Article

Granulocyte colony-stimulating factor: a noninvasive regeneration therapy for treating atherosclerotic peripheral artery disease.

Department of Cardiology, Regeneration Medicine and Bioethics, Gifu University Graduate School of Medicine, Japan.
Circulation Journal (Impact Factor: 3.69). 10/2006; 70(9):1093-8.
Source: PubMed

ABSTRACT The purpose of this study was to determine whether treatment with granulocyte colony-stimulating factor (G-CSF), which mobilizes endothelial progenitor cells from bone marrow, can safely improve the clinical outcomes of patients with atherosclerotic peripheral artery disease (PAD).
Thirty-nine patients with intractable PAD were randomly assigned to 3 groups: a negative control group (n=12) treated with conventional drug therapy; a positive control group (n=13) treated with conventional drug therapy plus bone marrow transplantation (BMT); and a G-CSF group (n=14) treated with conventional therapy plus subcutaneous injection of 2-5 microg/kg of recombinant human G-CSF once daily for 10 days. One month after treatment, subjective symptoms improved significantly in the G-CSF and BMT groups. Ankle-brachial pressure index and transcutaneous oxygen pressure increased significantly in the BMT and G-CSF groups, but no such improvements were seen in the group receiving conventional therapy alone.
G-CSF improves the clinical signs and symptoms of patients with intractable PAD to the same degree as BMT does. This noninvasive treatment may thus represent a useful new approach to managing the disease.

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    • "Thus, interventions that increase circulating progenitor cells may promote angiogenesis and improve walking performance in people with PAD [16]. However, results of studies conducted to date have been mixed [11] [19] [20]. Therefore, it is currently unclear whether interventions that increase progenitor cell levels improve walking performance in patients with PAD. "
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    • "Growth factors that can naturally mobilize bone marrow progenitor cells to peripheral blood have been tested for their ability to treat various atherosclerotic diseases. While favourable results have been reported in peripheral arterial disease, such as improvement in limb perfusion [96], limited benefits were shown in patients with myocardial infarction [97] [98], although men seemed more susceptible to favourable effects [99]. Moreover, doubts remain regarding the functional integrity of EPCs mobilized by those pharmacological agents [87]. "
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