Reply to “Peripheral Blood Mononuclear Cells Therapy for Treatment of Lower Limb Ischemia in Diabetic Patient: It Is Really True?”

2019 ◽  
Vol 58 ◽  
pp. 387-388
Author(s):  
Francesca Persiani ◽  
Sergio Furgiuele
Keyword(s):  
Diabetic Patient ◽  
Peripheral Blood Mononuclear Cells ◽  
Lower Limb ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Limb Ischemia ◽  
Peripheral Blood Mononuclear ◽  
Lower Limb Ischemia ◽  
Blood Mononuclear Cells

scholarly journals Autologous Peripheral Blood Mononuclear Cells for Limb Salvage in Diabetic Foot Patients with No-Option Critical Limb Ischemia

2021 ◽  
Vol 10 (10) ◽  
pp. 2213
Author(s):  
Alessia Scatena ◽  
Pasquale Petruzzi ◽  
Filippo Maioli ◽  
Francesca Lucaroni ◽  
Cristina Ambrosone ◽  
...  
Keyword(s):  
Peripheral Blood Mononuclear Cells ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Limb Ischemia ◽  
Control Group ◽  
Peripheral Blood Mononuclear ◽  
Blood Mononuclear Cells

Peripheral blood mononuclear cells (PBMNCs) are reported to prevent major amputation and healing in no-option critical limb ischemia (NO-CLI). The aim of this study is to evaluate PBMNC treatment in comparison to standard treatment in NO-CLI patients with diabetic foot ulcers (DFUs). The study included 76 NO-CLI patients admitted to our centers because of CLI with DFUs. All patients were treated with the same standard care (control group), but 38 patients were also treated with autologous PBMNC implants. Major amputations, overall mortality, and number of healed patients were evaluated as the primary endpoint. Only 4 out 38 amputations (10.5%) were observed in the PBMNC group, while 15 out of 38 amputations (39.5%) were recorded in the control group (p = 0.0037). The Kaplan–Meier curves and the log-rank test results showed a significantly lower amputation rate in the PBMNCs group vs. the control group (p = 0.000). At two years follow-up, nearly 80% of the PBMNCs group was still alive vs. only 20% of the control group (p = 0.000). In the PBMNC group, 33 patients healed (86.6%) while only one patient healed in the control group (p = 0.000). PBMNCs showed a positive clinical outcome at two years follow-up in patients with DFUs and NO-CLI, significantly reducing the amputation rate and improving survival and wound healing. According to our study results, intramuscular and peri-lesional injection of autologous PBMNCs could prevent amputations in NO-CLI diabetic patients.

Therapeutic neovascularization by transplantation of mobilized peripheral blood mononuclear cells for limb ischemia

2006 ◽  
Vol 95 (02) ◽  
pp. 301-311 ◽  
Author(s):  
Shu Li ◽  
Bin Zhou ◽  
Zhong Han
Keyword(s):  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Human Peripheral Blood ◽  
Limb Ischemia ◽  
Doppler Imaging ◽  
Peripheral Blood Mononuclear ◽  
Therapeutic Efficiency ◽  
Cd34 Cells ◽  
Blood Mononuclear Cells

SummaryAutolougous transplantation of granulocyte colony-stimulating factor (G-CSF)-mobilized human peripheral blood mononuclear cells (PBMNCs) improves limb ischemia in patients with arteriosclerosis obliterans of lower extremities and with diabetic foot. However, the mechanism of action of PBMNCs remains elusive. Here, we studied comparatively the effects of the G-CSF-mobilized PBMNCs and CD34-depleted G-CSF-mobilized PBMNCs in an ischemia model of athymic nude mice. Fluorescence-labeled human PBMNCs [1×106] were intramuscularly injected into the unilateral ischemic hindlimbs of mice. Laser Doppler imaging analysis revealed a significantly augmented blood perfusion at day 7, 14 and 28 after operation. The capillary density was also markedly increased and the rate of limb loss was significantly reduced in cell-transplanted groups when compared with those in PBS group. In comparison with G-CSF-mobilized PBMNCs, the therapeutic efficiency of G-CSF-mobilized PBMNCs deprived of CD34+ cells was impaired. Transplanted cells were found to accumulate around arterioles and scatter in capillary networks. Incorporation of transplanted cells into new capillaries was observed in the G-CSF-mobilized PBMNCs group, but was not detected in the group deprived of CD34+ cells. There was an elevated expression of VEGF in ischemic tissue. Colocalization of VEGF and transplanted mononuclear cells within adductor tissue was demonstrated. These findings indicate that G-CSF-mobilized PBMNCs promote vascular growth not only by incorporating into vessel walls but also by supplying angiogenic factors. The depletion of CD34+ cells attenuated the therapeutic efficiency of G-CSF-mobilized PBMNCs in response to ischemia-induced neovascularization.

scholarly journals Use of autologous peripheral blood mononuclear cells in a case of diabetic foot

2019 ◽  
Vol 22 (4) ◽  
pp. 230
Author(s):  
Di Vieste, G.
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Blood Mononuclear Cells ◽  
Critical Limb Ischemia ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Limb Ischemia ◽  
Major Amputation ◽  
Peripheral Blood Mononuclear ◽  
Blood Mononuclear Cells ◽  
The Right

The implantation of peripheral blood mononuclear cells (PBMNC), an autologous concentrate with high angiogenic and regenerative capability is an innovative therapeutic approach in the treatment of peripheral arteriopathies of patients with critical limb ischemia. We describe the case of a 59-year-old patient with type 2 diabetes mellitus who had a gangrene of the right toe. The critical limb ischemia required an angioplasty that was ineffective due to the widespread, obstructive, intractable and calcific disease of the distal tibial vessels and of the foot vessels. Because of the therapeutic failure, being the patient otherwise candidated for major amputation, it was decided to use a PBMNC therapy. This approach consists in the inoculation in the perilesional area and along the vascular axes of the affected lower limb of a concentrate of mononuclear cells taken from peripheral blood by using a selective filtration separation system. The patient underwent to amputation of the first necrotic toe and three PBMNC treatment sessions with complete surgical wound haeling and limb rescue. KEYWORDS diabetes mellitus; critical limb ischemia; mononuclear cells therapy.

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