Safety and efficacy of autologous progenitor cell transplantation for therapeutic angiogenesis in patients with critical limb ischemia
Safety and efficacy of autologous progenitor cell transplantation for therapeutic angiogenesis in patients with critical limb ischemia
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DOI：
10.1253/circj.71.196
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发表时间：
2007-02-01
影响因子：
3.3
通讯作者：
Murohara, Toyoaki
中科院分区：
文献类型：
--
作者：
Kajiguchi, Masahiro;Kondo, Takahisa;Murohara, Toyoaki
背景 使用细胞移植治疗性血管生成（TACT）是一种针对严重肢体缺血（CLI）无选择患者的治疗策略。然而，由于三分之一的治疗患者未能做出反应，本研究旨在探索该治疗方案的反应者和无反应者的特征。 方法和结果 7 名 CLI 患者（3 名患有布尔格氏病，4 名患有动脉硬化闭塞症并接受慢性血液透析 (ASO-HD)）根据 TACT 方案进行治疗（n = 6：骨髓单核细胞） （跨国公司）； n = 1：外周血-MNC）。评估主观症状（视觉模拟量表）和客观结果（溃疡范围、踝臂压力指数、经皮氧分压、热成像和血管造影）。计数移植的CD34(+)、CD133(+)和CD34(+)CD133(+)细胞的数量。还检查了治疗前后循环CD34(+)和CD133+细胞数量的变化。所有应答者 (n = 3) 均患有布尔格氏病，而 ASO-HD 患者的应答不佳。在有反应者中，治疗后 1 个月内，循环 CD34(+) 和 CD133(+) 细胞数量持续增加，但无反应者则没有。 结论 在这项小型研究中，TACT 方案改善了 Buerger 病患者的 CLI，但没有改善 ASO-HD 患者的 CLI。在应答者中，手术后循环 CD34+ 和 CD133+ 细胞持续增加 1 个月（ClinicalTrials.gov 标识符：NCT00145262，TACT-NAGOYA）。
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 I 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).