Use of a non-specific immunomodulation therapy as a therapeutic vasculogenesis strategy in no-option critical limb ischemia patients

被引：22

作者：

Marfella, Raffaele ^{[1
]}

Luongo, Carlo ^{[2
]}

Coppola, Antonino ^{[3
]}

Luongo, Margherita ^{[2
]}

Capodanno, Paola ^{[2
]}

Ruggiero, Roberto ^{[1
]}

Mascolo, Luigi ^{[2
]}

Ambrosino, Immacolata ^{[1
]}

Sardu, Celestino ^{[1
]}

Boccardi, Virginia ^{[1
]}

Lettieri, Biagio ^{[2
]}

Paolisso, Giuseppe ^{[1
]}

机构：

[1] Univ Naples 2, Dept Geriatr & Metab Dis, I-80138 Naples, Italy

[2] Univ Naples 2, Dept Anesthesiol & Emergency, I-80138 Naples, Italy

[3] Osped S Maria Misericordia, Operat Unit Cardiol, Sorrento, Italy

来源：

ATHEROSCLEROSIS | 2010年 / 208卷 / 02期

关键词：

Oxygen/ozone therapy; Limb ischemia; Inflammation; Endothelial cells; ENDOTHELIAL PROGENITOR CELLS; TUMOR-NECROSIS-FACTOR; KAPPA-B; ANGIOGENESIS; MOBILIZATION; DISEASE; TCPO2;

D O I：

10.1016/j.atherosclerosis.2009.08.005

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background/aims: Inflammatory mediators contribute to the impairment of vasculogenesis by reducing endothelial progenitor cells (EPCs) mobilization in atherosclerotic vasculopathy. We tested the hypothesis that administration of an oxygen/ozone mixture (IMT) might counteract this pathophysiological mechanism and enhance limb tissue perfusion in patients with critical limb ischemia (CLI). Methods: Randomized patients with rest pain or ischemic ulcers and transcutaneous oxygen tension (TcPO2) <40 mmHg and/or toe pressure <50 mmHg received placebo (n = 74) or a non-specific immunomodulation therapy (IMT) (n = 77), autologous blood exposed to oxygen/ozone gas mixture by intragluteal injection, on day 1, 2, 7, and once a week thereafter for at least 22 weeks. Patients were evaluated for changes in TcPO2, levels of circulating EPCs (CD34/KDR-positive cells) and inflammation (tumor necrosis factor-alpha-TNF-alpha). Results: TcPO2 and CD34/CD133-positive cells increased at 22 weeks in IMT group (P < 0.01) whereas no changes were observed in placebo group. TNF-alpha levels decreased at 6 months in IMT group (P < 0.001) whereas no changes were observed in placebo group. There was a strong positive correlation between CD34/KDR-positive cells and TcPO2 (r = 0.56, P < 0.01). Moreover, there was an inverse correlation between CD34/KDR-positive cells and TNF-alpha (r = -0.51, P < 0.01). Conclusions: Intramuscular injection of IMT may improve wound healing and limb salvage in patients with CLI. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

引用

页码：473 / 479

页数：7

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