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MSC Secretome Therapy for Cognitive Recovery After Subacute Ischemic Stroke

23 juli 2026 uppdaterad av: Jumraini Tammasse

Efficacy of Mesenchymal Stem Cell Secretome Therapy on Cognitive Recovery in Patients With Subacute Ischemic Stroke: A Pilot Randomized Controlled Trial Using qEEG, BDNF, and Interleukin-1β Evaluation

Post-stroke cognitive impairment can limit rehabilitation, independence, and quality of life after ischemic stroke. This pilot randomized controlled trial evaluates whether mesenchymal stem cell-derived secretome, given in addition to standard stroke care and rehabilitation, improves cognitive recovery in patients with subacute ischemic stroke. Participants aged 40 to 75 years with ischemic stroke occurring 7 days to 3 months previously and mild-to-moderate cognitive impairment will be randomly assigned in a 1:1 ratio to receive standard care and rehabilitation plus MSC secretome or standard care and rehabilitation without MSC secretome. The primary outcome is the change in the Indonesian version of the Montreal Cognitive Assessment score. Secondary outcomes include quantitative electroencephalography parameters, serum brain-derived neurotrophic factor, serum interleukin-1β, NIHSS, modified Rankin Scale, and adverse events.

Studieöversikt

Detaljerad beskrivning

This study is a pilot, parallel-group, randomized controlled trial with blinded outcome assessment. The study population consists of patients aged 40 to 75 years with clinically and radiologically confirmed subacute ischemic stroke, defined as 7 days to 3 months after stroke onset. Eligible participants must be hemodynamically stable, able to undergo a basic neuropsychological assessment, and have mild-to-moderate cognitive impairment based on the Indonesian version of the Montreal Cognitive Assessment.

Participants will be randomized in a 1:1 ratio using block randomization with allocation concealment. The intervention group will receive standard stroke care and rehabilitation plus umbilical cord mesenchymal stem cell-derived secretome. The control group will receive standard medical treatment and standardized stroke rehabilitation without MSC secretome. Outcome assessors will remain unaware of treatment allocation.

Baseline assessments include demographic and vascular risk factor data, NIHSS, modified Rankin Scale, MoCA-Ina, quantitative electroencephalography, serum brain-derived neurotrophic factor, and serum interleukin-1β. Follow-up assessments will include cognitive, neurological, functional, electrophysiological, biomarker, and safety evaluations at the prespecified study visits.

The primary outcome is the change in MoCA-Ina total score from baseline to week 8. Secondary outcomes include changes in delta-to-alpha ratio, delta-theta-to-alpha-beta ratio, relative alpha power, relative theta power, serum BDNF, serum IL-1β, NIHSS, modified Rankin Scale, and the incidence of adverse events. The primary analysis will follow the intention-to-treat principle, with per-protocol analysis as an additional analysis.

Studietyp

Interventionell

Inskrivning (Beräknad)

70

Fas

  • Inte tillämpbar

Kontakter och platser

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

Studiekontakt

  • Namn: Jumraini Tammasse, Sp.N, Subsp.NRE(K)
  • Telefonnummer: +6282188833368
  • E-post: tejayanovi@gmail.com

Studieorter

    • South Sulawesi
      • Makassar, South Sulawesi, Indonesien, 90245
        • Rekrytering
        • Hasanuddin University Hospital
        • Kontakt:
        • Kontakt:
        • Huvudutredare:
          • Jumraini Tammasse, Sp.N, Subsp.NRE(K)

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

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  1. Age 40 to 75 years.
  2. Diagnosis of ischemic stroke confirmed by clinical examination and computed tomography or magnetic resonance imaging.
  3. Stroke onset between 7 days and 3 months before enrollment.
  4. Hemodynamically stable.
  5. Able to undergo a basic neuropsychological assessment.
  6. Mild-to-moderate cognitive impairment based on the Indonesian version of the Montreal Cognitive Assessment.
  7. Willing to participate in the study and provide written informed consent.

Exclusion Criteria:

  1. Hemorrhagic stroke or mixed ischemic and hemorrhagic stroke.
  2. Severe aphasia, impaired consciousness, or severe sensory deficits that make cognitive assessment invalid.
  3. History of dementia before stroke or a major neurodegenerative disorder.
  4. Active infection, active autoimmune disease, active malignancy, severe renal failure, or severe liver failure.
  5. Uncontrolled epilepsy.
  6. Concurrent participation in another clinical trial.
  7. Contraindication to any study intervention or study procedure.

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: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: MSC Secretome Plus Standard of Care
Participants receive standard medical treatment and standardized stroke rehabilitation plus umbilical cord mesenchymal stem cell-derived secretome. The secretome intervention is administered according to the study protocol, with safety monitoring during and after administration.
Umbilical cord mesenchymal stem cell-derived secretome is administered in addition to standard medical treatment and standardized stroke rehabilitation. The intervention is administered twice, on day 1 and day 8, according to the investigational product protocol. Participants are monitored during and after administration for hypersensitivity reactions, fever, and other adverse events.
Andra namn:
  • USEPro
Participants receive standard medical management for subacute ischemic stroke and standardized stroke rehabilitation according to the treating physician and institutional clinical practice. The same standard care and rehabilitation are provided to both study groups.
Aktiv komparator: Standard of Care Alone
Participants receive standard medical treatment and standardized stroke rehabilitation without MSC secretome.
Participants receive standard medical management for subacute ischemic stroke and standardized stroke rehabilitation according to the treating physician and institutional clinical practice. The same standard care and rehabilitation are provided to both study groups.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Montreal Cognitive Assessment-Indonesian Version Total Score
Tidsram: Baseline to week 8
The MoCA-Ina assesses visuospatial-executive function, naming, attention, language, abstraction, delayed recall, and orientation. The total score ranges from 0 to 30, with higher scores indicating better cognitive performance. The outcome is the change in total MoCA-Ina score from baseline to the final follow-up assessment.
Baseline to week 8

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Delta-to-Alpha Ratio on Quantitative Electroencephalography
Tidsram: Baseline, week 4, and week 8
The delta-to-alpha ratio is calculated from quantitative electroencephalography spectral power measurements. The outcome is the change in DAR from baseline to week 4 and week 8.
Baseline, week 4, and week 8
Change in Delta-Theta-to-Alpha-Beta Ratio on Quantitative Electroencephalography
Tidsram: Baseline, week 4, and week 8
The delta-theta-to-alpha-beta ratio is calculated from quantitative electroencephalography spectral power measurements. The outcome is the change in DTABR from baseline to week 4 and week 8.
Baseline, week 4, and week 8
Change in Relative Alpha Power on Quantitative Electroencephalography
Tidsram: Baseline, week 4, and week 8
Relative alpha power is derived from quantitative electroencephalography spectral power analysis. The outcome is the change in relative alpha power from baseline to week 4 and week 8.
Baseline, week 4, and week 8
Change in Relative Theta Power on Quantitative Electroencephalography
Tidsram: Baseline, week 4, and week 8
Relative theta power is derived from quantitative electroencephalography spectral power analysis. The outcome is the change in relative theta power from baseline to week 4 and week 8.
Baseline, week 4, and week 8
Change in Serum Brain-Derived Neurotrophic Factor Concentration
Tidsram: Baseline and week 8
Serum brain-derived neurotrophic factor concentration is measured using an enzyme-linked immunosorbent assay. The outcome is the change in serum BDNF concentration from baseline to week 8.
Baseline and week 8
Change in Serum Interleukin-1 Beta Concentration
Tidsram: Baseline and week 8
Serum interleukin-1 beta concentration is measured using an enzyme-linked immunosorbent assay. The outcome is the change in serum IL-1 beta concentration from baseline to week 8.
Baseline and week 8
Change in National Institutes of Health Stroke Scale Score
Tidsram: Baseline, week 4, and week 8
The National Institutes of Health Stroke Scale assesses neurological impairment. Scores range from 0 to 42, with higher scores indicating greater neurological impairment. The outcome is the change in NIHSS score from baseline to week 4 and week 8.
Baseline, week 4, and week 8
Change in Modified Rankin Scale Score
Tidsram: Baseline, week 4, and week 8
The modified Rankin Scale assesses global disability after stroke. Scores range from 0 to 6, with higher scores indicating greater disability or death. The outcome is the change in modified Rankin Scale score from baseline to week 4 and week 8.
Baseline, week 4, and week 8
Incidence of Treatment-Emergent Adverse Events
Tidsram: From the first intervention through week 8
The number and proportion of participants experiencing adverse events, including hypersensitivity reactions, fever, administration-related reactions, hospitalization, seizure, infection, neurological deterioration, and death, will be recorded.
From the first intervention through week 8

Samarbetspartners och utredare

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

Utredare

  • Huvudutredare: Jumraini Tammasse, Sp.N, Subsp.NRE(K), Hasanuddin 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 (Faktisk)

9 juli 2026

Primärt slutförande (Beräknad)

1 november 2026

Avslutad studie (Beräknad)

1 december 2026

Studieregistreringsdatum

Först inskickad

23 juli 2026

Först inskickad som uppfyllde QC-kriterierna

23 juli 2026

Första postat (Faktisk)

28 juli 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

28 juli 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

23 juli 2026

Senast verifierad

1 juli 2026

Mer information

Termer relaterade till denna studie

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

Individual participant data sharing is not currently planned. Participant data will be coded, stored securely, and reported only in aggregate form without direct personal identifiers.

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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