Cardiology Letters 2017, 26(1):5-13

Cell therapy of limbs ischemia

Maďarič J

Klinika kardiológie a angiológie NÚSCH, a.s. a LF SZU, Národný ústav srdcových a cievnych chorôb, a.s., Bratislava, Slovenská republika

Cell therapy has been proposed as an alternative strategy in patients with critical limb ischemia not eligible for endovascular or surgical revascularization. Several pre-clinical and clinical studies suggest that delivery of stem cells with regenerative potential and paracrine ability can improve tissue perfusion and thus prevent amputation via the induction of capillary or collateral growth in a process called "therapeutic angiogenesis". Many cell types have been tested, but results of most clinical trials to date rely on the use of adult autologous bone marrow-derived mononuclear cells or cultured peripheral blood-derived proangiogenic mononuclear cells, all typically delivered unaltered in their native state. Of increasing interest are mesenchymal stem cells with the capability for multipotent differentiation, cytoprotection, and damaged tissue restoration. Although the meta-analyses of randomized clinical trials demonstrate a positive benefit-to-risk ratio of cellbased therapy, its promising potential needs to be confirmed by larger randomized, placebo-controlled trials. This paper provides current evidence about cell therapy of limb ischemia and appraises some of the future perspectives of regenerative therapy.

Keywords: critical limb ischemia; angiogenesis; stem cells; neovascularization; paracrine activity

Published: January 1, 2017  Show citation