Reparative therapy for acute ischemic stroke with allogeneic mesenchymal stem cells from adipose tissue: a safety assessment: a phase II randomized, double-blind, placebo-controlled, single-center, pilot clinical trial

J Stroke Cerebrovasc Dis. 2014 Nov-Dec;23(10):2694-2700. doi: 10.1016/j.jstrokecerebrovasdis.2014.06.011. Epub 2014 Oct 7.

Abstract

Background: Few studies have evaluated the possible beneficial effect of the administration of stem cells in the early stages of stroke. Intravenous administration of allogeneic mesenchymal stem cells (MSCs) from adipose tissue in patients with acute stroke could be a safe therapy for promoting neurovascular unit repair, consequently supporting better functional recovery. We aim to assess the safety and efficacy of MSC administration and evaluate its potential as a treatment for cerebral protection and repair.

Materials: A Phase IIa, prospective, randomized, double-blind, placebo-controlled, single-center, pilot clinical trial. Twenty patients presenting acute ischemic stroke will be randomized in a 1:1 proportion to treatment with allogeneic MSCs from adipose tissue or to placebo (or vehicle) administered as a single intravenous dose within the first 2 weeks after the onset of stroke symptoms. The patients will be followed up for 2 years. Primary outcomes for safety analysis: adverse events (AEs) and serious AEs; neurologic and systemic complications, and tumor development. Secondary outcomes for efficacy analysis: modified Rankin Scale; NIHSS; infarct size; and biochemical markers of brain repair (vascular endothelial growth factor, brain-derived neurotrophic factor, and matrix metalloproteinases 9).

Results and conclusions: To our knowledge, this is the first, phase II, pilot clinical trial to investigate the safety and efficacy of intravenous administration of allogeneic MSCs from adipose tissue within the first 2 weeks of stroke. In addition, its results will help us define the best criteria for a future phase III study.

Keywords: Acute ischemic stroke; clinical trial; reparative therapy; safety; stem cells.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / cytology*
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Brain Ischemia / blood
  • Brain Ischemia / pathology
  • Brain Ischemia / therapy*
  • Brain-Derived Neurotrophic Factor / blood
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Infarction / pathology
  • Infusions, Intravenous
  • Male
  • Matrix Metalloproteinase 9 / blood
  • Mesenchymal Stem Cell Transplantation / adverse effects*
  • Mesenchymal Stem Cell Transplantation / methods*
  • Mesenchymal Stem Cells / cytology*
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Stroke / blood
  • Stroke / pathology
  • Stroke / therapy*
  • Time Factors
  • Transplantation, Homologous / methods
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / blood

Substances

  • Biomarkers
  • Brain-Derived Neurotrophic Factor
  • Vascular Endothelial Growth Factor A
  • brain-derived growth factor
  • Matrix Metalloproteinase 9