Autologous Peripheral Blood Mononuclear Cell Implantation for Patients With Peripheral Arterial Disease Improves Limb Ischemia

Akio Ishida; Yusuke Ohya; Hitoshi Sakuda; Katsuhiko Ohshiro; Yasushi Higashiuesato; Moriyasu Nakaema; Shinobu Matsubara; Shizuko Yakabi; Ayano Kakihana; Mika Ueda; Chiharu Miyagi; Nobuhisa Yamane; Kageharu Koja; Kimihiro Komori; Shuichi Takishita

doi:10.1253/circj.69.1260

Clinical Investigation

Autologous Peripheral Blood Mononuclear Cell Implantation for Patients With Peripheral Arterial Disease Improves Limb Ischemia

Akio Ishida, Yusuke Ohya, Hitoshi Sakuda, Katsuhiko Ohshiro, Yasushi Higashiuesato, Moriyasu Nakaema, Shinobu Matsubara, Shizuko Yakabi, Ayano Kakihana, Mika Ueda, Chiharu Miyagi, Nobuhisa Yamane, Kageharu Koja, Kimihiro Komori, Shuichi Takishita

Author information

Akio Ishida
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine
Yusuke Ohya
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine
Hitoshi Sakuda
Second Department of Surgery, University of the Ryukyus School of Medicine
Katsuhiko Ohshiro
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine
Yasushi Higashiuesato
Department of Clinical Laboratories, University of the Ryukyus School of Medicine
Moriyasu Nakaema
Second Department of Surgery, University of the Ryukyus School of Medicine
Shinobu Matsubara
Second Department of Surgery, University of the Ryukyus School of Medicine
Shizuko Yakabi
Blood Transfusion Department, University of the Ryukyus School of Medicine
Ayano Kakihana
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine
Mika Ueda
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine
Chiharu Miyagi
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine
Nobuhisa Yamane
Blood Transfusion Department, University of the Ryukyus School of Medicine
Kageharu Koja
Second Department of Surgery, University of the Ryukyus School of Medicine
Kimihiro Komori
Division of Vascular Surgery, Department of Surgery, Nagoya University, Graduate School of Medicine
Shuichi Takishita
Division of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine

Keywords: Granulocyte-colony stimulating factor, Peripheral arterial disease, Peripheral blood mononuclear cells, Therapeutic angiogenesis

JOURNAL FREE ACCESS

2005 Volume 69 Issue 10 Pages 1260-1265

DOI https://doi.org/10.1253/circj.69.1260

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Abstract

Background Implantation of bone marrow mononuclear cells, including endothelial progenitor cells, into ischemic limbs has been shown to improve collateral vessel formation. In the present study the safety and feasibility of autologous peripheral blood mononuclear cells (PBMNCs) implantation after granulocyte-colony stimulating factor (G-CSF)-induced mobilization was investigated in patients with severe peripheral arterial disease. Methods and Results Six cases were enrolled: 5 of thromboangitis obliterans and 1 of arteriosclerosis obliterans. Following administration of G-CSF (10 μg · kg^-1 · day^-1), PBMNCs were harvested and injected intramuscularly (5 legs and 1 arm) for 2 days for the patients with ischemia of the legs. No serious adverse events related to G-CSF administration, harvest or implantation were observed during this study period. Improvement in the ankle - brachial pressure index (ABI: >0.1) was seen in 4 patients at 4 weeks and ischemic ulcers improved in 3 of 3 patients. The mean maximum walking distance significantly increased from 203 m to 559 m (p=0.031) at 4 weeks and was sustained for 24 weeks. Significant improvement was seen in physiological functioning subscale of Short Form-36. Conclusion Implantation of PBMNCs collected after G-CSF administration could be an alternative to therapeutic angioplasty in patients with severe peripheral arterial disease. (Circ J 2005; 69: 1260 - 1265)

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