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Safety Study of Stem Cell Transplant to Treat Limbus Insufficiency Syndrome

Primary Purpose

Limbus Corneae Insufficiency Syndrome

Status
Completed
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
Stem Cell with Amniotic Membrane Transplant
Sponsored by
Instituto Universitario de Oftalmobiología Aplicada (Institute of Applied Ophthalmobiology) - IOBA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Limbus Corneae Insufficiency Syndrome focused on measuring limbus, cornea, insufficiency syndrome, stem cell transplant

Eligibility Criteria

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

Inclusion Criteria:

  • Male or Female older than 18 years.
  • Signed Informed consent
  • Negative pregnancy test at inclusion for any potential childbearing female.
  • Compromise of contraceptive method during all trial for any potential childbearing female.
  • Diagnosis of Ocular Surface Failure due to Limbus Insufficiency Syndrome, based in any of the published characteristics as corneal surface neovascularization, loss of corneal transparency, epithelial irregularities, history of punctate keratitis, erosions or repetitive ulcers and presence of symptoms and confirmed by the presence of epithelial phenotype cells assessed with conjunctival impression cytology.
  • Availability for all the scheduled visits during the study

Exclusion Criteria:

  • Uncontrolled systemic disease (e.g. hypertension or diabetes) or any disease that under medical decision might put the patient at risk during the surgery or follow-up examinations or may cause any hazard in data analysis.
  • Active ocular infection in any eye. If the infection can be cured, inclusion can be considered after 30 days of inactive infection since its end.
  • Alterations in lid statics / dynamics or any other pathology (e.g. severe dry eye syndrome) except the one that originated the Limbus Insufficience that under medical opinion might alter the results. Any of these must be corrected 3 months prior to patient inclusion, before reconsidering rescreening.
  • Limbus insufficiency syndrome which has not been previously treated with all medical (not surgical) procedures available.
  • No availability for all scheduled visits during the study.
  • Any other circumstance under investigator´s opinion that prevents patient inclusion even though normal inclusion and exclusion criteria are met.

Sites / Locations

  • IOBA

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Bone Marrow mesenchymal stem cell

Allogenic limbal stem cell Transplant

Arm Description

Allogenic Bone Marrow mesenchymal stem cell in amniotic membrane transplant

Stem Cell with Amniotic Membrane Transplant

Outcomes

Primary Outcome Measures

Viability and safety of mesenchymal stem cell transplant
Absence of cell metaplasia with phenotype different to corneal or conjunctival as expected, confirmed by corneal impression cytology and in vivo confocal laser ophthalmoscopy

Secondary Outcome Measures

Absence of complications in pre and peri surgical implantation
Correct handling and implantation of stem cell with amniotic membrane transplant following an 4 step classification.
Improvement of 2 lines in Best Corrected Visual Acuity
Improvement in visual acuity compared to baseline values before transplant

Full Information

First Posted
March 22, 2012
Last Updated
January 7, 2015
Sponsor
Instituto Universitario de Oftalmobiología Aplicada (Institute of Applied Ophthalmobiology) - IOBA
Collaborators
University of Valladolid, Centro en Red de Medicina Regenerativa de Castilla y Leon, Red de Terapia Celular
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1. Study Identification

Unique Protocol Identification Number
NCT01562002
Brief Title
Safety Study of Stem Cell Transplant to Treat Limbus Insufficiency Syndrome
Official Title
Advanced Therapy for Ocular Surface Reconstruction. Allogenic Limbus Epithelial Stem-cell Transplant vs Bone Marrow Mesenchymal Stem-cell Transplant in Limbus Insufficiency Syndrome. Double-masked Randomized Trial
Study Type
Interventional

2. Study Status

Record Verification Date
January 2015
Overall Recruitment Status
Completed
Study Start Date
March 2012 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
December 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Instituto Universitario de Oftalmobiología Aplicada (Institute of Applied Ophthalmobiology) - IOBA
Collaborators
University of Valladolid, Centro en Red de Medicina Regenerativa de Castilla y Leon, Red de Terapia Celular

4. Oversight

5. Study Description

Brief Summary
The purpose of the study is to determine whether allogenic bone marrow stem cell transplant is safe and effective in the treatment of limbus insufficiency syndrome versus allogenic limbus stem cell transplant.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Limbus Corneae Insufficiency Syndrome
Keywords
limbus, cornea, insufficiency syndrome, stem cell transplant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bone Marrow mesenchymal stem cell
Arm Type
Experimental
Arm Description
Allogenic Bone Marrow mesenchymal stem cell in amniotic membrane transplant
Arm Title
Allogenic limbal stem cell Transplant
Arm Type
Active Comparator
Arm Description
Stem Cell with Amniotic Membrane Transplant
Intervention Type
Procedure
Intervention Name(s)
Stem Cell with Amniotic Membrane Transplant
Intervention Description
Single stem cell expansion in amniotic membrane transplant
Primary Outcome Measure Information:
Title
Viability and safety of mesenchymal stem cell transplant
Description
Absence of cell metaplasia with phenotype different to corneal or conjunctival as expected, confirmed by corneal impression cytology and in vivo confocal laser ophthalmoscopy
Time Frame
1 Year
Secondary Outcome Measure Information:
Title
Absence of complications in pre and peri surgical implantation
Description
Correct handling and implantation of stem cell with amniotic membrane transplant following an 4 step classification.
Time Frame
1 Week
Title
Improvement of 2 lines in Best Corrected Visual Acuity
Description
Improvement in visual acuity compared to baseline values before transplant
Time Frame
12 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or Female older than 18 years. Signed Informed consent Negative pregnancy test at inclusion for any potential childbearing female. Compromise of contraceptive method during all trial for any potential childbearing female. Diagnosis of Ocular Surface Failure due to Limbus Insufficiency Syndrome, based in any of the published characteristics as corneal surface neovascularization, loss of corneal transparency, epithelial irregularities, history of punctate keratitis, erosions or repetitive ulcers and presence of symptoms and confirmed by the presence of epithelial phenotype cells assessed with conjunctival impression cytology. Availability for all the scheduled visits during the study Exclusion Criteria: Uncontrolled systemic disease (e.g. hypertension or diabetes) or any disease that under medical decision might put the patient at risk during the surgery or follow-up examinations or may cause any hazard in data analysis. Active ocular infection in any eye. If the infection can be cured, inclusion can be considered after 30 days of inactive infection since its end. Alterations in lid statics / dynamics or any other pathology (e.g. severe dry eye syndrome) except the one that originated the Limbus Insufficience that under medical opinion might alter the results. Any of these must be corrected 3 months prior to patient inclusion, before reconsidering rescreening. Limbus insufficiency syndrome which has not been previously treated with all medical (not surgical) procedures available. No availability for all scheduled visits during the study. Any other circumstance under investigator´s opinion that prevents patient inclusion even though normal inclusion and exclusion criteria are met.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Margarita Calonge, MD, PhD
Organizational Affiliation
Instituto Universitario de Oftalmobiología Aplicada (Institute of Applied Ophthalmobiology) - IOBA
Official's Role
Principal Investigator
Facility Information:
Facility Name
IOBA
City
Valladolid
ZIP/Postal Code
47011
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
30578758
Citation
Calonge M, Perez I, Galindo S, Nieto-Miguel T, Lopez-Paniagua M, Fernandez I, Alberca M, Garcia-Sancho J, Sanchez A, Herreras JM. A proof-of-concept clinical trial using mesenchymal stem cells for the treatment of corneal epithelial stem cell deficiency. Transl Res. 2019 Apr;206:18-40. doi: 10.1016/j.trsl.2018.11.003. Epub 2018 Nov 22.
Results Reference
derived

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Safety Study of Stem Cell Transplant to Treat Limbus Insufficiency Syndrome

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