Abstract | BACKGROUND: The purpose of this study was to determine the effect of a combination of bone marrow mononuclear cell (BM-MNC) implantation and sarpogrelate, a selective 5-HT(2A) antagonist, on endothelial function in patients with critical limb ischemia (CLI). METHODS: We evaluated the leg blood flow (LBF) responses to acetylcholine (ACh) and sodium nitroprusside before and after BM-MNC implantation in 16 patients with CLI. We divided patients with CLI into 2 groups: those cotreated with sarpogrelate orally for 12 weeks ( sarpogrelate group, n = 8) and those who remained on conventional therapy (control group, n = 8). LBF was measured by strain gauge plethysmography. RESULTS: BM-MNC implantation improved ankle brachial pressure index, transcutaneous oxygen pressure, and pain-free walking time. There was no significant difference in these parameters between the 2 groups. Before BM-MNC implantation, LBF responses to ACh were similar in the sarpogrelate group and control group. Twelve weeks of BM-MNC implantation enhanced LBF responses to ACh in the sarpogrelate and control groups. After 12 weeks of BM-MNC implantation, LBF response to ACh was significantly greater in the sarpogrelate group than in the control group. BM-MNC implantation did not alter the LBF responses to sodium nitroprusside in either group. CONCLUSIONS: These findings suggest that BM-MNC implantation improved not only limb ischemic symptoms but also endothelium-dependent vasodilation in patients with CLI. A combination of BM-MNC implantation and sarpogrelate had a more beneficial effect on vascular function in these patients.
|
Authors | Yukihito Higashi, Masanori Miyazaki, Chikara Goto, Hiroaki Sanada, Taijiro Sueda, Kazuaki Chayama |
Journal | Journal of cardiovascular pharmacology
(J Cardiovasc Pharmacol)
Vol. 55
Issue 1
Pg. 56-61
(Jan 2010)
ISSN: 1533-4023 [Electronic] United States |
PMID | 19834330
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Serotonin 5-HT2 Receptor Antagonists
- Serotonin Antagonists
- Succinates
- Vasodilator Agents
- Nitroprusside
- sarpogrelate
- Acetylcholine
|
Topics |
- Acetylcholine
(pharmacology)
- Aged
- Bone Marrow Transplantation
(methods)
- Combined Modality Therapy
- Endothelium, Vascular
(drug effects, physiopathology)
- Female
- Follow-Up Studies
- Humans
- Ischemia
(physiopathology, therapy)
- Leg
(blood supply)
- Male
- Middle Aged
- Nitroprusside
(pharmacology)
- Serotonin 5-HT2 Receptor Antagonists
- Serotonin Antagonists
(pharmacology)
- Succinates
(pharmacology)
- Transplantation, Autologous
- Vasodilator Agents
(pharmacology)
|