التفاصيل البيبلوغرافية
| العنوان: |
Results of a prospective observational study of autologous peripheral blood mononuclear cell therapy for no-option critical limb-threatening ischemia and severe diabetic foot ulcers. |
| المؤلفون: |
Panunzi, Andrea, Madotto, Fabiana, Sangalli, Elena, Riccio, Federica, Sganzaroli, Adriana Barbara, Galenda, Paolo, Bertulessi, Amelia, Barmina, Maria Francesca, Ludovico, Ornella, Fortunato, Orazio, Setacci, Francesco, Airoldi, Flavio, Tavano, Davide, Giurato, Laura, Meloni, Marco, Uccioli, Luigi, Bruno, Antonino, Spinetti, Gaia, Caravaggi, Carlo Maria Ferdinando |
| المصدر: |
Cardiovascular Diabetology; 9/28/2022, Vol. 21 Issue 1, p1-10, 10p |
| مصطلحات موضوعية: |
MONONUCLEAR leukocytes, DIABETIC foot, CELLULAR therapy, ISCHEMIA, LONGITUDINAL method, FOOT diseases |
| مستخلص: |
Background: Cell therapy with autologous peripheral blood mononuclear cells (PB-MNCs) may help restore limb perfusion in patients with diabetes mellitus and critical limb-threatening ischemia (CLTI) deemed not eligible for revascularization procedures and consequently at risk for major amputation (no-option). Fundamental is to establish its clinical value and to identify candidates with a greater benefit over time. Assessing the frequency of PB circulating angiogenic cells and extracellular vesicles (EVs) may help in guiding candidate selection. Methods: We conducted a prospective, non-controlled, observational study on no-option CLTI diabetic patients that underwent intramuscular PB-MNCs therapy, which consisted of more cell treatments repeated a maximum of three times. The primary endpoint was amputation rate at 1 year following the first treatment with PB-MNCs. We evaluated ulcer healing, walking capability, and mortality during the follow-up period. We assessed angiogenic cells and EVs at baseline and after each cell treatment, according to primary outcome and tissue perfusion at the last treatment [measured as transcutaneous oxygen pressure (TcPO2)]. Results: 50 patients were consecutively enrolled and the primary endpoint was 16%. TcPO2 increased after PB-MNCs therapy (17.2 ± 11.6 vs 39.1 ± 21.8 mmHg, p <.0001), and ulcers healed with back-to-walk were observed in 60% of the study population (88% of survivors) during follow-up (median 1.5 years). Patients with a high level of TcPO2 (≥ 40 mmHg) after the last treatment showed a high frequency of small EVs at enrollment. Conclusions: In no-option CLTI diabetic patients, PB-MNCs therapy led to an improvement in tissue perfusion, a high rate of healing, and back-to-walk. Coupling circulating cellular markers of angiogenesis could help in the identification of patients with a better clinical benefit over time. [ABSTRACT FROM AUTHOR] |
|
Copyright of Cardiovascular Diabetology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder