Human Cord Blood Mononuclear Cells in the Treatment of Refractory Diabetic Foot

Last updated: August 13, 2023
Sponsor: The First Affiliated Hospital with Nanjing Medical University
Overall Status: Active - Recruiting

Phase

N/A

Condition

Diabetes And Hypertension

Treatment

human cord blood-derived mononuclear cells (HCB-MNCs)

Clinical Study ID

NCT05999656
2022-SR-752
  • Ages 18-80
  • All Genders

Study Summary

Refractory diabetic foot is one of the most serious and costly chronic complications of diabetes. It is the leading cause of nontraumatic lower-extremity amputations while the conventional treatment is not effective. Therefore, new therapeutic methods are urgently needed. Cell therapy has shown unique advantages and potential in tissue regeneration and wound repair, and is considered as a new effective method to treat diabetic foot. Meanwhile, human cord blood-derived mononuclear cells (HCB-MNCs) with its sufficient sources, strong ability of proliferation and differentiation, and weak immunogenicity, is suitable for the treatment of diabetic foot. It is a prospective, single-arm, single-center clinical study to investigate the efficacy and safety of local injection of HCB-MNCs in the treatment of refractory diabetic foot.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Patients aged 18-80 years;
  2. Meet the diagnostic criteria of diabetic foot by International Clinical Guidelines forDiabetic Foot;
  3. Ulcer course ≥8 weeks, Wagner grade ≥2;
  4. There was no healing trend (no reduction in wound size and no obvious new granulationtissue) after 4 weeks or above treatment. Or the ulcer was further aggravated (byWagner's grade assessment) in the course of standardized treatment;
  5. Fasting blood glucose ≤9mmol/L, 2h postprandial blood glucose ≤13mmol/L;
  6. Signing informed consent.

Exclusion

Exclusion Criteria:

  1. Patients with a history of ketoacidosis and hyperosmosis within 6 months;
  2. Patients with viral infection (treponema pallidum, active hepatitis, HIV, Epstein-Barrvirus, etc.)
  3. Patients with malignant disease or cured of basal cell carcinoma within the past 5years;
  4. Creatinine clearance < 45ml/min;
  5. Patients with severe heart failure (NYHA III-IV);
  6. Patients with a history of myocardial infarction or cerebral infarction in the last 3months;
  7. Patients who have received cell or growth factor therapy in the past year;
  8. Patients during pregnancy or lactation;
  9. Patients with abnormal thyroid dysfunction history or abnormal control through drugtreatment;
  10. Patients with severe hepatic failure (ALT, AST: above 3 times the upper limit ofnormal);
  11. Lower extremity arterial with large artery occlusion by ultrasound image;
  12. Patients with a history of severe coagulation disorder or hemorrhagic disease;
  13. Patients with sequelae of cerebral infarction or other reasons that cannot extendtheir lower limbs flat;
  14. Patients with psychological or mental disorders who cannot cooperate with treatment;
  15. Participate in other clinical research within the past three months;
  16. Patients are unable to complete the study or comply with the requirements of the studyby investigator's judgment.

Study Design

Total Participants: 24
Treatment Group(s): 1
Primary Treatment: human cord blood-derived mononuclear cells (HCB-MNCs)
Phase:
Study Start date:
May 28, 2023
Estimated Completion Date:
November 28, 2024

Study Description

Refractory diabetic foot is one of the most serious and costly chronic complications of diabetes, and is the leading cause of nontraumatic lower-extremity amputations. Conventional treatment is symptomatic supportive treatment such as controlling blood sugar, fighting infection, improving blood circulation, using topical medications, etc. But the effectiveness is barely satisfactory, while the wound heals slowly, and the large blood vessels that have been blocked cannot be re-opened. Therefore, an effective method is needed to relieve lower limb ischemia, promote ulcer healing and shorten the treatment time.

Cell therapy has shown unique advantages and potential in tissue regeneration and wound repair, and is considered as a new effective method to treat diabetic foot. Cell treatment for diabetic foot include local injection, intravenous infusion and arterial infusion. At present, local intramuscular injection is used in most studies at home and abroad.

HCB-MNCs is composed of immature immune cells and pluripotent stem cells, which is adequate, superior proliferative and immature , is a favorable source of cells for the treatment of diabetic foot. A few clinical studies have found that local intramuscular injection of HCB-MNCs or combined with gel dressing can effectively treat diabetic foot ulcers and relieve pain and other symptoms of patients. In this study, 24 patients with refractory diabetic foot will be enrolled. HCB-MNCs will be injected into the diabetic foot wound area 3 times at a week interval to explore its effectiveness and safety.

The primary objective of this study is to investigate the safety of local application of HCB-MNCs in the treatment of refractory diabetic foot and the change of wound area. The secondary objective is to assess changes in the visual analogue scale, total symptoms score and wagner scale.

Connect with a study center

  • the First Affiliated Hospital of Nanjing Medical University

    Nanjing,
    China

    Active - Recruiting

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