Int J Stem Cells.  2013 May;6(1):37-44.

A Phase I Study of Human Cord Blood-Derived Mesenchymal Stem Cell Therapy in Patients with Peripheral Arterial Occlusive Disease

Affiliations
  • 1Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dikim@skku.edu
  • 2Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Veterinary Public Health, College of Veterinary Medicine, Seoul National University, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Half of patients with critical limb ischemia (CLI) are ineligible for revascularization at diagnosis. The aim of this study was to assess the safety and feasibility of intramuscular human umbilical cord blood-derived mesenchymal stem cell (hUCB-MSC) therapy in patients with CLI due to atherosclerosis obliterans (ASO) or thromboangiitis obliterans (TAO).
METHODS AND RESULTS
A total of eight patients (all male, median age 52 years, range 31~77) with CLI were enrolled in this phase I trial. All patients were considered ineligible for further revascularization to improve CLI. We injected 1x10(7) hUCB-MSCs per single dose intramuscularly into the affected limb. The primary end points of safety were occurrence of adverse events (procedure-related complication, allergic reaction to hUCB-MSCs, graft-versus-host disease, cardiovascular and cerebrovascular events) and improvement of symptoms/clinical parameters (healing of foot ulcer, ankle-brachial index, and pain-free walking distance). Angiogenesis was measured with conventional angiography and scored by an independent reviewer. There were four adverse events in three patients. One patient, developed whole body urticaria after injection on treatment day, which disappeared after one day of antihistamine treatment. The other adverse events included diarrhea, oral ulceration, and elevation of serum creatinine level; all conditions improved without treatment. Abnormal results of laboratory parameters were not detected in any patients. Three of four ulcerations (75%) healed completely. Angiographic scores increased in three of eight patients.
CONCLUSIONS
This phase I study demonstrates that intramuscular hUCB-MSC injection is a safe and well tolerated treatment for patients with end-stage CLI due to ASO and TAO.

Keyword

Stem cell; Cord blood; PAOD; Mesenchymal

MeSH Terms

Angiography
Ankle Brachial Index
Arterial Occlusive Diseases
Atherosclerosis
Creatinine
Diarrhea
Extremities
Fetal Blood
Foot Ulcer
Graft vs Host Disease
Humans
Hypersensitivity
Ischemia
Male
Mesenchymal Stromal Cells
Oral Ulcer
Oxalates
Stem Cells
Thromboangiitis Obliterans
Troleandomycin
Ulcer
Umbilical Cord
Urticaria
Walking
Creatinine
Oxalates
Troleandomycin
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