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脐带组织来源间充质基质细胞治疗 COVID-19 相关急性呼吸窘迫综合征的可行性研究。

Feasibility Study of Cord Tissue Derived Mesenchymal Stromal Cells in COVID-19-Related Acute Respiratory Distress Syndrome.

机构信息

Marcus Center for Cellular Cures, Duke University, Durham, NC, USA.

Department of Medicine, Duke University, Durham, NC, USA.

出版信息

Stem Cells Transl Med. 2023 Apr 17;12(4):185-193. doi: 10.1093/stcltm/szad009.

Abstract

BACKGROUND

Treatment options for patients with COVID-19-related acute respiratory distress syndrome (ARDS) are desperately needed. Allogeneic human umbilical cord derived mesenchymal stromal cells (hCT-MSCs) have potential therapeutic benefits in these critically ill patients, but feasibility and safety data are lacking.

MATERIALS AND METHODS

In this phase I multisite study, 10 patients with COVID-19-related ARDS were treated with 3 daily intravenous infusions of hCT-MSCs (1 million cells/kg, maximum dose 100 million cells). The primary endpoint assessed safety.

RESULTS

Ten patients (7 females, 3 males; median age 62 years (range 39-79)) were enrolled at 2 sites and received a total of 30 doses of study product. The average cell dose was 0.93 cells/kg (range 0.56-1.45 cells/kg and total dose range 55-117 million cells) with 5/30 (17%) of doses lower than intended dose. Average cell viability was 85% (range 63%-99%) with all but one meeting the >70% release criteria. There were no infusion-related reactions or study-related adverse events, 28 non-serious adverse events in 3 unique patients, and 2 serious adverse events in 2 unique patients, which were expected and unrelated to the study product. Five patients died: 3 by day 28 and 5 by day 90 of the study (median 27 days, range 7-76 days). All deaths were determined to be unrelated to the hCT-MSCs.

CONCLUSION

We were able to collect relevant safety outcomes for the use of hCT-MSCs in patients with COVID-19-related ARDS. Future studies to explore their safety and efficacy are warranted.

摘要

背景

COVID-19 相关急性呼吸窘迫综合征(ARDS)患者的治疗选择迫在眉睫。同种异体人脐带衍生间充质基质细胞(hCT-MSCs)对这些重症患者具有潜在的治疗益处,但缺乏可行性和安全性数据。

材料和方法

在这项 I 期多中心研究中,10 名 COVID-19 相关 ARDS 患者接受了 3 次每日静脉输注 hCT-MSCs(100 万细胞/kg,最大剂量 1 亿细胞)。主要终点评估安全性。

结果

2 个中心共招募了 10 名患者(7 名女性,3 名男性;中位年龄 62 岁(范围 39-79)),共接受了 30 剂研究产品。平均细胞剂量为 0.93 细胞/kg(范围 0.56-1.45 细胞/kg,总剂量范围 55-11700 万细胞),其中 5/30(17%)剂量低于预期剂量。平均细胞活力为 85%(范围 63%-99%),除 1 剂外,所有细胞均符合>70%释放标准。无输注相关反应或研究相关不良事件,3 名独特患者出现 28 例非严重不良事件,2 名独特患者出现 2 例严重不良事件,均为预期且与研究产品无关。5 名患者死亡:3 名在第 28 天,5 名在第 90 天(中位 27 天,范围 7-76 天)。所有死亡均被认为与 hCT-MSCs 无关。

结论

我们能够为 COVID-19 相关 ARDS 患者使用 hCT-MSCs 收集相关安全性结果。需要进一步研究以探索其安全性和疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b324/10108718/6ebdc8a8d7a8/szad009f0001.jpg

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