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There is evidence that human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) can differentiate into oligodendrocytes and neurons, and improve the recovery of nerve function, which strongly suggests the feasibility and effectiveness of hUCB-MSCs as an intervention treatment for spinal cord injury. At present, there are only a few clinical centers in which hUCB-MSCs transplantation for treatment of chronic spinal cord injury has been performed and a certain degree of efficacy has been achieved. However, this has not been supported by systematic standardized randomized controlled trials. Therefore, the investigators design a prospective, randomized, open-label, parallel, controlled trial to evaluate the efficacy of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs)/hUCB-MSCs to treat spinal cord injury. The primary objective of this study was to investigate whether hUC-MSCs)/hUCB-MSCs transplantation can improve the locomotor function of patients with spinal cord injury. The secondary objectives were to investigate whether hUC-MSCs)/hUCB-MSCs transplantation can improve the muscle tension of patients with spinal cord injury and investigate the complications and safety of hUC-MSCs)/hUCB-MSCs transplantation.
Patient recruitment will be performed via information dissemination on bulletin boards to advertise the study among patients at the clinics and wards of the First Affiliated Hospital of Dalian Medical University, China. Patients interested in participation in this study or their legal guardians contact the project manager via telephone. Patients will be screened according to the inclusion and exclusion criteria after providing signed informed consent. Eligible patients with chronic spinal cord injury will receive intravenous, lumbar, and local administration of hUC-MSCs/hUCB-MSCs (provided by Cell Bank of Stem Cell Clinical Research Institute, The First Affiliated Hospital of Dalian Medical University). The primary outcome measure of this study is neurologic function scores, including ASIA (American Spinal Injury Association) motor score, ASIA sensory score, ASIA impairment scale (ASIA classification), and acupuncture score. These scores will be used to evaluate the recovery of nerve function after spinal cord injury and determine the therapeutic efficacy and persistence. The secondary outcome measures of this study include Walking Index of Spinal Cord Injury (WISCI), Spinal Cord Independence Measure (SCIM), Kunming Locomotion Scale (KLS), Modified Ashworth Scale (MAS), and Visual Analogous Scale (VAS) scores and the incidence of adverse reactions. At 1, 3, 6 and 12 months after treatment, patients will be followed up to evaluate the efficacy and safety of hUC-MSCs)/hUCB-MSCs transplantation in the treatment of spinal cord injury.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rehabilitation control group | Other | Routine rehabilitation treatment for chronic spinal cord injury and Intravenous injection of 100 mL 0.9% saline solution. |
|
| hUC-MSCs intravenous administration group | Experimental | intravenous administration of 100 mL of cell suspension containing 5×107 hUC-MSCs |
|
| hUC-MSCs lumbar administration group | Experimental | lumbar administration of a solution prepared by 5 mL of cell suspension containing 5×107 hUC-MSCs and 5 mL of cerebrospinal fluid |
|
| hUC-MSCs local administration group | Experimental | hUC-MSCs (100,000 cells/μL) were injected via 4 points in the edge of injured spinal cord (2 points in the upper edge and 2 points in the lower edge), 16 μL hUC-MSCs/point. |
|
| hUCB-MSCs intravenous administration group | Experimental | intravenous administration of 100 mL of cell suspension containing 5×107 hUCB-MSCs |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stem cell transplantation | Other | The eligible patients with chronic spinal cord injury included in this study will receive intravenous, lumbar, and local administration of hUC-MSCs/hUCB-MSCs and routine rehabilitation treatment. At 1, 3, 6 and 12 months after treatment, patients will be followed up and evaluated. |
| Measure | Description | Time Frame |
|---|---|---|
| Neurologic function score | ASIA motor score, ASIA sensory score, ASIA impairment scale (ASIA classification), and acupuncture score will be obtained to evaluate the recovery of nerve function after spinal cord injury and determine the therapeutic efficacy and persistence. | Change from Baseline at 12 months after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Walking Index of Spinal Cord Injury (WISCI) | To evaluate walking ability | Change from Baseline at 12 months after treatment |
| Spinal Cord Independence Measure (SCIM) | To evaluate ability of daily activities after spinal cord injury |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of adverse reactions | To record adverse reactions after treatment | Before and 1, 3, 6, and 12 months after treatment |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jing Liu, Ph.D | Contact | 86041184394568 | liujing.dlrmc@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Jing Liu, Ph.D | The First Affiliated Hospital of Dalian Medical University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of Dalian Medical University | Recruiting | Dalian | Liaoning | 116011 | China |
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| ID | Term |
|---|---|
| D013119 | Spinal Cord Injuries |
| D010146 | Pain |
| ID | Term |
|---|---|
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
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| ID | Term |
|---|---|
| D033581 | Stem Cell Transplantation |
| ID | Term |
|---|---|
| D017690 | Cell Transplantation |
| D064987 | Cell- and Tissue-Based Therapy |
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
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participants are assigned to one of two or more groups in parallel for the duration of the study
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| hUCB-MSCs lumbar administration group | Experimental | lumbar administration of a solution prepared by 5 mL of cell suspension containing 5×107 hUCB-MSCs and 5 mL of cerebrospinal fluid |
|
| hUCB-MSCs local administration group | Experimental | hUCB-MSCs (100,000 cells/μL) were injected via 4 points in the edge of injured spinal cord (2 points in the upper edge and 2 points in the lower edge), 16 μL hUCB-MSCs/point. |
|
|
| Change from Baseline at 12 months after treatment |
| Kunming Locomotion Scale (KLS) | To evaluate walking ability | Change from Baseline at 12 months after treatment |
| Modified Ashworth Scale (MAS) | 0-4 score, to evaluate spasticity | Change from Baseline at 12 months after treatment |
| Visual Analogous Scale (VAS) | To evaluate the degree of pain | Change from Baseline at 12 months after treatment |
| D014947 | Wounds and Injuries |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D014180 |
| Transplantation |
| D013514 | Surgical Procedures, Operative |