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Alzheimer Disease (AD)Phase 1NCT07554872

Study of Neural Stem Cell-Derived Exosomes in Moderate-to-Severe Early-Onset Alzheimer's Disease

A Phase 1 study testing Neural Stem Cell-Derived Exosomes in people with Alzheimer Disease (AD), run by Shanghai Mental Health Center at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This is an open-label, single-center, phase I clinical study in patients with moderate-to-severe early-onset Alzheimer's disease. The study aims to evaluate the safety, tolerability, and preliminary efficacy of neural stem cell-derived exosomes (NSC-EVs) administered by the intranasal route. Read more about this study

Who is it for?
Ages 50 to 75 years
Conditions the study is for
Alzheimer Disease (AD)
What is being tested?
Neural Stem Cell-Derived Exosomes
Could I receive a placebo?
No, everyone receives an active treatment
How many people
9 participants
Where
1 siteChina
Study dates
May 2026to Dec 2027
Phase
Phase 1
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 50 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or postmenopausal female, aged 50 to 75 years.
  • Meets the 2011 NIA-AA criteria for probable Alzheimer's disease dementia.
  • Age at onset ≤65 years.
  • CMMS score 5-20
  • Stable dose for at least 2 months before enrollment if receiving pro-cognitive or psychiatric medications.
  • Primary school education or above and able to complete study-required cognitive assessments.
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  • Hachinski Ischemic Score ≤4.
  • GDS-30 total score ≤10.
  • Screening brain MRI+DWI+SWI meeting protocol-defined cerebrovascular exclusion thresholds and no major structural abnormalities inconsistent with Alzheimer's disease.
  • Positive amyloid pathology confirmed by Aβ-PET at screening or before enrollment.
  • Adequate vision and hearing to complete assessments.
  • Has a reliable caregiver able to accompany the participant to study visits and provide information for assessments.
  • Willing to participate and sign informed consent.

Who cannot join

  • Dementia due to causes other than Alzheimer's disease.
  • Brain MRI showing any of the following: Fazekas white matter hyperintensity score >2; more than 2 lacunar infarcts >1.5 cm; lacunar infarcts involving critical regions such as the thalamus, hippocampus, entorhinal cortex, or parahippocampal region; cerebral hemorrhage, subdural hematoma, aneurysm, arteriovenous malformation, intracranial mass lesion, or other clinically significant structural abnormalities.
  • Allergy to stem cell-derived exosomes or PET examination.
  • Severe psychiatric disorder or symptoms.
  • Significant active physical illness, including severe cardiac disease, severe systemic infection, or severe liver/kidney dysfunction.
  • Elevated tumor markers or tumor history.
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  • Immune-related disease.
  • Significant nasal obstruction.
  • Serious suicide risk.
  • Participation in another clinical trial or stem cell therapy within the past 6 months.
  • Any other condition judged inappropriate by the investigator.
  • Contraindications to MRI or inability to complete MRI examinations, including non-MRI-compatible metallic implants, certain stents, plates, pacemakers, or severe claustrophobia.

Trial locations and contacts

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

Yue Ling 岳玲, MD, PhD contact

18017311249

bellinthemoon@hotmail.com

China1 site
  • Shanghai Mental Health Center

    Shanghai, Shanghai Municipality, 200030

    Yue Ling 岳玲, MD, PhD, 18964352661, bellinthemoon@hotmail.com

Other trials in China

About this study

Official title: A Phase I, Open-Label, Single-Center, Frequency-Escalation Study of the Safety, Tolerability, and Preliminary Efficacy of Neural Stem Cell-Derived Exosomes in Patients With Moderate-to-Severe Early-Onset Alzheimer's Disease

This is an open-label, single-center, phase I clinical study in patients with moderate-to-severe early-onset Alzheimer's disease. The study aims to evaluate the safety, tolerability, and preliminary efficacy of neural stem cell-derived exosomes (NSC-EVs) administered by the intranasal route. A total of 9 participants will be enrolled in 3 frequency-escalation groups: once every 3 days, once every other day, and once daily, each for 28 days. Participants will undergo screening and baseline assessment, a 28-day treatment period, and follow-up visits at 4, 8, and 24 weeks after the end of treatment.

Read the detailed description

Early-onset moderate-to-severe Alzheimer's disease imposes a substantial burden on patients and families, and there is currently no truly effective treatment capable of reversing the pathological process. Neural stem cell-derived exosomes (NSC-EVs) are considered a promising therapeutic approach because they may have low immunogenicity, the ability to cross the blood-brain barrier, and a more standardized manufacturing pathway than cell-based therapy.

This study is designed as an open-label, single-center, three-group phase I clinical study to explore the safety, tolerability, and preliminary efficacy of intranasal NSC-EVs in patients with moderate-to-severe early-onset Alzheimer's disease. The study uses a 3+3 frequency-escalation design with sentinel-participant monitoring to determine the highest tolerated dosing frequency and to generate preliminary clinical data for future larger-scale studies.

A total of 9 participants are planned for enrollment. Participants will be assigned sequentially to 1 of 3 dosing-frequency groups: low-frequency, medium-frequency, or high-frequency. All groups will receive the same investigational product by intranasal administration for 28 days, with differences only in dosing frequency. The low-frequency group will receive treatment on Days 1, 4, 7, 10, 13, 16, 19, 22, 25, and 28; the medium-frequency group will receive treatment on Days 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, and 27; and the high-frequency group will receive treatment daily from Day 1 through Day 28.

After the 4-week treatment period, participants will enter a follow-up phase with visits scheduled at 4 weeks, 8 weeks, and 24 weeks after the end of treatment. Assessments during treatment and follow-up will include safety monitoring, clinical laboratory testing, cognitive and neuropsychiatric evaluations, and protocol-defined biomarker and imaging assessments as applicable. The primary objective is to evaluate safety and tolerability, while secondary and exploratory objectives include preliminary evaluation of cognitive, behavioral, functional, and biomarker changes over time.

Being tested
Neural Stem Cell-Derived Exosomes
Keywords
Early-Onset Alzheimer's Disease, Moderate-to-Severe Alzheimer's Disease, Neural Stem Cell-Derived Exosomes, Intranasal Administration, Phase I Clinical Study, Frequency Escalation, Safety, Tolerability
Medical subject headings
Alzheimer Disease

What participants receive

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

  • Neural Stem Cell-Derived ExosomesBiological

    Also called NSC-EVs

    The investigational product is a neural stem cell-derived exosome preparation administered intranasally. The product specification is 6 × 10^9 particles per 2 mL vial. The product is thawed to room temperature before administration and delivered into both nostrils. The same investigational product is used in all study groups; the groups differ only in dosing frequency.

Study groups in NCT07554872
Study groupRoleWhat they receive
Low-Frequency NSC-EVsExperimentalParticipants receive neural stem cell-derived exosomes by intranasal administration once every 3 days for 28 days. The single dose is 6 × 10^9 particles administered into both nostrils. In the low-frequency group, dosing is scheduled on Days 1, 4, 7, 10, 13, 16, 19, 22, 25, and 28, for a total of 10 doses.
Receives: Biological: Neural Stem Cell-Derived Exosomes
Medium-Frequency NSC-EVsExperimentalParticipants receive neural stem cell-derived exosomes by intranasal administration every other day for 28 days. The single dose is 6 × 10^9 particles administered into both nostrils. In the medium-frequency group, dosing is scheduled on Days 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, and 27, for a total of 14 doses.
Receives: Biological: Neural Stem Cell-Derived Exosomes
High-Frequency NSC-EVsExperimentalParticipants receive neural stem cell-derived exosomes by intranasal administration once daily for 28 days. The single dose is 6 × 10^9 particles administered into both nostrils. In the high-frequency group, dosing is scheduled daily from Day 1 through Day 28, for a total of 28 doses.
Receives: Biological: Neural Stem Cell-Derived Exosomes

What is being measured

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

  1. Number of Participants With Treatment-Related Adverse Events

    Number of participants experiencing treatment-related adverse events assessed according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.

    Measured: Baseline to Week 4

  2. Number of Participants With Treatment-Related Clinical Laboratory Abnormalities

    Number of participants with treatment-related clinical laboratory abnormalities during the treatment period.

    Measured: Baseline to Week 4

Secondary outcomes (8)
  1. Change in Chinese Mini-Mental Status (CMMS) Score

    Cognitive function will be assessed using the Chinese Mini-Mental Status (CMMS), a Chinese-language screening instrument for global cognitive impairment. Total scores range from 0 to 30, with higher scores indicating better cognitive performance.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

  2. Change in Severe Impairment Battery (SIB) Score

    Cognitive function will be assessed using the Severe Impairment Battery (SIB), a validated instrument for cognitive function in moderate-to-severe dementia. Total scores range from 0 to 100, with higher scores indicating better cognitive performance.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

  3. Change in Neuropsychiatric Inventory (NPI) Score

    Neuropsychiatric symptoms will be assessed using the Neuropsychiatric Inventory (NPI), a standardized instrument for behavioral and psychological symptoms in dementia. Total scores range from 0 to 144, with higher scores indicating greater neuropsychiatric symptom burden.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

  4. Change in Geriatric Depression Scale (GDS) Score

    Depressive symptoms will be assessed using the 30-item Geriatric Depression Scale (GDS-30), a questionnaire designed to assess depressive symptoms in older adults. Total scores range from 0 to 30, with higher scores indicating more severe depressive symptoms.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

  5. Change in Pittsburgh Sleep Quality Index (PSQI) Score

    Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), a questionnaire that evaluates subjective sleep quality and sleep disturbance. Total scores range from 0 to 21, with higher scores indicating poorer sleep quality.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

  6. Change in Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) Score

    Functional ability will be assessed using the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL), a caregiver-based instrument used to evaluate daily functioning in patients with Alzheimer's disease. Total scores range from 0 to 78, with higher scores indicating better functional ability.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

  7. Change in Zarit Burden Interview (ZBI) Score

    Caregiver burden will be assessed using the Zarit Burden Interview (ZBI), a questionnaire used to evaluate the perceived burden experienced by caregivers. Total scores range from 0 to 88, with higher scores indicating greater caregiver burden.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

  8. Change in Clinical Dementia Rating Scale-Sum of Boxes (CDR-SB) Score

    Global dementia severity will be assessed using the Clinical Dementia Rating Scale-Sum of Boxes (CDR-SB), which evaluates impairment across multiple cognitive and functional domains. Total scores range from 0 to 18, with higher scores indicating greater dementia severity.

    Measured: Baseline, Week 4 (end of treatment), and 4, 8, and 24 weeks after end of treatment

Timeline

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

  1. First posted28 Apr 2026
  2. Study startMay 2026 (estimated)
  3. Primary completion20 Oct 2027 (estimated)
  4. Study completionDec 2027 (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 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
This is a sequential, open-label, single-center phase 1 study using a 3+3 frequency-escalation design. Participants are enrolled from the lowest-frequency group to the highest-frequency group. Each group starts with 3 participants, including a sentinel participant, and escalation proceeds only after protocol-defined safety review. Expansion is permitted according to protocol-defined dose-limiting toxicity criteria.
Masking
None (open label)
Enrolment
9 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07554872
Sponsor's protocol ID
SMHC-EOAD-NSCEV-2026-01
Status last verified
May 2026
First submitted
21 Apr 2026
Last updated
15 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Neural Stem Cell-Derived Exosomes in people with Alzheimer Disease (AD), run by Shanghai Mental Health Center at 1 site in China.

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 13 inclusion and 12 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: opening soon, as of the sponsor's last update on 15 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 Yue Ling 岳玲, MD, PhD (18017311249, bellinthemoon@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Treatment-Related Adverse Events (time frame: Baseline to Week 4). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 15 May 2026.

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