What is it about?
The degree of symptomatology of a patient with peripheral arterial disease dictates the kind of treatment. Despite the known therapies, some patients continue to have pain with ambulation, which affects their quality of life. The therapeutic implications of the angiogenic growth factors were identified by the pioneering studies of Folkman et al. 2 decades ago. Further investigations established the possibility of the use of formulations of recombinant angiogenic growth factors, with the objective of developing or increasing the network of collaterals in animal models of chronic myocardial or limb ischemia. Researches suggest that primitive stem cells with whole bone marrow possess greater functional plasticity, capable of contributing to regeneration of ischemic limb muscle and vascular endothelium by adult stem cells.
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Why is it important?
Although both surgical bypass and endovascular procedures remains effective in the improvement of the blood flow in the ischemic legs, not all patients are candidates for intervention. The effort in basic science laboratories has showed us the safety of the therapeutic angiogenesis, but we need to wait for more randomized trials in order to draw further conclusions.
Perspectives
Local autologous marrow stromal cells implantation induces a neovascular response resulting in a significant increase in blood flow to the ischemic limb. In this article we review the studies that have established how the implantation of bone marrow cells into ischemic limbs increases collateral vessel formation.
Professor Paulo Eduardo Ocke Reis
Universidade Federal Fluminense
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This page is a summary of: Bone marrow stem cells and their role in angiogenesis, Jornal Vascular Brasileiro, January 2005, FapUNIFESP (SciELO),
DOI: 10.1590/s1677-54492005000400012.
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