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Kidney Int Rep. 2018 Jun 2;3(5):1119-1127. doi: 10.1016/j.ekir.2018.05.009. eCollection 2018 Sep.

Extracorporeal Stromal Cell Therapy for Subjects With Dialysis-Dependent Acute Kidney Injury.

Author information

1
Sentien Biotechnologies, Inc., Lexington, Massachusetts, USA.
2
Cold Spring Venture Advisors, LLC, Watertown, Massachusetts, USA.
3
EndPointe Clinical Resources, Inc., Hollis, New Hampshire, USA.
4
Department of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
5
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
6
Department of Surgery, Center for Surgery, Innovation, and Bioengineering, Massachusetts General Hospital, Harvard Medical School and the Shriners Hospitals for Children, Boston, Massachusetts, USA.
7
Harvard Stem Cell Institute, Cambridge, Massachusetts, USA.
8
Department of Biomedical Engineering, Rutgers University, Piscataway, New Jersey, USA.

Abstract

Introduction:

The pathophysiology of acute kidney injury (AKI) involves damage to renal epithelial cells, podocytes, and vascular beds that manifests into a deranged, self-perpetuating immune response and peripheral organ dysfunction. Such an injury pattern requires a multifaceted therapeutic to alter the wound healing response systemically. Mesenchymal stromal cells (MSCs) are a unique source of secreted factors that can modulate an inflammatory response to acute organ injury and enhance the repair of injured tissue at the parenchymal and endothelial levels. This phase Ib/IIa clinical trial evaluates SBI-101, a combination product that administers MSCs extracorporeally to overcome pharmacokinetic barriers of MSC transplantation. SBI-101 contains allogeneic human MSCs inoculated into a hollow-fiber hemofilter for the treatment of patients with severe AKI who are receiving continuous renal replacement therapy (CRRT). SBI-101 therapy is designed to reprogram the molecular and cellular components of blood in patients with severe organ injury.

Methods:

This study is a prospective, multicenter, randomized, double-blind, sham-controlled, study of subjects with a clinical diagnosis of AKI who are receiving CRRT. Up to 32 subjects may be enrolled to provide 24 evaluable subjects (as a per protocol population). Subjects will receive CRRT in tandem with a sham control (0 MSCs), or the low- (250 × 106 MSCs) or high-dose (750 × 106 MSCs) SBI-101 therapeutic.

Results:

The study will measure dose-dependent safety, renal efficacy, and exploratory biomarkers to characterize the pharmacokinetics and pharmacodynamics of SBI-101 in treated subjects.

Conclusion:

This first-in-human clinical trial will evaluate the safety and tolerability of SBI-101 in patients with AKI who require CRRT.

KEYWORDS:

bioreactor; critical care; ex vivo; mesenchymal stem cell

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