Safety and efficacy of autologous progenitor cell transplantation for therapeutic angiogenesis in patients with critical limb ischemia.
BACKGROUND
Therapeutic angiogenesis using cell transplantation (TACT) is a treatment strategy for no-option patients with critical limb ischemia (CLI). However, because one-third of treated patients fail to respond, the present study was an exploration of the characteristics of responders and non-responders to this treatment regimen.


RESULTS
Seven CLI patients (3 with Buerger's disease, 4 with arteriosclerosis obliterans undergoing chronic hemodialysis (ASO-HD)) were treated according to the TACT protocol (n=6: bone marrow-mononuclear cells (MNCs); n=1: peripheral blood-MNCs). Subjective symptoms (visual analog scale) and objective findings (extent of ulcer, ankle-brachial pressure index, transcutaneous oxygen pressure, thermography and angiography) were assessed. Numbers of transplanted CD34+, CD133+ and CD34+ CD133+ cells were counted. Changes in circulating CD34+ and CD133+ cell numbers were also examined before and after the treatment. All responders (n=3) had Buerger's disease, and ASO-HD patients did not respond well. Among the responders, the numbers of circulating CD34+ and CD133+ cells persistently increased for 1 month after the treatment, but not in non-responders.


CONCLUSIONS
The TACT regimen improved CLI in patients with Buerger's disease but not in those with ASO-HD in this small study. In responders, post procedural circulating CD34+ and CD133+ cells persistently increased for 1 month (ClinicalTrials.gov Identifier: NCT00145262, TACT-NAGOYA).
Kajiguchi
Masahiro
M
Department of Cardiology, Nagoya University Graduate School of Medicine, Japan.
Kondo
Takahisa
T
Izawa
Hideo
H
Kobayashi
Masayoshi
M
Yamamoto
Koji
K
Shintani
Satoshi
S
Numaguchi
Yasushi
Y
Naoe
Tomoki
T
Takamatsu
Junki
J
Komori
Kimihiro
K
Murohara
Toyoaki
T
D000071916:AC133 Antigen; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D001162:Arteriosclerosis Obliterans / Q000628:therapy; D016026:Bone Marrow Transplantation; D005260:Female; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000502:physiology*; D010455:Peptides / Q000378:metabolism; D036102:Peripheral Blood Stem Cell Transplantation; D013234:Stem Cells / Q000166:cytology* / Q000276:immunology; D013919:Thromboangiitis Obliterans / Q000628:therapy; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000071916:AC133 Antigen; D015703:Antigens, CD; D018952:Antigens, CD34; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides