A Study To Evaluate the Safety and Efficacy of Human Neural Stem Cells for Parkinson’s Disease Patient

Overview

This Pilot study will evaluate the safety and Efficacy of an investigational cell transplantation therapy, h-NSC, in patients with Parkinson's disease, through nasal drug delivery, a new delivery way. All patients will receive the therapy, which consists of human neural stem cells,

Full Title of Study: “A Single Arm, Open-Label,Pilot Study to Evaluate the Safety and Efficacy of Human Neural Stem Cells Injection (ANGE-S003) Through Nasal Way Delivery to Patients With Parkinson’s Disease”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: June 1, 2018

Detailed Description

h-NSC is a cellular therapeutic consisting of human fetal neural stem cells (h-NSC). h-NSC injection will be delivered through nasal way for patients with Parkinson's disease (PD). The study will enroll 12 moderate to severe PD patients to be treated with the cell injection therapy at the same dose. The total therapy course will be four weeks,one dose for one week. The follow up will be two times within 24 weeks after finishing the treatment. The main objective of the study is to evaluate the efficacy and safety of the cell transplantation by this new delivery way.

Interventions

  • Biological: human neural stem cell
    • human neural stem cell: 100ul/vessel,2 vessel/one bag,≥2×10 6cells/vessel

Arms, Groups and Cohorts

  • Experimental: h-NSC arm
    • human neural stem cell: 100ul/vessel,2 vessel/one bag,≥2×10 6cells/vessel,produced by Shanghai Angecon Biotechology Cooperate. One enrolled PD patient was given 2 vessels h-NSC througth nasal cavity weekly for 4 weeks。Total cell number will be over ≥4×10 6cells for one time.

Clinical Trial Outcome Measures

Primary Measures

  • The change of Unified Parkinson’s Disease Reting Scale(UPDRS)score from baseline
    • Time Frame: Baseline and 16, 28 weeks
    • Improvement rate of UPDRS motor score defined as below: Reduction rate =(baseline score 16, 28 weeks score after therapy)/ baseline score×100%. Based on reduction rate, the efficacy can be defined as complete remission, partial remission, effective and invalid The reduction rate will be 100%, >50%, >25-50%, ≤ 25% for complete remission, partial remission, effective and invalid. The improvement rate =[(complete+partial+effective patient number)/total patient number]×100%

Secondary Measures

  • motor function index
    • Time Frame: baseline and 16, 28 weeks
    • Hoehn-Yahr modified score
  • Non-motor function score:cognitive function
    • Time Frame: baseline and 16, 28 weeks
    • Minimum Mental State Examination and Montreal Cognitive Assessment to assess cognitive function
  • Non-motor function score:smell
    • Time Frame: baseline and 16, 28 weeks
    • Argentina Hyposmia Rating Scales is used to detect the smell
  • Non-motor function score:fatigue
    • Time Frame: baseline and 16, 28 weeks
    • Fatigue Severity Scale to assess the extent of fatigue
  • Non-motor function score:emotion
    • Time Frame: baseline and 16, 28 weeks
    • Hamilton Depression Scale to evaluate the degree of depression, Hamilton Anxiety Scale to evaluate the degree of anxiety
  • Non-motor function score:non-motor symptoms
    • Time Frame: baseline and 16, 28 weeks
    • non-motor symptoms in PD patients is evaluated used Non-motor Symptoms Questionnaire
  • Non-motor function score:autonomic symptoms
    • Time Frame: baseline and 16, 28 weeks
    • The scale for outcomes in PD for autonomic symptoms to assess autonomic dysfunction
  • Non-motor function score:the quality of life.
    • Time Frame: baseline and 16, 28 weeks
    • The 39-item Parkinson’s disease questionnaire to assess the quality of life.
  • Immunological index
    • Time Frame: baseline and 16, 28 weeks
    • CD3(%),CD4(%),CD8(%),Treg cells(%)
  • Imaging index
    • Time Frame: baseline and 16, 28 weeks
    • Magnetic Resonance Imaging or positron emission tomography
  • Blood routine examination
    • Time Frame: baseline and 16, 28 weeks
    • Blood routine examination includes the total number of red blood cells, hemoglobin, total number of white blood cells, white blood cells count, platelet count.
  • Biochemical routine examination
    • Time Frame: baseline and 16, 28 weeks
    • Biochemical routine examination includes liver function, renal function, blood glucose, blood lipid
  • Safety index
    • Time Frame: 1,2,3,4,weeks and 16, 28 weeks
    • Adverse Event and Serious Adverse Event

Participating in This Clinical Trial

Inclusion Criteria

  • Patient diagnosed with idiopathic PD, at least with two key symptoms (Static tremor, bradykinesia, rigidity ) , without any other evidence of Secondary Parkinson's syndrome. – Disease course ≥7 years,modified Hoehn-Yahr is 3-5 stage – Patient age ≥35 years – Patients receiving a stable dose of levodopa for at least 1 months with the expectation that the treatment will remain unchanged throughout the course of the study – The doses of levodopa ≥300mg •Signed informed consent form (ICF) by patient self or his law-in relationship before enrollment. Exclusion Criteria:

  • Hepatic dysfunction(transaminase ≥1.5 normal range), Renal dysfunction(Cr>2.0mg/dl or 177μmol/L),Cardiac dysfunction or other severe systematic diseases etc. – Suffering malignancy or during anti-cancer treatment period. – Pregancy, lactation or possible pregancy and plan to pregancy patient – Attended other intervention clinical trial within 3 months aftre getting ICF, or during other ongoing intervention clinical trial – Investigator think inappropriate patient for this protocol

Gender Eligibility: All

Minimum Age: 35 Years

Maximum Age: 70 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Second Affiliated Hospital of Soochow University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Chun-Feng Liu, Professor – Second Affiliated Hospital of Soochow University
  • Overall Official(s)
    • Jie Li, Principal Investigator, Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou

Citations Reporting on Results

Hallett PJ, Cooper O, Sadi D, Robertson H, Mendez I, Isacson O. Long-term health of dopaminergic neuron transplants in Parkinson's disease patients. Cell Rep. 2014 Jun 26;7(6):1755-61. doi: 10.1016/j.celrep.2014.05.027. Epub 2014 Jun 6.

Kefalopoulou Z, Politis M, Piccini P, Mencacci N, Bhatia K, Jahanshahi M, Widner H, Rehncrona S, Brundin P, Bjorklund A, Lindvall O, Limousin P, Quinn N, Foltynie T. Long-term clinical outcome of fetal cell transplantation for Parkinson disease: two case reports. JAMA Neurol. 2014 Jan;71(1):83-7. doi: 10.1001/jamaneurol.2013.4749.

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