Setia Ocean, Lee Shin-Rong, Dardik Alan
Vascular Biology and Therapeutics Program, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
Adv Wound Care (New Rochelle). 2024 May;13(5):253-279. doi: 10.1089/wound.2022.0114. Epub 2023 May 8.
Chronic limb threatening ischemia (CLTI) is a severe form of peripheral arterial disease (PAD) that is associated with high rates of morbidity and mortality, and especially limb loss. In patients with no options for revascularization, stem cell therapy is a promising treatment option. Cell therapy directly delivered to the affected ischemic limb has been shown to be a safe, effective, and feasible therapeutic alternative for patients with severe PAD. Multiple methods for cell delivery, including local, regional, and combination approaches, have been examined in both pre-clinical studies and clinical trials. This review focuses on delivery modalities used in clinical trials that deliver cell therapy to patients with severe PAD. Patients with CLTI are at high risk for complications of the disease, such as amputations, leading to a poor quality of life. Many of these patients do not have viable options for revascularization using traditional interventional or surgical methods. Clinical trials have shown therapeutic benefit for cell therapy in these patients, but methods of cell treatment are not standardized, including the method of cell delivery to the ischemic limb. The ideal delivery approach for stem cell therapy in PAD patients remains unclear. Further studies are needed to determine the best modality of cell delivery to maximize clinical benefits.
严重肢体缺血（CLTI）是外周动脉疾病（PAD）的一种严重形式，与高发病率和死亡率相关，尤其是肢体丧失。对于没有血管重建选择的患者，干细胞疗法是一种有前景的治疗选择。直接将细胞疗法应用于受影响的缺血肢体已被证明是重度PAD患者安全、有效且可行的治疗选择。在临床前研究和临床试验中都已对多种细胞递送方法进行了研究，包括局部、区域和联合方法。本综述重点关注在临床试验中用于将细胞疗法应用于重度PAD患者的递送方式。CLTI患者发生截肢等疾病并发症的风险很高，导致生活质量较差。许多此类患者没有使用传统介入或手术方法进行血管重建的可行选择。临床试验已表明细胞疗法对这些患者具有治疗益处，但细胞治疗方法尚未标准化，包括将细胞递送至缺血肢体的方法。PAD患者干细胞疗法的理想递送方法仍不明确。需要进一步研究以确定细胞递送的最佳方式，以最大化临床益处。
