<原著>骨髄細胞移植を行った難治性 Buerger 病の一症例 : 当科における TACT trial 第一例目の経験

概要

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Buerger's disease (or thromboangitis obliterans; TAO) is defined as a nonatherosclerotic segmental inflammatory disease that most commonly affects the small and medium-seized arteries, veins and nerves of the arms and legs. Recently, the global proportion of this disease has declined, but in eastern Asia (Japan and Korea), the prevalence of the disease is higher than that in Western Europe. Complete surgical revascularization is usually impossible because of the involvement of diffuse and distal arteries, so palliative care by prostanoid is still the main treatment. Especially, in patients with limb ulceration (Fontaine grade IV) , their quality of life (QOL) is very impaired. In 1998, Isner JM et al. reported the impact of treatment for the disease with the intramuscular gene transfer of vascular endothelial growth factor (VEGF) . Later, Asahara et al. disclosed that bone marrow-derived endothelial progenitor cells (EPCs) contribute to postnatal vasculogenesis. Preclinical studies have established that implantation of bone marrow mononuclear cells (BM-MNCs) including EPCs into ischemic limbs augments collateral vessel formation. Here, our first experience of autologous implantation of BM-MNCs is reported in patients with critical limb ischemia (CLI) due to Buerger's disease.
新潟大学の論文
2003-04-10