Advances in Cell-based therapies for peripheral arterial disease

Area of Science:

• Regenerative Medicine
• Vascular Biology
• Translational Research

Background:

• Peripheral arterial disease (PAD) presents significant unmet needs, especially in critical limb ischemia (CLI) patients.
• Conventional treatments for PAD have limitations, necessitating novel therapeutic approaches.

Purpose of the Study:

• To review recent advances in cell-based therapies for PAD.
• To evaluate mechanisms, clinical applications, and regulatory aspects of these therapies.
• To assess the potential of various cell types for treating PAD and CLI.

Main Methods:

• Literature review of preclinical and clinical studies (Phase I-III) on cell therapies for PAD.
• Evaluation of mesenchymal stem cells (MSCs), endothelial progenitor cells (EPCs), bone marrow mononuclear cells (BMMNCs), and adipose-derived stem cells (ADSCs).
• Analysis of regulatory frameworks, including the FDA's approach to HCT/Ps.

Main Results:

• Preclinical studies show improved limb perfusion and neovascularization with cell therapies.
• Clinical trials with MSCs and BMMNCs indicate positive outcomes in wound healing and reduced amputation rates.
• Therapeutic effects are mediated by angiogenesis, paracrine signaling, immunomodulation, and tissue repair.

Conclusions:

• Cell-based therapies offer promising treatment potential for PAD, particularly for CLI patients.
• Standardization of cell characterization and potency assays are key challenges.
• Future research should focus on optimizing delivery, identifying optimal cell types, and conducting large-scale clinical trials.