Treatment of diabetic peripherial artery disease with autologous bone marrow or peripherial blood derived cells

Abstract

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Diabetic foot syndrome occurs in 10,0% of cases among patients with diabetes mellitus, ulcers heal too long, are accompanied by infectious processes and occurs gradually leading to the amputation of the affected limb. Some authors suggest, that the paracrine factors secreted by mononuclear stem cells (MNCs) are these the main driving force behind its therapeutic activity. In the current study, we investigate the efficacy and safety of the therapy of ischemia using stem cells in patients with diabetes mellitus. An assessment of the paracrine functionality of the patient's cells was performed. There were three groups: the patients from the main group were treated with intramuscular injections of mobilized autologous mononuclear cells (12) or bone marrow autologous cells (5). The patients of the control group (20) had similar conservative and endovascular treatment within the same time period without stem cells. We analyzed cell types, level of cell proliferation and viability, promising effects of MNCs conditioned medias on proliferation of lines fibroblasts, MSCs from patients without diabetes mellitus and EaHy926, migration on the wound model. The tolerance of patients to cell therapy is high, the number and volume of surgical interventions on the foot after cell therapy are less, epithelialization of trophic ulcers and restoration of the support function of the limb are higher in the main group. There is a patient-specific correlation between the composition of the cellular product, conditioned media and their clinical effect. We suggest that MNCs conditioned medias can be employed in regenerative medicine for therapeutic angiogenesis and skin repair in difficult-to-heal conditions such as diabetic foot.