Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
J Thorac Cardiovasc Surg. 2010 Feb;139(2):459-65. doi: 10.1016/j.jtcvs.2009.07.053. Epub 2009 Sep 13.
The implantation of autologous bone marrow-derived cells has been used for the treatment of ischemic diseases, but obvious interindividual differences were observed in the improvement of regional perfusion and cardiac function after treatment. We examined the angiogenic potency of bone marrow cells from patients with different clinical backgrounds.
Bone marrow cells were collected from 25 patients scheduled to undergo sternotomy for various surgical procedures. We examined the quality of bone marrow cells and investigated their angiogenic potency by using an ischemic limb model in mice with severe combined immunodeficiency.
When compared with their control cohort, bone marrow cells from patients with advanced age, renal failure, or anemia had significantly less c-kit- and CD34-positive stem cells (P < .05) and showed significantly lower vascular endothelial growth factor production and colony-forming units in culture (P < .05). Furthermore, the implantation of bone marrow cells from patients with advanced age, renal failure, or anemia into the ischemic limbs of mice also resulted in significantly worse blood flow recovery and clinical score when compared with the implantation of bone marrow cells from their control cohorts (P < .05). However, the bone marrow cells from patients with diabetes and hypertension did not show significant impairment of angiogenic potency when compared with their control cohorts.
The quality and angiogenic potency of bone marrow cells differs among patients. Advanced age, renal failure, and anemia should be the risk factors related to poor angiogenic potency of bone marrow cells for the treatment of ischemic diseases.
自体骨髓来源细胞的移植已被用于治疗缺血性疾病，但在治疗后局部灌注和心功能的改善方面，观察到明显的个体间差异。我们研究了不同临床背景患者的骨髓细胞的血管生成能力。
从 25 名因各种手术程序而计划行胸骨切开术的患者中采集骨髓细胞。我们通过严重联合免疫缺陷小鼠的缺血肢体模型来检查骨髓细胞的质量，并研究其血管生成能力。
与对照组相比，高龄、肾衰竭或贫血患者的骨髓细胞中 c-kit 和 CD34 阳性干细胞明显减少（P <.05），血管内皮生长因子产生和培养中的集落形成单位也明显减少（P <.05）。此外，与对照组相比，将高龄、肾衰竭或贫血患者的骨髓细胞植入到缺血肢体的小鼠中，也导致血流恢复和临床评分明显更差（P <.05）。然而，与对照组相比，糖尿病和高血压患者的骨髓细胞并未显示出明显的血管生成能力受损。
骨髓细胞的质量和血管生成能力在患者之间存在差异。高龄、肾衰竭和贫血应该是与治疗缺血性疾病的骨髓细胞血管生成能力差相关的危险因素。
