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      Allogeneic Human Mesenchymal Stem Cells in Patients With Idiopathic Pulmonary Fibrosis via Intravenous Delivery (AETHER) : A Phase I Safety Clinical Trial

      research-article
      , MD a , b , c , , , PhD a , , MD d , , MA a , , MD b , , RN, BSN a , e , , MD a , , PhD a , e , , MBA a , e , , PhD f , , MD g , , MD h , , MD, PhD a , , MD, MPH i , , PhD j , , MD a , e
      Chest
      American College of Chest Physicians
      bone marrow, idiopathic pulmonary fibrosis, mesenchymal stem cells, safety trial, 6-MWT, 6-min walk test, Dlco, diffusing capacity of the lungs for carbon monoxide, FDA, Food and Drug Administration, hMSCs, human mesenchymal stem cells, HRCT, high-resolution CT, IPF, idiopathic pulmonary fibrosis, MedDRA, Medical Dictionary for Regulatory Activities, MSCs, mesenchymal stem cells

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          Abstract

          Background

          Despite Food and Drug Administration approval of 2 new drugs for idiopathic pulmonary fibrosis (IPF), curative therapies remain elusive and mortality remains high. Preclinical and clinical data support the safety of human mesenchymal stem cells as a potential novel therapy for this fatal condition. The Allogeneic Human Cells (hMSC) in patients with Idiopathic Pulmonary Fibrosis via Intravenous Delivery (AETHER) trial was the first study designed to evaluate the safety of a single infusion of bone marrow–derived mesenchymal stem cells in patients with idiopathic pulmonary fibrosis.

          Methods

          Nine patients with mild to moderate IPF were sequentially assigned to 1 of 3 cohorts and dosed with a single IV infusion of 20, 100, or 200 × 10 6 human bone marrow–derived mesenchymal stem cells per infusion from young, unrelated, men. All baseline patient data were reviewed by a multidisciplinary study team to ensure accurate diagnosis. The primary end point was the incidence (at week 4 postinfusion) of treatment-emergent serious adverse events, defined as the composite of death, nonfatal pulmonary embolism, stroke, hospitalization for worsening dyspnea, and clinically significant laboratory test abnormalities. Safety was assessed until week 60 and additionally 28 days thereafter. Secondary efficacy end points were exploratory and measured disease progression.

          Results

          No treatment-emergent serious adverse events were reported. Two nontreatment-related deaths occurred because of progression of IPF (disease worsening and/or acute exacerbation). By 60 weeks postinfusion, there was a 3.0% mean decline in % predicted FVC and 5.4% mean decline in % predicted diffusing capacity of the lungs for carbon monoxide.

          Conclusions

          Data from this trial support the safety of a single infusion of human mesenchymal stem cells in patients with mild-moderate IPF.

          Trial Registry

          ClinicalTrials.gov; No.: NCT02013700; URL: www.clinicaltrials.gov.

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          Author and article information

          Contributors
          Journal
          Chest
          Chest
          Chest
          American College of Chest Physicians
          0012-3692
          1931-3543
          May 2017
          24 November 2016
          : 151
          : 5
          : 971-981
          Affiliations
          [a ]Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, FL
          [b ]Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL
          [c ]Department of Pediatrics, University of Miami Leonard M. Miller School of Medicine, Miami, FL
          [d ]Department of Medicine, Florida International University Herbert Wertheim College of Medicine, Miami, FL
          [e ]University of Miami Interdisciplinary Stem Cell Institute, Miami, FL
          [f ]Department of Cardiology, University of Louisville, Louisville, KY
          [g ]Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
          [h ]Bristol-Myers Squibb, Lawrenceville, NJ
          [i ]Department of Medicine, University of Vermont College of Medicine, Burlington, VT
          [j ]The EMMES Corporation, Rockville, MD
          Author notes
          [] CORRESPONDENCE TO: Marilyn Glassberg, MD, Department of Medicine, Interstitial Lung Disease Program, University of Miami Miller School of Medicine. 1600 NW 10th Ave RMSB 7056 (D-60), Miami, FL 33136 mglassbe@ 123456med.miami.edu
          Article
          PMC6026255 PMC6026255 6026255 S0012-3692(16)62462-5
          10.1016/j.chest.2016.10.061
          6026255
          27890713
          378f7b0e-d12d-4435-a8be-553ccf11221b
          © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
          History
          Categories
          Diffuse Lung Disease

          MSCs, mesenchymal stem cells,bone marrow,idiopathic pulmonary fibrosis,mesenchymal stem cells,safety trial,6-MWT, 6-min walk test,Dlco, diffusing capacity of the lungs for carbon monoxide,FDA, Food and Drug Administration,hMSCs, human mesenchymal stem cells,HRCT, high-resolution CT,IPF, idiopathic pulmonary fibrosis,MedDRA, Medical Dictionary for Regulatory Activities

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