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Autologous Bone Marrow Mononuclear Cells Therapy in Diabetic Lower Limb Ischemia

3 december 2013 uppdaterad 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.

Studieöversikt

Status

Okänd

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Förväntat)

10

Fas

  • Fas 1

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Kina
    • Hebei
      • Shijiazhuang, Hebei, Kina, 050000
        • Rekrytering
        • The First Hospital of Hebei Medical University
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

20 år till 80 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Cell transplantation related side effect
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
ulcer size
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Hebei Medical University

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 januari 2012

Primärt slutförande (Faktisk)

1 september 2013

Avslutad studie (Förväntat)

1 december 2014

Studieregistreringsdatum

Först inskickad

4 september 2013

Först inskickad som uppfyllde QC-kriterierna

6 september 2013

Första postat (Uppskatta)

9 september 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

4 december 2013

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

3 december 2013

Senast verifierad

1 december 2013

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 12276102D

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