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| ID | Type | Description | Link |
|---|---|---|---|
| 9R44HL066965-02 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Heart, Lung, and Blood Institute (NHLBI) | NIH |
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Bronchopulmonary Dysplasia (BPD) is a multi-factorial disease process that is the end result of an immature, surfactant deficient lung that has been exposed to hyperoxia, mechanical ventilation and infection. These conditions initiate an inflammatory response characterized by elevated inflammatory cell infiltrates and proinflammatory cytokines that lead to the development of significant acute and chronic lung injury.
The study drug, rhCC10, is a recombinant version of natural human CC10 protein. Native CC10 is produced primarily by non-ciliated respiratory epithelial cells, called Clara cells and is the most abundant protein in the mucosal fluids in normal healthy lungs.
The purpose of this study was to evaluate the pharmacokinetics, safety, tolerability and anti-inflammatory effects of a single intratracheal (IT) dose of rhCC10 to intubated premature infants receiving positive pressure ventilation for treatment of respiratory distress syndrome (RDS) to prevent long term respiratory complications referred to as bronchopulmonary dysplasia, and, more recently, as chronic respiratory morbidity (CRM; asthma, cough, wheezing, multiple respiratory infections).
CC10 regulates inflammatory responses and protects the structural integrity of pulmonary tissue while preserving pulmonary mechanical function during various insults (eg. viral infection, bacterial endotoxin, ozone, allergens, hyperoxia). Together these properties suggest that administration of rhCC10 may help to facilitate development of normal airway epithelia and prevent the inflammation that leads to CRM in these infants.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | Placebo Comparator |
| |
| High dose rhCC10 | Experimental | 5 mg/kg study drug (rhCC10) |
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| Low Dose rhCC10 | Experimental | 1.5 mg/kg study drug (rhCC10) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| recombinant human CC10 (rhCC10) | Drug | 5 mg/kg rhCC10, single dose delivered intratracheally (IT). Treatment was delivered within four hours after surfactant treatment. Dose was delivered IT in two (2) equal aliquots via a premeasured feeding tube placed in the distal third of the endotracheal tube with the patient in the right and then left lateral decubitus position and 30 degrees of Trendelenburg. |
| Measure | Description | Time Frame |
|---|---|---|
| Number and type of adverse events | All adverse events were monitored according to the NCI Common Toxicity Criteria. In addition, adverse events specific to, or likely to occur in, premature infants were also monitored, including apnea/bradycardia, sepsis (culture-confirmed), patent ductus arteriosus, retinopathy of prematurity, intraventricular hemorrhage, periventricular leukomalacia, and necrotizing enterocolitis (NEC). | Adverse events were monitored through 36 wks post-menstrual age (PMA) or hospital discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of pulmonary inflammatory markers | Total cell and neutophil counts were performed on TAF fluids. In addition, a panel of cytokines were measured in TAF from patients at times 0, 1, and 2 days | Days 0-7 |
| Total number of days on mechanical ventilation |
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Inclusion Criteria:
Newborn infants were considered for the study if the following criteria were met:
Exclusion Criteria:
• Major congenital abnormalities (chromosomal, genetic, cardiac, pulmonary, or renal);
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| Name | Affiliation | Role |
|---|---|---|
| Jonathan M Davis, MD | Dept of pediatrics, Winthrop University Hospital, SUNY Stony Brook School of Medicine | Principal Investigator |
| Ira Gewolb, M.D. | University of Maryland, Baltimore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Christiana HealthCare Systems | Wilmington | Delaware | 19899 | United States | ||
| University of Maryland School of Medicine |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15774846 | Result | Levine CR, Gewolb IH, Allen K, Welch RW, Melby JM, Pollack S, Shaffer T, Pilon AL, Davis JM. The safety, pharmacokinetics, and anti-inflammatory effects of intratracheal recombinant human Clara cell protein in premature infants with respiratory distress syndrome. Pediatr Res. 2005 Jul;58(1):15-21. doi: 10.1203/01.PDR.0000156371.89952.35. Epub 2005 Mar 17. |
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| recombinant human CC10 (rhCC10) | Drug | 1.5 mg/kg rhCC10, single dose delivered intratracheally (IT). Treatment was delivered within four hours after surfactant treatment. Dose was delivered IT in two (2) equal aliquots via a premeasured feeding tube placed in the distal third of the endotracheal tube with the patient in the right and then left lateral decubitus position and 30 degrees of Trendelenburg |
|
|
| placebo | Drug | Half normal saline solution; single dose delivered intratracheally (IT). Treatment was delivered within four hours after surfactant treatment. Dose was delivered IT in two (2) equal aliquots via a premeasured feeding tube placed in the distal third of the endotracheal tube with the patient in the right and then left lateral decubitus position and 30 degrees of Trendelenburg. |
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| Through 36 wks postmenstrual age or discharge |
| Hospitalization at 36 weeks PMA | Through 36 wks postmenstrual age or discharge |
| Chronic Respiratory Morbidity | Physical exams and Bayley neurological exams were performed at 12 months PMA. Data pertaining to respiratory outcomes were collected at 6 and 12 months PMA. | 6 & 12 months postmenstrual age |
| Baltimore |
| Maryland |
| 21201 |
| United States |
| Mercy Medical Center | Baltimore | Maryland | 21202 | United States |
| Winthrop-University Hospital, SUNY Stony Brook School of Medicine | Mineola | New York | 11501 | United States |
| ID | Term |
|---|---|
| D001997 | Bronchopulmonary Dysplasia |
| D047928 | Premature Birth |
| D011014 | Pneumonia |
| ID | Term |
|---|---|
| D055397 | Ventilator-Induced Lung Injury |
| D055370 | Lung Injury |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D007235 | Infant, Premature, Diseases |
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007752 | Obstetric Labor, Premature |
| D007744 | Obstetric Labor Complications |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D014598 | Uteroglobin |
| ID | Term |
|---|---|
| D060765 | Secretoglobins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
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