Use of Mesenchymal Stem Cells in Inflammatory Bowel Disease

Inflammatory Bowel Diseases Clinical Trial

Official title:

Ulcerative Colitis Stem Cell Therapy

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03299413
• Other study ID #: IBDUJCTC
• Status: Active, not recruiting
• Phase: Phase 1/Phase 2
• Start date: June 5, 2017
• Est. completion date: January 2020

Study information

• Verified date: April 2019
• Source: University of Jordan
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Scientists hypothesize that directly or parentally injecting Mesenchymal stem cells (MSCs) to affected areas will have a positive impact through reducing or abolishing intestinal inflammation in part via inhibition of neutrophil Myeloperoxidase (MPOx) activity. Inhibiting MPOx should modify disease progression as well as reduce colitis associated cancer risk.

Description:

Chronic inappropriate mucosal immune activation, due to aberrant host interactions with intestinal microbiota, is at the heart of inflammatory bowel disease (IBD) pathogenesis. Currently, there is no cure for IBD and mainstays of therapy are limited to non-cell specific immunosuppression/immunomodulation, antibiotics and surgery. Advanced ulcerative colitis patients cost approximately 10,000JD in therapy per year with 12.4% of patients presenting with rectal bleeding in Jordan being diagnosed with ulcerative colitis. The role of MSCs in immune modulation is well established in many diseases. However, the therapeutic potential of MSCs directly injected into the inflamed large intestine or parentally has not been fully investigated. Injected MSCs may modulate the IBD immune response particularly lymphoid T-cell and neutrophil activities. While a variety of immune cells contribute to the disease, increased neutrophil activity is associated with greater frequency and severity of active inflammation, as well as increased colitis associated cancer risk. MPOx can transform lipids and polyamines into reactive carbonyl species (RCS) capable of modifying proteins and DNA, altering cell signalling pathways. Finally, MPOx is reported as a useful tool in screening and risk stratification of human ulcerative colitis and colorectal cancer. Inhibiting MPOx in an accelerated preclinical mouse model did reduce incidence and tumor load resulting from gut inflammation. Additionally, in similar preclinical models others have reported that MSC transplantation reduces colitis severity and inflammatory markers including MPOx activity. Even in the absence of the well-known MSC T-cell immune modulation, disease activity indices and MPOx activity were reduced in these models. In addition to following traditional clinical outcomes, Reseachers will analyze gut immune responses, specifically neutrophil MPOx activity along with other IBD immune markers.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 20
• Est. completion date: January 2020
• Est. primary completion date: November 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• Single/unmarried females or married females using two modalities of contraception for six months after completion of the study.

• Signed informed consent.

• Patients with previous diagnosis of ulcerative colitis (UC) or newly diagnosed UC based on endoscopic or histopathologic features

• Colitis of any activity

Exclusion Criteria:

• Mental disability that impedes adequate understanding of the study and of the associated procedures.

• Extensive severe toxic colitis requiring admission and IV steroids or biological treatment/surgery.

• Patients with previous colectomies.

• History of malignant disease.

• Pregnant or breastfeeding women.

• Presence of severe concomitant diseases such as chronic obstructive pulmonary disease, Diabetes Mellitus, Cardiovascular and other autoimmune diseases.

• Positive to one or more of the infectious disease panel

Related Conditions & MeSH terms

• Inflammatory Bowel Diseases
• Intestinal Diseases

Intervention

Biological:
• Wharton Jelly Mesenchymal stem cells
Wharton Jelly Mesenchymal stem cells will be injected intravenously

Locations

Country	Name	City	State
Jordan	Cell Therapy Center	Amman

Sponsors (2)

Lead Sponsor	Collaborator
Hanan Jafar	Scientific Research Support fund

Country where clinical trial is conducted

Jordan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]	Treatment adverse events are defined by any adverse event leading to hospitalization, organ failure or death	6 months
Secondary	Evaluation of the efficacy of the injected cells (Change from Baseline in partial mayo score)	Remission will be considered if reaches 0 points and response if the score diminishes. Endoscopy will be performed at 0 and 12 weeks.	3 months