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Traumatic Brain InjuryPhase 2TRAUMACELLNCT06146062

Effects of Intravascular Administration of Mesenchymal Stromal Cells Derived from Wharton's Jelly of the Umbilical Cord on Systemic Immunomodulation and Neuroinflammation After Traumatic Brain Injury.

A Phase 2 study testing Mesenchymal Stromal Cells (MSC) in people with Traumatic Brain Injury, run by Assistance Publique - Hôpitaux de Paris at 3 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Traumatic brain injuries (TBI) are one of the leading causes of death and disability worldwide. These patients are burdened by physical, cognitive, and psychosocial deficits, leading to an important economic impact for society. Read more about this study

Who is it for?
Ages 18 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Traumatic Brain Injury
What is being tested?
Mesenchymal Stromal Cells (MSC)
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
68 participants
Where
3 sitesFrance
Study dates
25 Jun 2024to 31 Mar 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Age 18-50 years
  • ASA 1 classification (healthy patient)

Who cannot join

  • Lack of written consent
  • Neurological history likely to alter the image (epilepsy, transient ischaemic attack, meningitis, head trauma)
  • Vulnerable person according to article L1121-6 of the CSP
  • Protected adult person
  • No affiliation to a social security regime
  • Pregnancy
Show all 52Show fewer
  • Contraindication for MRI and PET-MRI
  • patients with Pacemaker and defibrillator
  • MR-incompatible prosthetic heart valve
  • Metallic intraocular, intra cerebral or intra medullary foreign bodies
  • Implantable neurostimulation systems
  • Cochlear implants/ear implant
  • Metallic fragments such as bullets, shotgun pellets, and metal shrapnel
  • Cerebral artery aneurysm clips
  • Ventriculo peritoneal shunt with metallic component generating significant artefacts on the MR sequence
  • Catheters with metallic components (Swan-Ganz catheter)
  • Patient unable to remain supine and motionless during the duration of the examination
  • 68 severe TBI patients with the following inclusion and exclusion criteria will be included"
  • Patient Inclusion criteria
  • Age 18-50 years
  • Severe TBI defined by:
  • Glasgow score <12 within the 48 first hours,
  • Brain traumatic lesion on CT scan,
  • Need for intracranial pressure monitoring
  • No other significant organ trauma (AIS <2)
  • Unresponsive to verbal commands 5 days after sedation discontinuation, for whom, after usual clinical and paraclinical evaluation there has been no decision to interrupt active therapies within 10 days after sedation discontinuation
  • Written consent signed by the close relative
  • Patient Exclusion criteria
  • History of disease or treatment impairing current or previous year immunity function ( hematologic disease (leukemia, myeloma), viral disease affecting immunity (like HIV), immunological treatment (corticoid, anti rejection medication, anti TNFα, chemotherapy)
  • History of severe neurological or psychiatric disease likely to alter neurological assessment
  • HTAP > grade III OMS/WHO
  • Ongoing uncontrolled infection with organ failure (septic shock, ARDS) including those due to severe COVID-19
  • Platelets <100 G/L or <100000/μL, Hb <8 g/dL, lymphocytes count <1.5 G/L or 1500 μL , neutrophils count < 2.5G/L or <2500/μL, , creatinin > 100 μmol/L
  • Liver function abnormalities (bilirubin> 2.5mg / dL or transaminases> 5x the ULN). Patients with Gilbert's disease are eligible if liver tests are normal excluding bilirubinemia
  • Known HIV seropositivity
  • Neoplasia ongoing or treated in the 3 years before screening
  • Bone marrow transplant recipient
  • History of transfusion reaction or hypersensitivity
  • Pregnancy
  • Contraindication for MRI and PET-MRI:
  • Patient with Pacemaker and defibrillator
  • MR-incompatible prosthetic heart valve o Metallic intraocular, intra cerebral or intra medullary foreign bodies
  • Implantable neurostimulation systems o Cochlear implants/ ear implant
  • Metallic fragments such as bullets, shotgun pellets, and metal shrapnel
  • Cerebral artery aneurysm clips
  • Ventriculo peritoneal shunt with metallic component generating significant artefacts on the MR sequence
  • Catheters with metallic components (Swan-Ganz catheter)
  • Patient unable to remain supine and motionless during the duration of the examination
  • Participation in another interventional clinical trial of an investigational therapy within 30 days of consent
  • No affiliation to a social security regime
  • Vulnerable person according to article L1121-6 of the CSP
  • Protected adult person

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

France3 sites, 3 recruiting
  • Hôpital National d'Instruction des Armées Percy

    Clamart

    Mathieu BOUTONNET

    BOUTONNET Mathieu

    Recruiting
  • Beaujon Hospital

    Clichy

    Stéphanie SIGAUT

    Recruiting
  • Hôpital de la Pitié Salpêtrière - AP-HP

    Paris

    DEGOS Vincent

    Recruiting

Other trials in France

About this study

Traumatic brain injuries (TBI) are one of the leading causes of death and disability worldwide. These patients are burdened by physical, cognitive, and psychosocial deficits, leading to an important economic impact for society. Treatments for TBI patients are limited and none has been shown to provide prolonged and long-term neuroprotective or neurorestorative effects. TBI related disability is linked to the severity of the initial injury but also to the following neuroinflammatory response which may persist long after the initial injury.

Moreover, a growing body of evidence suggests a link between TBI-induced neuro-inflammation and neurodegenerative post traumatic disorders. Consequently, new therapies triggering immunomodulation and promoting neurological recovery are the subject of major research efforts.

Read more

In this context, mesenchymal cell-based therapies are currently investigated to treat various neurological disorders due to their ability to modulate neuroinflammation and to promote simultaneous neurogenesis, angiogenesis, and neuroprotection.

Clinical trials using intravenous MSC have been conducted for various pathologies, all these studies showing a good safety profile.

The hypothesis of the study is that intravenous repeated treatment with MSC derived from Wharton's Jelly of the umbilical cord may be associated with a significant decrease of post-TBI neuroinflammation and improvement of neuroclinical status.

The main objective of the study is to evaluate the effect of iterative IV injections of MSC on post-traumatic neuroinflammation measured in corpus callosum by PET-MRI at 6 months in severe brain injured patients unresponsive to simple verbal commands 5 days after sedation discontinuation.

Read the detailed description

Traumatic brain injuries (TBI) are one of the leading causes of death and disability worldwide. These patients are burdened by physical, cognitive, and psychosocial deficits, leading to an important economic impact for society. Treatments for TBI patients are limited and none has been shown to provide prolonged and long-term neuroprotective or neurorestorative effects. TBI related disability is linked to the severity of the initial injury but also to the following neuroinflammatory response which may persist long after the initial injury.

Moreover, a growing body of evidence suggests a link between TBI-induced neuro-inflammation and neurodegenerative post traumatic disorders. Consequently, new therapies triggering immunomodulation and promoting neurological recovery are the subject of major research efforts.

In this context, mesenchymal cell-based therapies are currently investigated to treat various neurological disorders due to their ability to modulate neuroinflammation and to promote simultaneous neurogenesis, angiogenesis, and neuroprotection. Indeed, several experimental studies have reported that human umbilical cord-derived mesenchymal stromal cells (MSC) have the ability to improve neurological outcomes and recovery in cerebral injury animal models, including TBI.

Clinical trials using intravenous MSC have been conducted for various pathologies, all these studies showing a good safety profile. In TBI, small clinical trials using different modalities for administration of mesenchymal cells are available but none about MSC derived from Wharton's Jelly of the umbilical cord.

The hypothesis of the study is that intravenous repeated treatment with MSC derived from Wharton's Jelly of the umbilical cord may be associated with a significant decrease of post-TBI neuroinflammation and improvement of neuroclinical status.

The main objective of the study is to evaluate the effect of iterative IV injections of MSC on post-traumatic neuroinflammation measured in corpus callosum by PET-MRI at 6 months in severe brain injured patients unresponsive to simple verbal commands 5 days after sedation discontinuation.

Being tested
Mesenchymal Stromal Cells (MSC), placebo
Medical subject headings
Brain Injuries, Traumatic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mesenchymal Stromal Cells (MSC)Drug

    3 injections one week apart

  • placeboDrug

    3 injections one week apart

Study groups in NCT06146062
Study groupRoleWhat they receive
InterventionExperimentalFinal product is a MSC solution at the concentration of 2.10^6/kg in 150 mL of NaCl 0.9% and human albumin 0.5%, conditioned aseptically and identified for IV administration. 3 injections one week apart.
Receives: Drug: Mesenchymal Stromal Cells (MSC)
controlPlacebo comparatorThe placebo will be a solution of NaCl 0.9% 3 injections one week apart.
Receives: Drug: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. effect of iterative IV injections of WJ-UC-MSC on post-traumatic neuroinflammation

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in corpus callosum (Region of Interest, ROI) measured by dynamic PET-MRI

    Measured: 6 months after the last injection

Secondary outcomes (27)
  1. radiological markers from PET-MRI_1

    The regional fractional anisotropy (FA) from DTI acquisition of PET-MRI

    Measured: 6 months after the last injection

  2. radiological markers from PET-MRI_2

    The mean diffusibility (MD) from DTI acquisition of PET-MRI

    Measured: 6 months after the last injection

  3. Treatment feasibility

    number of treatments administrated to the patient

    Measured: at the third injection

  4. Neurological clinical Score M6

    Glasgow Outcome Scale-Extended

    Measured: 6 months after the last injection

  5. Neurological clinical Score M12

    Glasgow Outcome Scale-Extended

    Measured: 12 months after the last injection

  6. cognitive assessment M6

    MOCA scale

    Measured: 6 months after the last injection

  7. cognitive assessment M12

    MOCA scale

    Measured: 12 months after the last injection

  8. short term Tolerance D10

    Common Terminology Criteria for Adverse Events

    Measured: 10 days after the last injection

  9. long term Tolerance M6

    Common Terminology Criteria for Adverse Events

    Measured: 6 months after the last injection

  10. long term Tolerance M12

    Common Terminology Criteria for Adverse Events

    Measured: 6 months after the last injection

  11. neuroinflammation of pericontusional

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in pericontusional

    Measured: 6 months after the last injection

  12. neuroinflammation of grey matter

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in grey matter

    Measured: 6 months after the last injection

  13. neuroinflammation of white matter

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in white matter

    Measured: 6 months after the last injection

  14. neuroinflammation of frontal area

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in frontal area

    Measured: 6 months after the last injection

  15. neuroinflammation of parietal area

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in parietal area

    Measured: 6 months after the last injection

  16. neuroinflammation of occipital area

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in occipital area

    Measured: 6 months after the last injection

  17. neuroinflammation of hippocampus

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in hippocampus,

    Measured: 6 months after the last injection

  18. neuroinflammation of thalamus

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in thalamus,

    Measured: 6 months after the last injection

  19. neuroinflammation of mesencephalus

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in mesencephalus

    Measured: 6 months after the last injection

  20. neuroinflammation of cerebellum

    [18F]-DPA-714 Standard Uptake Value ratio (SUVr) in cerebellum

    Measured: 6 months after the last injection

  21. Cytokine and chemokine levels in plasma

    Luminex magnetic beads technology

    Measured: 6 months after the last injection

  22. PBMC profile

    High-dimensional characterization of immune reprogramming during the treatment by single-cell RNA-sequencing of PBMC.

    Measured: 6 months after the last injection

  23. Transcriptomics and regulatory epigenomics of circulating monocytes and lymphocytes 1.

    H3K27ac

    Measured: 6 months after the last injection

  24. Transcriptomics and regulatory epigenomics of circulating monocytes and lymphocytes 2.

    H3K4me3

    Measured: 6 months after the last injection

  25. Transcriptomics and regulatory epigenomics of circulating monocytes and lymphocytes 3.

    ChIP-seq

    Measured: 6 months after the last injection

  26. Transcriptomics and regulatory epigenomics of circulating monocytes and lymphocytes 4.

    ATAC-seq

    Measured: 6 months after the last injection

  27. Genome-wide single-nucleotide polymorphism (SNP) genotype.

    DNA sample

    Measured: After 1 injection

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Nov 2023
  2. Study start25 Jun 2024
  3. Primary completion31 Aug 2027 (estimated)
  4. Study completion31 Mar 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
68 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06146062
Sponsor's protocol ID
APHP211509
Other IDs
2021-006873-50
Acronym
TRAUMACELL
Status last verified
Oct 2024
First submitted
17 Nov 2023
Last updated
16 Oct 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sigaut S, Tardivon C, Jacquens A, Bottlaender M, Gervais P, Habert MO, Monsel A, Roquilly A, Boutonnet M, Galanaud D, Cras A, Boucher-Pillet H, Florence AM, Cavalier I, Menasche P, Degos V, Couffignal C. Effects of intravascular administration of mesenchymal stromal cells derived from Wharton's Jelly of the umbilical cord on systemic immunomodulation and neuroinflammation after traumatic brain injury (TRAUMACELL): study protocol for a multicentre randomised controlled trial. BMJ Open. 2024 Dec 31;14(12):e091441. doi: 10.1136/bmjopen-2024-091441.

    PubMed 39740941

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Mesenchymal Stromal Cells (MSC) in people with Traumatic Brain Injury, run by Assistance Publique - Hôpitaux de Paris at 3 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 52 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 16 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Vincent Degos (142163761 ext. 33, vincent.degos@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

effect of iterative IV injections of WJ-UC-MSC on post-traumatic neuroinflammation (time frame: 6 months after the last injection). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06146062, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2024.

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