Angiographic Demonstration of Neoangiogenesis after Intra-arterial Infusion of Autologous Bone Marrow Mononuclear Cells in Diabetic Patients with Critical Limb Ischemia

Cell Transplantation

Article

Abdelkrim Hmadcha¹  Bernat Soria¹  Rafael Ruiz-Salmeron²  Antonio De La Cuesta-Diaz²  Francisco Marcos-Sánchez²  Immaculada Pérez-Camacho²  Manuel Constantino-Bermejo² 

[1] Centro Andaluz de Biología Molecular y Medicina Regenerativa (CABIMER), Sevilla, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain;Hospitales Universitarios San Lázaro and Virgen Macarena, Sevilla, Spain;

关键词: Bone marrow-derived mononuclear cells (BMMNCs);    Peripheral artery disease (PAD);    Critical limb ischemia (CLI);    Ankle-brachial index (ABI);    Digital subtraction angiography (DSA);    Below the knee;   

DOI  :  10.3727/096368910X0177

 received in 2010-06-02, accepted in 2010-12-29,  发布年份 2011

来源: Sage Journals

【 摘 要 】

Critical limb ischemia in diabetic patients is associated with high rates of morbidity and mortality. Suboptimal responses to the available medical and surgical treatments are common in these patients, who also demonstrate limited vascular homeostasis. Neovasculogenesis induced by stem cell therapy could be a useful approach for these patients. Neovasculogenesis and clinical improvement were compared at baseline and at 3 and 12 months after autologous bone marrow-derived mononuclear cell (BMMNC) transplantation in diabetic patients with peripheral artery disease. We conducted a prospective study to evaluate the safety and efficacy of intra-arterial administration of autologous BMMNCs (100–400 × 106 cells) in 20 diabetic patients with severe below-the-knee arterial ischemia. Although the time course of clinical effects differed among patients, after 12 months of follow-up all patients presented a notable improvement in the Rutherford-Becker classification, the University of Texas diabetic wound scales, and the Ankle-Brachial Index in the target limb. The clinical outcome was consistent with neovasculogenesis, which was assessed at 3 months by digital subtraction angiography and quantified by MetaMorph software. Unfortunately, local cell therapy in the target limb had no beneficial effect on the high mortality rate in these patients. In diabetic patients with critical limb ischemia, intra-arterial perfusion of BMMNCs is a safe procedure that generates a significant increase in the vascular network in ischemic areas and promotes remarkable clinical improvement.

【 授权许可】

Unknown   
© 2011 Cognizant Comm. Corp.

【 图 表 】

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