Add Some Fat to Vascular Progenitor Cell Therapy

Abstract

See related articles, pages 1410–1420 Are cell therapy approaches aiming for the improvement of tissue neovascularization still a big hope for the treatment of cardiovascular diseases? Yes indeed, even after the big hype about cell therapy has settled, now it is apparent that cardiovascular morbidity and mortality is still leading in industrial countries requiring novel advanced therapies to deal with. However, it has become clear now that cell-based treatment strategies require much more strategic advancement than initially anticipated from preclinical studies in mouse models of tissue ischemia. Indeed, we have just achieved to climb up to the very first level of small improvements in tissue perfusion and function that are unlikely to translate into major changes in the clinical outcome of our patients.1 Limited neovascularization, however, is not only a major obstacle for cardiovascular diseases but also affects different kinds of transplants. Apart from whole organ transplants that most likely could also benefit from improved neovascularization to improve long-term graft survival, a clinically very important example represents pancreatic islet transplantation in patients with type I diabetes. Transplantation of human β-cell islets is a procedure that has already helped a number of patients to at least temporarily reduce their demand for insulin. However, long-term engraftment of the infused islets has been a major limitation of this novel treatment approach. Successful islet transplantation does not only depend on the infusion of sufficient numbers of islets but even more on their immediate and adequate neovascularization.2 Compared to the transplantation of whole organs, where perfusion is rapidly obtained by the reconnection of blood supply, β-cell islets completely lack vascularization during the first days after transplantation. Ischemia and insufficient oxygen supply seem …