Adult Stem Cells and the Clinical Arena: Are we Able to Widely Use this Therapy in Patients with Chronic Limbs Arteriopathy and Ischemic Ulcers without Possibility of Revascularization?

Amelia      Casamassimi; Vincenzo      Grimaldi; Teresa      Infante; Mohammed      Al-Omran; Valeria      Crudele; Claudio      Napoli

Abstract

The following paper is an overview on stem cells therapy in patients with peripheral vascular diseases. Recent research shows the ability of stem cells to develop and strengthen the collateral network in ischemic legs. Here, we discuss this clinical and therapeutic approach. To date, research has been mainly focused on patients with ischemic ulcers without possibility of revascularization. Non-invasive stem cell therapy has been proposed as an alternative to the amputation of such patients, but when the ulcers appear it is sometime too late. In our point of view, the selection of patients is a very important issue and we believe that the best candidate for this treatment is the patient with intermittent claudication before the development of ulcers. This choice could allow the optimization of results by the type of treated patients and not only by the type of infused cells. Indeed, several variables still remain to be elucidated for stem cell therapy, including the type of cells to be used, the infusion route, and more importantly, the stage of patients to be treated.

Keywords: Angiogenesis, autologous transplantation, bone marrow cells, circulating endothelial progenitor cells, clinical trials, Fontaine’s stage, gangrene, intermittent claudication, limb ischemia, peripheral arterial disease, revascularization