Autologous bone-marrow mononuclear cell implantation improves endothelium-dependent vasodilation in patients with limb ischemia
Autologous bone-marrow mononuclear cell implantation improves endothelium-dependent vasodilation in patients with limb ischemia
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DOI：
10.1161/01.cir.0000121427.53291.78
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发表时间：
2004-03-16
期刊：
影响因子：
37.8
通讯作者：
Yoshizumi, M
中科院分区：
文献类型：
--
作者：
Higashi, Y;Kimura, M;Yoshizumi, M
背景-肢体缺血的患者与内皮功能障碍有关。本研究旨在探讨自体骨髓单个核细胞(BM-MNC)植入是否能改善肢体缺血患者的内皮功能障碍。方法与结果：我们评价了7例肢体缺血患者植入BM-MNC前后对血管内皮依赖性扩张剂乙酰胆碱(ACh)和非内皮依赖性血管扩张剂硝普钠(SNP)的反应。用充满汞的硅橡胶应变片容积仪测量LBF。移植于缺血肢体的BM-MNCs数为1.6×10(9)+/-0.3×10(9)。BM-MNC中CD34(+)细胞数为3.8×10(7)+/-1.6×10(7)。植入BM-MNC后，踝臂压指数(0.33+/-0.21~0.39+/-0.17，P=0.06)、经皮血氧分压(28.4+/-11.5~36.6+/-5.2 mm Hg，P=0.03)和无痛步行时间(0.8+/-0.6~2.9+/-2.2分钟，P=0.02)明显改善。植入BM-MNC后，LBF对ACh的反应性增强(19.3+/-6.8mLvs29.6+/-7.1mL100mLvs29.6+/-7.1mLmin，P=0.002)。SNP在植入BM-MNC前后的血管扩张作用相似。结论--这些发现提示BM-MNC植入可增强肢体缺血患者的内皮依赖性血管扩张。
Background - Patients with limb ischemia were associated with endothelial dysfunction. The purpose of this study was to determine whether autologous bone-marrow mononuclear cell (BM-MNC) implantation improves endothelial dysfunction in patients with limb ischemia.Methods and Results - We evaluated the leg blood flow (LBF) response to acetylcholine (ACh), an endothelium-dependent vasodilator, and sodium nitroprusside ( SNP), an endothelium-independent vasodilator, before and after BM-MNC implantation in 7 patients with limb ischemia. LBF was measured with a mercury-filled Silastic strain-gauge plethysmograph. The number of BM-MNCs implanted into ischemic limbs was 1.6 x 10(9) +/- 0.3 x 10(9). The number of CD34(+) cells included in the implanted BM-MNCs was 3.8 x 10(7) +/- 1.6 x 10(7). BM-MNC implantation improved the ankle-brachial pressure index (0.33 +/- 0.21 to 0.39 +/- 0.17, P = 0.06), transcutaneous oxygen pressure (28.4 +/- 11.5 to 36.6 +/- 5.2 mm Hg, P = 0.03), and pain-free walking time (0.8 +/- 0.6 to 2.9 +/- 2.2 minutes, P = 0.02). After BM-MNC implantation, LBF response to ACh was enhanced (19.3 +/- 6.8 versus 29.6 +/- 7.1 mL/min per 100 mL; P = 0.002). The vasodilatory effect of SNP was similar before and after BM-MNC implantation.Conclusions - These findings suggest that BM-MNC implantation augments endothelium-dependent vasodilation in patients with limb ischemia.