Therapeutic angiogenesis by transplantation of autologous bone marrow and peripheral blood mononuclear cells in patients with peripheral arterial disease

Keiji Matsui; Yoshiaki Murakami; Tohru Yoshioka; Kazuo Muroi; Haruyuki Kasuda; Masahisa Shimpo; Masafumi Takahashi; Hisao Toei; Osamu Kamisawa; Koichi Takeuchi; Keiya Ozawa; Kazuyuki Shimada; Uichi Ikeda

doi:10.1007/s00547-003-0977-3

International Journal of Angiology, Inhaltsverzeichnis

Int J Angiol 2003; 12(3): 155-161
DOI: 10.1007/s00547-003-0977-3

Original Article

Therapeutic angiogenesis by transplantation of autologous bone marrow and peripheral blood mononuclear cells in patients with peripheral arterial disease

Keiji Matsui¹ , Yoshiaki Murakami¹ , Tohru Yoshioka² , Kazuo Muroi³ , Haruyuki Kasuda⁴ , Masahisa Shimpo¹ , Masafumi Takahashi² , Hisao Toei⁵ , Osamu Kamisawa⁶ , Koichi Takeuchi⁷ , Keiya Ozawa⁸ , Kazuyuki Shimada¹ , Uichi Ikeda²

¹Divisions of Cardiovascular Medicine, Jichi Medical School, Tochigi, Japan
²Department of Organ Regeneration, Shinshu University Graduate School of Medicine, Matsumoto, Japan
³Divisions of Cell Transplantation and Transfusion, Jichi Medical School, Tochigi, Japan
⁴Divisions of Anesthesiology, Jichi Medical School, Tochigi, Japan
⁵Divisions of Radiology, Jichi Medical School, Tochigi, Japan
⁶Divisions of Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan
⁷Divisions of Anatomy, Jichi Medical School, Tochigi, Japan
⁸Divisions of Hematology, Jichi Medical School, Tochigi, Japan

Abstract

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Abstract

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. In conclusion, 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.

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