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基于肝内动脉输注自体皮下脂肪组织来源的再生(干)细胞的肝硬化再生治疗:一项验证性多中心非对照临床试验方案

Regenerative Therapy for Liver Cirrhosis Based on Intrahepatic Arterial Infusion of Autologous Subcutaneous Adipose Tissue-Derived Regenerative (Stem) Cells: Protocol for a Confirmatory Multicenter Uncontrolled Clinical Trial.

作者信息

Sakai Yoshio, Fukunishi Shinya, Takamura Masayuki, Inoue Oto, Takashima Shinichiro, Usui Soichiro, Seki Akihiro, Nasti Alessandro, Ho Tuyen Thuy Bich, Kawaguchi Kazunori, Asai Akira, Tsuchimoto Yusuke, Yamashita Taro, Yamashita Tatsuya, Mizukoshi Eishiro, Honda Masao, Imai Yasuhito, Yoshimura Kenichi, Murayama Toshinori, Wada Takashi, Harada Kenichi, Higuchi Kazuhide, Kaneko Shuichi

机构信息

Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan.

Department of Gastroenterology, Osaka Medical College, Takatsuki, Japan.

出版信息

JMIR Res Protoc. 2020 Mar 31;9(3):e17904. doi: 10.2196/17904.

Abstract

BACKGROUND

Liver cirrhosis results from chronic hepatitis, and is characterized by advanced fibrosis due to long-term hepatic inflammation. Cirrhosis ultimately leads to manifestations of jaundice, ascites, and encephalopathy, and increases the risk of hepatocellular carcinoma. Once cirrhosis is established, resulting in hepatic failure, no effective treatment is available. Therefore, novel therapies to inhibit disease progression of cirrhosis are needed.

OBJECTIVE

The objective of this investigator-initiated clinical trial is to assess the safety and efficacy of autologous adipose tissue-derived regenerative (stem) cell therapy delivered to the liver via the hepatic artery in patients with liver cirrhosis.

METHODS

Through consultation with the Japan Pharmaceuticals and Medical Devices Agency, we designed a clinical trial to assess a therapy for liver cirrhosis based on autologous adipose tissue-derived regenerative (stem) cells, which are extracted using an adipose tissue dissociation device. The primary endpoints of the trial are the serum albumin concentration, prothrombin activity, harmful events, and device malfunction.

RESULTS

Enrollment and registration were initiated in November 2017, and the follow-up period ended in November 2019. Data analysis and the clinical study report will be completed by the end of March 2020.

CONCLUSIONS

Completion of this clinical trial, including data analysis, will provide data on the safety and efficacy of this novel liver repair therapy based on autologous adipose tissue-derived regenerative (stem) cells using an adipose tissue dissociation device.

TRIAL REGISTRATION

UMIN Clinical Trials Registry UMIN000022601; https://tinyurl.com/w9uqw3q.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17904.

摘要

背景

肝硬化由慢性肝炎发展而来,其特征是长期肝脏炎症导致肝纤维化进展。肝硬化最终会引发黄疸、腹水和肝性脑病等症状,并增加肝细胞癌的风险。一旦肝硬化形成并导致肝衰竭,就没有有效的治疗方法。因此,需要新的疗法来抑制肝硬化的疾病进展。

目的

本研究者发起的临床试验旨在评估通过肝动脉将自体脂肪组织来源的再生(干)细胞疗法应用于肝硬化患者的安全性和有效性。

方法

通过与日本药品和医疗器械局协商,我们设计了一项临床试验,以评估基于自体脂肪组织来源的再生(干)细胞的肝硬化治疗方法,这些细胞使用脂肪组织解离装置提取。该试验的主要终点是血清白蛋白浓度、凝血酶原活性、不良事件和设备故障。

结果

2017年11月开始入组和登记,随访期于2019年11月结束。数据分析和临床研究报告将于2020年3月底完成。

结论

包括数据分析在内的这项临床试验的完成,将提供有关使用脂肪组织解离装置的基于自体脂肪组织来源的再生(干)细胞的这种新型肝脏修复疗法的安全性和有效性的数据。

试验注册

UMIN临床试验注册中心UMIN000022601;https://tinyurl.com/w9uqw3q。

国际注册报告识别码(IRRID):DERR1-10.2196/17904。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b319/7319609/0e9822261425/resprot_v9i3e17904_fig1.jpg

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