title: Therapeutical potential of autologous peripheral blood mononuclear cell transplantation in patients with type 2 diabetic critical limb ischemia.
abstract: OBJECTIVE
  The aim was to evaluate the therapeutic effectiveness of granulocyte colony-stimulating factor (G-CSF) mobilized peripheral blood mononuclear cells (PBMNCs) in critical limb ischemia (CLI) of type 2 diabetic patients.
  
  
  METHODS
  Forty diabetic patients with CLI were enrolled and randomized to treatment and control groups. In the treatment group, the patients received subcutaneous injections of recombinant human G-CSF (30 MU/day) for 5 days to mobilize stem cells. PBMNCs were collected and transplanted by multiple intramuscular injections of 1 ml in 1-1.5-cm depth into ischemic limbs.
  
  
  RESULTS
  At the end of 12 weeks of follow-up, the baseline and end point results in transplant group were as follows: Fontaine score improved from 3.8±03 to 3±0.5 (P=.0001), ankle brachial pressure index increased from 0.68±0.24 to 0.87±024 (P=.001), transcutaneous oxygen increased from 33±14 mmHg to 44±10 mmHg (P=.0001), and 6-min walking distance improved from 280±82 m to 338±98 m (P=.0001). Pain score decreased from 8.2±1.3 to 5.63±1.6 (P=.001), and the number of patients with limb ulcers was reduced from 9/20 (45%) to 3/20 (15%) (P=.031). In the control group, Fontaine score, 6-min walking distance, and pain score were improved; ankle brachial pressure index and transcutaneous oxygen pressure were not improved. The number of patients with limb ulcers did not change in the control group. There are improvement in amputation rates, collateral vessel development, and number of limb ulcers healed.
  
  
  CONCLUSIONS
  These results indicate that the autologous transplantation of G-CSF that mobilized PBMNCs in CLI diabetic patients is safe and effective in patient compliant reduction and improved perfusion.
authors.affiliation: Gulhane Military Medical Academy Hematology Section, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozturk
authors.forename: Yasar
authors.initials: Y
authors.lastname: Kucukardali
authors.forename: Fatih
authors.initials: F
authors.lastname: Tangi
authors.forename: Alev
authors.initials: A
authors.lastname: Erikci
authors.forename: Gunalp
authors.initials: G
authors.lastname: Uzun
authors.forename: Cınar
authors.initials: C
authors.lastname: Bashekim
authors.forename: Huseyin
authors.initials: H
authors.lastname: Sen
authors.forename: Hakan
authors.initials: H
authors.lastname: Terekeci
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Narin
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozyurt
authors.forename: Sezai
authors.initials: S
authors.lastname: Ozkan
authors.forename: Ozkan
authors.initials: O
authors.lastname: Sayan
authors.forename: Osman
authors.initials: O
authors.lastname: Rodop
authors.forename: Selim
authors.initials: S
authors.lastname: Nalbant
authors.forename: Onur
authors.initials: O
authors.lastname: Sıldıroglu
authors.forename: Fevzi Firat
authors.initials: FF
authors.lastname: Yalnız
authors.forename: Ibrahim Volkan
authors.initials: IV
authors.lastname: Senkal
authors.forename: Hilmi
authors.initials: H
authors.lastname: Sabuncu
authors.forename: Cagatay
authors.initials: C
authors.lastname: Oktenli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D055109:Ankle Brachial Index / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000628:therapy*; D005080:Exercise Test; D005121:Extremities / Q000098:blood supply*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007511:Ischemia / Q000628:therapy; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D008297:Male; D010100:Oxygen / Q000097:blood; D059408:Pain Management; D011994:Recombinant Proteins / Q000627:therapeutic use; D014456:Ulcer / Q000628:therapy
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D010100:Oxygen