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The aim is to Investigate the safety and efficacy of Portal vein infusion Allogeneic Human umbilical cord mesenchymal stem cells combined with Allogeneic islet transplantation for the treatment of diabetes
This is an investigator-initiated trial (IIT). The first part is an open-label, dose-escalation study involving 9 patients between the ages of 18 and 70. The second part is a non-randomized, active comparator-controlled IIT with a parallel design, comparing allogeneic islet transplantation combined with human umbilical cord mesenchymal stem cells (hUCMSCs) to allogeneic islet transplantation alone in patients with diabetes.Besides safety, preservation of endogenous insulin production (measured as C-peptide concentrations) together with metabolic control, diabetes treatment satisfaction and immunological profile will be assessed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | allogeneic islet combined with hUCMSCs |
|
| Comparator | Active Comparator | allogeneic islet |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| human umbilical cord mesenchymal stem cells | Drug | Portal vein infusion human umbilical cord mesenchymal stem cells |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety assessment: Registration of adverse events | Changes in safety parameters of patients during the study period since baseline. Measured through the registration of adverse events. | Throughout the study until Week 52 |
| Efficacy Assessment: Evaluation of islet function | Change of C-peptide Area Under the Curve (AUC) (0-120 min) for Mixed Meal Tolerance Test (MMTT) at Week 52 compared to test performed before start of treatment. | Throughout the study until Week 52 |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy Assessment: HbA1c | Changes in patient HbA1c levels from baseline during the study period | Week 52 |
| Dose of exogenous insulin | Changes in daily exogenous insulin requirements during the study period |
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Inclusion Criteria:
Meets the 1999 World Health Organization diagnostic criteria for diabetes.
Aged 18-70, no gender restriction.
Islet function failure: fasting C-peptide < 0.1 nmol/L, 2-hour postprandial C-peptide < 0.2 nmol/L, and HbA1c ≥ 7%.
Meets the indications for islet transplantation alone:
i. Type 1 diabetes patients who experience unstable blood glucose despite strict insulin therapy, including frequent hypoglycemia or at least one severe hypoglycemic event in the past 12 months, or those with serious complications in other organs such as the kidneys; ii. Type 2 diabetes progressing to islet failure with poor blood glucose control as described above; iii. Patients with chronic pancreatitis or non-malignant pancreatic tumors who have undergone total or near-total pancreatectomy may receive autologous islet transplantation concurrently or allogeneic islet transplantation later.
The patient and their family or legal guardian voluntarily consent to stem cell transplantation therapy and sign the informed consent form.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hao Yin | Contact | 13901677738 | yinhaoshanghai@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Hao Yin | Shanghai Changzheng Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Changzheng Hospital | Recruiting | Shanghai | Shanghai Municipality | China |
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| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| allogeneic islet | Drug | Portal vein infusion of allogeneic islet |
|
| Week 52 |