Prospective, multicenter and multinational, open-label, uncontrolled clinical study to assess the safety and efficacy of autologous cultured epidermal grafts containing epidermal stem cells genetically modified transduced with a LAMB3-gamma retroviral vector. The purpose of this study is to demonstrate the safety and efficacy after one or more treatments with genetically corrected cultured epidermal autograft (Hologene 5) for restoration of the epidermis in patients with generalized intermediate LAMB3-dependent Junctional Epidermolysis Bullosa.
This trial aims to prove the efficacy and safety of RV-LAMB3-transduced epidermal stem cells and lead to a permanent therapy for the skin lesions affecting JEB patients. Patients are screened according to the Study Inclusion and Exclusion criteria and if found eligible, participants are candidate for the treatment. After confirmation of eligibility, patients will undergo to biopsy for the collection of the autologous epidermal cells used to produce the tissue for the treatment. If all criteria are met, the transplantation of the new cultured transgenic epidermis will be planned according to the procedures and the need of the patient. The study treatment consists of a surgical intervention for new restored stem cells implantation. The surgery is carried out in 2 stages, the first aims at taking biopsy to isolate epidermal cells including stem cells. The biopsy is processed in a laboratory of a regenerative medicine manufacturing site where the tissue is corrected, expanded and prepared as final sheets to be implanted. Afterward, the patient undergoes to the second intervention when the grafts containing genetically corrected cultured keratinocytes (Hologene-5) are implanted into the selected area under local or general anaesthesia. The treated area is then immobilized for some days after this surgery. Antibiotics and anti-inflammatory drugs may be administered (if necessary) to prevent infections and to minimise swelling. The follow-up after implantation is 12 months. The treatment can be repeated. The end of the trial is defined as the last visit of the last patient after the last treatment.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
2
Implantation of autologous cultured grafts containing genetically modified stem cells for restoration of functional skin on pre-selected areas
Hopital Necker-Enfants Malades
Paris, France
Struttura Complessa di Dermatologia Azienda Ospedaliero Universitaria Policlinico di Modena
Modena, Italy
Re-epithelialization
Re-epithelialization in absence of blisters in at least 50% of the transplanted area measured by the Investigator
Time frame: 12 months
Protein residual expression
Protein residual expression resulting in 'Yes' or 'Partial' measured by Immunofluorescence
Time frame: 12 months
Expression of transgenic mRNA
Expression of transgenic mRNA resulting in 'Yes' or 'Partial' measured by In situ hybridization
Time frame: 12 months
Hemidesmosomes presence
Presence of hemidesmosomes measured by electron microscopy
Time frame: 12 months
Skin stability
Negativity or positivity at the stripping test
Time frame: 12 months
Patient Reported Outcome
Chnage in Patient Reported Outcome score measured by 5-points Likert scale, where: 1=Definitely Worsened, 2=Slightly Worsened, 3=Unchanged, 4=Slightly Improved, 5=Definitely Improved
Time frame: 12 months
Re-epithelialization by Independent Assessor
% of re-epithelialization assessed by the Independent Assessor
Time frame: 12 months
Quality of Life improvement
Change in EBDASI (Epidermolysis Bullosa Disease Activity and Scarring Index) skin section score, where Best score=0 and Worse score=120 for Activity and Best score=0 and Worse score=84 for Damage
Time frame: 12 months
Treatment-emergent adverse events
Number and % of treatment-emergent adverse events
Time frame: 12 months
Serious adverse events
Number and % of serious adverse events
Time frame: 12 months
Adverse events of special interest
Number and % of adverse events of special interest
Time frame: 12 months
Adverse drug reactions
Number and % of adverse drug reactions
Time frame: 12 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.