Granulocyte colony-stimulating factor: a noninvasive regeneration therapy for treating atherosclerotic peripheral artery disease.
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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Article: Thromoboagiitis Obliterans (TAO)[Show abstract] [Hide abstract]
ABSTRACT: Thromboangiitis obliterans (TAO) is nonatherosclerotic inflammatory disease of the peripheral blood vessels, and TAO affects the small and medium sized vessels of the extremities. TAO is mainly seen in young males who smoke, and smoking is strongly associated with the disease course and progression. The diagnosis is made on the basis of the history, the physical examination and the clinical diagnostic criteria. As the bedrock for treating patients with TAO, absolute abstinence from tobacco is most important factor, and patients with TAO are usually managed conservatively. Surgical bypass or endovascular therapy is usually not possible for patients with TAO because of the diffuse segmental involvement and the distal nature of the disease. Therefore, stem cell therapy is considered to be a novel therapeutic modality for treating patients with TAO and who are not eligible for conventional revascularization therapies. In this paper, I have summarized the recent knowledge about TAO and I have reviewed the recent studies that have focused on the treatment of TAO.05/2010; 3(1):1-7. DOI:10.15283/ijsc.2010.3.1.1
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ABSTRACT: There is concern that regenerative cell-based therapies could result in increased risk of tumor formation. We investigated the long-term risks for systemic and site-specific cancers in patients who had received autologous bone marrow-derived stromal progenitor cells to treat orthopaedic lesions. A total of 1873 patients were treated from 1990 to 2006 with bone marrow-derived concentrated cells. Patients were monitored for cancer incidence from the date of the first operation (1990) until death, or until December 31, 2011. The mean follow-up time was 12.5 years (range, five to twenty-two years). The average number of colony-forming unit fibroblasts returned to the patients was 483,000 fibroblasts (range, 62,000 to 2,095,000 fibroblasts). The primary outcome was to evaluate with radiographs and/or magnetic resonance imaging the risk of tumorigenesis at the cell therapy treatment sites. The secondary outcome was to evaluate the risk of cancer diagnosed in areas other than the treatment site during the follow-up period. The relative risk of cancer was expressed as the ratio of observed and expected number of cases, that is, the standardized incidence ratio, according to the cancer incidence in the French population. No tumor formation was found at the treatment sites on the 7306 magnetic resonance images and 52,430 radiographs among the 1873 patients. Fifty-three cancers were diagnosed in areas other than the treatment site. On the basis of cancer incidence in the general population during the same period, the expected number of cancers was between ninety-seven and 108 for the same age and sex distribution. The range of the standardized incidence ratio for the follow-up period was between 0.49 and 0.54 (95% confidence interval, 0.30 to 0.80). This study found no increased cancer risk in patients after application of autologous cell-based therapy using bone marrow-derived stromal progenitor cells either at the treatment site or elsewhere in the patients after an average follow-up period of 12.5 years. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.The Journal of Bone and Joint Surgery 12/2013; 95(24):2215-21. DOI:10.2106/JBJS.M.00261 · 4.31 Impact Factor