Therapeutical potential of autologous peripheral blood mononuclear cell transplantation in patients with type 2 diabetic critical limb ischemia

详细信息	查看全文 | 推荐本文 |

• 作者：Ahmet Ozturk^a ; Yasar Kucukardali^b ; ^{yasarkardali@yahoo.com} ; Fatih Tangi^c ; Alev Erikci^a ; Gunalp Uzun^d ; C谋nar Bashekim^e ; Huseyin Sen^f ; Hakan Terekeci^c ; Yavuz Narin^g ; Mustafa Ozyurt^h ; Sezai Ozkan^f ; Ozkan Sayan^a ; Osman Rodopⁱ ; Selim Nalbant^c ; Onur S谋ld谋roglu^e ; Fevzi Firat Yaln谋z^b ; 陌brahim Volkan Senkal^b ; Hilmi Sabuncu^a ; Cagatay Oktenli^c
• 关键词：Diabetes ; Critical limb ischemia ; Angiogenesis ; Peripheral blood mononuclear cells ; Transplantation
• 刊名：Journal of Diabetes and its Complications
• 出版年：2012
• 期刊代码：154_10568727
• 类别：med
• 出版时间：January-February, 2012
• 卷：26
• 期：1
• 页码：29-33
• 文件大小：324 K

摘要

Aim

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.

Method

Forty diabetic patients with CLI were enrolled and randomized to treatment and control groups. In聽the treatment group, the patients received subcutaneous injections of recombinant human G-CSF (30聽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卤03 to 3卤0.5 (P=.0001), ankle brachial pressure index increased from 0.68卤0.24 to 0.87卤024 (P=.001), transcutaneous oxygen increased from 33卤14 mmHg to 44卤10 mmHg (P=.0001), and 6-min walking distance improved from 280卤82 m to 338卤98 m (P=.0001). Pain score decreased from 8.2卤1.3 to 5.63卤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.