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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Progenitor cell therapy in patients with critical limb ischemia without surgical options
Ralf W Sprengers1, Daniel J Lips, Frans L Moll
1Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Progenitor cell therapy shows promise for critical limb ischemia, a condition affecting many patients ineligible for traditional procedures. Further large-scale, controlled trials are necessary to confirm these encouraging findings.
Area of Science:
- Regenerative Medicine
- Vascular Biology
- Cell Therapy
Background:
- Critical limb ischemia (CLI) affects 500-1000 individuals per million annually, significantly impacting quality of life.
- Approximately 40% of CLI patients are ineligible for current surgical or radiologic revascularization.
- Novel therapeutic strategies are essential for CLI treatment.
Purpose of the Study:
- To review the current evidence on progenitor cell therapy for critical limb ischemia.
- To assess the potential of bone marrow-derived mononuclear cells as a therapeutic target for CLI.
Main Methods:
- A comprehensive literature search was conducted on progenitor cell therapy in CLI patients.
- Included studies reporting on mononuclear cells or progenitor cells for CLI treatment.
- Excluded studies not published in English.
Main Results:
- Twenty-five clinical studies were identified, with 18 included in this review.
- Pioneering studies suggest promising outcomes for progenitor cell therapies in CLI.
- Current evidence is limited by small study sizes and lack of double-blinded controls.
Conclusions:
- Progenitor cell-based therapies demonstrate potential for treating chronic limb ischemia.
- Definitive proof of efficacy is lacking due to limitations in existing clinical studies.
- Larger, randomized, blinded, placebo-controlled trials are required to validate bone marrow progenitor cell therapy for CLI.
Objective:
To provide a review on progenitor cell therapy for critical limb ischemia.
Summary Background Data:
Critical limb ischemia is estimated to develop in 500 to 1000 individuals per million persons per year and has a major impact on the quality of life. Despite recent advances in surgical and radiologic vascular procedures, a large number of patients ( approximately 40%) are not eligible for these revascularization procedures. New strategies for revascularization need to be explored. Recent evidence indicates that bone marrow-derived mononuclear cells are a potential new therapeutic target.
Methods:
A comprehensive review of all published literature on progenitor cell therapy in patients with critical limb ischemia was performed.
Results:
Twenty-five clinical studies that reported on the use of mononuclear cells or progenitor cells for the treatment of patients with critical limb ischemia have been published, of which 18 were included in this review. Seven studies were published in Chinese, Japanese, or Polish and, therefore, not included.
Conclusions:
Pioneering clinical studies report promising results for progenitor cell-based therapies for chronic limb ischemia, but no definite proof is available because the clinical studies thus far have been small and lacked double-blinded controls. Larger, randomized, blinded, placebo-controlled trials to investigate the potential clinical effects of bone marrow progenitor cell administration in patients with critical limb ischemia are needed.
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