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自体心脏干细胞注射治疗左心发育不良综合征患儿(CHILD 研究)。

Autologous Cardiac Stem Cell Injection in Patients with Hypoplastic Left Heart Syndrome (CHILD Study).

机构信息

Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL, 60611, USA.

Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, 1501 NW 10th Avenue, 9th Floor, Miami, FL, 33136, USA.

出版信息

Pediatr Cardiol. 2022 Oct;43(7):1481-1493. doi: 10.1007/s00246-022-02872-6. Epub 2022 Apr 8.

Abstract

Mortality in infants with hypoplastic left heart syndrome (HLHS) is strongly correlated with right ventricle (RV) dysfunction. Cell therapy has demonstrated potential improvements of RV dysfunction in animal models related to HLHS, and neonatal human derived c-kit cardiac-derived progenitor cells (CPCs) show superior efficacy when compared to adult human cardiac-derived CPCs (aCPCs). Neonatal CPCs (nCPCs) have yet to be investigated in humans. The CHILD trial (Autologous Cardiac Stem Cell Injection in Patients with Hypoplastic Left Heart Syndrome) is a Phase I/II trial aimed at investigating intramyocardial administration of autologous nCPCs in HLHS infants by assessing the feasibility, safety, and potential efficacy of CPC therapy. Using an open-label, multicenter design, CHILD investigates nCPC safety and feasibility in the first enrollment group (Group A/Phase I). In the second enrollment group, CHILD uses a randomized, double-blinded, multicenter design (Group B/Phase II), to assess nCPC efficacy based on RV functional and structural characteristics. The study plans to enroll 32 patients across 4 institutions: Group A will enroll 10 patients, and Group B will enroll 22 patients. CHILD will provide important insights into the therapeutic potential of nCPCs in patients with HLHS.Clinical Trial Registration https://clinicaltrials.gov/ct2/home NCT03406884, First posted January 23, 2018.

摘要

患有左心发育不全综合征 (HLHS) 的婴儿的死亡率与右心室 (RV) 功能障碍密切相关。细胞疗法已证明在与 HLHS 相关的动物模型中 RV 功能障碍具有潜在的改善作用,与成人来源的心脏衍生 CPCs (aCPCs) 相比,新生儿来源的 c-kit 心脏衍生祖细胞 (CPCs) 显示出更好的效果。尚未在人类中研究新生儿 CPCs (nCPCs)。CHILD 试验(Hypoplastic Left Heart Syndrome 患者自体心脏干细胞注射)是一项 I/II 期试验,旨在通过评估 CPC 治疗的可行性、安全性和潜在疗效,研究 HLHS 婴儿心肌内给予自体 nCPCs。该试验采用开放性、多中心设计,首先在第一组(A 组/ I 期)评估 nCPC 的安全性和可行性。在第二组中,CHILD 将采用随机、双盲、多中心设计(B 组/ II 期),根据 RV 功能和结构特征评估 nCPC 的疗效。该研究计划在 4 家机构招募 32 名患者:A 组将招募 10 名患者,B 组将招募 22 名患者。CHILD 将为 HLHS 患者 nCPCs 的治疗潜力提供重要的见解。临床试验注册 https://clinicaltrials.gov/ct2/home NCT03406884,首次发布于 2018 年 1 月 23 日。

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