Adjunctive Allogeneic Mesenchymal Stem Cells for Treatment-resistant Bipolar Depression

Last updated: June 17, 2025
Sponsor: The University of Texas Health Science Center, Houston
Overall Status: Active - Recruiting

Phase

1

Condition

Depression

Mood Disorders

Bipolar Disorder

Treatment

Allogeneic Bone Marrow Derived Multipotent Mesenchymal Stromal Cells (MSCs)

Placebo

Clinical Study ID

NCT03522545
HSC-MS-16-0657
  • Ages 18-65
  • All Genders

Study Summary

The overall objective of the investigators is to assess the therapeutic efficacy and tolerability of Allogeneic Bone Marrow Derived Multipotent Mesenchymal Stromal Cells (MSCs) isolated from hematogenous bone marrow for treatment of treatment-resistant bipolar depression patient (TRBD).

Eligibility Criteria

Inclusion

Inclusion criteria:

  1. Diagnosis of DSM-IV-TR of Bipolar I or Bipolar II disorder as verified by thesemi-structured diagnostic interviews SCID. The diagnosis may be supported byinformation from significant others, and from hospital records.

  2. Age: 18-65 years

  3. Severity: meet DSM-IV-TR criteria of depressive episode and MADRS of 25 or above

  4. Treatment resistance: None response to two trials (during lifetime) with moodstabilizers with proven efficacy in bipolar depression (lithium, lamotrigine,quetiapine, olanzapine) and/or antidepressants. a A trial is defined as at least 6 weeks in adequate or tolerated dose as reportedby the patient, or patients that have been unable to comply with 6 weeks trials ofmood stabilizer or an antidepressant. b None response: Less than 50% reduction in MADRS values or still meet DSM-IV-TRcriteria of depressive episode

  5. CRP concentration greater than 5 mg/L

  6. Female subjects whom are not pregnant, not breastfeeding, and not planning onbecoming pregnant during the study. Female patients of childbearing potential mustbe using a reliable method of contraception.

  7. Patient competent to give informed consent according to the judgment of theclinician

  8. Written informed consent

  9. Patient sufficiently fluent in English language to ensure valid responses topsychometric testing (needed for validated neurocognitive outcomes testing)

Exclusion

Exclusion criteria:

  1. MSCs transplant within the last six months

  2. Inability to comply with study protocol

  3. Patient at high suicidal risk according to clinicians' judgement

  4. History of previous brain injury; neurologic impairment and/or deficit; seizuredisorder requiring anti-convulsant therapy; renal disease or altered renal functionas defined by serum creatinine 2x ULN at admission; hepatic disease or altered liverfunction as defined by SGPT > 2 x ULN (non-contusion related), and/or T. Bilirubin 1.5 x ULN at admission; immunosuppression as defined by WBC<3,000 cells/ml atadmission; HIV, splenectomy or cancer

  5. Unstable serious medical conditions, including clinically relevant laboratoryabnormalities. Conditions that affect neuropsychological assessment such asParkinson's Disease, Multiple sclerosis, stroke, alcohol and substance abuse ordependence (according to SCID or DSM-IV-TR). Other serious medical illness that isnot adequately controlled and, in the investigator's opinion, would not permit thesubject to be managed according to the protocol.

  6. Hemodynamic instability at the time of MSCs infusion.

  7. Positive pregnancy test (at screening or baseline visits).

Study Design

Total Participants: 30
Treatment Group(s): 2
Primary Treatment: Allogeneic Bone Marrow Derived Multipotent Mesenchymal Stromal Cells (MSCs)
Phase: 1
Study Start date:
April 20, 2022
Estimated Completion Date:
December 01, 2026

Study Description

This clinical trial is a randomized, double-blind, placebo-controlled study aiming to study the efficacy and side effects of MSCs adjunctive to TAU compared to a normal saline solution in patients with TRBD. Relevant patients with bipolar depression will be addressed in order to establish whether they are willing to be screened for the study. The patients must be assigned a patient number and sign the consent form after receiving oral and written information about the study prior to undergoing any study procedures.

MSCs will be infused as a single dose up to one week after the inclusion of the patient. The treatment trial lasts eight weeks. Of note, the investigators will assess patients also at week 26 with a neurocognitive and clinical battery. It will not be allowed changes in psychiatric medication during this period. If a patient or the treating clinician decides that the patient could receive better treatment outside of the study, the patient may leave the study at all times, as specified in the informed consent. Patients were not allowed to take nonsteroidal or steroidal anti-inflammatory medications during the study. Medications for hypertension, diabetes, hypothyroidism, allergies, infections, or other medical conditions were allowed as dictated by the patients' treating physicians. The investigators defined refractory bipolar depression as depression that failed to respond to two trials (during lifetime) with antidepressants and/or mood stabilizer with proven efficacy in bipolar depression (lithium, lamotrigine, quetiapine, lurasidone, olanzapine) in adequate doses for at least 6 weeks or until cessation of treatment due to side effects (Schoeyen et al., 2015).

After the initial injection, patients will continue maintenance treatment with their current psychiatrist. During this time, they will not receive additional injections but will receive treatment as usual per their clinician's choice. Patients will remain on stable psychiatric medications during this period. If patients need to change medications, they will be removed from the study protocol.

Connect with a study center

  • The University of Texas Health Science Center at Houston

    Houston, Texas 77054
    United States

    Active - Recruiting

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