TITLE:
Critical appraisal of stem cell therapy in peripheral arterial disease: Do current scientific breakthroughs offer true promise or false hope?
AUTHORS:
Sherif Sultan, Niamh Hynes
KEYWORDS:
Peripheral Arterial Disease; Stem Cell Therapy; Therapeutic Angiogenesis
JOURNAL NAME:
Journal of Biomedical Science and Engineering,
Vol.7 No.2,
February
19,
2014
ABSTRACT: Over
the last forty years in the field of peripheral arterial disease, there has
been a plethora of research into cell-based therapies for tissue repair,
regeneration and angiogenesis, progressing
from protein-based therapies to gene therapies to stem cell research. Initial
pre-clinical research successes have given birth to a whole industry, aimed at
translating these laboratory hopes into clinical successes. However, heretofore
these expected clinical results have failed to materialize, in part due to the
lack of attention to the ischaemic desert like tissue and systemically diseased
patient into which the stem cells are being implanted. Unsatisfactory clinical
outcomes on the treatment of Critical Limb Ischaemia (CLI) have forced researchers
to direct their efforts to the less intimidating challenge of claudication and
to lower their clinical outcome thresholds
from superior to “non-inferior”. Major questions on safety and
durability have also arisen. What needs to be objectively established is the
impact on the net health outcome of these
therapies. Infusion or injection for stem cell therapy is still
considered experimental and investigational.
In this review we examine the clinical evidence for angiogenic
therapies, focusing specifically on stem cell trials, in an attempt to answer
the question “Is stem cell therapy a failed experiment
or will there be light at the end of the tunnel?”