Biological aspects and clinical application of bone-marrow stem cells in critical lower limb ischaemia

Orekhov P.Yu., Troitsky A.V., Chupin A.V.

Vascular Surgery Department, Federal Scientific Clinical Centre of Specialized Types of Medical Care and Medical Technologies under the Federal Biomedical Agency of Russia, Moscow, Russia

Critical lower-limb ischaemia (CLLI) is associated with high risk of limb loss and a lethal outcome, as well as with decreased quality of life. The underlying cause of the disease is imbalance between blood supply of ischaemized tissues and their metabolic demands. Restoration of adequate perfusion with the help of standard medicamentous therapy or operative treatment is often inefficient or impossible. Cell therapy (CT) is a novel strategy making it possible to stimulate the growth of the microvascular bed and the mechanisms of molecular-cellular repair. One of the most promising trends is the use of bone marrow stem cells (BMSCs). Sufficient evidence concerning safety and relative efficacy of CT has by now been accumulated. The existing differences in the results of studies are related to numerous peculiarities of both CT itself and methods of its application. The present review is dedicated to contemporary notions of the biology of BMSCs, assessment of safety of CT and the results of its application in treatment of CLLI.

KEY WORDS: critical lower-limb ischemia, cell therapy, brain marrow stem cells, mesenchymal stem cells, arteriogenesis.

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