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Umbilical Mesenchymal Stem Cells and Mononuclear Cells Infusion in Type 1 Diabetes Mellitus

Primary Purpose

Type 1 Diabetes Mellitus

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Umbilical mesenchymal stem cell (UC-MSCs) infusion
traditional therapy
Sponsored by
Fuzhou General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes Mellitus focused on measuring type 1 diabetes mellitus, umbilical mesenchymal stem cell, mononuclear cell

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male and female patients age 18 to 65 years of age.
  • Ability to provide written informed consent.
  • Mentally stable and able to comply with the procedures of the study protocol.
  • Clinical history compatible with type 1 diabetes (T1DM) as defined by the Expert Committee on the Diagnosis and classification of Diabetes Mellitus
  • Onset of T1DM disease at ≤ 35 years of age.
  • T1DM duration ≥ 2 and ≤ 20 years at the time of enrollment.
  • Basal C-peptide ≤ 0.3 ng/mL
  • HbA1c ≥ 7.5 at time of enrollment.

Exclusion Criteria:

  • BMI >35 kg/m^2.
  • Insulin requirements of > 100 U/day.
  • C-reactive protein (hs-CRP) >3.00ng/ml
  • Uncontrolled blood Pressure: SBP >160 mmHg or DBP >100 mmHg at the time of enrollment.
  • Evidence of renal dysfunction, serum creatinine > 1.5 mg/dl (males) and 1.4 mg/dl (females).
  • Proteinuria > 300 mg/day
  • Evidence of cardiovascular disease, existing congestive cardiac failure on physical exam and/or acute coronary syndrome in past 6 months.
  • For female participants: Positive pregnancy test, presently breast-feeding, or unwillingness to use effective contraceptive measures for the duration of the study. For male participants: intent to procreate 3 months before or after the intervention or unwillingness to use effective measures of contraception. Oral contraceptives, Norplant®, Depo-Provera®, and barrier devices with spermicide are acceptable contraceptive methods; condoms used alone are not acceptable
  • Active infection including hepatitis C, HIV, or TB as determined by a positive skin test or clinical presentation, or under treatment for suspected TB. Positive tests are acceptable only if associated with a history of previous vaccination in the absence of any sign of active infection. Positive tests are otherwise not acceptable, even in the absence of any active infection at the time of evaluation
  • Known active alcohol or substance abuse including cigarette/cigar smoking
  • Baseline Hemoglobin below the lower limits of normal at the local laboratory; lymphopenia (<1,000/L), neutropenia (<1,500/L), or thrombocytopenia (platelets <100,000/L).
  • A history of Factor V deficiency or other coagulopathy defined by INR >1.5, PTT >40, PT >15.
  • Any coagulopathy or medical condition requiring long-term anticoagulant therapy (e.g., warfarin) after transplantation (low-dose aspirin treatment is allowed) or patients with an INR >1.5.
  • Acute or chronic pancreatitis.
  • Symptomatic peptic ulcer disease.
  • Hyperlipidemia despite medical therapy (fasting LDL cholesterol >130 mg/dl, treated or untreated; and/or fasting triglycerides > 200 mg/dl).
  • Receiving treatment for a medical condition requiring chronic use of systemic steroids.
  • Symptomatic cholecystolithiasis.
  • Use of any investigational agents within 4 weeks of enrollment.
  • Admission to hospital for any reason in the 14 days prior to enrollment (signing consent).
  • Presence of active proliferative diabetic retinopathy or macular edema
  • Any malignancy
  • Abnormal liver function >1.5 x ULN
  • Abdominal aortic aneurysm
  • History of cerebro-vascular accident
  • Any patient with acute or subacute decompensation from diabetes
  • Any acute or chronic infectious condition that in the criteria of the investigator would be a risk for the patient.
  • Subjects with hypoproteinemia, cachexia or terminal states
  • Subjects with history of anorexia/bulimia
  • Subjects with respiratory insufficiency
  • Any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial.

Sites / Locations

  • Fuzhou General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Stem Cell Infusion

traditional therapy control

Arm Description

Outcomes

Primary Outcome Measures

c-peptide area under the curve during OGTT

Secondary Outcome Measures

The incidence and severity of adverse events related to the stem cell infusion procedure
The reduction in fasting blood glucose (FBG)
The increase in basal C-peptide
The reduction in exogenous insulin requirements
Decrease in HbA1c
insulin area under the curve during OGTT

Full Information

First Posted
June 15, 2011
Last Updated
November 18, 2012
Sponsor
Fuzhou General Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT01374854
Brief Title
Umbilical Mesenchymal Stem Cells and Mononuclear Cells Infusion in Type 1 Diabetes Mellitus
Official Title
Umbilical Mesenchymal Stem Cells and Mononuclear Cells Infusion in Type 1 Diabetes Mellitus: A Randomized Controlled Open-label Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Unknown status
Study Start Date
January 2009 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
December 2014 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fuzhou General Hospital

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Umbilical mesenchymal stem cells (UC-MSCs) infusion is supposed be a promising regeneration therapy with mild side effect as indicated by large quantities of animal experiments and some clinical trials. There are few UC-MSCs clinical trials with regard to diabetes mellitus. The investigators hypothesize that infusion of USC-MSCs may provide multiple signals for beta-cell regeneration and even re-differentiate into local tissues in diabetes mellitus patients, resulting in improvement of diabetic control, of which the effect may be promoted by concomitant infusion of bone marrow mononuclear cells and maximized by intra-arterial pancreatic infusion through angiography.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes Mellitus
Keywords
type 1 diabetes mellitus, umbilical mesenchymal stem cell, mononuclear cell

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stem Cell Infusion
Arm Type
Experimental
Arm Title
traditional therapy control
Arm Type
Active Comparator
Intervention Type
Biological
Intervention Name(s)
Umbilical mesenchymal stem cell (UC-MSCs) infusion
Intervention Description
1×10^6/kg UC-MSCs is infused through pancreatic artery along with mononuclear cells by interventional therapy and another same dose of UC-MSCs is administered one week post-intervention.
Intervention Type
Drug
Intervention Name(s)
traditional therapy
Intervention Description
exogenous insulin injection daily
Primary Outcome Measure Information:
Title
c-peptide area under the curve during OGTT
Time Frame
1 year
Secondary Outcome Measure Information:
Title
The incidence and severity of adverse events related to the stem cell infusion procedure
Time Frame
1 year
Title
The reduction in fasting blood glucose (FBG)
Time Frame
1 year
Title
The increase in basal C-peptide
Time Frame
1 year
Title
The reduction in exogenous insulin requirements
Time Frame
1 year
Title
Decrease in HbA1c
Time Frame
1 year
Title
insulin area under the curve during OGTT
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients age 18 to 65 years of age. Ability to provide written informed consent. Mentally stable and able to comply with the procedures of the study protocol. Clinical history compatible with type 1 diabetes (T1DM) as defined by the Expert Committee on the Diagnosis and classification of Diabetes Mellitus Onset of T1DM disease at ≤ 35 years of age. T1DM duration ≥ 2 and ≤ 20 years at the time of enrollment. Basal C-peptide ≤ 0.3 ng/mL HbA1c ≥ 7.5 at time of enrollment. Exclusion Criteria: BMI >35 kg/m^2. Insulin requirements of > 100 U/day. C-reactive protein (hs-CRP) >3.00ng/ml Uncontrolled blood Pressure: SBP >160 mmHg or DBP >100 mmHg at the time of enrollment. Evidence of renal dysfunction, serum creatinine > 1.5 mg/dl (males) and 1.4 mg/dl (females). Proteinuria > 300 mg/day Evidence of cardiovascular disease, existing congestive cardiac failure on physical exam and/or acute coronary syndrome in past 6 months. For female participants: Positive pregnancy test, presently breast-feeding, or unwillingness to use effective contraceptive measures for the duration of the study. For male participants: intent to procreate 3 months before or after the intervention or unwillingness to use effective measures of contraception. Oral contraceptives, Norplant®, Depo-Provera®, and barrier devices with spermicide are acceptable contraceptive methods; condoms used alone are not acceptable Active infection including hepatitis C, HIV, or TB as determined by a positive skin test or clinical presentation, or under treatment for suspected TB. Positive tests are acceptable only if associated with a history of previous vaccination in the absence of any sign of active infection. Positive tests are otherwise not acceptable, even in the absence of any active infection at the time of evaluation Known active alcohol or substance abuse including cigarette/cigar smoking Baseline Hemoglobin below the lower limits of normal at the local laboratory; lymphopenia (<1,000/L), neutropenia (<1,500/L), or thrombocytopenia (platelets <100,000/L). A history of Factor V deficiency or other coagulopathy defined by INR >1.5, PTT >40, PT >15. Any coagulopathy or medical condition requiring long-term anticoagulant therapy (e.g., warfarin) after transplantation (low-dose aspirin treatment is allowed) or patients with an INR >1.5. Acute or chronic pancreatitis. Symptomatic peptic ulcer disease. Hyperlipidemia despite medical therapy (fasting LDL cholesterol >130 mg/dl, treated or untreated; and/or fasting triglycerides > 200 mg/dl). Receiving treatment for a medical condition requiring chronic use of systemic steroids. Symptomatic cholecystolithiasis. Use of any investigational agents within 4 weeks of enrollment. Admission to hospital for any reason in the 14 days prior to enrollment (signing consent). Presence of active proliferative diabetic retinopathy or macular edema Any malignancy Abnormal liver function >1.5 x ULN Abdominal aortic aneurysm History of cerebro-vascular accident Any patient with acute or subacute decompensation from diabetes Any acute or chronic infectious condition that in the criteria of the investigator would be a risk for the patient. Subjects with hypoproteinemia, cachexia or terminal states Subjects with history of anorexia/bulimia Subjects with respiratory insufficiency Any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jianming Tan, professor
Organizational Affiliation
Fuzhou General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fuzhou General Hospital
City
Fuzhou
State/Province
Fujian
ZIP/Postal Code
350025
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
35086778
Citation
Wu Z, Xu X, Cai J, Chen J, Huang L, Wu W, Pugliese A, Li S, Ricordi C, Tan J. Prevention of chronic diabetic complications in type 1 diabetes by co-transplantation of umbilical cord mesenchymal stromal cells and autologous bone marrow: a pilot randomized controlled open-label clinical study with 8-year follow-up. Cytotherapy. 2022 Apr;24(4):421-427. doi: 10.1016/j.jcyt.2021.09.015. Epub 2022 Jan 25.
Results Reference
derived
PubMed Identifier
26628416
Citation
Cai J, Wu Z, Xu X, Liao L, Chen J, Huang L, Wu W, Luo F, Wu C, Pugliese A, Pileggi A, Ricordi C, Tan J. Umbilical Cord Mesenchymal Stromal Cell With Autologous Bone Marrow Cell Transplantation in Established Type 1 Diabetes: A Pilot Randomized Controlled Open-Label Clinical Study to Assess Safety and Impact on Insulin Secretion. Diabetes Care. 2016 Jan;39(1):149-57. doi: 10.2337/dc15-0171. Epub 2015 Dec 1.
Results Reference
derived

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Umbilical Mesenchymal Stem Cells and Mononuclear Cells Infusion in Type 1 Diabetes Mellitus

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