diabetic Nephropathy
Official Title
Umbilical Cord Mesenchymal Stem Cells Therapy for Diabetic Nephropathy
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Recruiting
Study Start Date
April 1, 2020 (Actual)
Primary Completion Date
September 1, 2024 (Anticipated)
Study Completion Date
September 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Yan'an Affiliated Hospital of Kunming Medical University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This clinical trial assessed the safety of human umbilical cord mesenchymal stem cell therapy in 15 patients with diabetic nephropathy. Fifteen subjects received umbilical cord mesenchymal stem cell therapy 3 times. Approximately 1 × 106/kg of human umbilical cord mesenchymal stem cells were administered by peripheral intravenous infusion once a month .Endpoints:Primary endpoint: Safety and adverse events (safety and tolerability of umbilical cord mesenchymal stem cell therapy within 60 weeks).Secondary endpoint indicators:Efficacy measures: eGFR, urinary albumin-to-creatinine ratio, and percentage changes of 24-h urinary protein quantities from baseline to 60 weeks.
Detailed Description
Dosage and administration method: Fifteen subjects received umbilical cord mesenchymal stem cell therapy 3 times. Approximately 1 × 106/kg of human umbilical cord mesenchymal stem cells were administered by peripheral intravenous infusion once a month at 0, 4, and 8 weeks. Routine medications were used. Follow-up: Patient follow-up was performed 7 times at 0, 4, 8, 20, 32, 48, and 60 weeks. Blood and urine were collected for determination of urinary albumin-to-creatinine ratio, 24-h urine protein ratio, liver and kidney function, fasting blood glucose, 2-h postprandial blood glucose, glycosylated hemoglobin, eGFR, blood lipids, and blood electrolytes at each follow-up visit. The daily dose of insulin was recorded. Blood samples were taken after each infusion of stem cells for flow cytometry and for the detection of CD3, CD4, CD8, CD28+, Treg, CD80, CD86, HLA-DR, CD83, and CD1a cells. Plasma levels of the cytokines IFN-gamma, TNF, IL-2, IL-4, IL-10, IL-6, IL-12P70, IL-8, and IL-1 beta were also determined. Endpoints: Primary endpoint: Safety and adverse events (safety and tolerability of umbilical cord mesenchymal stem cell therapy within 60 weeks): The number and severity of adverse events, an evaluation of their association with the umbilical cord mesenchymal stem cell treatment, and the outcome of the adverse events. The patients' discomfort and clinical symptoms during the study period were recorded. The subjects' relevant laboratory test indices, 12-lead electrocardiogram, vital signs, and physical examination results were recorded during the study. Secondary endpoint indicators: Efficacy measures: eGFR, urinary albumin-to-creatinine ratio, and percentage changes of 24-h urinary protein quantities from baseline to 60 weeks. Data analysis: The number of adverse events and the number of severity adverse events were determined based on the changes in the data summary (i.e., descriptive statistics). A multilevel statistical analysis model (mixed effects model) was used to infer the relationship between treatment factors and key indicators, reflect the changing trend of key indicators in different time periods, and draw statistical analysis conclusions.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mesenchymal Stem Cells, Diabetic Nephropathy
Keywords
Human umbilical cord mesenchymal stem cells, Diabetic nephropathy

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Human umbilical cord mesenchymal stem cells
Arm Type
Experimental
Arm Description
Human umbilical cord mesenchymal stem cells were given to each diabetic nephropathy subject once a month, peripheral intravenous injection, a total of three times
Intervention Type
Drug
Intervention Name(s)
Human umbilical cord mesenchymal stem cells
Intervention Description
Human umbilical cord mesenchymal stem cells were given to each diabetic nephropathy subject once a month, peripheral intravenous injection, a total of three times
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent and Treatment-Chronic Adverse Events of human umbilical cord mesenchymal stem cells for diabetic nephropathy patient
Description
The patient's discomfort and clinical symptoms during the study were recorded, as well as the related laboratory test indicators and physical examination abnormalities of the subjects during the study.Describe the association with umbilical cord mesenchymal stem cell therapy and calculate the incidence of treatment-related acute and chronic adverse events.
Time Frame
60 weeks
Secondary Outcome Measure Information:
Title
Changes in eGFR before and after treatment; Changes in 24h urine protein quantification before and after treatment
Description
Main evaluation index of curative effect:percentage changes in estimated glomerular filtration rate (eGFR), urinary albumin creatinine ratio, and 24-hour urinary protein quantification from baseline to 60 weeks of treatment. Other efficacy indicators included fasting blood glucose, blood glucose 2 hours after breakfast, HbA1c, blood and urine routine, liver and renal function, blood lipid, blood electrolyte, and daily insulin dosage.
Time Frame
60Weeks,but the major evaluated time is 12 weeks after the last treatment, compared with baseline (0W)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Enrollment criteria: Adult patients (age 18-60 years) who met the WHO 1999 diagnostic criteria for type 2 diabetes, regardless of gender; Concomitant proteinuria ,3500 mg/day≥24h urinary protein excretion ≥500 mg/day, and uncontrolled disease course; Pathological examination of puncture biopsy resulting in diagnosis of type IIa, IIb, III, or IV diabetic nephropathy. (In 2010, an international expert group led by Bruijn of Leiden University in the Netherlands published a pathological classification system for diabetic nephropathy); eGFR between 30 ml/min/1.732 m2 and 60 ml/min/1.732 m2; Diabetes treatment according to guidelines and norms before the umbilical cord mesenchymal stem cell therapy; If there is a possibility of pregnancy in female, must be negative pregnancy test, not in lactation, and confirm that is receiving the method of contraception recognized by the researchers, and agree to maintain the method of contraception throughout the study. Sexually active male patients must agree to the use of an appropriate contraceptive method for birth control from the first administration of the study treatment until 24 weeks after the last administration. participate in all visits, examinations, and treatments as required by the experimental protocol. Exclusion criteria: Patients with kidney biopsy diagnosis of type I diabetic nephropathy or a diagnosis of another glomerular disease; Patients with abnormal renal function (serum creatinine ≥ the upper limit of normal); Patients with HbA1c ≥10%; Patients with active liver disease or abnormal liver function test results (ALT or AST ≥2 times the upper limit of normal); Patients with blood leukocyte count <3.0 × 109/L, hemoglobin <90 g/L, platelet count <100 × 109/L, or those who have other hematologic diseases (severe anemia, idiopathic thrombocytopenic purpura, splenomegaly, coagulation dysfunction, etc.); Patients with serious and unstable cardiovascular or cerebrovascular diseases (unstable angina pectoris, coronary artery disease, cerebrovascular disease, transient ischemic attack, congestive heart failure, etc.), acute and difficult to control the disease, after treatment has not been effectively controlled severe hypertension (blood pressure >160/100 mm Hg), or organ transplantation; Patients with increased use of hypotensive drugs in the past 3 months; Patients with uncontrolled infection; Patients with tumors or abnormal tumor marker levels; Patients with blood-borne diseases (i.e., HIV, syphilis, hepatitis B, and hepatitis C); Pregnancy, the potential for pregnancy, or lactation; Patients receiving immunosuppressive therapy; Patients with a history of allergy, especially patients allergic to human blood albumin; Patients with mental illness affecting their voluntarism, ability to make decisions, and ability to communicate; A history of alcoholism or known drug addiction in the last 2 years; Participation in another clinical trial within the last 3 months; Patients judged inappropriate for this study by the physicians.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
wang xiaodan
Phone
0871-63211326
Email
52830538@qq.com
First Name & Middle Initial & Last Name or Official Title & Degree
Tang zhe
Phone
0871-63211272
Facility Information:
Facility Name
Yan'an Hospital of Kunming City
City
Kunming
ZIP/Postal Code
650051
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhouliu Hou
Phone
0871-63211326
Email
hzl579@163.com

12. IPD Sharing Statement

Plan to Share IPD
No

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Umbilical Cord Mesenchymal Stem Cells Therapy for Diabetic Nephropathy

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