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2015 ; 13
(ä): 344
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Safety of allogeneic bone marrow derived mesenchymal stromal cell therapy in
renal transplant recipients: the neptune study
#MMPMID26537851
Reinders ME
; Dreyer GJ
; Bank JR
; Roelofs H
; Heidt S
; Roelen DL
; Zandvliet ML
; Huurman VA
; Fibbe WE
; van Kooten C
; Claas FH
; Rabelink TJ
; de Fijter JW
J Transl Med
2015[Nov]; 13
(ä): 344
PMID26537851
show ga
BACKGROUND: Mesenchymal stromal cells (MSC) may serve as an attractive therapy in
renal transplantation due to their immunosuppressive and reparative properties.
While most studies have used autologous MSCs, allogeneic MSCs offer the advantage
of immediate availability for clinical use. This is of major importance for
indications where instant treatment is needed, for example allograft rejection or
calcineurin inhibitor toxicity. Clinical studies using allogeneic MSCs are
limited in number. Although these studies showed no adverse reactions, allogeneic
MSCs could possibly elicit an anti-donor immune response, which may increase the
incidence of rejection and impact the allograft survival in the long term. These
safety issues should be addressed before further studies are planned with
allogeneic MSCs in the solid organ transplant setting. METHODS/DESIGN: 10 renal
allograft recipients, 18-75 years old, will be included in this clinical phase
Ib, open label, single center study. Patients will receive two doses of 1.5 ×
10(6) per/kg body weight allogeneic bone marrow derived MSCs intravenously, at 25
and 26 weeks after transplantation, when immune suppression levels are reduced.
The primary end point of this study is safety by assessing biopsy proven acute
rejection (BPAR)/graft loss after MSC treatment. Secondary end points, all
measured before and after MSC infusions, include: comparison of fibrosis in renal
biopsy by quantitative Sirius Red scoring; de novo HLA antibody development and
extensive immune monitoring; renal function measured by cGFR and iohexol
clearance; CMV and BK infection and other opportunistic infections. DISCUSSION:
This study will provide information on the safety of allogeneic MSC infusion and
its effect on the incidence of BPAR/graft loss. TRIAL REGISTRATION: NCT02387151.