CD34陽性細胞移植による血管・組織の再生治療

Abstract

CD34 is a cell surface marker, which is expressed in various somatic stem/progenitor cells such as bone marrow (BM)-derived hematopoietic stem cells and endothelial progenitor cells (EPCs), skeletal muscle satellite cells, epithelial hair follicle stem cells, and adipose tissue mesenchymal stem cells. CD34+ cells in BM and peripheral blood are known as a rich source of EPCs; therefore, therapeutic application of BM-derived CD34+ cells has been attempted for vascular regeneration in cardiovascular diseases. Preclinical and early clinical studies of BM or granulocyte colony-stimulating factor (GCSF)-mobilized CD34+ cell therapy revealed promising outcomes with regard to safety, feasibility, and potential efficacy in critical limb ischemia (CLI) by atherosclerosis obliterans or Buerger’s disease, acute myocardial infarction, chronic myocardial ischemia (refractory angina), and dilated cardiomyopathy. Our research group is now preparing for a phase III clinical trial of CD34+ cell therapy in CLI on the basis of previous phase I/II and phase II trials. Recently, CD34+ cell therapy has also been applied to non-healing fractures and decompensated liver cirrhosis, in which reduced blood supply is a key factor associated with disease progression. Both preclinical and pilot clinical investigations indicated the safety, feasibility, and effectiveness of GCSF-mobilized CD34+ cell therapy in these non-cardiovascular diseases. This review provides an overview of the preclinical and clinical reports to demonstrate the usefulness, current limitations, and future prospects of cell-based therapy in various types of diseases.