Clinical Study
Transcatheter Arterial Infusion of Autologous CD133
+
Cells for
Diabetic Peripheral Artery Disease
Xiaoping Zhang,
1,2
Weishuai Lian,
1
Wensheng Lou,
3
Shilong Han,
1
Chenhui Lu,
1
Keqiang Zuo,
1
Haobo Su,
3
Jichong Xu,
1
Chuanwu Cao,
1
Tao Tang,
1
Zhongzhi Jia,
1
Tao Jin,
1
Georges Uzan,
4
Jianping Gu,
3
and Maoquan Li
1,2
1
Department of Interventional and Vascular Surgery, Shanghai Tenth People’s Hospital, Tongji University,
No. 301 Middle Yan Chang Road, Shanghai 200072, China
2
Institution of Interventional and Vascular Surgery, Tongji University, No. 301 Middle Yan Chang Road, Shanghai 200072, China
3
Department of Interventional Radiology, Nanjing First Hospital, No. 68 Changle Road, Nanjing, Jiangsu 210001, China
4
Unit´ e de Recherche INSERM 602, 94807 Villejuif Cedex, France
Correspondence should be addressed to Jianping Gu; jrxglmq@163.com and Maoquan Li; cjr.limaoquan@vip.163.com
Received 13 October 2015; Revised 10 December 2015; Accepted 4 January 2016
Academic Editor: Yingmei Feng
Copyright © 2016 Xiaoping Zhang et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Microvascular lesion in diabetic peripheral arterial disease (PAD) still cannot be resolved by current surgical and interventional
technique. Endothelial cells have the therapeutic potential to cure microvascular lesion. To evaluate the efcacy and immune-
regulatory impact of intra-arterial infusion of autologous CD133
+
cells, we recruited 53 patients with diabetic PAD (27 of CD133
+
group and 26 of control group). CD133
+
cells enriched from patients’ PB-MNCs were reinfused intra-arterially. Te ulcer healing
followed up till 18 months was 100% (3/3) in CD133
+
group and 60% (3/5) in control group. Te amputation rate was 0 (0/27) in
CD133
+
group and 11.54% (3/26) in control group. Compared with the control group, TcPO
2
and ABI showed obvious improvement
at 18 months and signifcant increasing VEGF and decreasing IL-6 level in the CD133
+
group within 4 weeks. A reducing trend of
proangiogenesis and anti-infammatory regulation function at 4 weeks afer the cells infusion was also found. Tese results indicated
that autologous CD133
+
cell treatment can efectively improve the perfusion of morbid limb and exert proangiogenesis and anti-
infammatory immune-regulatory impacts by paracrine on tissue microenvironment. Te CD133
+
progenitor cell therapy may be
repeated at a fxed interval according to cell life span and immune-regulatory function.
1. Backgrounds
Angiopathy and neuropathy are commonly recognized as
the basic pathological changes of diabetes, leading to the
development of foot complications in diabetic patients [1].
Te treatment of purely diabetic neuropathy includes neu-
ronutrition treatment, restricting weight bearing, and foot
care therapy, but with limited efects [2]. Ischemia caused by
angiopathy is another important factor preventing healing.
One of the main features of the angiopathy in patients with
diabetic peripheral artery disease (PAD) is that it usually
involves both great and small blood vessels.
PAD in diabetics is ofen multisegmental, typically infrap-
opliteal, and poorly compensated [3]. With the advancement
of surgical skill and the merging of newly developed endovas-
cular instruments, a large number of the aortic-iliac, femoral-
popliteal, and infrapopliteal artery lesions can be treated
to reestablish sufcient blood supply of the lower limb at
macrovascular level; however, there are 20–30% of patients
not considered candidates, resulting in amputation as the
only option [4, 5]. Moreover, the microvascular lesion in
diabetic PAD still cannot be resolved by the current surgical
and interventional technique [6].
Endothelial progenitor cells (EPCs) have the capacity of
diferentiation to mature toward endothelial cells, angiogen-
esis, and repairmen of impaired vascular walls [7]; therefore,
we assumed that EPCs have the therapeutic potential to
cure the microvascular lesion of diabetic PAD [8]. Available
Hindawi Publishing Corporation
Stem Cells International
Volume 2016, Article ID 6925357, 8 pages
http://dx.doi.org/10.1155/2016/6925357