Stem cell therapy for critical limb ischemia: what can we learn from cell therapy for chronic wounds?

Abstract

Although much progress has been made regarding our knowledge of stem cells and their potential applications for therapeutic angiogenesis, there has been less success with the clinical application of this knowledge to patients with critical limb ischemia (CLI). Patients with CLI often have chronic wounds and newer cell-based therapies for chronic wounds show interesting parallels to stem cell therapy for CLI. Several human-derived wound care products and therapies, including human neonatal fibroblast-derived dermis (Dermagraft®), bilayered bioengineered skin substitute (Apligraf®), recombinant human platelet-derived growth factor and autologous platelet-rich plasma may provide insight into the mechanisms through which differentiated cells can be used as therapy for chronic wounds, and, analogously, by which stem cells might function therapeutically in CLI.

Figure 1

Sequential photographs of a wound unresponsive to conventional dressings treated with human neonatal fibroblast-derived dermis (Dermagraft®); A) At time of presentation, B) 2 weeks, C) 4 weeks, D) 6 weeks, E) 8 weeks