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| Name | Class |
|---|---|
| Weston Brain Institute | OTHER |
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The goal of this clinical trial is to learn if stem cell therapy works to treat brain inflammation in adults. Inflammation in the brain may be involved in adults who have memory or thinking problems. The stem cells will be taken from participant's fat samples, processed and given back to participants, so they are their own donor. The main questions this trial aims to answer are:
Participants will:
This is a Phase 1b/2a open label study to assess the safety and tolerability, as well as reduction of neuroinflammation after four IV-infusions of autologous, adipose-derived, Mesenchymal Stem Cells (adMSCs) over a 13-week treatment period in 12 subjects who are clinically diagnosed with late pre-symptomatic or prodromal AD, exhibit an Alzheimer's pathology and peripheral inflammatory profile.
To date, most drugs for AD primarily treat symptoms. Moreover, several anti-amyloid antibodies have reduced amyloid burden, but have only modestly affected cognitive progression, suggesting that other pathways are also important for AD progression. Neuroinflammation may be important for AD progression. The discovery of increased levels of inflammatory markers in patients at different clinical stages of AD, and the iden-tification of AD risk genes associated with innate immune functions, suggest that neuroinflammation may affect AD pathogenesis, making it an optimal candidate for targeted therapy to reduce disease progression. In this study, we aim to treat neuroinflammation with autologous adMSCs. These cells may represent a superior therapeutic alternative for AD be-cause they exhibit multi-therapeutic effects, including anti-inflammatory properties, reduced amyloid-β activity, and neurogenesis, which collec-tively, may reduce disease progression and improve brain activity. In addition, autologous adMSCs demonstrate low immunogenicity, which limits Graft Versus Host Disease (GVHD) during cell administration. Furthermore, our preclinical and clinical studies with adMSCs have shown that they are safe and effective at reducing inflammation and improving cognitive outcomes. A positive outcome would result in a paradigm shift in the treatment of AD that could potentially be a standard of care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| adMSC | Experimental | IV-infusions of autologous, adipose-derived, Mesenchymal Stem Cells (adMSCs) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| adMSC | Biological | IV-infusion of autologous, adipose-derived, Mesenchymal Stem Cells (adMSCs), of approximately 2x10(8) adMSCs in 250mL saline. |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in TSPO levels, measured by the PET scan, from baseline to midpoint and baseline to end of study | Level of TSPO PET tracer will be measured for each PET scan. TSPO positivity, which is a marker for activated microglia, correlates with neuroinflammation | Baseline, midpoint (169 days from 1st infusion) |
| Inflammatory cytokines in CSF following adMSC therapy | Inflammatory cytokine panel in CSF will be measured using commercially available immunosorbent assays to determine potential treatment effects. Aggregate values and percentages will be reported. | Baseline, midpoint (169 days from 1st infusion) |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with treatment-related adverse events | Safety endpoints will be monitored throughout the study and number of incidents reported at end of study. Aggregate values and percentages will be reported | Baseline - End of Study (337 days from 1st infusion) |
| Changes in neurofilament light chain (Nf-L) in CSF following adMSC therapy |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Harshali Patel | Contact | 713-486-0531 | Harshali.Patel@uth.tmc.edu | |
| Javier Ortiz, PhD | Contact | 713-486-0505 | Guadalupe.J.Ortiz@uth.tmc.edu |
| Name | Affiliation | Role |
|---|---|---|
| Paul E Schulz, MD | The University of Texas Health Science Center, Houston | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Texas Health Science Center at Houston (UTHealth) | Recruiting | Houston | Texas | 77054 | United States |
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| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| D000544 | Alzheimer Disease |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D003704 | Dementia |
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This is a Phase 1b/2a open label study to assess the safety and tolerability, as well as reduction of neuroinflammation after four IV-infusions of autologous, adipose-derived, Mesenchymal Stem Cells (adMSCs) over a 13-week treatment period in 12 subjects who are clinically diagnosed with late pre-symptomatic or prodromal AD, exhibit an Alzheimer's pathology and peripheral inflammatory profile.
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Levels of Nf-L in CSF will be measured using commercially available immunosorbent assays to determine potential treatment effects. Aggregate values and percentages will be reported. |
| Baseline, midpoint (169 days from 1st infusion) |
| Changes in Glial fibrillary acidic protein (GFAP) in CSF following adMSC therapy | Levels of GFAP in CSF will be measured using commercially available immunosorbent assays to determine potential treatment effects. Aggregate values and percentages will be reported. | Baseline, midpoint (169 days from 1st infusion) |
| Changes in Total Tau/phosphor-Tau ratios in CSF following adMSC therapy | Levels of Total Tau/phosphor-Tau ratios in CSF will be measured using commercially available immunosorbent assays to determine potential treatment effects. Aggregate values and percentages will be reported. | Baseline, midpoint (169 days from 1st infusion) |
| Changes in cerebral metabolism activity via FDG PET imaging from image baseline to midpoint | Levels of [18F]FDG radiotracer will be measured for each PET scan. The uptake of [18F]FDG by the brain is a marker for cerebral metabolism activity | Baseline, midpoint (169 days from 1st infusion) |
| Changes in amyloid-β 42/40 ratio in CSF following adMSC therapy | Levels of amyloid-β 42/40 ratio in CSF will be measured by LC/MS/MS assays. Aggregate values and percentages will be reported | Baseline, midpoint (169 days from 1st infusion) |
| Change in Mini-Mental Status Examination (MMSE) following adMSC therapy | Cognition measured by MMSE. Scoring: 24-30 no cognitive impairment; 18-23 mild cognitive impairment; 0-17 severe cognitive impairment. | Baseline, End of Study (337 days from 1st infusion) |
| Change in Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scores following adMSC therapy | Cognitive decline measured by RBANS. Total Score subtest ranges: List Learning (0-40); Story Memory (0-24); Figure Copy (0-20); Line Orientation (0-20); Picture Naming (0-10); Semantic Fluency (4-40); Digit Span (0-16); Coding (0-89); List Recall (0-10); List Recognition (0-20); Story Recall (0-12); Figure Recall (0-20). Use Stimulus Booklet to convert Total Scores to Index Scores and Sum of Index Scores to Total Scale. Total Scores can range from 40 to 160. The RBANS scores are displayed as standard scores with means of 100 and a standard deviation of 15. Average/Mild Impairment (standard scores of 70 or above), Moderate Impairment (standard scores from 55 to 69), and Severe Impairment (standard scores <54). | Baseline, End of Study (337 days from 1st infusion) |
| Change in instrumental activities of daily living via Lawton IADL Scale scores following adMSC therapy | The Lawton IADL scale contains eight items. Each ability measured by the scale relies on either cognitive or physical function, though all require some degree of both. The higher the score, the greater the person's abilities. Women are scored on all 8 areas of function, but, for men, the areas of food preparation, housekeeping, laundering are excluded. Clients are scored according to their highest level of functioning in that category. The final total score ranges from 0 (low function, dependent) to 8 (high function, independent) for women, and 0 through 5 for men. The final total score may be presented as a percentage of function. For example, a total score of 6 out of 8 would represent 75% function (75% independence, 25% dependence). Sequential scoring over time provides a measure of declining or | Baseline, End of Study (337 days from 1st infusion) |
| Measure immune pathway marker level changes in blood from screening/baseline to midpoint (D1-D169) and from screening/baseline to end of study (D1-D337) | A commercially available immunological panel that tests markers associated with immunological pathways will be performed in blood at the end of study. Aggregate values and percentages will be reported. | Baseline, midpoint (169 days from 1st infusion), End of Study (337 days from 1st infusion) |
| Measure immune pathway marker level changes from screening/baseline to midpoint (D1-D169) in CSF | A commercially available immunological panel that tests markers associated with immunological pathways will be performed in CSF at the end of study. Aggregate values and percentages will be reported. | Baseline, midpoint (169 days from 1st infusion) |
| D001927 |
| Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D024801 | Tauopathies |
| D019636 | Neurodegenerative Diseases |