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Bone marrow injection in ankle

Pawan K Gupta, Murali Krishna, Anoop Chullikana, Sanjay Desai, Rajkumar Murugesan, Santanu Dutta, Uday Sarkar, Radhakrishnan Raju, Anita Dhar, Rajiv Parakh, Lakshmanan Jeyaseelan, Pachaiyappan Viswanathan, Prasanth Kulapurathu Vellotare, Raviraja N Seetharam, Charan Thej, Mathiyazhagan Rengasamy, Sudha Balasubramanian, Anish S Majumdar
: : Critical limb ischemia (CLI) due to Buerger's disease is a major unmet medical need with a high incidence of morbidity. This phase II, prospective, nonrandomized, open-label, multicentric, dose-ranging study was conducted to assess the efficacy and safety of i.m. injection of adult human bone marrow-derived, cultured, pooled, allogeneic mesenchymal stromal cells (BMMSC) in CLI due to Buerger's disease. Patients were allocated to three groups: 1 and 2 million cells/kg body weight (36 patients each) and standard of care (SOC) (18 patients)...
October 5, 2016: Stem Cells Translational Medicine
Behnam Molavi, Mohammad Reza Zafarghandi, Ehsan Aminizadeh, Seyyedeh-Esmat Hosseini, Hamid Mirzayi, Leila Arab, Hossein Baharvand, Nasser Aghdami
BACKGROUND: Critical limb ischemia is a manifestation of peripheral arterial disease characterized by insufficient arterial blood flow for maintaining tissue viability in the lower extremities. Therapeutic angiogenesis is used for peripheral arterial disease patients who are not candidates for surgical revascularization or radiological intervention. There is accumulating evidence for the beneficial impact of autologous bone marrow mononuclear cell transplantation for treatment of critical limb ischemia in humans...
June 2016: Archives of Iranian Medicine
Mihra S Taljanovic, David M Melville, Lana H Gimber, Luke R Scalcione, Margaret D Miller, C Kent Kwoh, Andrea S Klauser
For the past 15 years, high-resolution ultrasonography (US) is being routinely and increasingly used for initial evaluation and treatment follow-up of rheumatologic diseases. This imaging technique is performed by using high-frequency linear transducers and has proved to be a powerful diagnostic tool in evaluation of articular erosions, simple and complex joint and bursal effusions, tendon sheath effusions, and synovitis, with results comparable to those of magnetic resonance imaging, excluding detection of bone marrow edema...
November 2015: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Taichi Kanetaka, Masaaki Mori, Ken-Ichi Nishimura, Tomo Nozawa, Masako Kikuchi, Nodoka Sakurai, Ryoki Hara, Kazuko Yamazaki, Shumpei Yokota
OBJECTIVE: To examine and delineate inflammatory focus in patients with juvenile idiopathic arthritis (JIA), (18)F-Fluoro-deoxy-glucose (FDG)-positron emission tomography (PET) ((18)F-FDG-PET) was applied to patients with JIA, and the images of these patients were compared. METHODS: Sixty-eight children (59 with systemic JIA (s-JIA) and 9 with polyarticular JIA) were included. The diagnosis of JIA was done to meet the International League of Associations for Rheumatology (ILAR) criteria...
2016: Modern Rheumatology
Randall W Franz, Kaushal J Shah, Richard H Pin, Thomas Hankins, Jodi F Hartman, Michelle L Wright
OBJECTIVE: This study was conducted to determine if intramuscular and intra-arterial stem cell injections delay or prevent major limb amputations, improve ankle-brachial index measurements, relieve rest pain, and improve ulcer healing. METHODS: A prospective case series with interventions occurring between December 2007 and September 2012 and a 3-month minimum follow-up was conducted at an urban tertiary care referral hospital. Patients with severe limb-threatening peripheral arterial disease, without other options for revascularization, were eligible for enrollment...
September 2015: Journal of Vascular Surgery
Mohsen Emadedin, Maede Ghorbani Liastani, Roghayeh Fazeli, Fatemeh Mohseni, Reza Moghadasali, Soura Mardpour, Seyyedeh Esmat Hosseini, Maryam Niknejadi, Fatemeh Moeininia, Aslan Aghahossein Fanni, Reza Baghban Eslaminejhad, Ahmad Vosough Dizaji, Narges Labibzadeh, Ali Mirazimi Bafghi, Hossein Baharvand, Nasser Aghdami
BACKGROUND: Osteoarthritis (OA) is a debilitating disease that typically affects a large number of the middle-aged and elderly population. Current treatment strategies have had limited success in these patients. This study aims to investigate the safety of treatment with autologous bone marrow (BM)-derived mesenchymal stem cells (MSCs) transplanted in patients with OA of the knee, ankle, or hip. METHODS: We enrolled 18 patients with different joint involvements (knee, ankle, or hip OA) and one was lost to follow-up...
June 2015: Archives of Iranian Medicine
Jan Skóra, Artur Pupka, Dariusz Janczak, Piotr Barć, Tomasz Dawiskiba, Krzysztof Korta, Dagmara Baczyńska, Agnieszka Mastalerz-Migas, Jerzy Garcarek
INTRODUCTION: Our study was designed to investigate the safety and efficacy of combined autologous bone marrow mononuclear cell (MNC) and gene therapy in comparison to conventional drug therapy in patients with critical limb ischemia (CLI). MATERIAL AND METHODS: Thirty-two patients with CLI persisting for 12-48 months (average time 27.5 months) were randomized into 2 groups, each group consisting of 16 patients. In the first group, administration of autologous bone marrow MNC and vascular endothelial growth factor (VEGF) plasmid was performed...
April 25, 2015: Archives of Medical Science: AMS
Seong Ji Woo, Kyu Lim, Su Yeon Park, Mun Yhung Jung, Hye Song Lim, Min-Gyu Jeon, Sang-Il Lee, Byung-Hyun Park
It is suggested that n-3 polyunsaturated fatty acids (PUFAs) can be used in the preventive or therapeutic management of rheumatoid arthritis (RA); however, controversial results have been reported. Here, we examined the effects of a decrease in the n-6/n-3 PUFA ratio on RA using fat-1 transgenic mice. First, we tested whether fat-1 expression modulated signaling pathways in fibroblast-like synoviocytes (FLSs) stimulated with tumor necrosis factor α (TNF-α). TNF-α activated p38 mitogen-activated protein kinase and increased phosphorylation of the signal transducer and activator of transcription 3 in wild type (WT) FLSs but not in fat-1 FLSs...
July 2015: Journal of Nutritional Biochemistry
Xi-Liang Shang, Hong-Yue Tao, Shi-Yi Chen, Yun-Xia Li, Ying-Hui Hua
PURPOSE: The purpose of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture surgery alone or in combination with hyaluronic acid (HA) injection in the treatment of osteochondral lesions of the talus. METHODS: Thirty-five patients with osteochondral lesions of the talus who underwent arthroscopic microfracture were included and followed up for at least 9 months post-operatively. The patients were randomly divided into non-injection group (n = 17) who received treatment with microfracture surgery alone and injection group (n = 18) who also accepted intra-articular injection of HA post-operatively...
April 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kasra Moazzami, Bobak Moazzami, Aria Roohi, Saharnaz Nedjat, Elena Dolmatova
BACKGROUND: Peripheral arterial disease is a major health problem, and in about 1% to 2% of patients the disease progresses to critical limb ischaemia (CLI). In a substantial number of patients with CLI, no effective treatment option other than amputation is available and around a quarter of these patients will require a major amputation during the following year. This is an update of the review first published in 2011. OBJECTIVES: To determine the effectiveness and safety of local intramuscular transplantation of autologous adult bone marrow mononuclear cells (BMMNCs) as a treatment for critical limb ischaemia (CLI)...
2014: Cochrane Database of Systematic Reviews
Emerson C Perin, Michael Murphy, John P Cooke, Lem Moyé, Timothy D Henry, Judy Bettencourt, Amir Gahremanpour, Nicholas Leeper, R David Anderson, William R Hiatt, Joao A Lima, Bharath Venkatesh, Shelly L Sayre, Rachel W Vojvodic, Doris A Taylor, Ray F Ebert, Alan T Hirsch
Peripheral artery disease (PAD) is recognized as a public health issue because of its prevalence, functional limitations, and increased risk of systemic ischemic events. Current treatments for claudication, the primary symptom in patients with PAD, have limitations. Cells identified using cytosolic enzyme aldehyde dehydrogenase (ALDH) may benefit patients with severe PAD but has not been studied in patients with claudication. PACE is a randomized, double-blind, placebo-controlled clinical trial conducted by the Cardiovascular Cell Therapy Research Network to assess the safety and efficacy of autologous bone marrow-derived ALDH(br) cells delivered by direct intramuscular injections in 80 patients with symptom-limiting intermittent claudication...
November 2014: American Heart Journal
Tomohisa Nakamura, Taketoshi Kushida, Naofumi Okamoto, Kenichi Oe, Atsushi Ikeura, Ming Li, Susumu Ikehara, Hirokazu Iida
SKG/Jcl (SKG) mice spontaneously develop T cell-mediated autoimmune arthritis and may be an effective model for studying human rheumatoid arthritis. We sought to confirm that arthritis in SKG mice was caused by stem cell disorders. We induced systemic arthritis in normal C57/BL6 (B6) mice (H-2(b) type) by injecting lineage-negative (lin(-)) immature cells isolated from bone marrow cells (BMCs) of SKG mice (H-2(d) type) directly into bone cavities. Twenty weeks later, we analyzed arthritis scores, hematoxylin-eosin (H-E) staining and tartrate-resistant acid phosphatase (TRAP) staining in ankle joints, H-2 type of hematolymphoid and osteoblast-like cells, serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and percentages of CD4(+) T cells and osteoblast-like cells expressing receptor activator of nuclear factor kappa-B ligand (RANKL) in recipient mice...
2014: Biological & Pharmaceutical Bulletin
Yoshiki Tsubosaka, Tatsuro Nakamura, Hiroyuki Hirai, Masatoshi Hori, Masataka Nakamura, Hiroshi Ozaki, Takahisa Murata
Although the cyclooxygenase metabolites PGs are known to be involved in the progression of arthritis, the role of PGD2 remains unclear. In this study, we evaluated the contribution of signaling mediated through a PGD2 receptor, chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2), in the progression of adjuvant-induced joint inflammation. Injection of CFA into the ankle joint stimulated PGD2 production and induced paw swelling in both CRTH2-naive (WT) and CRTH2(-/-) mice. CRTH2(-/-) mice presented more severe arthritic manifestations than did WT mice...
December 15, 2014: Journal of Immunology: Official Journal of the American Association of Immunologists
Yong Sang Kim, Ho Jin Lee, Yun Jin Choi, Yong Il Kim, Yong Gon Koh
BACKGROUND: Marrow stimulation for the treatment of osteochondral lesions of the talus (OLTs) is controversial in patients with poor prognostic factors of OLTs. Currently, mesenchymal stem cells (MSCs) are expected to biologically augment the treatment of OLTs. PURPOSE: To compare the clinical and magnetic resonance imaging (MRI) outcomes between an injection of MSCs with marrow stimulation and marrow stimulation alone in patients with OLTs. STUDY DESIGN: Cohort study; Level of evidence, 3...
October 2014: American Journal of Sports Medicine
Kristina A Giles, Eva M Rzucidlo, Philip P Goodney, Daniel B Walsh, Richard J Powell
OBJECTIVE: Bone marrow cell therapy (BMCT) for patients with critical limb ischemia (CLI) is a potential treatment in candidates with poor options for standard revascularization procedures. Whereas clinical trials are ongoing, there are few comparative data to assess its efficacy compared with bypass. METHODS: Patients with poor revascularization options underwent BMCT between 2011 and 2013. Outcomes were compared with those of a cohort of CLI patients undergoing infrainguinal bypass thought to be at high risk for graft failure (tissue loss, a tibial target, and a previous endovascular treatment or bypass)...
January 2015: Journal of Vascular Surgery
Nasser M Malyar, Stefan Radtke, Khalil Malyar, Jawed Arjumand, Peter A Horn, Knut Kröger, Eva Freisinger, Holger Reinecke, Bernd Giebel, Franz-Eduard Brock
BACKGROUND AIMS: The purpose of this study was to evaluate the effect of autologous bone marrow mononuclear cells (BM-MNCs) on symptoms and perfusion indices in severely symptomatic patients with peripheral arterial disease (PAD) without further option for endovascular or surgical revascularization. METHODS: Only patients with severe symptomatic PAD (Fontaine class IIb-IV, Rutherford category 3-6) not amenable for revascularization were treated. Bone marrow from both cristae iliacae was harvested; MNCs were isolated by the Ficoll density-gradient method and transplanted by means of intra-arterial and intramuscular injection in the index limb...
September 2014: Cytotherapy
Joseph Poole, Kreton Mavromatis, José N Binongo, Ali Khan, Qunna Li, Mohamed Khayata, Elizabeth Rocco, Matthew Topel, Xin Zhang, Charlene Brown, Matthew A Corriere, Jonathan Murrow, Salman Sher, Stephanie Clement, Khuram Ashraf, Amr Rashed, Tarek Kabbany, Robert Neuman, Alanna Morris, Arshad Ali, Salim Hayek, John Oshinski, Young-sup Yoon, Edmund K Waller, Arshed A Quyyumi
IMPORTANCE: Many patients with peripheral artery disease (PAD) have walking impairment despite therapy. Experimental studies in animals demonstrate improved perfusion in ischemic hind limb after mobilization of bone marrow progenitor cells (PCs), but whether this is effective in patients with PAD is unknown. OBJECTIVE: To investigate whether therapy with granulocyte-macrophage colony-stimulating factor (GM-CSF) improves exercise capacity in patients with intermittent claudication...
December 25, 2013: JAMA: the Journal of the American Medical Association
Sherif M Amr, Ashraf Gouda, Wael T Koptan, Ahmad A Galal, Dina Sabry Abdel-Fattah, Laila A Rashed, Hazem M Atta, Mohammad T Abdel-Aziz
OBJECTIVE: To investigate the effect of bridging defects in chronic spinal cord injury using peripheral nerve grafts combined with a chitosan-laminin scaffold and enhancing regeneration through them by co-transplantation with bone-marrow-derived mesenchymal stem cells. METHODS: In 14 patients with chronic paraplegia caused by spinal cord injury, cord defects were grafted and stem cells injected into the whole construct and contained using a chitosan-laminin paste...
January 2014: Journal of Spinal Cord Medicine
Ross A Hauser, Amos Orlofsky
Regenerative therapeutic strategies for joint diseases usually employ either enriched concentrates of bone marrow-derived stem cells, chondrogenic preparations such as platelet-rich plasma, or irritant solutions such as hyperosmotic dextrose. In this case series, we describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (WBM) into osteoarthritic joints in combination with hyperosmotic dextrose. Seven patients with hip, knee or ankle osteoarthritis (OA) received two to seven treatments over a period of two to twelve months...
2013: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Pawan K Gupta, Anoop Chullikana, Rajiv Parakh, Sanjay Desai, Anjan Das, Sanjay Gottipamula, Sagar Krishnamurthy, Naveen Anthony, Arun Pherwani, Anish S Majumdar
BACKGROUND: Peripheral vascular disease of the lower extremities comprises a clinical spectrum that extends from no symptoms to presentation with critical limb ischemia (CLI). Bone marrow derived Mesenchymal Stem Cells (BM- MSCs) may ameliorate the consequences of CLI due to their combinatorial potential for inducing angiogenesis and immunomodulatory environment in situ. The primary objective was to determine the safety of BM- MSCs in patients with CLI. METHODS: Prospective, double blind randomized placebo controlled multi-center study was conducted in patients with established CLI as per Rutherford classification in category II-4, III-5, or III-6 with infra-inguinal arterial occlusive disease and were not suitable for or had failed revascularization treatment...
2013: Journal of Translational Medicine
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