ClinicalTrials.gg
RecruitingNCT05189925Updated Nov 9, 2026

NADPH Oxidase Correction in mRNA-transfected Granulocyte-enriched Cells in Chronic Granulomatous Disease (CGD)

A Phase 1 interventional study of gp91 Grans in Chronic Granulomatous Disease and Infection, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Recruiting at 1 site in United States. Open to male participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-11-09.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2022; still recruiting 4 years 3 months later.
Phase
Phase 1
Study type
Interventional
Enrollment
25
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
Male
01

Study summary

Background:

CGD is caused by a gene mutation. For people with CGD, their cells cannot kill germs well, so they can get frequent or life-threatening infections. Researchers want to see if a new procedure can help a person s cells kill germs for a short time. It uses messenger RNA (mRNA) to deliver correct instructions for the gene mutation to the cells.

Objective:

To test a procedure in which mRNA is added to a person s blood cells.

Eligibility:

Males aged 18-75 with CGD with a mutation in the gene that makes the protein gp91phox.

Design:

Participants will be screened with:

Medical history

Physical exam

Blood and urine tests

Swab to test for strep throat

Some screening tests will be repeated during the study.

Participants will be admitted to the NIH Clinical Center hospital for at least 7 days. They will have apheresis. For this, a medicine is injected under their skin to prepare their white blood cells for collection. An IV line is placed into an arm vein. Blood goes through the IV line into a machine that divides whole blood into red blood cells, plasma, and white blood cells. The white blood cells are removed, and the rest of the blood is returned to the participant through an IV line in their other arm. The next day, they will get their mRNA-corrected cells via IV. They will be monitored for 3 more days.

After discharge, participants will keep a symptom diary. They will be contacted weekly for one month, and then once a month. They will have a follow-up visit 3 months after the infusion.

Read the detailed description

Study Design:

This is a phase 1, open-label, dose-escalation trial to assess the safety and feasibility of administering CGD-Grans to adult patients with X-linked CGD and to identify the maximum tolerated dose (MTD). Subjects will undergo granulocyte-enriched apheresis to provide cell product for mRNA-correction and then receive 1 administration of study agent. The first subjects enrolled will receive the study agent at the lowest dose, and when a level has been determined to be safe, the dose level will be increased to a second and then third dose level for subsequent subjects.Subjects will be hospitalized for at least 3 days after study agent administration and will return for a final study visit about 3 months after administration. Blood will be collected regularly for safety and research evaluations. The study hypothesis is that it is safe and feasible to administer mRNA-transfected autologous granulocyte-enriched apheresis product to restore protein expression and phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase function in patients with CGD.

Study Agent Description:

The study agent is one administration of autologous CGD mRNA transfected granulocyte-enriched cells, referred to as CGD-Grans. The study agent is derived from apheresis product enriched for granulocytes, which are then transfected with CGD mRNA and administered as an intravenous (IV) infusion. CGD-Grans will be evaluated using the 3+3 modified Fibonacci model at the following 3 escalating dosages:

Dose K: 1 x 10\^6 granulocyte-enriched cells/kg body mass

Dose K+1: 1 x 10\^7 granulocyte-enriched cells/kg body mass

Dose K+2: 1-5 x 10\^8 granulocyte-enriched cells/kg body mass

Each dose will be evaluated in at least 3 subjects. Dose escalation will be managed by a predetermined algorithm depending on the occurrence of drug-related toxicity (DRT). There will be at least 1 week between study agent administration to each subject.

Primary Objectives:

  1. Determine the safety and feasibility of CGD-Grans infusion.
  2. Determine an MTD for administration.

Secondary Objectives:

  1. Assess efficacy of CGD-Grans at restoring NADPH oxidase.
  2. Determine the kinetics of CGD-Grans.

Exploratory Objectives:

  1. Assess for inflammatory responses to CGD-Grans infusion.
  2. Assess for immune responses to protein expressed by the transfected mRNA.
  3. Evaluate in vitro bactericidal activity of CGD-Grans.

Primary Endpoints:

  1. Determine safety and feasibility by:

    Safety: Frequency of grade 3 or greater adverse events (AEs) or serious adverse events (SAEs) related to the study agent.

    Feasibility: Recruitment, implementation, and manufacturing of CGD-Grans for infusions.

  2. MTD determination based on the rate of AEs. MTD is defined as the highest dose level that does not cause the same grade 3 or 4 AEs in 3 or more patients.

Secondary Endpoints:

  1. Determine percent of circulating dihydrorhodamine (DHR) positive granulocytes following study agent infusion.
  2. Serial measurement of circulating DHR+ granulocytes from peripheral blood until day 3 following study agent infusion or disappearance of DHR+ granulocytes.

Exploratory Endpoint:

  1. Assess for increased expression of inflammation-related genes after study agent infusion.
  2. Evaluate for development of antibodies against mRNA-expressed CGDphox.
  3. Perform in vitro bactericidal activity of CGD-Grans.
02

Conditions studied

  • Chronic Granulomatous Disease
  • Infection

Keywords

  • Primary Immune Deficiency
  • systemic infection
  • autologous transfusion
  • Apheresis
03

In context

Granulomatous Disease, Chronic

79 studies on the registry are indexed under Granulomatous Disease, Chronic; 17 are open to participants now.

This study's planned enrollment of 25 is above the median of 12 across 57 interventional studies indexed under Granulomatous Disease, Chronic.

Browse Granulomatous Disease, Chronic studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,446 studies on the registry; 179 are open to participants now.

Of its 405 completed or terminated interventional studies of FDA-regulated products, 302 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Individuals must meet all of the following criteria to be eligible for study participation:

  • Males aged 18 to 75 years
  • CGD confirmed by DHR and deficiency subtype confirmed by protein analysis and/or genetic sequencing
  • Has a physician at home for follow-up care
  • Able to provide
  • For men who engage in activities that can result in pregnancy, agree to use when engaging in sexual activities that can result in pregnancy. Contraception must be used from screening through 3 months after the CGD-Grans infusion. Acceptable methods of contraception include the following:

    • Hormonal contraception
    • Male or female condom

Exclusion criteria

EXCLUSION CRITERIA:

Individuals meeting any of the following criteria will be excluded from study participation:

  • Clinically unstable due to moderate to severe acute systemic infections as defined by persistent resting tachypnea, tachycardia, or hypoxia of >20% from baseline and hypotension.
  • Current or history of stage 4 chronic kidney disease or estimated [eGFR] \<30 mL/min/1.73 m\^2 within 90 days of baseline.
  • Unstable diabetes mellitus with >7.0% and fasting serum glucose >200 mg/dL at screening.
  • Current or history of heart failure stage D as defined by the American College of Cardiology Foundation/American Heart Association guidelines.
  • History of arrhythmias that are symptomatic and deemed clinically unsafe for participation by NIH CC Cardiology consultation.
  • Current or history of invasive cancers that require chemotherapy within 5 years of screening.
  • Active , C, or infections at screening.
  • Unstable hypertension requiring addition of new anti-hypertensives within 2 weeks of screening.
  • Impaired renal function that is unstable, with serum creatinine >3.0 mg/dL and rising.
  • Serum transaminases and that are >3 x the .

NOTE: For prospective subjects who, per PI assessment at screening, have abnormal liver function tests, and/or a significant history of liver disease, and/or liver-related complications of CGD, and who otherwise meet eligibility criteria [i.e. those who do NOT meet any of the exclusion set forth herein], a hepatology consult will be required at screening, and participation must be approved in writing by hepatology to the PI.

  • abnormalities indicative of acute myocardial injury, or arrhythmias that presents anesthetic risks, at screening.
  • Anemia with \<8 g/dL (transfusions to correct anemia permitted).
  • Thrombocytopenia ( \<50 x10\^9 cells/L) (platelet transfusions to correct thrombocytopenia permitted).
  • Profound thrombocytopenia (platelet counts \<10,000/microliter) that is not reversible with platelet transfusions.
  • Abnormal /partial thromboplastin time (PT/PTT) values outside the ranges accepted at the NIH CC that are not corrected or that cannot be attributed to presence of Lupus anticoagulant (commonly found in CGD patients).
  • Inherited bleeding disorder that precludes line placement.
  • Severe oxygen-dependent pulmonary disease that increases risks of procedures that may require sedation.
  • History of or current evidence of alcohol or illicit drug abuse or dependence.
  • Participation in a clinical protocol that includes an intervention that, in the opinion of the investigator, may affect the results of the current study.

Subjects will be selected in an equitable manner from the available pool of potentially eligible individuals, without regard to factors such as gender, race, ethnicity, socioeconomic status, etc, except for age and sex.

Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    IV infusion of gp91-Grans at dose K: 1e6 cells/kg

    Adult CGD patients without systemic infection will participate in a dose-escalation trial to identify the most effective yet safe dose of study agent. Subjects enrolled will receive 1 administration of study agent at dose K, and safety of dose will be determined.

    Biological: gp91 Grans

  • Experimental
    IV infusion of gp91-Grans at dose K+1:1e7 cells/kg

    Adult CGD patients without systemic infection will participate in a dose-escalation trial to identify the most effective yet safe dose of study agent. Subjects enrolled will receive 1 administration of study agent at dose K+1, and safety of dose will be determined.

    Biological: gp91 Grans

  • Experimental
    IV infusion of gp91-Grans at dose K+2: 1-5e8 cells/kg

    Adult CGD patients without systemic infection will participate in a dose-escalation trial to identify the most effective yet safe dose of study agent. Subjects enrolled will receive 1 administration of study agent at dose K+2, and safety of dose will be determined.

    Biological: gp91 Grans

Interventions

  • Biologicalgp91 Grans

    Adults with gp91phox-deficient CGD without systemic infection will participate in a dose escalation trial to identify the MTD (the most effective yet safe dose) of gp91 Grans IV infusion.

06

What researchers measure

Primary outcomes

  1. Feasibility: Recruitment, implementation, and manufacturing of gp91-Grans for infusions.

    Determine feasibility of gp91-Grans infusion.

    Time frame: 3 months

  2. MTD determination based on the rate of AEs. MTD is defined as the highest dose level that does not cause the same grade 3 or 4 AEs in 3 or more patients

    Determine an MTD for administration.

    Time frame: 3 months

  3. Safety: Frequency of grade 3 or greater adverse events or serious adverse events related to the study agent

    Determine safety of gp91-Grans infusion.

    Time frame: 3 months

Secondary outcomes

  1. Determine percent of circulating dihydrorhodamine (DHR) positive granulocytes following study agent infusion.

    Assess efficacy of gp91-Grans at restoring NADPH oxidase

    Time frame: 3 months

  2. Serial measurement of circulating DHR+ granulocytes from peripheral blood until day 3 following study agent infusion or disappearance of DHR+ granulocytes.

    Determine the kinetics of gp91-Grans.

    Time frame: 3 days

07

Study locations

1 of 1 sites recruiting
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
    Recruiting
    • For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR) · Contactccopr@nih.gov · 800-411-1222
08

References and documents

Publications

  • Marciano BE, Allen ES, Conry-Cantilena C, Kristosturyan E, Klein HG, Fleisher TA, Holland SM, Malech HL, Rosenzweig SD. Granulocyte transfusions in patients with chronic granulomatous disease and refractory infections: The NIH experience. J Allergy Clin Immunol. 2017 Aug;140(2):622-625. doi: 10.1016/j.jaci.2017.02.026. Epub 2017 Mar 22. PubMed 28342916 ↗
  • Stroncek DF, Leonard K, Eiber G, Malech HL, Gallin JI, Leitman SF. Alloimmunization after granulocyte transfusions. Transfusion. 1996 Nov-Dec;36(11-12):1009-15. doi: 10.1046/j.1537-2995.1996.36111297091747.x. PubMed 8937413 ↗
  • Heim KF, Fleisher TA, Stroncek DF, Holland SM, Gallin JI, Malech HL, Leitman SF. The relationship between alloimmunization and posttransfusion granulocyte survival: experience in a chronic granulomatous disease cohort. Transfusion. 2011 Jun;51(6):1154-62. doi: 10.1111/j.1537-2995.2010.02993.x. Epub 2010 Dec 22. PubMed 21175646 ↗
09

Updates

4 registry updates since Sep 25, 2026
Minor edits
Nothing that changes what the study is or who can join. Edited: description and verification date
4 updates, last Nov 9, 2026
Show all 4 updates
  1. Nov 9, 2026
    Minor edits only
    + 1 other change: description
  2. Oct 29, 2026
    Minor edits only
    + 1 other change: description
  3. Oct 2, 2026
    Minor edits only
    + 2 other changes: verification date and description
  4. Sep 28, 2026
    Minor edits only
    + 1 other change: description

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05189925
Responsible party
Sponsor
First posted
Jan 13, 2022
Start date
Jul 22, 2022
Primary completion
Jul 1, 2027 (estimated)
Completion
Jul 1, 2027 (estimated)
Last update
Nov 9, 2026

Study contacts

Joanna L Peterson
Contact
joanna.peterson@nih.gov
(301) 346-9780
Suk S De Ravin, M.D.
Contact
sderavin@mail.nih.gov
(301) 496-6772
Suk S De Ravin, M.D.
principal investigator · National Institute of Allergy and Infectious Diseases (NIAID)

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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