Rheumatology Advance Access originally published online on February 19, 2007
Rheumatology 2007 46(5):882-884; doi:10.1093/rheumatology/kel436
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Local implantation of autologous mononuclear cells from bone marrow and peripheral blood for treatment of ischaemic digits in patients with connective tissue diseases
1Division of Rheumatology and Clinical Immunology, 2Division of Cardiovascular Medicine and 3Division of Cell Transplantation and Transfusion, Jichi Medical University, Tochigi-ken, Japan.
Correspondence to: Yasuyuki Kamata, MD, Division of Rheumatology and Clinical Immunology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan. E-mail: y.kamata{at}jichi.ac.jp
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Abstract |
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Objective. CD34-positive bone marrow mononuclear cells (MNCs) have been successfully used for regeneration of small arteries in Buerger's disease. The objective of this study is to examine the angiogenetic potential of autologous MNCs from bone marrow and peripheral blood implanted into the ischaemic digits from patients with connective tissue diseases.
Methods. Three patients with systemic sclerosis, two with mixed connective tissue disease, and one with CREST syndrome were enrolled who had painful ischaemic digits with necrosis refractory to several vasodilators including intravenous prostaglandins. MNCs obtained from 7 ml/kg bone marrow blood and 400 ml peripheral blood were implanted into 20 different sites in palms and/or soles. The study was performed open-labelled.
Results. Pain in the numeric rating scale improved remarkably up to 1 month after implantation of bone marrow or peripheral MNCs to the same extent, although no significant differences were found in transcutaneous oxygen pressure and thermogram before and after the implantation. Bone marrow MNCs increased blood flow of the hand determined by intra-arterial digital subtraction angiography, while peripheral MNCs did not.
Conclusions. Implantation of autologous MNCs from peripheral and bone marrow into the ischaemic digits was so effective in pain-relief and more clinical trials would be warranted to see whether this could be a new treatment modality for angiogenesis in connective tissue diseases as in Buerger's disease.
KEY WORDS: Connective tissue disease, Bone marrow mononuclear cell, Peripheral mononuclear cell, CD34-positive cell, Angiogenesis
Submitted 29 August 2006;
revised version accepted 8 December 2006.
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