Faculty of Health Sciences, Universidad Autónoma de Bucaramanga (UNAB), 681004153, Bucaramanga, Colombia.
Banco Multitejidos y Centro de Terapias Avanzadas, Fundación Oftalmológica de Santander-FOSCAL, 681004153, Floridablanca, Colombia.
Stem Cell Res Ther. 2022 Jul 26;13(1):345. doi: 10.1186/s13287-022-03043-3.
Peripheral arterial disease is atherosclerotic occlusive disease of the lower extremity arteries and afflicts hundreds of millions of individuals worldwide. Its most severe manifestation is chronic limb-threatening ischemia (Petersen et al. (Science 300(5622):1140-2, 2003)), which is associated with severe pain at rest in the limbs, which progresses to necrosis, limb amputation, and/or death of the patient. Consequently, the care of these patients is considered a financial burden for both patients and health systems. Multidisciplinary endeavors are required to address this refractory disease and to find definitive solutions that lead to improved living conditions. Revascularization is the cornerstone of therapy for preventing limb amputation, and both open vascular surgery and endovascular therapy play a key role in the treatment of patients with CLI. Around one-third of these patients are not candidates for conventional surgical treatment, however, leading to higher amputation rates (approaching 20-25% at one year) with high morbidity and lower quality of life. Advances in regenerative medicine have enabled the development of cell-based therapies that promote the formation of new blood vessels. Particularly, mesenchymal stem cells (MSCs) have emerged as an attractive therapeutic agent in various diseases, including CLI, due to their role in tissue regeneration and immunomodulation. This review discusses the characteristics of MSCs, as well as their regenerative properties and their action mechanisms on CLI.
外周动脉疾病是下肢动脉的动脉粥样硬化闭塞性疾病，影响着全球数亿人。其最严重的表现是慢性肢体缺血性疾病（CLI）（Petersen 等人，《科学》300(5622):1140-2, 2003），其特征是肢体在休息时出现严重疼痛，进而发展为坏死、截肢和/或患者死亡。因此，这些患者的治疗被认为是患者和医疗系统的经济负担。需要多学科努力来解决这种难治性疾病，并找到明确的解决方案，以改善患者的生活条件。血管再通是预防肢体截肢的治疗基石，开放血管手术和血管内治疗都在 CLI 患者的治疗中发挥着关键作用。然而，其中约三分之一的患者不适合传统的手术治疗，导致截肢率较高（一年内接近 20-25%），发病率较高，生活质量较低。再生医学的进步使得基于细胞的治疗方法得以发展，这些方法可以促进新血管的形成。特别是间充质干细胞（MSCs）因其在组织再生和免疫调节方面的作用，已成为包括 CLI 在内的各种疾病的有吸引力的治疗药物。本文综述了 MSCs 的特征，以及它们在再生和治疗 CLI 中的作用机制。
