title: Autologous peripheral blood mononuclear cell implantation for patients with peripheral arterial disease improves limb ischemia.
abstract: BACKGROUND
  Implantation of bone marrow mononuclear cells, including endothelial progenitor cells, into ischemic limbs has been shown to improve collateral vessel formation. In the present study the safety and feasibility of autologous peripheral blood mononuclear cells (PBMNCs) implantation after granulocyte-colony stimulating factor (G-CSF)-induced mobilization was investigated in patients with severe peripheral arterial disease.
  
  
  RESULTS
  Six cases were enrolled: 5 of thromboangitis obliterans and 1 of arteriosclerosis obliterans. Following administration of G-CSF (10 microg . kg(-1) . day(-1)), PBMNCs were harvested and injected intramuscularly (5 legs and 1 arm) for 2 days for the patients with ischemia of the legs. No serious adverse events related to G-CSF administration, harvest or implantation were observed during this study period. Improvement in the ankle - brachial pressure index (ABI: >0.1) was seen in 4 patients at 4 weeks and ischemic ulcers improved in 3 of 3 patients. The mean maximum walking distance significantly increased from 203 m to 559 m (p=0.031) at 4 weeks and was sustained for 24 weeks. Significant improvement was seen in physiological functioning subscale of Short Form-36.
  
  
  CONCLUSIONS
  Implantation of PBMNCs collected after G-CSF administration could be an alternative to therapeutic angioplasty in patients with severe peripheral arterial disease.
authors.affiliation: Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Okinawa, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Ishida
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohya
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sakuda
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ohshiro
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Higashiuesato
authors.forename: Moriyasu
authors.initials: M
authors.lastname: Nakaema
authors.forename: Shinobu
authors.initials: S
authors.lastname: Matsubara
authors.forename: Shizuko
authors.initials: S
authors.lastname: Yakabi
authors.forename: Ayano
authors.initials: A
authors.lastname: Kakihana
authors.forename: Mika
authors.initials: M
authors.lastname: Ueda
authors.forename: Chiharu
authors.initials: C
authors.lastname: Miyagi
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Yamane
authors.forename: Kageharu
authors.initials: K
authors.lastname: Koja
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Komori
authors.forename: Shuichi
authors.initials: S
authors.lastname: Takishita
mesh_terms: D000328:Adult; D001132:Arm / Q000098:blood supply*; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000628:therapy*; D013919:Thromboangiitis Obliterans / Q000628:therapy*; D014182:Transplantation, Autologous
chemical_list: D016179:Granulocyte Colony-Stimulating Factor