Vascular endothelial function in 36 patients with diabetic foot following autologous peripheral blood stem cell transplantation

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Abstract

To evaluate the efficacy of mobilized autologous peripheral blood stem cell (PBSC) transplantation and its effects on the function of vascular endothelium in patients with diabetic foot. A total of 36 patients with diabetic foot of tape 2 diabetes mellitus were enrolled at the Department of Endocrinology, Fourth Hospital, Hebei Medical University, and 12 healthy controls with matched sex and age served as normal control group. Patients received recombinant human granulocyte colony stimulating factor (rhG-CSF) via subcutaneous injection to mobilize autologous peripheral blood stem cells for 3 to 7 days. Mononuclear cells were collected, and prepared into stem cell suspension, and then intramuscularly injected into the ischemic areas of the two lower limbs at 2 hours. Injection range was defined according to angiography results. Compared with pretransplantation, severe pain lameness, local and cool-feeling were improved at 1 week, and mostly healed at 1 month after transplantation. Ankle brachial pressure indices significantly increased at 3 months following transplantation (P < 0.05). Digital subtraction angiographic scores showed new collateral vessel formation, and vascular diastolic function significantly recovered (t =8.28, P < 0.01), but still lower than in the normal control group (t=3.08, P < 0.01). Neither related complication nor adverse effect was observed. Transplantation of mobilized autologous peripheral blood stem cells might be a simple, safe, effective method, and could improve the vascular endothelial function for diabetic foot.

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