Burns Clinical Trial
Official title:
Evaluation of Tissue Regeneration Potential (in the Skin) of Child's Adipose Cells During the Development.
The beneficial effect related to the administration of adipose tissue-derived stromal cells (ADSC) is demonstrated in various situations of physiological and pathological wound healing, thus opening a new field for cell therapy. Despite the use of new technologies, management of burns in children as well as congenital malformation such as hypospadias and cleft lip and/ or cleft palate can lead to aesthetic and functional sequelae requiring multiple surgical procedures. Cell therapy based on the administration of the ADSC seems a promising issue in such indications, however, to date no study has been conducted with ADSC from a pediatric population. An initial study (Protocol 0808203) allowed investigors to obtain the first samples of adipose tissue from children and to conduct an in vitro comparative study on the characterization and properties of the ADSC from children compared to adults. In the continuity, this second study aims to complete knowledge on the efficacy and safety of children ADSC cell therapy assessed in an animal model of skin wound healing developed in the lab.
Through this study, the medium term objective is to approach a clinical protocol for
treatment of pathological scars in developing an appropriate way to deliver ADSC for a
future clinical application, while ensuring the safety of such procedure.
The primary goal of this work is to determine whether ADSC from children prepared according
to Good Manufacturing Practice (GMP), is associated with an improvement of wound healing in
vivo as demonstrated with adult ADSC. To answer this question, 40 samples of adipose tissue
of children obtained from settled surgery (inguinal hernia and vesico-ureteral reflux by
suprapubic way) will be performed within the 2 groups of children; 0 to 1 year and 2 to 13
years, defined from data acquired in the previous protocol. Wound healing will be evaluated
in a nude mouse model of skin burn. A macroscopic analysis will be carried out with two
indexes described in the literature (re-epithelialization and scar contraction) and
expressed as a percentage of the initial lesion at different times (3 days, 7 days, 10 days,
14 days, 21 days, 30 days). A microscopic analysis will be conducted to determine the rate
of re-epithelialization (day 7) and the evolution of the skin structural parameters (dermal
and epidermal thickness, density of collagen, inflammatory infiltration). These indexes will
be defined in the treated group (burned mice and injected with pediatric ADSC) from control
mice (burned but not injected with cells). A comparative analysis between the two groups of
age will be conducted that will be also compared to data collected with adult ADSC.
To answer to the second part of this primary goal regarding to safety, the study will
perform a long-term follow-up (1 yr) of burned mice injected with of ADSC, to obtain data in
the animal after transplantation of cells and for further clinical study.
Complementary in vitro investigations still seems necessary to better understand the
specificities of ADSC from pediatric origin and particularly to perform transcriptomic and
epigenetic studies.
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