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Selectins have been implicated in the pathogenesis of ischemia/reperfusion (I/R)-induced kidney injury and resultant delayed graft function (DGF). PSGL-1 is a ligand for P-, E-, and L-selectin. It has been reported that YSPSL (rPSGL-Ig) blocks P-selectin and, to a lesser degree, E- and L-selectin. Both sPSGL-1 and YSPSL (rPSGL-Ig) have been shown in animal models to reduce both cytokines and tissue damage associated with ischemia reperfusion and to improve renal function post-transplant. Therefore, the current phase I/II clinical study is designed to assess the safety and efficacy of YSPSL (rPSGL-Ig) in preventing DGF in patients undergoing cadaveric kidney transplants and to determine a dose for future pivotal studies.
This will be a multicenter, single-dose, dose-escalation study. The study will be in 2 parts: the first, Part A, will be an open label evaluation of single doses of four dose cohorts; the second, Part B will be a randomized, double-blind, placebo-controlled, single-dose study of two dose cohorts. Patients who are undergoing cadaveric kidney transplantation and are at risk for development of DGF, based upon known risk factors, will be eligible to participate in the study. A maximum of 24 patients will be enrolled in Part A. 60 patients will be enrolled in Part B.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Experimental |
| |
| 2 | Experimental |
| |
| 3 | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| YSPSL | Drug | YSPSL administered intravenously (IV) as a single bolus infusion of 1 mg/kg with 200 mL Lactated Ringer's for Injection USP total volume administered as an ex vivo flush intra-arterially to donor organ prior to implantation |
| Measure | Description | Time Frame |
|---|---|---|
| delayed graft function post transplant | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| renal function parameters through 6 months post transplant | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Stefan Hemmerich, PhD | Y's Therapeutics, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dumont-UCLA Transplant Center | Los Angeles | California | 90095 | United States | ||
| California Pacific Medical Center Department of Transplantation |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21114535 | Derived | Cheadle C, Watkins T, Ehrlich E, Barnes K, Gaber AO, Hemmerich S, Rabb H. Effects of anti-adhesive therapy on kidney biomarkers of ischemia reperfusion injury in human deceased donor kidney allografts. Clin Transplant. 2011 Sep-Oct;25(5):766-75. doi: 10.1111/j.1399-0012.2010.01365.x. Epub 2010 Nov 28. | |
| 20573162 | Derived |
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|
| placebo | Drug | 0.9% normal saline administered IV as a single bolus infusion with 200 mL Lactated Ringer's for Injection USP total volume administered as an ex vivo flush intra-arterially to donor organ prior to implantation |
|
| YSPSL | Drug | YSPSL administered intravenously (IV) as a single bolus infusion of 1 mg/kg with 10 mg YSPSL in 200 mL Lactated Ringer's for Injection USP total volume administered as an ex vivo flush intra-arterially to donor organ prior to implantation |
|
|
| San Francisco |
| California |
| 94115 |
| United States |
| University of Colorado Health Sciences Center | Denver | Colorado | 80262 | United States |
| Shands Hospital at University of Florida | Gainesville | Florida | 32610 | United States |
| Lifelink Foundation | Tampa | Florida | 33606 | United States |
| Rush University Medical Center | Chicago | Illinois | 60612 | United States |
| Tulane University Hospital & Clinic | New Orleans | Louisiana | 70112 | United States |
| Henry Ford Hospital Transplant Institute | Detroit | Michigan | 48202 | United States |
| Saint Barnabas Medical Center | Livingston | New Jersey | 07039 | United States |
| Westchester Medical Center, New York Medical College | Hawthorne | New York | 10532 | United States |
| University of Cincinnati, Department of Internal Medicine | Cincinnati | Ohio | 45267 | United States |
| Methodist Healthcare University Hospital | Memphis | Tennessee | 38104 | United States |
| Baylor University Medical Center Transplantation Services | Dallas | Texas | 75246 | United States |
| The Methodist Hospital | Houston | Texas | 77030 | United States |
| University of Texas, Organ Transplantation | Houston | Texas | 77030 | United States |
| Gaber AO, Mulgaonkar S, Kahan BD, Woodle ES, Alloway R, Bajjoka I, Jensik S, Klintmalm GB, Patton PR, Wiseman A, Lipshutz G, Kupiec-Weglinski J, Gaber LW, Katz E, Irish W, Squiers EC, Hemmerich S. YSPSL (rPSGL-Ig) for improvement of early renal allograft function: a double-blind, placebo-controlled, multi-center Phase IIa study. Clin Transplant. 2011 Jul-Aug;25(4):523-33. doi: 10.1111/j.1399-0012.2010.01295.x. Epub 2010 Jun 22. |
| ID | Term |
|---|---|
| D007674 | Kidney Diseases |
| D051799 | Delayed Graft Function |
| ID | Term |
|---|---|
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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