Unité de thérapie cellulaire, Laboratoire d’hématologie, hôpital Robert‐Debré, 51092 Reims cedex. Laboratoire d’hématologie, centre hospitalo‐universitaire, 1, place Victor‐Pauchet, 80054 Amiens cedex. Institut national de la transfusion sanguine, 6, rue Alexandre‐Cabanel, 75015 Paris.
- Key words: cellular therapy, angiogenesis, vasculogenesis
- Page(s) : 146-57
- Published in: 2004
Experimental results suggest that, in postnatal, the formation, the development and\or the repair of vascular structures are guaranteed by the process of angiogenesis or vasculogenesis. The circulating endothelial progenitors are cells of medullar origin capable
in vitro of generating endothelial cells and share a common origin with haematopoietic stem cells. Other stem cells may also be implicated (mesenchymal stem cells and multipotent adult progenitor cells). It is also possible that monocytes play a role by secreting angiogenic factors or by differentiation of endothelial cells. These data have led to the conception of angiogenic cellular therapy, mainly in cases characterised by a failure in artery vascularization: the ischemia of lower members and myocardial ischemia. Several studies have been undertaken in animals through local intramuscular implantation after inducing ischemia of a member: whatever the cells used, an increase of the local neovascularization was observed, with a functional effect seen in the increase of the vascular flow. The only assay in humans published to this day reports the efficiency and safety of the implant of mononuclear medullar cells in the ischemia of the lower members. After studies in animals, a few non randomised trials have been reported in patients with myocardial ischemia. Many questions remain: what type of cell should be used? What quantity, where, how and when should they be implanted?