Therapeutic angiogenesis by cell transplantation

近年来，自体骨髓单个核细胞（BM-MNCs）移植治疗缺血性肢体血管生成的有效性和安全性得到了报道。我们研究了外周血单个核细胞（PB-MNCs）移植对外周动脉疾病患者是否与bm - mncs移植同样有效。5例患者单侧缺血肢体行BM-MNC移植，5例患者双侧缺血肢体行BM-MNC和pb - mnc移植（重度缺血肢体行BM-MNCs移植，对侧轻度缺血肢体行相同数量的PB-MNCs移植）。在24小时的培养过程中，PB-MNCs的CD34^+细胞数量比BM-MNCs少约100倍，而PB-MNCs分泌大量的血管内皮生长因子（VEGF）。单独移植BM-MNCs后血清VEGF水平没有升高，而移植BM-MNCs和PB-MNCs后血清VEGF水平均有显著升高。移植后2周，bm - mnc移植肢体的踝肱指数和经皮氧压显著升高，而pb - mnc移植肢体的这些参数均无显著升高。我们证明，骨髓间质干细胞的自体移植是一种新的、有前途的临床应用策略，旨在重建缺血组织，但骨髓间质干细胞移植没有明确的治疗效果。

Recently, the effectiveness and safety of therapeutic angiogenesis by transplantation of autologous bone marrow mononuclear cells (BM-MNCs) to ischemic limbs have been reported. We investigated whether transplantation of peripheral blood mononuclear cells (PB-MNCs) would also be as effective as BM-MNC-transplantation in patients with peripheral arterial disease. BM-MNC-transplantation into unilateral ischemic limbs was performed in five patients, and both BM-MNC and PB-MNC-transplantation into bilateral ischemic limbs (BM-MNCs into severe ischemic limbs and the same number of PB-MNCs into contralateral less ischemic limbs) were performed in five patients. The number of CD34^+ cells in PB-MNCs was 〜100-fold less than that in BM-MNCs, while PB-MNCs secreted substantial amounts of vascular endothelial growth factor (VEGF) during a 24-hour incubation. There was no increase in the serum VEGF levels by BM-MNC-transplantation alone, while there was a significant increase in the serum VEGF levels after transplantation of both BM-MNCs and PB-MNCs. Two weeks after transplantation, the ankle-brachial index and transcutaneous oxygen pressure were significantly increased in BM-MNC-transplanted limbs, while there were no significant increases in these parameters in PB-MNC-transplanted limbs.We demonstrate that autologous transplantation of BM-MNCs represents a new and promising strategy for clinical application designed to revascularize ischemic tissues, but there were no definite therapeutic effects of transplantation of PB-MNCs.