羊膜上皮干细胞滴眼液治疗慢性移植物抗宿主病相关干眼症: 单臂、开放性临床研究

注册号:

Registration number:

ChiCTR2200057857 

最近更新日期:

Date of Last Refreshed on:

2023-07-25 08:57:30 

注册时间:

Date of Registration:

2022-03-19 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

羊膜上皮干细胞滴眼液治疗慢性移植物抗宿主病相关干眼症: 单臂、开放性临床研究

Public title:

Amniotic epithelial stem cell eye drops for ocular cGVHD : a single arm, open clinical study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

羊膜上皮干细胞滴眼液治疗慢性移植物抗宿主病相关干眼症: 单臂、开放性临床研究

Scientific title:

Amniotic epithelial stem cell eye drops for chronic graft versus host disease associated dry eye: a single arm, open clinical study

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

黄瑞昊 

研究负责人:

张曦 

Applicant:

Ruihao Huang 

Study leader:

Xi Zhang 

申请注册联系人电话:

Applicant telephone:

+86 18984398751

研究负责人电话:

Study leader's
telephone:

+86 13808310064

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

1169731117@qq.com

研究负责人电子邮件:

Study leader's E-mail:

zhangxxi@sina.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

重庆市沙坪坝区新桥街道183号

研究负责人通讯地址:

重庆市沙坪坝区新桥街道183号

Applicant address:

183 Xinqiao Street, Shapingba District, Chongqing

Study leader's address:

183 Xinqiao Street, Shapingba District, Chongqing

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

中国人民解放军陆军军医大学新桥医院

Applicant's institution:

Xinqiao hospital of the army medical university

研究负责人所在单位:

中国人民解放军陆军军医大学新桥医院

Affiliation of the Leader:

Xinqiao hospital of the army medical university

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2022-研第057-02

伦理委员会批件附件:

Approved file of Ethical Committee:

批准本研究的伦理委员会名称:

中国人民解放军陆军军医大学第二附属医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of second Affiliated Hospital of Army Medical University, PLA

伦理委员会批准日期:

Date of approved by ethic committee:

2022-04-20 00:00:00

伦理委员会联系人:

刘丹

Contact Name of the ethic committee:

Dan Liu

伦理委员会联系地址:

陆军军医大学第二附属医院药学部3楼伦理委员会办公室

Contact Address of the ethic committee:

Ethics Committee Office, 3F Pharmacy Department, the Second Affiliated Hospital of Army Medical University

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 23 6875 5422

伦理委员会联系人邮箱:

Contact email of the ethic committee:

xqyyethics@163.com

研究实施负责(组长)单位:

陆军军医大学第二附属医院血液科

Primary sponsor:

The Hematology Department of the Second Affiliated Hospital of the Army Medical University

研究实施负责(组长)单位地址:

中国重庆市沙坪坝区新桥街道183号

Primary sponsor's address:

183 Xinqiao Street, Shapingba District, Chongqing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆

市(区县):

沙坪坝

Country:

china

Province:

Chongqing

City:

Shapingba

单位(医院):

陆军军医大学第二附属医院

具体地址:

中国重庆市沙坪坝区新桥街道183号

Institution
hospital:

Department of Hematology, Xinqiao Hospital of Army Medical University

Address:

183 Xinqiao Street, Shapingba District, Chongqing

经费或物资来源:

国家重点研究计划(2017YFA0105502)

Source(s) of funding:

National Basic Research Program of China (2017YFA0105502)

研究疾病:

眼部移植物抗宿主病  

Target disease:

ocular Graft Versus Host Disease

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

单臂 

Study design:

Single arm 

研究目的:

移植物抗宿主病(GVHD)是异基因造血干细胞移植的主要并发症,发生在大约一半的移植患者中。而在慢性移植物抗宿主病(cGVHD)患者中, 40%-60%的患者会出现眼部受累情况。主要由于患者主、副泪腺T淋巴细胞浸润,这可能导致其腺泡、导管纤维化而引起角膜表面干燥[2]。因此,干眼症是其最常见的症状,cGVHD的其他眼部表现还包括砂砾感、瘢痕性结膜炎、干燥性角膜结膜炎和点状角膜病变的融合区等[3]。对于与cGVHD相关的干眼症,很大比例的患者对传统的药物疗法,如人工泪液、局部抗炎滴剂和治疗性软性隐形眼镜很难治愈,且这些疗法大多不是为了逆转潜在的免疫过程,而是为了减轻症状和维持眼表。因此,急需探索cGVHD干眼症治疗的新方法,提高患者的生活质量。 羊膜上皮干细胞(AESCs):形成羊膜的最内层,这些细胞可以很容易地分离出来,并表现出特殊和独特的性质,如可塑性、低免疫原性、无毒性、非致瘤性、具有向三个胚层分化的潜力、抗炎抗菌的旁分泌效应等,这都可能有助于受损或患病组织和器官的再生和/或修复[5]。此前,我们在临床中发现羊膜移植可以显著缓解cGVHD患者干眼症的症状且未发现有不良反应。目前,我们计划在临床研究中探究羊膜中羊膜上皮细胞治疗慢性移植物抗宿主病相关干眼症安全性和有效性。  

Objectives of Study:

The efficacy of AHST derives from activation of the immune system against malignant cells. Graft-versus- host disease (GVHD) is the result of an overactive systemic inflammatory response, which can lead to the destruction of normal host tissues. Chronic GVHD (cGVHD) is the most common cause of non-relapsing morbidity and mortality in patients greater than 2 years from transplant, occurring in 30% to 70% of patients. Chronic GVHD not only affects the organs that can be damaged in acute GVHD, but more frequently involve the eyes, musculoskeletal systems, lymphohematopoietic systems, hair and nails, and genitals. Approximately 40% to 90% of patients with chronic GVHD will develop ocular symptoms. Ocular manifestations include moderate to severe keratoconjunctivitis sicca, bilateral marginal keratitis, anterior uveitis, corneal ulceration and neovascularization, and conjunctival scarring. Ocular GVHD (oGVHD) can be debilitating and severely impact patients' quality of life. It is often difficult to diagnosis and treat due to limited understanding of its pathophysiology and somewhat confusing diagnostic and scoring systems. Human amniotic/amnion epithelial cells (hAECs) are derived from the innermost layer of the term placenta closest to the fetus, and they have been shown to have the potential to be seed cells for allogeneic cell therapies. the characteristics of plasticity, low immunogenicity, non toxicity, non tumorigenicity have been shown a promising method in tissue repairing. Therefore, we design a clinical trial using AESCs for ocular cGVHD..

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.对本研究药物的任何成分过敏者;
2.有活动性真菌、细菌或病毒性角膜炎或结膜炎等急性眼部疾病者;
3.有与慢性移植物抗宿主病无关的其它慢性眼部疾病者:如葡萄膜炎、视网膜色素变性等;
4.戴隐形眼镜,不愿意在研究期间摘下者;
5.近三个月内做过眼科手术(包括白内障手术);
6.孕妇或哺乳期妇女;
7.无法按照研究者的要求完成研究;
8.其他任何研究者认为不适合入组该研究的情况。

Exclusion criteria:

1. People who are allergic to any component of the study drug;
2. Have active fungus, bacteria, viral keratitis or conjunctivitis and other acute eye diseases;
3. People with other chronic eye diseases unrelated to chronic graft-versus-host disease: such as uveitis, retinitis pigmentosa, etc;
4. Those who wear contact lenses and are unwilling to remove them during the study;
5. Ophthalmic surgery (including cataract surgery) has been performed in recent three months;
6. Pregnant or lactating women;
7. Unable to complete the study as required by the researcher;
8. Any other situation that the researcher thinks is not suitable for the study.

研究实施时间:

Study execute time:

From 2022-04-21 00:00:00 To 2024-04-20 00:00:00  

征募观察对象时间:

Recruiting time:

From 2022-06-20 00:00:00 To 2023-12-01 00:00:00

干预措施:

Interventions:

组别:

G1

样本量:

10

Group:

G1

Sample size:

干预措施:

羊膜上皮干细胞滴眼液

干预措施代码:

Intervention:

Amniotic epithelial stem cell eye drops

Intervention code:

组别:

G2

样本量:

10

Group:

G2

Sample size:

干预措施:

羊膜上皮干细胞滴眼液

干预措施代码:

Intervention:

Amniotic epithelial stem cell eye drops

Intervention code:

组别:

G3

样本量:

10

Group:

G3

Sample size:

干预措施:

羊膜上皮干细胞滴眼液

干预措施代码:

Intervention:

Amniotic epithelial stem cell eye drops

Intervention code:

组别:

G4

样本量:

10

Group:

G4

Sample size:

干预措施:

羊膜上皮干细胞滴眼液

干预措施代码:

Intervention:

Amniotic epithelial stem cell eye drops

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

新桥医院 

单位级别:

三甲 

Institution
hospital:

Xinqiao Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

眼表疾病指数

指标类型:

主要指标

Outcome:

Ocular Surface Disease Index (OSDI)

Type:

Primary indicator

测量时间点:

-3天、1周、2周、3周、4周、5周、6周、7周、8周、9周、10周、11周、12周。治疗结束后,每月随访时填写一次,随访9个月

测量方法:

OSDI 是一份由 12 个问题组成的问卷,评分从 0 到 4。OSDI 评分范围为 0-100,其中 0-12 为正常,13-22 为轻度 DED,23-32 为中度 DED,以及 >33 严重的 DED。 OSDI=[(答题总分)×100]/[(答题总数)×4]

Measure time point of outcome:

-3 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

OSDI is a patient reported questionnaire consisting of 12 questions which are scored from 0 to 4. OSDI score range from 0-100 with score 0-12 being normal, 13-22 being mild DED, 23-32 being moderate DED, and >33 being severe DED. OSDI=[(sum of scores for questions answered)×100]/[(total questions answered)×4

指标中文名:

Schirmer 试验

指标类型:

次要指标

Outcome:

Schirmer test

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

Schirmer 试验测量患者产生的泪液分泌量,以毫米 (mm) 为单位。

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

Schirmer tear test measures the amount of tear secretion produced by a patient in millimeters (mm).

指标中文名:

泪液破裂时间

指标类型:

次要指标

Outcome:

Tear film break-up time (TBUT)

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

泪膜破裂时间测量每次眨眼后泪膜完全覆盖眼表的时间(以秒为单位)。 泪膜完全覆盖眼表的时间越长越好

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

Tear Film Break-Up Time measures the amount of time, in seconds, that the tear film completely coats the ocular surface after each blink. The longer the amount of time the tear film completely coats the ocular surface is considered to be better than a shorter amount of time.

指标中文名:

最佳矫正视力(BCVA)

指标类型:

次要指标

Outcome:

Best-corrected visual acuity (BCVA)

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8 周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

观察视力变化

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

Observe the changes in vision.

指标中文名:

结膜发红评分

指标类型:

次要指标

Outcome:

the score of conjunctival redness

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8 周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

根据Allergan 干眼红肿量表对比,每个象限分0~4分,其中:0=正常; 1=痕迹发红; 2=轻度发红; 3=中度发红; 4=严重发红

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

According to the comparison of the Allergan Dry Eye Redness Scale, each quadrant is scored from 0 to 4 points, where: 0=normal; 1=redness of traces; 2=slight redness; 3=moderate redness; 4=severe redness

指标中文名:

泪河高度

指标类型:

次要指标

Outcome:

Tear meniscus height (TMH)

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8 周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

TMH 以 mm 为单位,其中小于 0.2mm 为异常

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

TMH measured in mm where less than 0.2mm is worse.

指标中文名:

眼共聚焦显微镜

指标类型:

次要指标

Outcome:

In?vivo?confocal?microscopic? (IVCM)

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8 周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

从细胞水平, 观察各种细胞的变化。

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

Observe the changes of various cellular.

指标中文名:

眼前节照相检查

指标类型:

次要指标

Outcome:

Photographic examination of the anterior segment

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8 周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

观察眼前节的变化。

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

Observe the changes in the anterior segment.

指标中文名:

角膜OCT检查

指标类型:

次要指标

Outcome:

Optical Coherence Tomography (OCT) imaging test

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8 周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

对组织进行扫描,通过不同组织的不同反射吸收和散射能力,可以清晰区分组织结构。

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

Through the different reflection absorption and scattering capabilities of different tissues, the tissues are scanned to clearly distinguish the tissue structure.

指标中文名:

角膜荧光素染色

指标类型:

次要指标

Outcome:

Corneal fluorescein staining

Type:

Secondary indicator

测量时间点:

-3天、2周、4周、6周、8 周、10周、12周,治疗结束后,每月随访时检查一次,随访9个月

测量方法:

使用国家眼科研究所 (NEI) 分级量表通过染料染色测量的角膜染色评分。 将染料涂在每只眼睛上,并使用裂隙灯观察角膜染色。 NEI 量表依赖于将角膜分为 5 个部分的图表,并根据点状染色的密度为每个部分分配一个从 0(不存在)到 3(严重)的值,最终染色分数是各个部分分数的总和 0(最小)-15(最大)点的范围。

Measure time point of outcome:

-3 days, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks. After treatment, follow up once a month for 9 months

Measure method:

Corneal staining score as measured by dye staining using National Eye Institute (NEI) grading scale. Dye was applied to each eye and a slit lamp was used to observe corneal staining. NEI scale relies on a chart that divides the cornea into 5 sections and assigns a value from 0 (absent) to 3&

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 65 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

未决定

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

not decided

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

CRF表记录

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF recording

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2022-03-19 18:13:00