Recruiting
Phase 1

Anti-CD8+ T Cell Minibodies

Sponsor:

National Institute of Neurological Disorders and Stroke (NINDS)

Code:

NCT05849467

Conditions

Progressive Multifocal Leukoencephalopathy

Multiple Sclerosis

Other Neuroinflammatory Diseases With BBB Leakage

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Interventions

89 Zr-Df-crefmirlimab

Study Details

Brief summary:

Background:

Multiple sclerosis (MS) and progressive multifocal leukoencephalopathy (PML) are disorders that affect the central nervous system (CNS). The CNS includes the brain, spinal cord, and optic nerves. Both diseases can cause muscle weakness and impair vision, speech, and coordination. Researchers are working to better understand how MS and PML affect the CNS.

Objective: To test whether an experimental radioactive tracer (minibody) can help positron emission tomography (PET) scans detect certain immune cells in the CNS of people with MS and PML.

Eligibility:

People aged 18 years and older with MS, other neuroinflammatory diseases with BBB leakage, or PML.

Design:

Participants will come to the clinic for at least 3 visits over 4 to 6 weeks.

Participants will undergo testing. They will have a physical and neurological exam. They will have blood tests and tests of their heart function. They will have a magnetic resonance imaging (MRI) scan of the brain. They may have a spinal tap: Their lower back will be numbed, and a needle will be inserted between the bones of the spine to withdraw fluid from around the spinal cord.

Minibody is given through a tube with a needle placed in a vein in the arm. This takes 5 to 10 minutes. Participants will have heart function tests before and after receiving the minibody.

Participants may have a PET scan on the day of the Minibody and will return the next day for another PET scan. They will lie on a table that moves through a doughnut-shaped machine. This scan will take about 1 hour.

Participants with PML may opt to repeat the minibody infusion and the PET scan within 6 months.

Conditions

Progressive Multifocal Leukoencephalopathy

Multiple Sclerosis

Other Neuroinflammatory Diseases With BBB Leakage

Study ID

NCT05849467

Start date

Oct 19, 2023

Status verified date

Jun 3, 2026

Completion date

Dec 1, 2030

Anticipated

Primary completion date

Apr 1, 2030

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

  • INCLUSION CRITERIA:

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

Multiple Sclerosis Inclusion Criteria

  • Enrolled in the NINDS Natural History Study for MS (protocol 89-N-0045)
  • Able to understand, and willing to sign, a written, informed consent document.
  • Willing to comply with all study procedures and available for the duration of the study.
  • Male or female, aged >=18.
  • Diagnosis of MS according to the 2017 revision of the McDonald diagnostic criteria48 (in the presence or absence of a clinical relapse).

PML Inclusion Criteria

  • Enrolled in the NINDS Natural History Study for PML (protocol 13-N-0017)
  • Able to understand and willing to sign a written, informed consent document
  • Willing to comply with all study procedures and available for the duration of the study.
  • Male or female, aged >=18.
  • Diagnosis of definite PML according to 2013 AAN Consensus Criteria49 or PML-IRIS based on clinical, radiological and laboratory evidence.

Patients with Known or Suspected Neuroinflammatory Diseases and Evidence of Open BBB Inclusion Criteria

-Clinical evaluation suggesting an inflammatory disorder of the central nervous system other than MS or PML. Other confirmed neuroinflammatory disorders may include -MOGAD, NMOSD, Behcet's syndrome, and neurosarcoidosis. Unconfirmed, though

suspected cases of neuroinflammation may also be included.

  • Recent brain MRI (within 1 month) with gadolinium enhancement indicating open BBB.
  • Able to understand and willing to sign a written, informed consent document.
  • Willing to comply with all study procedures and available for the duration of the study.
  • Male or female, aged >=18.

EXCLUSION CRITERIA:

An individual who meets any of the following criteria will be excluded from participation in this study:

  • Pregnant or lactating.
  • Contraindications for MRI gadolinium contrast administration or 3T MRI.
  • History of, or current diagnosis with, concomitant medical or clinical conditions that would adversely affect participation in this study.
  • Weighs > 350 lb. (158 kg; weight limit for the scanner table) or is unable to fit within the MRI or PET imaging gantry.
  • Severe claustrophobia unresponsive to oral anxiolytics.
  • Has an alkaline phosphatase level greater than 2x ULN (unless known to have non-liver related disorder) OR AST greater than 1.5 x ULN OR ALT greater than 1.5 x ULN.
  • Has a total bilirubin >1.5X ULN, unless known to have elevated bilirubin due to nonliver related disorder or Gilbert s.
  • Creatinine clearance < 60 mL/min as estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)
  • For females of reproductive potential: inability to use highly effective contraception for at least one month prior to screening and during study participation.

Study Design

Enrollment

15 participants

Anticipated

Intervention Model

Single group

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Multiple Sclerosis

MS cohort- Up to four study visits. (1) Baseline; (2) Day 0: MRI brain/spinal cord (with gadolinium) followed by an intravenous injection of anti-CD8 minibody (aka"PET/CT tracer"); (3) Day 1: PET/CT scan(4) Optional Visit: PET/CT scan

experimental: Other Neuroinflammatory diseases with BBB leakage

Up to four study visits: (1) Baseline; (2) Day 0: MRI brain/spinal cord (with gadolinium) followed by an intravenous injection of anti-CD8 minibody (aka "PET/CT tracer"); (3) Day 1: PET/CT scan(4) Optional Visit: PET/CT scan

experimental: Progressive Multifocal Leukoencephalopathy

PML cohort- Up to seven study visits. (1) Baseline; (2) Day 0: MRI brain (with gadolinium) followed by an intravenous injection of anti-CD8 minibody (aka "PET/CT tracer"); (3) Day 1: PET/CT scan; (4) Study visit 4 (optional): PET/CT scan. (5) Study visit 5 (optional; time-period between study visit 3 and 5 is variable based on radiological criteria): MRI brain (with gadolinium) followed by an intravenous injection of anti-CD8 minibody (aka "PET/CT tracer"); (6) Study visit 6: PET/ CT scan; (7) Study visit 7: PET/CT scan.

Interventions

89 Zr-Df-crefmirlimab

an 80 kDa minibody (Mb) with high

affinity to CD8 glycoprotein (binding EC50 = 0.4 nM) that is conjugated with deferoxamine (Df)

and radiolabeled with the positron emitting radionuclide, Zr-89 (T1/2 78.4 hours).

Primary outcome measure

  • Infiltration of CD8+ T cells in the CNS of adults with MS and PML via PET-CT scans using a minibody with high affinity for CD8+ T cells. [ Time Frame: Day 1 Study Visit ]

Central Contacts and Locations

Central contacts

Maria I Gaitan, M.D.

(301) 496-1801maria.gaitan@nih.gov

Daniel S Reich, M.D.

(301) 496-1801reichds@ninds.nih.gov

Locations

National Institutes of Health Clinical Center

Recruiting

Bethesda, Maryland, United States, 20892

Contacts

NIH Clinical Center Office of Patient Recruitment (OPR)

800-411-1222ccopr@nih.gov

More Information

Sponsor

National Institute of Neurological Disorders and Stroke (NINDS)

Last update posted

Jun 5, 2026

Last verified

Jun 3, 2026

Keywords

  • 89 Zr-Df-crefmirlimab
  • PET Imaging

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by National Institute of Neurological Disorders and Stroke (NINDS) on 2026-06-05.