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细胞疗法治疗严重肢体缺血:治疗严重糖尿病血管病变患者的优势、局限性和新视角。

Cell Therapy for Critical Limb Ischemia: Advantages, Limitations, and New Perspectives for Treatment of Patients with Critical Diabetic Vasculopathy.

机构信息

Bristol Medical School, Translational Health Sciences, University of Bristol, Upper Maudlin Street, Bristol, BS2 8HW, UK.

Laboratory of Cardiovascular Research, IRCCS, MultiMedica, Milan, Italy.

出版信息

Curr Diab Rep. 2021 Mar 2;21(3):11. doi: 10.1007/s11892-021-01378-4.

Abstract

PURPOSE OF REVIEW

To provide a highlight of the current state of cell therapy for the treatment of critical limb ischemia in patients with diabetes.

RECENT FINDINGS

The global incidence of diabetes is constantly growing with consequent challenges for healthcare systems worldwide. In the UK only, NHS costs attributed to diabetic complications, such as peripheral vascular disease, amputation, blindness, renal failure, and stroke, average £10 billion each year, with cost pressure being estimated to get worse. Although giant leaps forward have been registered in the scope of early diagnosis and optimal glycaemic control, an effective treatment for critical limb ischemia is still lacking. The present review aims to provide an update of the ongoing work in the field of regenerative medicine. Recent advancements but also limitations imposed by diabetes on the potential of the approach are addressed. In particular, the review focuses on the perturbation of non-coding RNA networks in progenitor cells and the possibility of using emerging knowledge on molecular mechanisms to design refined protocols for personalized therapy. The field of cell therapy showed rapid progress but has limitations. Significant advances are foreseen in the upcoming years thanks to a better understanding of molecular bottlenecks associated with the metabolic disorders.

摘要

目的综述

介绍细胞疗法治疗糖尿病患者严重肢体缺血的最新进展。

最近发现

随着全球糖尿病发病率的不断上升,给世界各地的医疗保健系统带来了挑战。仅在英国,NHS 因糖尿病并发症(如外周血管疾病、截肢、失明、肾衰竭和中风)而产生的费用每年平均为 100 亿英镑,预计成本压力将会更大。尽管在早期诊断和最佳血糖控制方面取得了巨大进展,但仍缺乏有效的严重肢体缺血治疗方法。本综述旨在提供再生医学领域正在进行的工作的最新进展。文中探讨了糖尿病对该方法潜力的影响,包括近期进展和局限性。特别是,本综述侧重于祖细胞中非编码 RNA 网络的改变,以及利用新兴的分子机制知识设计用于个性化治疗的精细方案的可能性。细胞疗法领域进展迅速,但存在局限性。由于对与代谢紊乱相关的分子瓶颈有了更好的理解,预计在未来几年内会取得重大进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b94/7925447/0cfe2399ea11/11892_2021_1378_Fig1_HTML.jpg

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