CD81 通过阻断 CD274/PD-L1 的选择性自噬降解驱动放射抵抗性胶质母细胞瘤的免疫逃逸
CD81 drives immune evasion in radioresistant glioblastoma by blocking selective autophagic degradation of CD274/PD-L1.
我们的工作确立了CD81作为连接放射抵抗与免疫逃逸的关键桥梁,其通过维持GBM中CD274的丰度发挥作用,并突显CD81作为优化放射免疫治疗的有前景的治疗靶点。
英文原题:Human Umbilical Cord Mesenchymal Stem Cell-derived Small Extracellular Vesicles for the Treatment of Dry Eye Disease
这是一项早期 I 期注册临床试验,评估人源脐带间充质干细胞治疗急性淋巴细胞白血病的安全性、可行性及初步疗效。当前状态:招募中。计划入组 20 例。试验地点:中国 · 厦门(共 1 个中心,其中中国 1 个)。登记号:NCT07623382。
不限性别 · ≥ 18 Years
纳入标准: • 自愿参加并签署知情同意书,愿意遵守方案规定的治疗安排并按时随访。 • 年龄≥18岁,不限性别。 • 筛查访视(访视1,V1)时双眼最佳矫正视力(BCVA)≥0.1。 • 筛查前有双眼干眼病史,且至少有一项主观症状:眼干、异物感、灼热感、眼疲劳、不适、发红或视力波动。 • 筛查访视时满足以下任一项:角膜荧光素染色阳性、泪膜破裂时间(TBUT)<10秒且眼表疾病指数(OSDI)≥13;或角膜荧光素染色阴性、TBUT<5秒且OSDI≥13。 排除标准: • 当前有眼部疱疹或其他眼部感染/炎症,或筛查前30天内有眼部疱疹或其他眼部感染史。 • 存在眼部疾病,研究者认为可能增加风险或干扰结局,包括眼睑缘结构异常(外翻、内翻、松弛等)、严重结膜松弛、Salzmann结节性角膜变性、结膜杯状细胞受损(如维生素A缺乏)、进展性翼状胬肉、湿性年龄相关性黄斑变性(wAMD)、青光眼、糖尿病视网膜病变、视网膜静脉阻塞等。 • 存在继发性眼部瘢痕,研究者认为可能影响依从性或结局评价,如放射性瘢痕、化学烧伤、Stevens-Johnson综合征、瘢痕性类天疱疮等。 • 患有继发性干燥综合征或其他自身免疫病(如类风湿关节炎、系统性红斑狼疮等),除非同时满足:未因该病使用类固醇、免疫调节剂或免疫抑制剂;研究者判定该病不会影响结果。 • 有器官或骨髓移植史。 • 筛查前30天内佩戴过隐形眼镜。 • 筛查前30天内接受过干眼物理治疗,包括眼睑清洁、睑板腺挤压、热敷、熏蒸或双眼强脉冲光(IPL)治疗。 • 给药前30天内口服阿司匹林或含阿司匹林药物、使用非甾体抗炎药(局部眼用或全身用),或使用已知可引起眼干的药物(如抗胆碱药、SSRI等);若给药前已稳定使用至少30天且研究期间预计不调整剂量者除外。 • 给药前在规定期限内使用以下药物:14天内使用抗组胺药(眼用或全身用)或任何局部眼用药;14天内使用人工泪液;30天内使用类固醇或肥大细胞稳定剂(眼用或全身用);30天内使用伐尼克兰或地夸磷索;6周内局部眼用环孢素或他克莫司。 • 筛查前12周内植入泪点塞或有泪点栓塞术史。 • 筛查前3个月内使用抗青光眼药物;做过非激光青光眼手术;或筛查前6个月内接受过青光眼激光手术。 • 筛查前6个月内接受Nd:YAG激光后囊切开术,或前12个月内接受角膜屈光手术(如LASIK)。 • 已知对荧光素过敏、有多种药物过敏或严重过敏性疾病。 • 其他控制不佳的临床疾病,如严重慢性感染、严重心肺疾病、未控制的高血压(接受降压治疗后收缩压仍≥150 mmHg或舒张压仍≥100 mmHg)、未控制糖尿病、恶性肿瘤等。 • 妊娠试验阳性或正在哺乳的女性;有生育能力女性或伴侣有生育能力的男性不愿在研究期间及研究药物末次给药后1个月内避孕。 • 筛查前30天内参加过其他研究药物或器械临床试验。 • 研究者判定不符合入组条件的其他情况(如抑郁症等)。
Inclusion Criteria: * Subjects who voluntarily participate and sign the informed consent form, are willing to comply with the treatment schedule specified in the study protocol, and attend follow-up visits on time. * Aged ≥ 18 years, with no gender restriction. * Best-corrected visual acuity (BCVA) of both eyes (OU) ≥ 0.1 at the Screening Visit (Visit 1, V1). * History of dry eye disease in both eyes prior to the Screening Visit (Visit 1, V1), with at least one of the following subjective symptoms: ocular dryness, foreign body sensation, burning sensation, eye fatigue, discomfort, redness, or fluctuating visual acuity. * Meeting one of the following criteria at the Screening Visit (Visit 1, V1): i. Positive corneal fluorescein staining, TBUT \< 10 s, and OSDI score ≥ 13; ii. Negative corneal fluorescein staining, TBUT \< 5 s, and OSDI score ≥ 13 Exclusion Criteria: * Subjects with current ocular herpes or any other ocular infection or inflammation, or a history of ocular herpes or any other ocular infection within 30 days prior to screening. * Subjects with ocular diseases including structural abnormalities of the eyelid margin (ectropion, entropion, eyelid laxity, etc.), severe conjunctivochalasis, Salzmann nodular corneal degeneration, damaged conjunctival goblet cells (e.g., vitamin A deficiency), progressive pterygium, wet age-related macular degeneration (wAMD), glaucoma, diabetic retinopathy, retinal vein occlusion, etc., which, in the investigator's opinion, may increase subject risk or interfere with study outcomes. * Subjects with secondary ocular scarring that, in the investigator's assessment, may affect subject compliance or outcome evaluation (e.g., radiation scars, chemical burns, Stevens-Johnson syndrome, cicatricial pemphigoid, etc.). * Subjects with secondary Sjögren's syndrome or other autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus, etc.), unless the subject meets all of the following conditions: 1. Not receiving steroids, immunomodulatory, or immunosuppressive agents for the disease; 2. The investigator determines that the medical condition will not impact study results. * Subjects with a history of organ or bone marrow transplantation. * Subjects who wore contact lenses within 30 days prior to screening. * Subjects who received physical therapy for dry eye within 30 days prior to screening, including eyelid scrubbing, meibomian gland expression, warm compresses, fuming, or IPL laser therapy for bilateral dry eye. * Subjects who received oral aspirin or aspirin-containing medications, or used NSAIDs (topical ocular or systemic), or drugs known to induce ocular dryness (e.g., anticholinergics, SSRIs, etc.) within 30 days before dosing, unless the subject has been on a stable dose of such medication for at least 30 days before the baseline visit, with no expected changes during the study. * Subjects who used the following medications within the specified periods before dosing: 1. Antihistamines (ocular or systemic) or any topical ophthalmic medications within 14 days before dosing; 2. Artificial tears within 14 days before dosing; 3. Steroids or mast cell stabilizers (ocular or systemic) within 30 days before dosing; 4. Varenicline or diquafosol within 30 days before dosing; 5. Topical ocular cyclosporine or tacrolimus within 6 weeks before dosing. * Subjects with punctal plugs implantation or a history of punctal cautery within 12 weeks prior to screening. * Subjects who used antiglaucoma medications within 3 months prior to screening, had non-laser glaucoma surgery, or underwent glaucoma laser surgery within 6 months prior to the screening visit. * Subjects who underwent Nd:YAG laser capsulotomy within 6 months prior to screening, or corneal refractive surgery (e.g., LASIK) within 12 months prior to screening. * Subjects with known allergy to fluorescein, multiple drug allergies, or severe allergic diseases. * Subjects with other poorly controlled clinical conditions, such as severe chronic infection, severe cardiopulmonary disease, uncontrolled hypertension (defined as systolic blood pressure ≥ 150 mmHg or diastolic blood pressure ≥ 100 mmHg despite antihypertensive treatment), uncontrolled diabetes mellitus, malignant tumors, etc. * Female subjects with a positive pregnancy test or lactating subjects; female subjects of childbearing potential or male subjects whose partners are of childbearing potential who are unwilling to use contraception during the study and for 1 month after the last dose of study medication. * Subjects who participated in any other clinical trial of investigational drugs or devices within 30 days prior to screening. * Any other conditions deemed by the investigator to make the subject ineligible for enrollment (e.g., depression, etc.).
以上为辅助阅读译文。是否适合入组须由主治医生判断,最终以登记平台与研究者确认为准。
主要终点:Total Corneal Fluorescein Staining Score (TCSS) · To Evaluate Changes in the Total Corneal Fluorescein Staining Score (TCSS) in Subjects · 4 Weeks;Tear Film Break-up Time (TBUT) · To Observe Changes in Tear Film Break-up Time (TBUT) in Subjects · 4 Weeks
本临床试验拟初步评估人脐带间充质干细胞小细胞外囊泡滴眼液治疗干眼病患者的安全性和疗效。研究期间每次滴眼1滴,每日4次,治疗4周;治疗期间每周随访并检查。治疗结束后每2周随访一次,共2次;之后进入长期随访,在第3个月和第6个月评估长期安全性和疗效。受试者须记录用药情况及可能的不良反应。
This clinical trial aims to preliminarily evaluate the safety and efficacy of human umbilical cord mesenchymal stem cell small extracellular vesicle eye drops in patients with dry eye disease. 1. Human mesenchymal stem cell small extracellular vesicle eye drops: Administer one drop each time, 4 times daily, for a treatment duration of 4 weeks. 2. During treatment, subjects will be followed up and undergo examinations and related tests weekly. 3. After completion of treatment, follow-up visits will be conducted every 2 weeks for a total of 2 visits. 4. Subsequently, subjects will enter a long-term follow-up period, with follow-up assessments at 3 months and 6 months to observe longer-term safety and efficacy. 5. Subjects shall record medication usage and any possible adverse reactions.
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