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Autologous Bone-Marrow vs. Peripheral Blood Mononuclear Cells Therapy for Peripheral Artery Disease in Diabetic Patients

International Journal of Stem Cells 2021년 14권 1호 p.21 ~ 32
Yunir Em, Kurniawan Farid, Rezaprasga Edo, Wijaya Ika Prasetya, Suroyo Indrati, Matondang Sahat, Irawan Cosphiadi, Soewondo Pradana,
소속 상세정보
 ( Yunir Em ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine
 ( Kurniawan Farid ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine
 ( Rezaprasga Edo ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine
 ( Wijaya Ika Prasetya ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine
 ( Suroyo Indrati ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Radiology
 ( Matondang Sahat ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Radiology
 ( Irawan Cosphiadi ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine
 ( Soewondo Pradana ) - Universitas Indonesia Faculty of Medicine Dr. Cipto Mangunkusumo National General Hospital Department of Internal Medicine

Abstract


Diabetes mellitus (DM) remains one of the most important risk factors for peripheral artery disease (PAD), with approximately 20% of DM patients older than 40 years old are affected with PAD. The current standard management for severe PAD is endovascular intervention with or without surgical bypass. Unfortunately, up to 40% of patients are unable to undergo these revascularization therapies due to excessive surgical risk or adverse vascular side effects. Stem cell therapy has emerged as a novel therapeutic strategy for these ‘no-option’ patients. Several types of stem cells are utilized for PAD therapy, including bone marrow mononuclear cells (BMMNC) and peripheral blood mononuclear cells (PBMNC). Many studies have reported the safety of BMMNC and PBMNC, as well as its efficacy in reducing ischemic pain, ulcer size, pain-free walking distance, ankle-brachial index (ABI), and transcutaneous oxygen pressure (TcPO2). However, the capacity to establish the efficacy of reducing major amputation rates, amputation free survival, and all-cause mortality is limited, as shown by several randomized placebo-controlled trials. The present literature review will focus on comparing safety and efficacy between BMMNC and PBMNC as cell-based management in diabetic patients with PAD who are not suitable for revascularization therapy.

키워드

Peripheral artery disease; Diabetes mellitus; Stem cell therapy; Bone marrow mononuclear cells; Peripheral blood mononuclear cells

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