Infusion Of Bone Marrow Stem Cells Research Articles

Fertility rescue and ovarian follicle growth promotion by bone marrow stem cell infusion

To assess if infusion of human bone marrow-derived stem cells (BMDSCs) could promote follicle development in patients with impaired ovarian functions. Experimental design. University research laboratories. Immunodeficient NOD/SCID female mice. Human BMDSCs were injected into mice with chemotherapy-induced ovarian damage and into immunodeficient mice xenografted with human cortex from poor-responder patients (PRs). Follicle development, ovulation, and offspring. Apoptosis, proliferation, and vascularization were evaluated in mouse and human ovarian stroma. Fertility rescue and spontaneous pregnancies were achieved in mice ovaries mimicking PRs and ovarian insufficiency, induced by chemotherapy, after BMDSC infusion. Furthermore, BMDSC treatment resulted in production of higher numbers of preovulatory follicles, metaphase II oocytes, 2-cell embryos, and healthy pups. Stem cells promoted ovarian vascularization and cell proliferation, along with reduced apoptosis. In xenografted human ovarian tissues from PRs, infusion of BMDSCs and their CD133+ fraction led to their engraftment close to follicles, resulting in promotion of follicular growth, increases in E2 secretion, and enhanced local vascularization. Our results raised the possibility that promoting ovarian angiogenesis by BMDSC infusion could be an alternative approach to improve follicular development in women with impaired ovarian function. NCT02240342.

Changes in biochemical markers of liver fibrosis in patients with decompensated liver cirrhosis after autologous bone marrow stem cell infusion

Changes in biochemical markers of liver fibrosis in patients with decompensated liver cirrhosis after autologous bone marrow stem cell infusion

Advances in Cardiology: Clinical Trial Update

Multiple key cardiology trials have been presented or published over recent months, several with the potential to change clinical practice. In this article, we summarize and place in clinical context new trial findings regarding anticoagulation in the cardiac catheterization laboratory (enoxaparin, fondaparinux and unfractionated heparin), the implications of genetic polymorphisms and functional testing for antiplatelet therapy (clopidogrel and ticagrelor), new oral anticoagulants for use in atrial fibrillation (apixiban and rivaroxaban), optimal pacing strategies and pharmacological agents in heart failure (ivabradine, eplerenone, cardiac resynchronization therapy, telemonitoring and intracoronary bone marrow stem cell infusion). Clinical trials in percutaneous structural intervention (transcatheter aortic valve implantation, MONARC™ mitral annular implant, STARFlex(®) patent foramen ovale device) and advanced percutaneous coronary intervention (everolimus-eluting stents, biodegradable polymer/polymer-free technologies and contemporary use of intravascular ultrasound) are also discussed.

Stem Cells Improve Left Ventricular Function in Acute Myocardial Infarction

Animal studies have suggested dramatic improvement in cardiac function after acute myocardial infarction (AMI) through regeneration of the myocardium or neovascularization by transfer of cells derived from bone marrow (BMC) generated clinical studies. Recently published small sized studies have yielded mixed results, leaving the question unanswered. We analyzed data from these studies in a meta-analysis to investigate if intracoronary stem cell therapy was effective in improving cardiac function. A total of 7 randomized controlled trials meeting the inclusion criteria were identified by a systematic literature search. Primary endpoint was change in global left ventricular ejection fraction (LVEF) baseline to follow-up (ranging between 3 to 6 months). The meta-analysis consisted of 516 patients (BMC group, 256; control group, 260). A 2-sided alpha error of less than .05 was considered to be statistically significant (P<.05). There were no significant differences in patient characteristics between the BMC treatment and control groups at baseline. Compared to the control group, patients in the BMC treatment group had significantly greater increase in LVEF from baseline to follow-up (mean difference: 6.108%; SE: 1.753%; 95% confidence interval [CI]: 2.672%- 9.543%; P<.001). The present meta-analysis suggests that intracoronary bone marrow stem cell infusion may be effective in improving left ventricular systolic function in patients after acute myocardial infarction.

Regenerative cell therapy and pharmacotherapeutic intervention in heart failure: Part 2: Pharmacological targets, agents and intervention perspectives.

Regenerative medicine represents a promising perspective on therapeutic angiogenesis in patients with cardiovascular disease, including heart failure. However, previous or ongoing clinical trials show ambiguous outcomes with respect to the benefit of regenerative therapy by means of bone marrow stem cell infusion in myocardial infarction patients. Therefore, it is necessary to set up a rational therapeutic strategy in the treatment of congestive heart failure. Chemokines, cytokines and growth factors, as well as pharmaceutical agents, may have an impact on endothelial progenitor cell (EPC) physiology and thus can provide targets for pharmacological intervention. Indeed, EPCs and stem cell niches both in bone marrow and myocardial tissue can be treated as an integral target for recruitment of EPCs from the bone marrow to the cardiac ischaemic niche. In this article, we individually place the signalling factors in their specified context, and explain their roles in the various phases of neovascularisation (see Part 1). (Neth Heart J 2008;16:337-43.).

Even coagulase negative staphylococcus infections following reduced intensity transplantation are associated with increased transplant complications and poorer overall survival

Reduced intensity transplantation (RIT) is associated with lower transplant related mortality (TRM) but the incidence of infectious complications remains controversial. We analyzed the incidence of bacteremia during the first 100 days post-transplantation in 106 patients with various malignancies who underwent a reduced intensity regimen of extracorporeal photopheresis × 2 cycles, pentostatin 8 mg/m2 by continuous intravenous infusion over 48 hours, and total body irradiation 600cGy, followed by allogeneic bone marrow stem cell infusion from a 6/6 HLA matched related donor (n = 68), 5/6 HLA matched related donor (n = 8), 6/6 HLA matched unrelated donor (n = 29), or 5/6 HLA matched unrelated donor (n = 1). GVHD prophylaxis consisted of continuous infusion cyclosporin A and short course methotrexate. All patients received fluoroquinolone prophylaxis until neutrophil engraftment. During the first 100 days post-transplantation, grade 2–4 acute GVHD occurred in 19% of patients, and 56 patients (53%) had positive blood cultures. Median days to positive cultures were 21 (range −7 to 97). Blood cultures were positive for coagulase negative staphylococcus (CoNS) (n = 36: 63%), other gram-positive cocci (GPC) (n = 10: 10%), gram-negative rods (GNR) (n=5: 9%), fungus (n = 3: 5%), gram-positive rods (GPR) (n = 2: 4%), or anaerobes (n = 1: 1%). Recurrent infections (same species >30 days later) occurred in 7 patients (7%), and multiple infections with different organisms occurred in 16 patients (15%). Three patients died of sepsis. The incidence of bacteremia was higher in patients with grade 2–4 acute GVHD versus grade 0–1 acute GVHD (70% versus 45%: p = 0.05), and in mismatched related or matched unrelated transplants versus matched related transplants (66% versus 46%: p = 0.05). Bacteremia was associated with higher day 100 TRM (26% versus 11%: p = 0.06) and lower median overall survival (OS) (9 months versus 35 months: p = 0.01). CoNS bacteremia had similar day 100 TRM as other GPC bacteremia like staphylococcus aureus and enterococcus (22% versus 38%: p = 0.37) and similar day 100 TRM as non-GPC bacteremia (22% versus 30%: p = 0.61). There was a trend towards lower median OS in patients with CoNS bacteremia versus other GPC bacteremia (7 months versus 14 months: p = 0.18). In patients undergoing RIT, CoNS bacteremia, like other bacteremia, was associated with increased TRM and poorer overall survival. Future studies on RIT will need to address the issue of bacteremia, especially CoNS bacteremia.