Safety and efficacy of autologous progenitor cell transplantation for therapeutic angiogenesis in patients with critical limb ischemia
Masahiro Kajiguchi, Takahisa Kondo, Hideo Izawa, Masayoshi Kobayashi, Koji Yamamoto, Satoshi Shintani, Yasushi Numaguchi, Tomoki Naoe, Junki Takamatsu, Kimihiro Komori, Toyoaki Murohara, Masahiro Kajiguchi, Takahisa Kondo, Hideo Izawa, Masayoshi Kobayashi, Koji Yamamoto, Satoshi Shintani, Yasushi Numaguchi, Tomoki Naoe, Junki Takamatsu, Kimihiro Komori, Toyoaki Murohara
Abstract
Background: Therapeutic angiogenesis using cell transplantation (TACT) is a treatment strategy for no-option patients with critical limb ischemia (CLI). However, because one-third of treated patients fail to respond, the present study was an exploration of the characteristics of responders and non-responders to this treatment regimen.
Methods and results: Seven CLI patients (3 with Buerger's disease, 4 with arteriosclerosis obliterans undergoing chronic hemodialysis (ASO-HD)) were treated according to the TACT protocol (n=6: bone marrow-mononuclear cells (MNCs); n=1: peripheral blood-MNCs). Subjective symptoms (visual analog scale) and objective findings (extent of ulcer, ankle-brachial pressure index, transcutaneous oxygen pressure, thermography and angiography) were assessed. Numbers of transplanted CD34+, CD133+ and CD34+ CD133+ cells were counted. Changes in circulating CD34+ and CD133+ cell numbers were also examined before and after the treatment. All responders (n=3) had Buerger's disease, and ASO-HD patients did not respond well. Among the responders, the numbers of circulating CD34+ and CD133+ cells persistently increased for 1 month after the treatment, but not in non-responders.
Conclusions: The TACT regimen improved CLI in patients with Buerger's disease but not in those with ASO-HD in this small study. In responders, post procedural circulating CD34+ and CD133+ cells persistently increased for 1 month (ClinicalTrials.gov Identifier: NCT00145262, TACT-NAGOYA).
Source: PubMed