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ANGIOGRAPHIC DEMONSTRATION OF NEOANGIOGENESIS AFTER INTRA-ARTERIAL INFUSION OF AUTOLOGOUS BONE MARROW MONONUCLEAR CELLS IN DIABETIC PATIENTS WITH CRITICAL LIMB ISCHAEMIA
Authors: Rafael Ruiz-Salmeron, Antonio de la Cuesta-Diaz, Manuel Constantino-Bermejo, Inmaculada Pérez-Camacho, Francisco Marcos-Sánchez, Abdelkrim Hmadcha, Bernat Soria
Source: Cell Transplantation
Publisher: Cognizant Communication Corporation
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Abstract:
Critical limb ischaemia in diabetic patients is associated with high rates of morbidity and mortality. Sub-optimal 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 ischaemia. 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 ischaemia, intra-arterial perfusion of BMMNCs is a safe procedure that generates a significant increase in the vascular network in ischaemic areas and promotes remarkable clinical improvement.Document Type:
DOI: http://dx.doi.org/10.3727/096368910X564526
Appeared or available online: April 1, 2011
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