Autologous peripheral blood mononuclear cell implantation for patients with peripheral arterial disease improves limb ischemia.
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.
Ishida
Akio
A
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Okinawa, Japan.
Ohya
Yusuke
Y
Sakuda
Hitoshi
H
Ohshiro
Katsuhiko
K
Higashiuesato
Yasushi
Y
Nakaema
Moriyasu
M
Matsubara
Shinobu
S
Yakabi
Shizuko
S
Kakihana
Ayano
A
Ueda
Mika
M
Miyagi
Chiharu
C
Yamane
Nobuhisa
N
Koja
Kageharu
K
Komori
Kimihiro
K
Takishita
Shuichi
S
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
D016179:Granulocyte Colony-Stimulating Factor