Bronchopulmonary Dysplasia
Conditions
Keywords
Bronchopulmonary dysplasia, pulmonary hypertension, stem cell therapy, mesenchymal stem cells, very low weight preterm babies
Brief summary
Bronchopulmonary Dysplasia (BPD) is the most frequent disease related to a premature birth, 15-50% of very low birth newborns (\<1500 gr.) will develop BPD. The prevalence of BPD is increasing due to the advances in neonatology, with a rise in the survival of smaller and more premature babies. The etiology of BPD is multifactorial, in which oxygen, maternal chorioamnionitis, insufficient pulmonary maturation etc. have an important role. These factors lead to a pathological development of the lung and pulmonary vessels, developing secondary Pulmonary Hypertension (PH). Nowadays there is no efficient treatment; this generates a important sanitary burden and a decrease in life quality. Multiple experimental models in mice have studied Mesenchymal Stem Cell (MSC) therapy as prevention of BPD, also recently some clinical trials have tried this therapy on premature newborns with promising results. Hypothesis: MSC therapy in patients at high risk of BPD prevents pulmonary lesions. Methods: The investigators have designed a clinical trial to evaluate the feasibility and security of MSC therapy in patients at high risk of developing BPD.
Interventions
BIOLOGICALMesenchymal Stem Cell (MSC) therapy
3 doses of 5 million MSC will be administered
Sponsors
Instituto de Salud Carlos III
Fundación de Ayuda a la Investigación sobre la Hipertensión pulmonar
Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Weeks to 28 Weeks
Healthy volunteers
No
Inclusion criteria
* Preterm newborns ≤ 28 weeks gestational age * Birth Weight \<1250 gr. * Still on of mechanical ventilation FiO2 \> 0,3 at day + 14
Exclusion criteria
* Other congenital pathology (pulmonary malformations, active pulmonary bleeding, renal malformations, CHD, malformative syndromes, chromosomopathies) * Severe neurological lesion. * HIV infection * Cardiovascular instability due to any cause * 72 hours after mayor surgery * Necrotizing enterocolitis grades II or higher, according to Bell classification, at the time of inclusion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility and security of MSC therapy in very low birth weight preterm babies at risk of developing bronchopulmonary dysplasia (Number of participants with adverse events) | 24 months | Number of participants with adverse events as a measure of safety and tolerability |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Biomarker analysis (IL-1beta, IL-6, IP-10, INF-gamma, TGF beta, NLRP3, RAGE, HMGB1, VEGFA, GREMLIN1, sVEGFR1, IGF, ENDOTHELIN-1, SMPD-1, SP-D, SMPD3. | 24 months | biomarkers will be measured in pg/ml |
| Changes in the echocardiographic parameters related with PH and preterm birth, in patients treated with MSC (Number of participants with echocardiographic adverse events) | 24 months | Flattening of the interventricular septum will be the main parameter (tipe I, I-II, II, II-III OR III) |
| Incidence of BPD and PH in very low birth weight babies treated with MSC | 24 months | Diagnosed at 36 weeks of postmenstrual age |
Countries
Spain
Outcome results
None listed