Bone Marrow Mononuclear Cells vs Mesenchymal Stem Cells in Diabetic Patients With Chronic Limb Ischemia
Comparison of the Therapeutic Potential of Autologous Bone Marrow Mononuclear Cells Versus Allogenic Wharton Jelly-derived Mesenchymal Stem Cells in Diabetic Patients With Chronic Limb-threatening Ischemia
Fundación Oftalmológica de Santander Clínica Carlos Ardila Lulle
Patients in the severe stages of Chronic limb-threatening ischemia (CLTI) are prone to amputation and death, leading to poor quality of life and a great socioeconomic burden.
There is an urgent need to develop an effective therapeutic strategy to treat this disease. In this context, autologous bone marrow mononuclear cells (BM-MNC) and allogeneic mesenchymal stem cells derived from different sources have emerged as promising therapeutic approaches for this condition.
Registry Overview
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
Recruitment status
completed
Actual enrollment (reported)
24 participants
Study completion date
October 28, 2022
Actual (reported)
Listed locations
1 countries · 1 sites
Trial Relationships
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Related Scientific Literature
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Study Timeline
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
Bone marrow mononuclear cellsMesenchymal stem cells
Outcome Measures
Primary Outcomes (10)
Safety profile: (adverse events (AEs) and serious AEs)
AEs: (i) local toxicity, including signs of local inflammation (swelling, warmth, impairment of function), worsening of ulcer, new ulcer, or hematomas after auto-BM-MNC or allo-WJ-MSCs administration.
(ii) systemic toxicity as fever, allergies. (iii) maximum grade toxicity for tissue.
12 months
Safety profile
Serious AEs: hospitalization, malignancy, amputation, persistent or significant disability, or death.
12 months
Efficacy profile: Rutherford's classification
0 to 6
12 months
TcPO2
mmHg
12 months
Study Arms (3)
Placebo group
PLACEBO COMPARATOR
Placebo group (n=10), which consisted of 15 injections of 1 mL of vehicle (1 mL saline solution with 2% of autologous serum) on periadventitial arteries in one dose at day 0.
Biological: Cell-based therapy
Auto-BM-MNC
EXPERIMENTAL
Auto-BM-MNC (n=7) were obtained from diabetic patients. Fifteen injections of 7.197x106 ± 2.984x106 cells/mL each with 2% of autologous serum were periadventitial arteries administrated in one dose at day 0.
Biological: Cell-based therapy
Allo-WJ-MSCs
EXPERIMENTAL
Interventions
Cell-based therapyBiological
One dose of auto-BM-MNC, one dose of allo-WJ-MSCs, or one dose of placebo solution (saline solution with 2% of autologous serum), were periadventitial arteries administration in CTLI patients.
Allo-WJ-MSCsAuto-BM-MNCPlacebo group
Registry-reported names are shown in full. Names without a link have not yet been matched to a Syfrah profile.
Eligibility Criteria
Age40 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
You may qualify if:
Adult male or female, 40 years of age or over (until 85 years old)
Arango-Rodriguez ML, Mateus LC, Sossa CL, Becerra-Bayona SM, Solarte-David VA, Ochoa Vera ME, Viviescas LTG, Berrio AMV, Serrano SE, Vargas O, Isla AC, Benitez A, Rangel G. A novel therapeutic management for diabetes patients with chronic limb-threatening ischemia: comparison of autologous bone marrow mononuclear cells versus allogenic Wharton jelly-derived mesenchymal stem cells. Stem Cell Res Ther. 2023 Aug 25;14(1):221. doi: 10.1186/s13287-023-03427-z.
Fundación Oftalmológica de Santander Clínica Carlos Ardila Lulle
PRINCIPAL INVESTIGATOR
Enrollment
24 participants (actual enrollment reported by the registry).
Study Design
Study Type
interventional
Phase
phase 1 2
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Director Technical and Scientific Centro de Terapias Avanzadas Fundación Ofalmológica de Santander (FOSCAL)
Study Record Dates
First Submitted
October 30, 2022
First Posted
November 30, 2022
Study Start
January 1, 2019
Actual (reported)
NCT02287974
Clinical Trial I/II Opened, Randomized and Controlled for the Study of the Use of Stem Cells Therapy in Insulinized Diabetic Patients Type 2 With Critical Ischemia in Lower Limbs (CLI): Study of the Needs of Insulin
Allo-WJ-MSCs (n=7) were obtained from culturing the WJ from healthy cordon umbilical donors unrelated to the patient. Fifteen injections of 1.333x106 cells/mL each with 5% of human serum albumin serum were periadventitial arteries administrated in one dose at day 0.
Biological: Cell-based therapy
Diagnosis of diabetes.
Patients with signs of critical ischemia such as (i) ulcer that does not heal, (ii) necrosis or loss of tissue, (iii) pain at rest, and (iv) intermittent claudication.
Basal Rutherford classification stage 3 to 5.
Non-revascularizable patients due to comorbidities and/or anatomy.
Patients that despite revascularization (vascular surgery), have adequate distal beds to perfuse the limb.
Ankle/brachial index less than 0.4.
Stenosis or occlusion of the infrapatellar arteries.
You may not qualify if:
Participants that do not sign the informed consent.
Presence of osteomyelitis.
Hemodynamic instability (MAP\<65 mmHg or vasopressor requirement).
Any acute systemic infectious disease process.
Severe sepsis.
Uncontrolled coagulopathy.
Condition of cancer.
Use of immunosuppressive or cytotoxic drugs
Alterations of the bone marrow that do not allow the adequate extraction of the components to be used as: acute leukemia, chronic leukemia, marrow aplasia, myelodysplastic syndrome, and myelophthisis.
Contraindication of sedation for bone marrow aspirate.
Patients who have suffered in a period \< six months of myocardial infarction, disease cerebrovascular or coronary intervention.
Patients with liver failure indicated by serum transaminases (aspartate aminotransferase and alanine aminotransferase), with values twice the normal limit.
Any acute or chronic contagious disease including hepatitis B, hepatitis C, and HIV.
Any other comorbidity that the treating vascular surgeon considers as a contraindication to cell treatments.
Contact the study team to confirm eligibility.
Ischemia
Glucose Metabolism Disorders
Metabolic Diseases
Nutritional and Metabolic Diseases
Endocrine System Diseases
Intervention Hierarchy (Ancestors)
Biological TherapyTherapeutics
Primary Completion
September 30, 2020
Actual (reported)
Study Completion
October 28, 2022
Actual (reported)
Last Updated
November 30, 2022
Record last verified: 2022-11
Data Sharing
IPD Sharing
Will not share
Source record
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Source: ClinicalTrials.gov.
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