Stem cell-based peripheral vascular regeneration

Chronic critical limb ischemia (CLI) represents an end-stage manifestation of peripheral arterial disease (PAD). CLI patients are at very high risk of amputation and cardiovascular complications, leading to severe morbidity and mortality. Because many patients with CLI are ineligible for conventiona...

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Bibliographic Details
Published in:Advanced drug delivery reviews 2017-10, Vol.120, p.25-40
Main Authors: Fujita, Yasuyuki, Kawamoto, Atsuhiko
Format: Article
Language:English
Subjects:
Angiogenesis
Cell therapy
Critical limb ischemia
Neovascularization
Peripheral artery disease
Vasculogenesis
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Summary:Chronic critical limb ischemia (CLI) represents an end-stage manifestation of peripheral arterial disease (PAD). CLI patients are at very high risk of amputation and cardiovascular complications, leading to severe morbidity and mortality. Because many patients with CLI are ineligible for conventional revascularization procedures, it is urgently needed to explore alternative strategies to improve blood supply in the ischemic tissue. Although researchers initially focused on gene/protein therapy using proangiogenic growth factors/cytokines, recent discovery of somatic stem/progenitor cells including bone marrow (BM)-derived endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) has drastically developed the field of therapeutic angiogenesis for CLI. Overall, early phase clinical trials demonstrated that stem/progenitor cell therapies may be safe, feasible and potentially effective. However, only few late-phase clinical trials have been conducted. This review provides an overview of the preclinical and clinical reports to demonstrate the usefulness and the current limitations of the cell-based therapies. [Display omitted]
ISSN:0169-409X
1872-8294
DOI:10.1016/j.addr.2017.09.001