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Grégoire C, Layios N, Lambermont B, Lechanteur C, Briquet A, Bettonville V, Baudoux E, Thys M, Dardenne N, Misset B, Beguin Y. Bone Marrow-Derived Mesenchymal Stromal Cell Therapy in Severe COVID-19: Preliminary Results of a Phase I/II Clinical Trial. Front Immunol 2022; 13:932360. [PMID: 35860245 PMCID: PMC9291273 DOI: 10.3389/fimmu.2022.932360] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 12/15/2022] Open
Abstract
BackgroundTreatment of acute respiratory distress syndrome (ARDS) associated with COronaVIrus Disease-2019 (COVID-19) currently relies on dexamethasone and supportive mechanical ventilation, and remains associated with high mortality. Given their ability to limit inflammation, induce immune cells into a regulatory phenotype and stimulate tissue repair, mesenchymal stromal cells (MSCs) represent a promising therapy for severe and critical COVID-19 disease, which is associated with an uncontrolled immune-mediated inflammatory response.MethodsIn this phase I-II trial, we aimed to evaluate the safety and efficacy of 3 intravenous infusions of bone marrow (BM)-derived MSCs at 3-day intervals in patients with severe COVID-19. All patients also received dexamethasone and standard supportive therapy. Between June 2020 and September 2021, 8 intensive care unit patients requiring supplemental oxygen (high-flow nasal oxygen in 7 patients, invasive mechanical ventilation in 1 patient) were treated with BM-MSCs. We retrospectively compared the outcomes of these MSC-treated patients with those of 24 matched control patients. Groups were compared by paired statistical tests.ResultsMSC infusions were well tolerated, and no adverse effect related to MSC infusions were reported (one patient had an ischemic stroke related to aortic endocarditis). Overall, 3 patients required invasive mechanical ventilation, including one who required extracorporeal membrane oxygenation, but all patients ultimately had a favorable outcome. Survival was significantly higher in the MSC group, both at 28 and 60 days (100% vs 79.2%, p = 0.025 and 100% vs 70.8%, p = 0.0082, respectively), while no significant difference was observed in the need for mechanical ventilation nor in the number of invasive ventilation-free days, high flow nasal oxygenation-free days, oxygen support-free days and ICU-free days. MSC-treated patients also had a significantly lower day-7 D-dimer value compared to control patients (median 821.0 µg/L [IQR 362.0-1305.0] vs 3553 µg/L [IQR 1155.0-6433.5], p = 0.0085).ConclusionsBM-MSC therapy is safe and shows very promising efficacy in severe COVID-19, with a higher survival in our MSC cohort compared to matched control patients. These observations need to be confirmed in a randomized controlled trial designed to demonstrate the efficacy of BM-MSCs in COVID-19 ARDS.Clinical Trial Registration(www.ClinicalTrials.gov), identifier NCT04445454
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Affiliation(s)
- Céline Grégoire
- Department of Clinical Hematology, University Hospital Center of Liège, Liège, Belgium
- Hematology Research Unit, Groupe Interdisciplinaire de Génoprotéomique Appliquée - Infection, Immunité & Inflammation (GIGA-I3), Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA) Institute, University of Liège, Liège, Belgium
- *Correspondence: Céline Grégoire, ; Yves Beguin,
| | - Nathalie Layios
- Department of Intensive Care, University Hospital Center of Liège, Liège, Belgium
- Laboratory of Cardiology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA) Institute, University of Liège, Liège, Belgium
| | - Bernard Lambermont
- Department of Intensive Care, University Hospital Center of Liège, Liège, Belgium
- Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA)-In silico Medicine, University of Liège, Liège, Belgium
| | - Chantal Lechanteur
- Laboratory of Cell and Gene Therapy, University Hospital Center of Liège and University of Liège, Liège, Belgium
| | - Alexandra Briquet
- Laboratory of Cell and Gene Therapy, University Hospital Center of Liège and University of Liège, Liège, Belgium
| | - Virginie Bettonville
- Laboratory of Cell and Gene Therapy, University Hospital Center of Liège and University of Liège, Liège, Belgium
| | - Etienne Baudoux
- Laboratory of Cell and Gene Therapy, University Hospital Center of Liège and University of Liège, Liège, Belgium
| | - Marie Thys
- Department of Medico-Economic Information, University Hospital Center of Liège, Liège, Belgium
| | - Nadia Dardenne
- University Hospital Center of Biostatistics, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Benoît Misset
- Department of Intensive Care, University Hospital Center of Liège, Liège, Belgium
| | - Yves Beguin
- Department of Clinical Hematology, University Hospital Center of Liège, Liège, Belgium
- Hematology Research Unit, Groupe Interdisciplinaire de Génoprotéomique Appliquée - Infection, Immunité & Inflammation (GIGA-I3), Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA) Institute, University of Liège, Liège, Belgium
- Laboratory of Cell and Gene Therapy, University Hospital Center of Liège and University of Liège, Liège, Belgium
- *Correspondence: Céline Grégoire, ; Yves Beguin,
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Grégoire C, Servais S, Willems E, Baudoux E, Lechanteur C, Briquet A, Bettonville V, Detry O, Erpicum P, Jouret F, Louis E, Baron F, Beguin Y. [Cellular immunotherapy at the University Hospital of Liege : advances, challenges and prospects]. Rev Med Liege 2022; 77:206-211. [PMID: 35389003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cellular immunotherapy consists in using the cells of the immune system as a therapeutic weapon. In this constantly evolving field, the therapeutic strategies developed at the University Hospital of Liege are hematopoietic stem cell transplantation, mesenchymal stromal cells and targeted therapy with CAR-T cells (Chimeric Antigen Receptor T cells). The first two modalities represent a form of non-targeted cell therapy that has been developed over the past decades. While hematopoietic stem cell transplantation is established as the reference treatment for many hematological diseases, mesenchymal stromal cells are still under investigation in various pathologies (notably Crohn's disease, organ transplantation, COVID-19 and pulmonary fibrosis). By contrast, CAR-T cells represent a recently developed and extremely promising targeted immunotherapy. This therapeutic approach has already revolutionized the treatment of B-cell lymphopathies, and has the potential to do the same for many other diseases in the near future.
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Affiliation(s)
- C Grégoire
- Service d'Hématologie clinique, CHU Liège, Belgique
- Laboratoire d'Hématologie, GIGA-I3, ULiège, Belgique
| | - S Servais
- Service d'Hématologie clinique, CHU Liège, Belgique
- Laboratoire d'Hématologie, GIGA-I3, ULiège, Belgique
| | - E Willems
- Service d'Hématologie clinique, CHU Liège, Belgique
| | - E Baudoux
- Laboratoire de Thérapie Cellulaire et Génique (LTCG), CHU Liège, Belgique
| | - C Lechanteur
- Laboratoire de Thérapie Cellulaire et Génique (LTCG), CHU Liège, Belgique
| | - A Briquet
- Laboratoire de Thérapie Cellulaire et Génique (LTCG), CHU Liège, Belgique
| | - V Bettonville
- Laboratoire de Thérapie Cellulaire et Génique (LTCG), CHU Liège, Belgique
| | - O Detry
- Service de Chirurgie Abdominale et Transplantation, CHU Liège, Belgique
| | - P Erpicum
- Service de Néphrologie, Dialyse et Transplantation Rénale, CHU Liège, Belgique
- Laboratoire de Recherche Translationnelle en Néphrologie, GIGA-Cardiovascular Sciences, ULiège, Belgique
| | - F Jouret
- Service de Néphrologie, Dialyse et Transplantation Rénale, CHU Liège, Belgique
- Laboratoire de Recherche Translationnelle en Néphrologie, GIGA-Cardiovascular Sciences, ULiège, Belgique
| | - E Louis
- Service de Gastro-Entérologie, Hépatologie et Oncologie digestive, CHU Liège, Belgique
- Laboratoire de Gastroentérologie Translationnelle, GIGA-I3, ULiège, Belgique
| | - F Baron
- Service d'Hématologie clinique, CHU Liège, Belgique
- Laboratoire d'Hématologie, GIGA-I3, ULiège, Belgique
| | - Y Beguin
- Service d'Hématologie clinique, CHU Liège, Belgique
- Laboratoire d'Hématologie, GIGA-I3, ULiège, Belgique
- Laboratoire de Thérapie Cellulaire et Génique (LTCG), CHU Liège, Belgique
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Lechanteur C, Briquet A, Bettonville V, Baudoux E, Beguin Y. MSC Manufacturing for Academic Clinical Trials: From a Clinical-Grade to a Full GMP-Compliant Process. Cells 2021; 10:1320. [PMID: 34073206 PMCID: PMC8227789 DOI: 10.3390/cells10061320] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
Following European regulation 1394/2007, mesenchymal stromal cell (MSCs) have become an advanced therapy medicinal product (ATMP) that must be produced following the good manufacturing practice (GMP) standards. We describe the upgrade of our existing clinical-grade MSC manufacturing process to obtain GMP certification. Staff organization, premises/equipment qualification and monitoring, raw materials management, starting materials, technical manufacturing processes, quality controls, and the release, thawing and infusion were substantially reorganized. Numerous studies have been carried out to validate cultures and demonstrate the short-term stability of fresh or thawed products, as well their stability during long-term storage. Detailed results of media simulation tests, validation runs and early MSC batches are presented. We also report the validation of a new variant of the process aiming to prepare fresh MSCs for the treatment of specific lesions of Crohn's disease by local injection. In conclusion, we have successfully ensured the adaptation of our clinical-grade MSC production process to the GMP requirements. The GMP manufacturing of MSC products is feasible in the academic setting for a limited number of batches with a significant cost increase, but moving to large-scale production necessary for phase III trials would require the involvement of industrial partners.
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Affiliation(s)
- Chantal Lechanteur
- Laboratory of Cell and Gene Therapy, Department of Hematology, CHU of Liège, 4000 Liège, Belgium; (A.B.); (V.B.); (E.B.); (Y.B.)
| | - Alexandra Briquet
- Laboratory of Cell and Gene Therapy, Department of Hematology, CHU of Liège, 4000 Liège, Belgium; (A.B.); (V.B.); (E.B.); (Y.B.)
| | - Virginie Bettonville
- Laboratory of Cell and Gene Therapy, Department of Hematology, CHU of Liège, 4000 Liège, Belgium; (A.B.); (V.B.); (E.B.); (Y.B.)
| | - Etienne Baudoux
- Laboratory of Cell and Gene Therapy, Department of Hematology, CHU of Liège, 4000 Liège, Belgium; (A.B.); (V.B.); (E.B.); (Y.B.)
| | - Yves Beguin
- Laboratory of Cell and Gene Therapy, Department of Hematology, CHU of Liège, 4000 Liège, Belgium; (A.B.); (V.B.); (E.B.); (Y.B.)
- Division of Hematology, Department of Medicine, CHU of Liège, University of Liège, 4000 Liège, Belgium
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Bettonville V, Nicol JTJ, Furst T, Thelen N, Piel G, Thiry M, Fillet M, Jacobs N, Servais AC. Quantitation and biospecific identification of virus-like particles of human papillomavirus by capillary electrophoresis. Talanta 2017; 175:325-330. [PMID: 28841998 DOI: 10.1016/j.talanta.2017.07.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/11/2017] [Accepted: 07/14/2017] [Indexed: 01/28/2023]
Abstract
Capillary electrophoresis (CE) for HPV-VLP quantitation is a very interesting alternative technique compared to those currently used in viral analysis, such as SDS-PAGE, Western blot or protein assay that are destructive and semi-quantitative or non specific. In this study, the quantitative performance of the CE method was evaluated. A main issue in virus quantitation is the absence of reference material. Therefore, the concentration of a HPV16-VLP sample produced in the laboratory was determined using ELISA with Gardasil®, after adjuvant dissolution, as reference material and conformational H16.V5 antibody. HPV16-VLP concentration was found to influence particles electrophoretic mobility until a plateau was reached for concentrations ≤ 50µgml-1. As zeta potential is directly proportional to the electrophoretic mobility, it was measured at different HPV-VLP concentrations and the results were in complete accordance with the measured electrophoretic mobilities. The concentration dependence of the electrophoretic mobility could be explained by an overlap of the electrical double layers of adjacent particles. The HPV16-VLP peak identity was demonstrated unequivocally by the study of HPV16-VLP/H16.V5 antibody complex formation using affinity CE. Finally, the CE method was successfully validated following the ICH Q2R1 guidelines. To overcome the sample heterogeneity issue, a well-designed sample preparation was used. Considering sample complexity, validation results were satisfactory with maximum repeatability and intermediate precision RSD of 12.2% and a maximum relative bias of 1.4%.
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Affiliation(s)
- Virginie Bettonville
- Laboratory for the Analysis of Medicines (LAM), Dept. of Pharmaceutical Sciences, CIRM, University of Liège, Liège, Belgium
| | - Jérôme T J Nicol
- Cellular and Molecular Immunology, GIGA-Research University of Liège, Liège, Belgium
| | - Tania Furst
- Laboratory of Pharmaceutical Technology and Biopharmacy, Dept. of Pharmaceutical Sciences, CIRM, University of Liège, Liège, Belgium
| | - Nicolas Thelen
- Cellular and Tissular Biology, GIGA-Neurosciences, University of Liège, Liège, Belgium
| | - Géraldine Piel
- Laboratory of Pharmaceutical Technology and Biopharmacy, Dept. of Pharmaceutical Sciences, CIRM, University of Liège, Liège, Belgium
| | - Marc Thiry
- Cellular and Tissular Biology, GIGA-Neurosciences, University of Liège, Liège, Belgium
| | - Marianne Fillet
- Laboratory for the Analysis of Medicines (LAM), Dept. of Pharmaceutical Sciences, CIRM, University of Liège, Liège, Belgium
| | - Nathalie Jacobs
- Cellular and Molecular Immunology, GIGA-Research University of Liège, Liège, Belgium
| | - Anne-Catherine Servais
- Laboratory for the Analysis of Medicines (LAM), Dept. of Pharmaceutical Sciences, CIRM, University of Liège, Liège, Belgium.
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Furst T, Bettonville V, Farcas E, Frere A, Lechanteur A, Evrard B, Fillet M, Piel G, Servais AC. Capillary electrophoresis method to determine siRNA complexation with cationic liposomes. Electrophoresis 2016; 37:2685-2691. [PMID: 27396918 DOI: 10.1002/elps.201600249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 06/27/2016] [Accepted: 07/04/2016] [Indexed: 11/08/2022]
Abstract
Small interfering RNA (siRNA) inducing gene silencing has great potential to treat many human diseases. To ensure effective siRNA delivery, it must be complexed with an appropriate vector, generally nanoparticles. The nanoparticulate complex requires an optimal physiochemical characterization and the complexation efficiency has to be precisely determined. The methods usually used to measure complexation in gel electrophoresis and RiboGreen® fluorescence-based assay. However, those approaches are not automated and present some drawbacks such as the low throughput and the use of carcinogenic reagents. The aim of this study is to develop a new simple and fast method to accurately quantify the complexation efficiency. In this study, capillary electrophoresis (CE) was used to determine the siRNA complexation with cationic liposomes. The short-end injection mode applied enabled siRNA detection in less than 5 min. Moreover, the CE technique offers many advantages compared with the other classical methods. It is automated, does not require sample preparation and expensive reagents. Moreover, no mutagenic risk is associated with the CE approach since no carcinogenic product is used. Finally, this methodology can also be extended for the characterization of other types of nanoparticles encapsulating siRNA, such as cationic polymeric nanoparticles.
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Affiliation(s)
- Tania Furst
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium.
| | - Virginie Bettonville
- Laboratory for the Analysis of Medicines, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
| | - Elena Farcas
- Laboratory for the Analysis of Medicines, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
| | - Antoine Frere
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
| | - Anna Lechanteur
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
| | - Brigitte Evrard
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
| | - Marianne Fillet
- Laboratory for the Analysis of Medicines, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
| | - Géraldine Piel
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
| | - Anne-Catherine Servais
- Laboratory for the Analysis of Medicines, Department of Pharmaceutical Sciences - CIRM, University of Liege, Liege, Belgium
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Bettonville V, Nicol JTJ, Thelen N, Thiry M, Fillet M, Jacobs N, Servais AC. Study of intact virus-like particles of human papillomavirus by capillary electrophoresis. Electrophoresis 2016; 37:579-86. [DOI: 10.1002/elps.201500431] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 11/13/2015] [Accepted: 11/27/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Virginie Bettonville
- Laboratory for the Analysis of Medicines (LAM), Department of Pharmaceutical Sciences, CIRM; University of Liège; Liège Belgium
| | - Jérôme T. J. Nicol
- Cellular and Molecular Immunology; GIGA-Research University of Liège; Liège Belgium
| | - Nicolas Thelen
- Cellular and Tissular Biology, GIGA-Neurosciences; University of Liège; Liège Belgium
| | - Marc Thiry
- Cellular and Tissular Biology, GIGA-Neurosciences; University of Liège; Liège Belgium
| | - Marianne Fillet
- Laboratory for the Analysis of Medicines (LAM), Department of Pharmaceutical Sciences, CIRM; University of Liège; Liège Belgium
| | - Nathalie Jacobs
- Cellular and Molecular Immunology; GIGA-Research University of Liège; Liège Belgium
| | - Anne-Catherine Servais
- Laboratory for the Analysis of Medicines (LAM), Department of Pharmaceutical Sciences, CIRM; University of Liège; Liège Belgium
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