Intrathecal Stem Cells in Brain Injury (ISC)

Study Description

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

The purpose of this study is to determine whether the plasticity of autologous intrathecal hematopoietic cells would improve the neurologic evolution of the pediatric patients with hypoxic/ischemic brain injury.

Condition or disease	Intervention/treatment	Phase
Hypoxia-Ischemia, Cerebral; Cerebral Palsy	Procedure: Intrathecal Autologous Stem Cells	Not Applicable

Detailed Description:

There is accumulating evidence that shows that the placement of hematopoietic cells in the brain may increase growth-enhancing factors of axons and generate active neurons in the receptor. It has been found that after introducing hematopoietic cells in the subarachnoid space of the spinal cord, these cells may be transported through the cerebrospinal fluid and can be deliver more efficiently to the injured area, when compared to the intravenous route. Patients will be stimulated 4 times and then harvest the bone marrow. Bone marrow will be processed in order to obtain hematopoietic cells (CD34+) and minimize the erythrocytes amount. A inoculum of 5 to 10mL of stem cells will be infused intrathecally. Patients will be evaluated with the "Battelle Developmental Inventory" before the procedure and one and six months after that. An MRI will be performed before the procedure and six months after that.

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	18 participants
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	Intrathecal Autologous Stem Cells for Children With Hipoxic/Ischemic Brain Injury
Study Start Date :	July 2009
Actual Primary Completion Date :	April 2010
Actual Study Completion Date :	January 2011

Arms and Interventions

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Arm	Intervention/treatment
Experimental: Patients; Children whom will receive intrathecal autologous stem cells	Procedure: Intrathecal Autologous Stem Cells; Patients will be stimulated with Granulocyte Colony Stimulating Factor (G-CSF) 5 times, harvest bone marrow and infused 8 to 10 mL of stem cells (CD34+) by intrathecal via.; Other Name: Autologous Stem Cells Transplantation

Outcome Measures

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Primary Outcome Measures :

1. Score of "Battelle Developmental Inventory" [ Time Frame: 30 days ]

Secondary Outcome Measures :

1. Score of "Battelle Developmental Inventory" [ Time Frame: 180 days ]

Eligibility Criteria

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Ages Eligible for Study:	1 Year to 8 Years (Child)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Patients with hypoxic/ischemic brain injury, with an between 1 month and 18 years, regardless the age at the time of injury, time post-injury, or previously received therapies, different from ours.

Exclusion Criteria:

• Patients with neurodegenerative or autoimmune diseases.
• Patients with active infection in any organ or tissue at the time of entering the study, the onset of stimulation with G-CSF or at the procedure.
• Patients who do not sign the informed consent form.

Elimination Criteria

• Patients with severe meningeal abnormalities at the time of procedure.
• Patients who did not attend subsequent assessments 30 and 180 days after the procedure.
• Patients who die from causes related to neurological disease within 180 days after procedure.
• Patients who are diagnosed with neurodegenerative or autoimmune diseases after the procedure.
• Patients who do not bear the proper stimulation process with Granulocyte Colony Stimulating Factor (G-CSF), either by misapplication, lack thereof, or severe adverse drug reaction.
• Patients choosing to leave the study.

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

Mexico
Hospital Universitario Dr. Jose E. Gonzalez
Monterrey, Nuevo Leon, Mexico, 64460

Sponsors and Collaborators

Hospital Universitario Dr. Jose E. Gonzalez

Investigators

Principal Investigator:	Maria C Mancias-Guerra, MD	Hospital Universitario Dr. Jose E. Gonzalez
Study Director:	Arturo Garza-Alatorre, MD	Hospital Universitario Dr. Jose E. Gonzalez
Study Chair:	Laura N Rodriguez-Romo, MD	Hospital Universitario Dr. Jose E. Gonzalez

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications:

Felling RJ, Snyder MJ, Romanko MJ, Rothstein RP, Ziegler AN, Yang Z, Givogri MI, Bongarzone ER, Levison SW. Neural stem/progenitor cells participate in the regenerative response to perinatal hypoxia/ischemia. J Neurosci. 2006 Apr 19;26(16):4359-69.

Glascoe FP, Byrne KE. The usefulness of the Battelle Developmental Inventory Screening Test. Clin Pediatr (Phila). 1993 May;32(5):273-80.

Berls AT, McEwen IR. Battelle developmental inventory. Phys Ther. 1999 Aug;79(8):776-83.

Levison SW, Rothstein RP, Romanko MJ, Snyder MJ, Meyers RL, Vannucci SJ. Hypoxia/ischemia depletes the rat perinatal subventricular zone of oligodendrocyte progenitors and neural stem cells. Dev Neurosci. 2001;23(3):234-47.

Hayashi T, Iwai M, Ikeda T, Jin G, Deguchi K, Nagotani S, Zhang H, Sehara Y, Nagano I, Shoji M, Ikenoue T, Abe K. Neural precursor cells division and migration in neonatal rat brain after ischemic/hypoxic injury. Brain Res. 2005 Mar 15;1038(1):41-9.

Mehta T, Feroz A, Thakkar U, Vanikar A, Shah V, Trivedi H. Subarachnoid placement of stem cells in neurological disorders. Transplant Proc. 2008 May;40(4):1145-7. doi: 10.1016/j.transproceed.2008.03.026.

Goldman SA, Schanz S, Windrem MS. Stem cell-based strategies for treating pediatric disorders of myelin. Hum Mol Genet. 2008 Apr 15;17(R1):R76-83. doi: 10.1093/hmg/ddn052. Review.

Eglitis MA, Mezey E. Hematopoietic cells differentiate into both microglia and macroglia in the brains of adult mice. Proc Natl Acad Sci U S A. 1997 Apr 15;94(8):4080-5.

Mezey E, Key S, Vogelsang G, Szalayova I, Lange GD, Crain B. Transplanted bone marrow generates new neurons in human brains. Proc Natl Acad Sci U S A. 2003 Feb 4;100(3):1364-9. Epub 2003 Jan 21.

Li Y, Chen J, Chen XG, Wang L, Gautam SC, Xu YX, Katakowski M, Zhang LJ, Lu M, Janakiraman N, Chopp M. Human marrow stromal cell therapy for stroke in rat: neurotrophins and functional recovery. Neurology. 2002 Aug 27;59(4):514-23.

Gordon PH, Yu Q, Qualls C, Winfield H, Dillon S, Greene PE, Fahn S, Breeze RE, Freed CR, Pullman SL. Reaction time and movement time after embryonic cell implantation in Parkinson disease. Arch Neurol. 2004 Jun;61(6):858-61.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Mancías-Guerra C, Marroquín-Escamilla AR, González-Llano O, Villarreal-Martínez L, Jaime-Pérez JC, García-Rodríguez F, Valdés-Burnes SL, Rodríguez-Romo LN, Barrera-Morales DC, Sánchez-Hernández JJ, Cantú-Rodríguez OG, Gutiérrez-Aguirre CH, Gómez-De León A, Elizondo-Riojas G, Salazar-Riojas R, Gómez-Almaguer D. Safety and tolerability of intrathecal delivery of autologous bone marrow nucleated cells in children with cerebral palsy: an open-label phase I trial. Cytotherapy. 2014 Jun;16(6):810-20. doi: 10.1016/j.jcyt.2014.01.008. Epub 2014 Mar 15.

Mackie AR, Losordo DW. CD34-positive stem cells: in the treatment of heart and vascular disease in human beings. Tex Heart Inst J. 2011;38(5):474-85. Review.

Responsible Party:	Maria del Consuelo Mancías Guerra, Hospital Universitario Dr. José E. González
ClinicalTrials.gov Identifier:	NCT01019733 History of Changes
Other Study ID Numbers:	HE09-014
First Posted:	November 25, 2009
Last Update Posted:	January 26, 2011
Last Verified:	January 2011

Keywords provided by Hospital Universitario Dr. Jose E. Gonzalez:

Hypoxia; Ischemia; Brain; Children; Cerebral Palsy

Additional relevant MeSH terms:

Brain Injuries; Ischemia; Cerebral Palsy; Hypoxia; Brain Ischemia; Hypoxia-Ischemia, Brain; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Craniocerebral Trauma	Trauma, Nervous System; Wounds and Injuries; Pathologic Processes; Brain Damage, Chronic; Signs and Symptoms, Respiratory; Signs and Symptoms; Cerebrovascular Disorders; Vascular Diseases; Cardiovascular Diseases; Hypoxia, Brain