Actively Recruiting
Effects of Intravascular Administration of Mesenchymal Stromal Cells Derived from Wharton's Jelly of the Umbilical Cord on Systemic Immunomodulation and Neuroinflammation After Traumatic Brain Injury.
Led by Assistance Publique - Hôpitaux de Paris · Updated on 2024-10-16
68
Participants Needed
3
Research Sites
196 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Traumatic brain injuries (TBI) are one of the leading causes of death and disability worldwide. These patients are burdened by physical, cognitive, and psychosocial deficits, leading to an important economic impact for society. Treatments for TBI patients are limited and none has been shown to provide prolonged and long-term neuroprotective or neurorestorative effects. TBI related disability is linked to the severity of the initial injury but also to the following neuroinflammatory response which may persist long after the initial injury. Moreover, a growing body of evidence suggests a link between TBI-induced neuro-inflammation and neurodegenerative post traumatic disorders. Consequently, new therapies triggering immunomodulation and promoting neurological recovery are the subject of major research efforts. In this context, mesenchymal cell-based therapies are currently investigated to treat various neurological disorders due to their ability to modulate neuroinflammation and to promote simultaneous neurogenesis, angiogenesis, and neuroprotection. Clinical trials using intravenous MSC have been conducted for various pathologies, all these studies showing a good safety profile. The hypothesis of the study is that intravenous repeated treatment with MSC derived from Wharton's Jelly of the umbilical cord may be associated with a significant decrease of post-TBI neuroinflammation and improvement of neuroclinical status. The main objective of the study is to evaluate the effect of iterative IV injections of MSC on post-traumatic neuroinflammation measured in corpus callosum by PET-MRI at 6 months in severe brain injured patients unresponsive to simple verbal commands 5 days after sedation discontinuation.
CONDITIONS
Official Title
Effects of Intravascular Administration of Mesenchymal Stromal Cells Derived from Wharton's Jelly of the Umbilical Cord on Systemic Immunomodulation and Neuroinflammation After Traumatic Brain Injury.
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age 18-50 years
- Healthy volunteers classified as ASA 1
- Severe traumatic brain injury defined by Glasgow score less than 12 within 48 hours
- Brain traumatic lesion visible on CT scan
- Need for intracranial pressure monitoring
- No other significant organ trauma (AIS less than 2)
- Unresponsive to verbal commands 5 days after sedation discontinuation
- No decision to stop active therapies within 10 days after sedation discontinuation
- Written consent signed by a close relative
You will not qualify if you...
- Lack of written consent
- Neurological history likely to alter imaging (epilepsy, transient ischemic attack, meningitis, head trauma)
- Vulnerable person according to article L1121-6 of the CSP
- Protected adult person
- No social security affiliation
- Pregnancy
- Contraindications for MRI and PET-MRI including pacemaker, defibrillator, MR-incompatible heart valve, metallic foreign bodies, neurostimulation systems, cochlear or ear implants, metallic fragments, aneurysm clips, ventriculo peritoneal shunts with metallic components, catheters with metallic components
- Inability to remain supine and motionless during examination
- History of disease or treatment impairing immunity in current or previous year (hematologic diseases, viral diseases like HIV, immunological treatments)
- Severe neurological or psychiatric disease affecting assessment
- Pulmonary arterial hypertension grade III or higher
- Uncontrolled infection with organ failure including severe COVID-19
- Low blood counts (platelets, hemoglobin, lymphocytes, neutrophils) or elevated creatinine
- Liver function abnormalities except Gilbert's disease with normal liver tests
- Known HIV seropositivity
- Ongoing or recent neoplasia treatment within 3 years
- Bone marrow transplant recipient
- History of transfusion reaction or hypersensitivity
- Participation in another interventional clinical trial within 30 days of consent
AI-Screening
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Trial Site Locations
Total: 3 locations
1
Hôpital National d'Instruction des Armées Percy
Clamart, France
Actively Recruiting
2
Beaujon Hospital
Clichy, France
Actively Recruiting
3
Hôpital de la Pitié Salpêtrière - AP-HP
Paris, France
Actively Recruiting
Research Team
V
Vincent Degos
CONTACT
S
Stéphanie Sigaut
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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