Both autologous bone marrow mononuclear cell and peripheral blood progenitor cell therapies similarly improve ischaemia in patients with diabetic foot in comparison with control treatment

被引:83
作者
Dubsky, M. [1 ,4 ]
Jirkovska, A. [1 ]
Bem, R. [1 ]
Fejfarova, V. [1 ]
Pagacova, L. [2 ]
Sixta, B. [3 ]
Varga, M. [3 ]
Langkramer, S. [5 ]
Sykova, E. [6 ]
Jude, E. B. [7 ]
机构
[1] Diabet Ctr Prague, Prague, Czech Republic
[2] Autotransfus Unit Prague, Prague, Czech Republic
[3] Inst Clin & Expt Med Prague, Clin Transplant Surg, Prague, Czech Republic
[4] Charles Univ Prague, Fac Med 1, Prague, Czech Republic
[5] Charles Univ Prague, Fac Med 2, Ctr Cell Therapy & Tissue Repair, Prague, Czech Republic
[6] Czech Acad Sci Prague, Inst Expt Med, Prague, Czech Republic
[7] Tameside Gen Hosp, Ctr Diabet, Ashton Under Lyne, Lancs, England
关键词
stem cell therapy; diabetic foot; critical limb ischaemia; CRITICAL LIMB ISCHEMIA; THERAPEUTIC ANGIOGENESIS; ARTERIAL-DISEASE; DOUBLE-BLIND; RESTORE-CLI; STEM-CELL; TRANSPLANTATION; ULCER; POPULATION; MANAGEMENT;
D O I
10.1002/dmrr.2399
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The aim of our study was to compare the effect of bone marrow mononuclear cell and peripheral blood progenitor cell therapies in patients with diabetic foot disease and critical limb ischaemia unresponsive to revascularization with conservative therapy. Methods Twenty-eight patients with diabetic foot disease (17 treated by bone marrow cells and 11 by peripheral blood cell) were included into an active group and 22 patients into a control group without cell treatment. Transcutaneous oxygen pressure and rate of major amputation, as the main outcome measures, were compared between bone marrow cells, peripheral blood cell and control groups over 6months; both cell therapy methods were also compared by the characteristics of cell suspensions. Possible adverse events were evaluated by changes of serum levels of angiogenic cytokines and retinal fundoscopic examination. Results The transcutaneous oxygen pressure increased significantly (p<0.05) compared with baseline in both active groups after 6months, with no significant differences between bone marrow cells and peripheral blood cell groups; however, no change of transcutaneous oxygen pressure in the control group was observed. The rate of major amputation by 6months was significantly lower in the active cell therapy group compared with that in the control group (11.1% vs. 50%, p=0.0032), with no difference between bone marrow cells and peripheral blood cell. A number of injected CD34+ cells and serum levels of angiogenic cytokines after treatment did not significantly differ between bone marrow cells and peripheral blood cell. Conclusions Our study showed a superior benefit of bone marrow cells and peripheral blood cell treatments of critical limb ischaemia in patients with diabetic foot disease when compared with conservative therapy. There was no difference between both cell therapy groups, and no patient demonstrated signs of systemic vasculogenesis. Copyright (c) 2013 John Wiley & Sons, Ltd.
引用
收藏
页码:369 / 376
页数:8
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