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Collection and Characterisation of Human Olfactory Ensheathing Cells

Collection and Characterisation of Human Olfactory Ensheathing Cells

Status
UNKNOWN
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT02870426
Enrollment
50
Registered
2016-08-17
Start date
2018-04-09
Completion date
2023-07-31
Last updated
2018-05-04

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Spinal Cord Injury

Keywords

Olfactory ensheathing cells

Brief summary

We aim to retrieve olfactory bulbs (OBs) from suitable human donors. We have defined two groups who will qualify: Group 1 - Deceased Donors: 1A: Donors after brainstem death (DBDs) undergoing solid organ donation 1B: Donors after brainstem death (DBDs) considered unsuitable for solid organ donation Group 2 - Living Donors: Neurosurgical patients undergoing anterior cranial surgery in which the olfactory nerve (ON) is cut as part of the surgical procedure. The OB of the concomitant severed ON would be donated. We aim to optimise OB collection and Olfactory Ensheathing Cell (OEC) culture and storage. We will study the effects of patient diagnosis, age, cause of death (if applicable), co-morbidities and warm ischaemic time on cell survival and regenerative function. In future studies we aim to store OECs in a GMP facility and transplant OECs into patients with spinal cord injuries.

Detailed description

Spinal cord injury (SCI) is a devastating condition. To date there is no treatment to improve outcome. There is limited regenerative capacity of the central nervous system (CNS), such that damaged neurons and severed axons are not replaced. A substantial body of evidence suggests that olfactory ensheathing cells (OECs) obtained from olfactory bulbs (OBs) facilitate neuronal regeneration in rodents and humans with SCI. Indeed, transplanting autologous OECs from an OB into the injury site improved neurological outcome in a patient with SCI. Harvesting autologous OBs to culture OECs has several disadvantages: 1. If the OECs do not grow in vitro, the transplantation is abandoned; 2. The retrieval procedure exposes a paralysed patient to the risks of craniotomy; 3. Excising an OB can impair the sense of smell; and 4. The number of OECs obtained is limited to one OB. Investigators will collect human OECs from suitable donors which we have defined as two groups. Group 1 patients will be brain dead donors identified by the neuro-intensive care team as potential candidates for solid organ donation. The OBs will be retrieved as near to death as possible. Group 2 patients will be living donors undergoing elective neurosurgery in which the olfactory nerve is sacrificed as part of that procedure. There are two OBs located at the anterior skull base, responsible for transmitting the sensation of smell from the nose to the brain. Obtaining OECs requires a craniotomy (opening the skull) to remove the OBs. PHASE 1 will be divided into 2 stages. In stage 1 we will culture OECs and characterise them in the central laboratory. We aim to determine how the yield of OECs and their regenerative properties are affected by freeze-thaw, time left at room temperature and time left at 40C before culture as well as patient age. Each harvested sample will be transferred to the lab for further processing. Processing includes but is not limited to histological fixation, sectioning and staining, cell culture and storage. Some OECs will be frozen in liquid nitrogen to determine whether they can indeed be stored. In stage 2 we will transfer OECs outside St. George's to a GMP facility (to be determined). In the GMP facility, the OECs will be processed and stored according to the optimised conditions we have determined. In PHASE 2, the OECs will be transplanted into patients with SCI.

Interventions

PROCEDUREFrontal Craniotomy and retrieval of OBs

For Group 1A the craniotomy will occur during organ retrieval for transplantation under aseptic technique. For Group 1B it would occur as a separate surgical procedure prior to palliation under full asepsis.

PROCEDUREOB Retrieval During Anterior Cranial Surgery

Group 2: The patients routine anterior cranial surgery would proceed as planned without change to the surgical procedure. In the event that the ON had to be sacrificed for the purposes of surgery the OB of the concomitant nerve would be retrieved.

Sponsors

St George's, University of London
Lead SponsorOTHER

Study design

Observational model
OTHER
Time perspective
OTHER

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Group 1 - Deceased Donors 1A 1. Diagnosis of brainstem death, AND 2. Consent from next of kin (NoK) for organ donation 3. Consent from NoK for removal of olfactory bulbs (OBs) 4. Coroner's consent for removal of OBs (when needed). 1B 1. Diagnosis of brainstem death, AND 2. Contraindications for solid organ donation 3. Consent from NoK for removal of OBs 4. Coroners consent for removal of OBs (when needed) Group 2 - Living Donors 1. Patients having anterior cranial surgery in which the ON may be cut or removed as part of the procedure. 2. Consent from the operating surgeon to remove the OB of the corresponding ON in the event it is cut during the operation 3. Consent from the patient for removal of the OB of the corresponding ON in the event it is cut during the operation

Exclusion criteria

1. Children (\<18 years old) 2. Damage to anterior skull base including OBs 3. Meningitis And applicable to group 2 only: Patients unable to consent for surgery

Design outcomes

Primary

MeasureTime frameDescription
Ability to culture olfactory ensheathing cells from human donors10-15 daysNumber of olfactory ensheathing cells cultured per olfactory bulb at days 10-15 in vitro.

Secondary

MeasureTime frameDescription
Effect of patient age10-15 daysPlot of patient age vs. Number of olfactory ensheathing cells cultured per olfactory bulb at days 10-15 in vitro.
Effect of freeze/thaw cycles10-15 daysPlot of number of freeze/thaw cycles vs. Number of olfactory ensheathing cells cultured at days 10-15 in vitro.
Effect of cause of death for Group 1 donors10-15 daysPlot of cause of death vs. Number of olfactory ensheathing cells cultured per olfactory bulb at days 10-15 in vitro.
Effect of time from extraction to culture at room temperature1 monthPlot of time from extraction to culture vs. Number of olfactory ensheathing cells cultured.
Effect of time from extraction to culture at 4 deg C1 monthPlot of time from extraction to culture at 4 deg C vs. Number of olfactory ensheathing cells cultured.
Effect of storage in liquid nitrogenup to 1 monthPlot of Number of olfactory ensheathing cells cultured at days 10-15 in vitro when cells are cultured fresh vs. after one week and one month storage in liquid nitrogen.

Countries

United Kingdom

Contacts

Primary ContactMarios Papadopoulos, FRCS (SN)
mpapadop@sgul.ac.uk02087254179
Backup ContactFlorence Hogg, MBChB
fhogg@sgul.ac.uk

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026