An open-label phase 1 clinical trial of the allogeneic side population adipose-derived mesenchymal stem cells in SMA type 1 patients

Author(s):  
Rashin Mohseni ◽  
Amir Ali Hamidieh ◽  
Alireza Shoae-Hassani ◽  
Masood Ghahvechi-Akbari ◽  
Anahita Majma ◽  
...  
2020 ◽  
Author(s):  
Rashin Mohseni ◽  
Amir Ali Hamidieh ◽  
Alireza Shoae-Hassani ◽  
Masood Ghahvechi-Akbari ◽  
Anahita Majma ◽  
...  

Abstract Background Werdnig Hoffman (WH), a hereditary neurodegenerative disorder of lower motoneurons associated with progressive muscle weakness is the most common genetic cause of infant mortality. There is no effective treatment for WH exists. The field of translational research is active now, and clinical trials or case studies are ongoing. We present a phase 1 clinical trial in patients with WH who received side population adipose-derived mesenchymal stem cells (SPADMSCs). Methods The intervention group administered with three intrathecal administrations of escalating doses of SPADMSCs. The safety analysis was assessed by controlling the vital signs and efficacy analysis performed by the Ballard score and EMG test. These tests were performed previous to treatment and at the end of the follow-up. Results The treatment well-tolerated, without any adverse event related to the stem cell administration. Patients showed significant improvement in the amplitude response of motor in the tibial nerve (0.56 mV; p: 0.029). The weight of patients, ventilation days, and number of hospitalizations were not meaningful parameters in the response of patients in the intervention and control groups. One patient in the intervention group is still alive after 36 months. He gained a normal weight and has a normal growth rate. The patient can breathe without ventilator aid. Conclusion The present study for stem cell therapy shows safety and efficacy in WH patients, mainly in the recovery of the tibial nerve, respiratory system, and length of life.


2019 ◽  
Vol 11 (509) ◽  
pp. eaax3447 ◽  
Author(s):  
Michael C. Sneller ◽  
Katherine E. Clarridge ◽  
Catherine Seamon ◽  
Victoria Shi ◽  
Marek D. Zorawski ◽  
...  

Despite the substantial clinical benefits of antiretroviral therapy (ART), complete eradication of HIV has not been possible. The gastrointestinal tract and associated lymphoid tissues may play an important role in the pathogenesis of HIV infection. The integrin α4β7 facilitates homing of T lymphocytes to the gut by binding to the mucosal addressin cell adhesion molecule-1 (MAdCAM-1) expressed on venules in gut-associated lymphoid tissue. CD4+ T cells with increased expression of α4β7 are susceptible to HIV infection and may be key players in subsequent virus dissemination. Data from nonhuman primate models infected with simian immunodeficiency virus (SIV) have suggested that blockade of the α4β7/MAdCAM-1 interaction may be effective at preventing SIV infection and may have beneficial effects in animals with established viral infection. To explore whether these findings could be reproduced in HIV-infected individuals after interruption of ART, we conducted an open-label phase 1 clinical trial of vedolizumab, a monoclonal antibody against α4β7 integrin. Vedolizumab infusions in 20 HIV-infected individuals were well tolerated with no serious adverse events related to the study drug. After interruption of ART, the median time to meeting protocol criteria to restart therapy was 13 weeks. The median duration of plasma viremia of <400 copies/ml was 5.4 weeks. Only a single subject in the trial experienced prolonged suppression of plasma viremia after interruption of ART. These results suggest that blockade of α4β7 may not be an effective strategy for inducing virological remission in HIV-infected individuals after ART interruption.


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