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the Safety and the Efficacy Evaluation of Allogenic Adipose MSC-Exos in Patients With Alzheimer's Disease

Primary Purpose

Alzheimer Disease

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
low dosage MSCs-Exos administrated for nasal drip
mild dosage MSCs-Exos administrated for nasal drip
high dosage MSCs-Exos administrated for nasal drip
Sponsored by
Ruijin Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease

Eligibility Criteria

50 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects themselves and their legal representatives (or their immediate family members) voluntarily received the treatment and signed the consent form before this study;
  2. Age ≧ 50 years, males and females;
  3. Subjects diagnosed with Patients with mild or moderate Alzheimer's disease, based on the NIA/AA(2011).
  4. The Mini-Mental Status Examination (MMSE) score was 10-24 (inclusive);
  5. Modified Hachinski Ischemic Scale (MHIS) score was ≦ 4;
  6. Suspension of cognitive-enhancing drugs and marketed therapeutic drugs such as ginkgo, high-dose vitamin E, lecithin, estrogen, non-steroidal anti-inflammatory drugs (NSAIDs), Donepezil, Memantine, etc ;
  7. Based on medical history, physical examination, vital signs, laboratory tests and 12-lead electrocardiogram (ECG) results, subjects are generally in good condition;
  8. Subjects can walk independently or receive outpatient follow-up with assistive devices (wheelchairs, walkers or crutches), while the subject's vision and hearing (allowing glasses and / or hearing aids) do not affect the follow-up procedure;
  9. The subject has an identified and reliable caregiver who must also meet the following conditions:

(1) In the hospital, caregiver can independently read and understand relevant research documents, and can do necessary communication with the investigator; (2) Caregiver can follow clinical research procedures and ensure that accurate information about the status of the subject can be provided during the study; (3) Caregiver live with the subject; or take care of the subject no less than 3 days a week and no less than 2 hours a day; 10. Female subjects with fertility (including women of childbearing age and women less than 1 year after menopause) were required to take effective contraception throughout the study. At the same time, urine pregnancy tests were negative during screening.

Exclusion Criteria:

  1. The subjects with more serious allergic constitution;
  2. Received allogeneic mesenchymal progenitor cell therapy or its derived exosomes;
  3. Laboratory test (any item meets): neutrophil absolute number < 1.0 × 109 / L, platelet count < 100 × 109 / L, serum albumin < 30g / L, serum creatinine > upper limit of normal value range, total bilirubin, alanine aminotransferase, aspartate aminotransferase > upper limit of 2 times of normal value range;
  4. The subject has serious and poorly controlled concomitant diseases, such as (but not limited to) cardiovascular, cerebrovascular, liver, kidney, lung, endocrine and other system diseases;
  5. Severe Alzheimer's Disease;
  6. Severe depression;
  7. The subjects suffered from Parkinson's disease, multiple cerebral infarction, vascular dementia, Huntington's disease, hydrocephalus, progressive supranuclear paralysis, multiple sclerosis, epilepsy, mental retardation or major history of brain injury (with or without persistent neurological impairment) or known brain structural abnormalities;
  8. The subject has an history malignant tumor;
  9. The subject has severe generalized infectious diseases in the 3 months prior to this trial.;
  10. The subject has contraindication of MRI, included but not only: the subject installed heart pacemaker, defibrillator, heart bracket, heart valve prosthesis, metal clip after aneurysm surgery, drug infusion device implanted in vivo, any electronic device implanted in the body (nerve stimulator, bone growth stimulator) endovascular coil, strainer, ECG monitor, metal suture, shrapnel or sand of body, plate fixation and steel nail after fracture surgery, artificial cochlea, middle ear shift plant, metallic intraocular foreign body etc; the subject is a claustrophobia, critical ill patient and so on.
  11. The subject tests positive for: HIV, HBV, HCV and treponema pallidum;
  12. The subject has history of alcoholism, drug abuse, or mental illness in the 10 years prior to this trial.
  13. The subject has participated in any other clinical trial in the 6 months prior to this trial;
  14. The female subjects are pregnant, lactating or pregnant in the past half a year;
  15. The subject has any other unsuitable condition (such as factors reducing the follow-up compliance) to be determined by the investigator.

Sites / Locations

  • Ruijin Hospital Affiliated to Shanghai Jiaotong University School of MedicineRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

MSCs-Exos Dosage 1

MSCs-Exos Dosage 2

MSCs-Exos Dosage 3

Arm Description

MSCs-Exos. low-dose group

MSCs-Exos mid-dose group

MSCs-Exos high-dose group

Outcomes

Primary Outcome Measures

Number of participants with treatment-related abnormal laboratory values of Liver or kidney function
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Secondary Outcome Measures

Cognitive function
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Cognitive function
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Cognitive function
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Cognitive function
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Cognitive function
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Quality of life evaluation
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Quality of life evaluation
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Quality of life evaluation
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Quality of life evaluation
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Quality of life evaluation
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
MRI Neuroimaging
Evaluation of MRI(Magnetic Resonance Imaging)
MRI Neuroimaging
Evaluation of MRI(Magnetic Resonance Imaging)
PET-CT Neuroimaging
Evaluation of and PET-CT(Positron Emission Computed Tomography- Computed Tomography)
PET-CT Neuroimaging
Evaluation of and PET-CT(Positron Emission Computed Tomography- Computed Tomography)

Full Information

First Posted
April 28, 2020
Last Updated
June 23, 2021
Sponsor
Ruijin Hospital
Collaborators
Cellular Biomedicine Group Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04388982
Brief Title
the Safety and the Efficacy Evaluation of Allogenic Adipose MSC-Exos in Patients With Alzheimer's Disease
Official Title
Open-Label, Single-Center, Phase I/Ⅱ Clinical Trial to Evaluate the Safety and the Efficacy of Exosomes Derived From Allogenic Adipose Mesenchymal Stem Cells in Patients With Mild to Moderate Dementia Due to Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Unknown status
Study Start Date
July 1, 2020 (Actual)
Primary Completion Date
August 2021 (Anticipated)
Study Completion Date
August 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ruijin Hospital
Collaborators
Cellular Biomedicine Group Ltd.

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
Evaluate the Safety and Efficacy of Exosomes Derived from Allogenic Adipose Mesenchymal Stem Cells(MSCs-Exos)in Subjects with Alzheimer's disease.
Detailed Description
To date, the main pathological characteristics of AD patients are the accumulation of β-amyloid (Aβ) into senile plaques, the abnormal aggregation of intracellular Tau protein to form neuron fiber tangles (NFT) and neuron death. There are still no effective treatments to prevent, halt, or reverse Alzheimer's disease. Exosomes are naturally occurring nanosized vesicles and comprised of natural lipid bilayers with the abundance of adhesive proteins that readily interact with cellular membranes. These vesicles have a content that includes cytokines and growth factors, signaling lipids, mRNAs, and regulatory miRNAs. Exosomes are involved in cell-to-cell communication, cell signaling, and altering cell or tissue metabolism at short or long distances in the body, and can influence tissue responses to injury, infection, and disease. The purpose of this single center, open label, phase I/Ⅱ clinical trial, therefore, is to explore the safety and efficacy of the exosomes derived from allogenic adipose mesenchymal stem cells (MSCs-Exos) in the treatment of mild to moderate dementia due to Alzheimer's Disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
9 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
MSCs-Exos Dosage 1
Arm Type
Experimental
Arm Description
MSCs-Exos. low-dose group
Arm Title
MSCs-Exos Dosage 2
Arm Type
Experimental
Arm Description
MSCs-Exos mid-dose group
Arm Title
MSCs-Exos Dosage 3
Arm Type
Experimental
Arm Description
MSCs-Exos high-dose group
Intervention Type
Biological
Intervention Name(s)
low dosage MSCs-Exos administrated for nasal drip
Intervention Description
Dosage:5μg MSCs-Exos,Total volume: 1ml Frequency:Twice a week Duration:12 weeks
Intervention Type
Biological
Intervention Name(s)
mild dosage MSCs-Exos administrated for nasal drip
Intervention Description
Dosage:10μg MSCs-Exos,Total volume: 1ml Frequency:Twice a week Duration:12 weeks
Intervention Type
Biological
Intervention Name(s)
high dosage MSCs-Exos administrated for nasal drip
Intervention Description
Dosage:20μg MSCs-Exos,Total volume: 1ml Frequency:Twice a week Duration:12 weeks
Primary Outcome Measure Information:
Title
Number of participants with treatment-related abnormal laboratory values of Liver or kidney function
Time Frame
12 weeks
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Cognitive function
Description
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Time Frame
baseline
Title
Cognitive function
Description
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Time Frame
12 weeks
Title
Cognitive function
Description
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Time Frame
24 weeks
Title
Cognitive function
Description
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Time Frame
36 weeks
Title
Cognitive function
Description
ADAS-cog (Alzheimer 's disease assessment scale-cognitive section) consists of 12 items. Maximum value is 70 and higher score means a worse congnitive condition.
Time Frame
48 weeks
Title
Quality of life evaluation
Description
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Time Frame
baseline
Title
Quality of life evaluation
Description
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Time Frame
12 weeks
Title
Quality of life evaluation
Description
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Time Frame
24 weeks
Title
Quality of life evaluation
Description
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Time Frame
36 weeks
Title
Quality of life evaluation
Description
Scores of ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living) range from 0 to 54 and higher score means a better life quality.
Time Frame
48 weeks
Title
MRI Neuroimaging
Description
Evaluation of MRI(Magnetic Resonance Imaging)
Time Frame
baseline
Title
MRI Neuroimaging
Description
Evaluation of MRI(Magnetic Resonance Imaging)
Time Frame
48 weeks
Title
PET-CT Neuroimaging
Description
Evaluation of and PET-CT(Positron Emission Computed Tomography- Computed Tomography)
Time Frame
baseline
Title
PET-CT Neuroimaging
Description
Evaluation of and PET-CT(Positron Emission Computed Tomography- Computed Tomography)
Time Frame
48 weeks
Other Pre-specified Outcome Measures:
Title
Changes of AD biomarkers
Description
Changes of Aβ in serum and cerebrospinal fluid will be tested at baseline and 48 weeks
Time Frame
baseline and 48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects themselves and their legal representatives (or their immediate family members) voluntarily received the treatment and signed the consent form before this study; Age ≧ 50 years, males and females; Subjects diagnosed with Patients with mild or moderate Alzheimer's disease, based on the NIA/AA(2011). The Mini-Mental Status Examination (MMSE) score was 10-24 (inclusive); Modified Hachinski Ischemic Scale (MHIS) score was ≦ 4; Suspension of cognitive-enhancing drugs and marketed therapeutic drugs such as ginkgo, high-dose vitamin E, lecithin, estrogen, non-steroidal anti-inflammatory drugs (NSAIDs), Donepezil, Memantine, etc ; Based on medical history, physical examination, vital signs, laboratory tests and 12-lead electrocardiogram (ECG) results, subjects are generally in good condition; Subjects can walk independently or receive outpatient follow-up with assistive devices (wheelchairs, walkers or crutches), while the subject's vision and hearing (allowing glasses and / or hearing aids) do not affect the follow-up procedure; The subject has an identified and reliable caregiver who must also meet the following conditions: (1) In the hospital, caregiver can independently read and understand relevant research documents, and can do necessary communication with the investigator; (2) Caregiver can follow clinical research procedures and ensure that accurate information about the status of the subject can be provided during the study; (3) Caregiver live with the subject; or take care of the subject no less than 3 days a week and no less than 2 hours a day; 10. Female subjects with fertility (including women of childbearing age and women less than 1 year after menopause) were required to take effective contraception throughout the study. At the same time, urine pregnancy tests were negative during screening. Exclusion Criteria: The subjects with more serious allergic constitution; Received allogeneic mesenchymal progenitor cell therapy or its derived exosomes; Laboratory test (any item meets): neutrophil absolute number < 1.0 × 109 / L, platelet count < 100 × 109 / L, serum albumin < 30g / L, serum creatinine > upper limit of normal value range, total bilirubin, alanine aminotransferase, aspartate aminotransferase > upper limit of 2 times of normal value range; The subject has serious and poorly controlled concomitant diseases, such as (but not limited to) cardiovascular, cerebrovascular, liver, kidney, lung, endocrine and other system diseases; Severe Alzheimer's Disease; Severe depression; The subjects suffered from Parkinson's disease, multiple cerebral infarction, vascular dementia, Huntington's disease, hydrocephalus, progressive supranuclear paralysis, multiple sclerosis, epilepsy, mental retardation or major history of brain injury (with or without persistent neurological impairment) or known brain structural abnormalities; The subject has an history malignant tumor; The subject has severe generalized infectious diseases in the 3 months prior to this trial.; The subject has contraindication of MRI, included but not only: the subject installed heart pacemaker, defibrillator, heart bracket, heart valve prosthesis, metal clip after aneurysm surgery, drug infusion device implanted in vivo, any electronic device implanted in the body (nerve stimulator, bone growth stimulator) endovascular coil, strainer, ECG monitor, metal suture, shrapnel or sand of body, plate fixation and steel nail after fracture surgery, artificial cochlea, middle ear shift plant, metallic intraocular foreign body etc; the subject is a claustrophobia, critical ill patient and so on. The subject tests positive for: HIV, HBV, HCV and treponema pallidum; The subject has history of alcoholism, drug abuse, or mental illness in the 10 years prior to this trial. The subject has participated in any other clinical trial in the 6 months prior to this trial; The female subjects are pregnant, lactating or pregnant in the past half a year; The subject has any other unsuitable condition (such as factors reducing the follow-up compliance) to be determined by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gang Wang, MD,PhD
Phone
086-021-64370045
Email
wg11424@rjh.com.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gang Wang, MD,PhD
Organizational Affiliation
Ruijin Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Xiaoling Gao, PhD
Organizational Affiliation
Shanghai Jiao Tong University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xinyi Xie, MD
Phone
18616817612
Email
Xiexy0619@163.com

12. IPD Sharing Statement

Plan to Share IPD
Yes

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the Safety and the Efficacy Evaluation of Allogenic Adipose MSC-Exos in Patients With Alzheimer's Disease

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