Both autologous bone marrow mononuclear cell and peripheral blood progenitor cell therapies similarly improve ischaemia in patients with diabetic foot in comparison with control treatment M. Dubsky 1,4 * A. Jirkovska 1 R. Bem 1 V. Fejfarova 1 L. Pagacova 2 B. Sixta 3 M. Varga 3 S. Langkramer 5 E. Sykova 6 E. B. Jude 7 1 Diabetes Centre Prague, Czech Republic 2 Autotransfusion Unit Prague, Czech Republic 3 Clinic of Transplant Surgery, Institute for Clinical and Experimental Medicine Prague, Czech Republic 4 First Medical Faculty, Charles University Prague, Czech Republic 5 Centre for Cell Therapy and Tissue Repair, Second Medical Faculty, Charles University Prague, Czech Republic 6 Institute of Experimental Medicine, Czech Academy of Science Prague, Czech Republic 7 Diabetes Centre, Tameside General Hospital, Ashton-Under-Lyne Lancashire, UK *Correspondence to: Michal Dubsky, Videnska 1958/9, 14021 Prague 4, Czech Republic. E-mail: michal.dubsky@gmail.com Abstract Background The aim of our study was to compare the effect of bone marrow mononuclear cell and peripheral blood progenitor cell therapies in patients with diabetic foot disease and critical limb ischaemia unresponsive to revascu- larization with conservative therapy. Methods Twenty-eight patients with diabetic foot disease (17 treated by bone marrow cells and 11 by peripheral blood cell) were included into an active group and 22 patients into a control group without cell treatment. Transcutaneous oxy- gen pressure and rate of major amputation, as the main outcome measures, were compared between bone marrow cells, peripheral blood cell and control groups over 6 months; both cell therapy methods were also compared by the character- istics of cell suspensions. Possible adverse events were evaluated by changes of serum levels of angiogenic cytokines and retinal fundoscopic examination. Results The transcutaneous oxygen pressure increased significantly (p < 0.05) compared with baseline in both active groups after 6 months, with no significant differences between bone marrow cells and peripheral blood cell groups; however, no change of transcutaneous oxygen pressure in the control group was observed. The rate of major amputation by 6 months was significantly lower in the active cell therapy group compared with that in the control group (11.1% vs. 50%, p = 0.0032), with no difference between bone marrow cells and peripheral blood cell. A number of injected CD34+ cells and serum levels of angiogenic cytokines after treatment did not significantly differ between bone marrow cells and peripheral blood cell. Conclusions Our study showed a superior benefit of bone marrow cells and peripheral blood cell treatments of critical limb ischaemia in patients with diabetic foot disease when compared with conservative therapy. There was no difference between both cell therapy groups, and no patient demonstrated signs of systemic vasculogenesis. Copyright © 2013 John Wiley & Sons, Ltd. Keywords stem cell therapy; diabetic foot; critical limb ischaemia Introduction Peripheral arterial disease (PAD) is an important predictor of outcome of ulcer healing in patients with diabetic foot ulcers and often leads to major amputa- tions [1]. According to the multicentre EURODIALE study, the rate of major amputation was significantly higher in patients with PAD in comparison with RESEARCH ARTICLE Received: 14 September 2012 Revised: 14 January 2013 Accepted: 15 January 2013 Copyright © 2013 John Wiley & Sons, Ltd. DIABETES/METABOLISM RESEARCH AND REVIEWS Diabetes Metab Res Rev 2013; 29: 369–376. Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/dmrr.2399