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Autologous Bone Marrow Mononuclear Cells Therapy in Diabetic Lower Limb Ischemia

3. desember 2013 oppdatert av: Quanhai Li, Hebei Medical University

Safety and Efficacy Investigation of Patients With Diabetic Lower Limb Ischemia by Transplantation of Autologous Bone Marrow Mononuclear Cells

This study is to evaluate the safety and efficacy of autologous bone marrow mononuclear cells transplantation in diabetic patients with lower limb ischemia.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Diabetic lower limb ischemia as severe complication of diabetes influences the life quality of patients and currently the effective treatment for the disease is lacking. Bone marrow mononuclear cells have been proved to have multiple functions including the differentiation and proliferation. In animal model, bone marrow mononuclear cells could induce angiogenesis and may have therapeutic usage for ischemia disease. The investigators thereby design the study to investigate the possible therapy of diabetic lower limb ischemia with autologous bone marrow mononuclear cells. Patient with diabetic lower limb ischemia was treated with colony stimulating factor for improvement of bone marrow hematopoiesis. Then bone marrow was taken and mononuclear cells were isolated with deleting erythrocyte by density gradient centrifugation. Bone marrow mononuclear cells were transplanted into ischemia regions of lower limb through intramuscular injection. The investigators investigated the safety of the therapy with life signs like temperature, pulse, blood pressure, routine analysis of blood and urine etc. post the transplantation. And the efficacy was evaluated with the measurement of ulcer size, rest pain score, cold sensation score, resting ABI, resting TcPO2, collateral vessel score and skin microcirculation.

Studietype

Intervensjonell

Registrering (Forventet)

10

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Kina
    • Hebei
      • Shijiazhuang, Hebei, Kina, 050000
        • Rekruttering
        • The First Hospital of Hebei Medical University
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

20 år til 80 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  1. fontaine's stage 2-4 or resting ABI <0.7
  2. age between 20 and 80 years old
  3. sign informed consent, voluntary subjects
  4. diagnosis of diabetic lower limb ischemia

Exclusion Criteria:

  1. poorly controlled diabetes (HBA1c> 7.0%) and proliferative retinopathy (III-IV stage)
  2. malignancy history in the past five years or serum level of tumor markers elevated more than doubled
  3. severe heart, liver, kidney, respiratory failure or poor general condition can not tolerate bone marrow mononuclear cells transplantation
  4. serious infections (such as cellulitis, osteomyelitis, etc.)
  5. pregnant female, or reproductive age female who wants to give birth throughout the course of the study
  6. life expectancy less than half a year

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: autologous bone marrow mononuclear cells
Bone marrow come from the patients himself/herself. With a conventional method and reagent,Ficoll, mononuclear cells were isolated with deleting erythrocyte by density gradient centrifugation.
Biologisk: autologous bone marrow mononuclear cells
Bone marrow was taken from patient oneself and mononuclear cells were isolated with deleting erythrocyte by density gradient centrifugation. Bone marrow mononuclear cells were transplanted into ischemia regions of lower limb through intramuscular injection.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Cell transplantation related side effect
Tidsramme: 2 week after cell transplantation
Temperature,pulse,respiration,blood pressure,routine analysis of blood and urine, liver function,renal function,function of coagulation, ECG,cell transplantation related death and cell transplantation related unexpected amputation
2 week after cell transplantation

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
ulcer size
Tidsramme: Post cell transplantation: 1, 3, 6 months
Measuring ulcer area (cm2) and depth (mm)of limb : For each ulcer , photographically record the area and depth with a ruler in order to calculate the ulcer area in square millimeters.
Post cell transplantation: 1, 3, 6 months
rest pain score
Tidsramme: Post cell transplantation: 1,3, 6 months

Scoring the rest pain based on the degree of pain as following five scales): 0 level-0 point: no pain;

  1. level-1 point: occasional pain which can be recalled;
  2. level-2 points: the pain often but can be tolerated, without or with a little analgesics;
  3. level-3 points: often with need of general analgesics;
  4. level -4 points: affect sleeping due to the pain, general pain medication being difficult to alleviate.

Before transplantation: points; after transplantation: points.
Post cell transplantation: 1,3, 6 months
cold sensation score
Tidsramme: Post cell transplantation: 1,3, 6 months

based on a sense of cold as following five scales: 0 level-0 point: no cold sensation;

  1. level-1 point, or : Occasionally cold feeling;
  2. level-2 points: Often with cold feeling;
  3. level-3 points: significantly cold feeling. and can be significantly improved when using a local insulation.
  4. level-4 points: significantly cold feeling,and can not be significantly improved when using a local insulation.
Post cell transplantation: 1,3, 6 months
Resting ABI
Tidsramme: Post cell transplantation: 1,3, 6 months
Measurement of ABI(ankle brachial index, ABI): Measure arterial pressure with a laser Doppler, and then calculate the ankle-brachial index, that is a ratio of ankle arterial blood pressure to brachial arterial blood pressure at rest.
Post cell transplantation: 1,3, 6 months
Resting TcPO2 (mmHg)
Tidsramme: Post cell transplantation:1, 3, 6 months
Transcutaneous oxygen pressure(TcPO2) should be measured at the same site in the ischemic limb at rest.
Post cell transplantation:1, 3, 6 months
Collateral vessel score
Tidsramme: Post cell transplantation: 1,3, 6 months

Collateral vessel score: Using computed tomographic angiography to score the collateral vessel formation. A mean score is obtained for each ischemic limb by 3 independent interventionists based on the following 4 level score: 0 (no new collateral vessels)

  1. (A little new collateral vessels)
  2. (moderate new collateral blood vessels)
  3. (Rich new collateral vessels)
Post cell transplantation: 1,3, 6 months
Skin microcirculation measurement
Tidsramme: 1,3,6 months post cell transplantation
using PeriMed "laser-Doppler flowmetry" measure the skin microcirculation on the same site in the ischemic limb at rest.
1,3,6 months post cell transplantation

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Hebei Medical University

Etterforskere

  • Hovedetterforsker: Quanhai Li, doctor, The First Hospital of Hebei Medical University
  • Studieleder: Huimin Zhou, doctor, The First Hospital of Hebei Medical University
  • Hovedetterforsker: Xu Han, master, The First Hospital of Hebei Medical University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2012

Primær fullføring (Faktiske)

1. september 2013

Studiet fullført (Forventet)

1. desember 2014

Datoer for studieregistrering

Først innsendt

4. september 2013

Først innsendt som oppfylte QC-kriteriene

6. september 2013

Først lagt ut (Anslag)

9. september 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

4. desember 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. desember 2013

Sist bekreftet

1. desember 2013

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 12276102D

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