A jab of stem cells could help prevent pain while walking, ulcers and the need for amputation in patients with furred-up arteries in the leg.
Peripheral arterial disease (PAD) — when the arteries carrying blood from the heart to the legs become narrowed due to a build-up of fatty deposits called plaque — affects 2.7 million people aged 55 or older in the UK.
As the supply of blood is reduced, the muscles in the legs become starved of oxygen, leading to symptoms such as pain when walking.
The poor circulation can also cause muscle and skin tissue to die, with complications such as ulcers that won’t heal.
Left untreated, these can result in infections and may mean the limb needs to be amputated.
Patients with PAD are usually offered the same drugs that are prescribed for heart disease — such as statins to lower cholesterol, or aspirin and clopidogrel to prevent blood clots.
However, in many cases, this is not enough and patients often need surgery to insert a stent, a tiny tube, or a small balloon in the blood vessel to hold it open and improve blood flow.
Now, researchers in Canada, South Korea and Malaysia are investigating the use of stem cells to help ease PAD.
In many tissues, stem cells serve as a sort of internal repair system, dividing constantly to replenish cells that might be damaged.
When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialised function, such as a muscle cell, a red blood cell or a brain cell.
The theory is that, when injected into the leg muscle, the stem cells will be activated to become new blood vessels as the various growth factors and chemicals in the blood will tell them what’s required.
This will help bypass any blockages and restore normal blood flow and, researchers say, prevent PAD worsening and the need for amputation.
In the new treatment, stem cells are extracted from a patient’s bone marrow (where they are formed) using a needle and syringe under general anaesthetic — the stem cells are taken from the hip bone because it contains a large concentration of bone marrow and blood stem cells.
These cells are then injected straight into the patient’s leg near the site of the narrowed artery.
Results from a pilot study with 22 patients at Tehran University, Iran, show that those who were given the stem cell injections were able to walk further without pain after six months than those given placebo jabs.
In three ongoing studies — at the National University of Malaysia, Gachon University in South Korea and Toronto General Hospital — 160 PAD patients are being given either stem cell or placebo jabs and monitored to check various symptoms, such as pain when walking.
Commenting on the development, Stella Vig, a consultant vascular surgeon at Croydon University Hospital, says: ‘The use of stem cells adds an extra possibility for treatment, especially in diabetes patients with PAD where there are no blood vessels to bypass or open with a balloon.
‘The development of small vessels would ensure better circulation, helping those who previously could not be treated, leading to an amputation.’
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