This is a phase I/II, randomized, double-blind, placebo-controlled clinical trial thatwill evaluate the safety and potential efficacy of therapy with extracellular vesicles(EVs) obtained from mesenchymal stromal cells (MSCs), patients with moderate to severeacute respiratory distress syndrome due to COVID-19 or other etiology. Participants willbe allocated to receive EVs obtained from MSCs or placebo (equal volume of Plasma-LyteA). Blinding will cover the participants, the multidisciplinary intensive care team andthe investigators.
The studied population will consist of 15 patients diagnosed with acute respiratory
failure syndrome admitted to the intensive care unit of Hospital São Rafael. This
research aims to assess the safety and potential effectiveness of intravenous therapy
using extracellular vesicles derived from mesenchymal cells in patients with moderate to
severe acute respiratory distress syndrome. The treatment group will receive intravenous
administration of extracellular vesicles obtained from mesenchymal cells, while the
control group will receive a placebo.
EV group: will consist of 10 participants who will receive two infusions of 25 mL of the
investigational product (Plasma-Lyte A solution containing EVs obtained from MSCs),
intravenously, at intervals of 48 h.
Placebo group: will consist of 5 participants who will receive an equal volume of
Plasma-Lyte A, intravenously, following the same schedule as the IV group: two infusions
with an interval of 48 hours.
Biological: intravenous treatment with EVs
intravenous treatment with extracellular vesicles
Biological: intravenous treatment with placebo solution
intravenous treatment with placebo solution (without extracellular vesicles)
Inclusion Criteria:
- Age >= 18 years old;
- Chest CT radiological image with ground-glass opacities or chest X-ray with -
bilateral infiltrates characteristic of pulmonary edema;
- In invasive mechanical ventilation with PEEP 5 cm H2O and PaO2/FiO2<250mmHg;
- Respiratory failure not explained by cardiac causes or fluid overload.
Exclusion Criteria:
- Unable to provide informed consent;
- Pregnancy or breastfeeding;
- Patients with active malignancy who have received chemotherapy in the last 2 years;
- Life expectancy of less than 6 months or in exclusive palliative care;
- Severe liver failure, with a Child-Pugh score > 12;
- Previous renal failure: patients already undergoing dialysis or patients with GFR <
30ml/min/1.73 m2
- Clinical or radiological suspicion of tuberculosis;
- Chronic respiratory failure;
- Use of ECMO;
- Moribund (high probability of death within the next 48 hours).
Hospital São Rafael
Salvador, Bahia, Brazil
Investigator: Carolina Nonaka, phD
Contact: +55 (71) 3281-6970
carolina.nonaka@hsr.com.br
Carolina Nonaka, phD
+55 (71) 3281-6970
carolina.nonaka@hsr.com.br
Ingrid Barbosa, B.Sc
+551121098855
nape@idor.org