This clinical trial is a clinical trial for the evaluation of the safety and efficacy of umbilical cord blood (UCB) therapy, UCB and erythropoietin (EPO) combination therapy in adult stroke patients.
UCB is a high-quality source of mesenchymal stem cells, and studies are being actively developed for stroke patients. UCB therapy has a neuroprotective effect through anti-inflammatory effect and anti-apoptosis. However, UCB alone has not been able to provide sufficient improvement and is being studied for combination therapies with growth factors that can exert its effects. Among the various growth factors, EPO is a powerful factor that can act as a neurotrophic factor in neurons, astrocytes, oligodendrocytes, microglia, endothelial cells, and neural stem/precursor cells. In our previous study of subacute stroke animal models, investigators confirmed that the combined administration of UCB and EPO improved the behavioral assessment (mNSS, Cylinder test) compared to UCB only administration. The aim of this study is to investigate the difference in therapeutic effects between UCB alone therapy and UCB and EPO combination therapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
24
The umbilical cord blood is donated umbilical cord blood which is stored in the cord blood bank donated by Cha Hospital. The total number of nuclear cells should be at least 2 x 10 7 / kg, and at least three out of six of the six human leukocyte antigens (HLA-A, B, DR) should be selected. The cord blood that matches ABO and Rh blood type is preferentially used. Umbilical cord blood infusion is administered intravenously and is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.
Recombinant human erythropoietin is used and is administered intravenously at a maximum of 5 times at a rate of 500 IU / kg 2 times/week after cord blood peripheral blood infusion, calculated as the dose per body weight. Or subcutaneous administration if intravenous administration is not possible. Store in a sealed container at 2-8 °C in the refrigerator before dosing. Erythropoietin injection is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.
Bundang CHA Medical Center
Seongnam-si, Gyeonggi-do, South Korea
RECRUITINGChange of Functional Independence Measure
The difference in the FIM (Functional Independence Measure)score between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences in scores (total score\[18\~126\], motor score\[13\~90\], and cognition score\[5\~35\]. The total score is the sum of the motor score and the cognition score. The higher scores represent a better outcome )
Time frame: baseline - 3 months - 6 months
Change of Medical research council
The difference in the MRC (Medical research council) scale between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences. \[0, 1, 2, 2, 2+, 3-, 3, 3+, 4, 5\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of National Institutes of Health Stroke Scale
The difference in the NIHSS (National Institutes of Health Stroke Scale) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences.\[0\~42\] (The lower values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of Manual Function Test
The difference in the MFT (Manual Function Test) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences.\[0\~32 for each arm\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of Fugl-Meyer Assessment
The difference in the FMA (Fugl-Meyer Assessment) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences.\[0\~66 for each arm\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
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Placebo umbilical cord blood infusion is administered intravenously and is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.
Placebo erythropoietin injection is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.
Physical therapy and occupational therapy are performed daily.
Change of Berg Balance Scale
The difference in the BBS (Berg Balance Scale) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences.\[0\~56\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of Trunk Imbalance Scale
The difference in the TIS (Trunk Imbalance Scale) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences.\[0\~23\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of Korean Mini Mental State Exam
The difference in the K-MMSE (Korean Mini Mental State Exam) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences. \[0\~30\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of Korean Wechsler adult intelligence scale-IV
The difference in the K-WAIS-IV (Korean Wechsler adult intelligence scale-IV) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences.\[The total score is a standard score with a mean of 100 and a standard deviation of approximately 15.\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of Korean version of the Western Aphasia Battery
The difference in the K-WAB (Korean version of the Western Aphasia Battery) between the three groups at baseline, 90 days, and 180 days was confirmed by comparing differences.\[0\~100\] (The higher values represent a better outcome.)
Time frame: baseline - 3 months - 6 months
Change of Brain imaging
The difference in the Brain imaging (Basic brain MRI, functional brain MRI, diffusion tensor imaging brain MRI) between the three groups at baseline, and 180 days was confirmed by comparing differences.
Time frame: baseline - 6 months
Change of Biomarkers
The difference in the Biomarkers (TGFβ, IL-10, IL-8, PTX3, PCNT,...) between the three groups at baseline, 1 day, 15 days, 30 days, 90 days and 180 days was confirmed by comparing differences.
Time frame: baseline - 1 day - 15 days - 1 month - 3 months - 6 months