Hassanshahi Mohammadhossein, Khabbazi Samira, Peymanfar Yaser, Hassanshahi Alireza, Hosseini-Khah Zahra, Su Yu-Wen, Xian Cory J
School of Pharmacy and Medical Sciences, University of South Australia Cancer Research Institute, University of South Australia, Adelaide, SA, Australia.
Department of Genetics, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran.
J Cell Physiol. 2019 Sep;234(9):14445-14459. doi: 10.1002/jcp.28141. Epub 2019 Jan 13.
Critical limb ischemia (CLI) is the advanced stage of peripheral artery disease spectrum and is defined by limb pain or impending limb loss because of compromised blood flow to the affected extremity. Current conventional therapies for CLI include amputation, bypass surgery, endovascular therapy, and pharmacological approaches. Although these conventional therapeutic strategies still remain as the mainstay of treatments for CLI, novel and promising therapeutic approaches such as proangiogenic gene/protein therapies and stem cell-based therapies have emerged to overcome, at least partially, the limitations and disadvantages of current conventional therapeutic approaches. Such novel CLI treatment options may become even more effective when other complementary approaches such as utilizing proper bioscaffolds are used to increase the survival and engraftment of delivered genes and stem cells. Therefore, herein, we address the benefits and disadvantages of current therapeutic strategies for CLI treatment and summarize the novel and promising therapeutic approaches for CLI treatment. Our analyses also suggest that these novel CLI therapeutic strategies show considerable advantages to be used when current conventional methods have failed for CLI treatment.
严重肢体缺血（CLI）是外周动脉疾病谱的晚期阶段，其定义为由于受影响肢体的血流受损而导致的肢体疼痛或即将出现的肢体丧失。目前用于CLI的传统疗法包括截肢、搭桥手术、血管内治疗和药物治疗方法。尽管这些传统治疗策略仍然是CLI治疗的主要手段，但诸如促血管生成基因/蛋白质疗法和基于干细胞的疗法等新颖且有前景的治疗方法已经出现，以至少部分地克服当前传统治疗方法的局限性和缺点。当使用其他辅助方法（如利用合适的生物支架）来提高递送的基因和干细胞的存活率和植入率时，这种新颖的CLI治疗选择可能会变得更加有效。因此，在本文中，我们阐述了当前CLI治疗策略的优缺点，并总结了CLI治疗的新颖且有前景的治疗方法。我们的分析还表明，当当前传统方法在CLI治疗中失败时，这些新颖的CLI治疗策略显示出相当大的优势可被采用。
