Refractory Angina Cell Therapy (ReACT) Involving Autologous Bone Marrow Cells in Patients without Left Ventricular Dysfunction: A Possible Role for Monocytes
Document Type
Article
Publication Date
2009
Keywords
Monocytes, Angina, Cell therapy, Bone marrow mononuclear cell transplantation, Myocardia, Ischemia
Digital Object Identifier (DOI)
https://doi.org/10.3727/096368909X484671
Abstract
Autologous bone marrow mononuclear cell (BMMC) transplantation has emerged as a potential therapeutic option for refractory angina patients. Previous studies have shown conflicting myocardium reperfusion results. The present study evaluated safety and efficacy of CellPraxis Refractory Angina Cell Therapy Protocol (ReACT), in which a specific BMMC formulation was administered as the sole therapy for these patients. The phase I/IIa noncontrolled, open label, clinical trial, involved eight patients with refractory angina and viable ischemic myocardium, without left ventricular dysfunction and who were not suitable for conventional myocardial revascularization. ReACT is a surgical procedure involving a single series of multiple injections (40–90 injections, 0.2 ml each) into ischemic areas of the left ventricle. Primary endpoints were Canadian Cardiovascular Society Angina Classification (CCSAC) improvement at 18 months follow-up and myocardium ischemic area reduction (assessed by scintigraphic analysis) at 12 months follow-up, in correlation with a specific BMMC formulation. Almost all patients presented progressive improvement in angina classification beginning 3 months (p = 0.008) postprocedure, which was sustained at 18 months follow-up (p = 0.004), as well as objective myocardium ischemic area reduction at 12 months (decrease of 84.4%, p < 0.004). A positive correlation was found between monocyte concentration and CCSAC improvement (r = −0.759, p < 0.05). Improvement in CCSAC, followed by correlated reduction in scintigraphic myocardium ischemic area, strongly suggests neoangiogenesis as the main stem cell action mechanism. The significant correlation between number of monocytes and improvement strongly supports a cell-related effect of ReACT. ReACT appeared safe and effective.
Was this content written or created while at USF?
Yes
Citation / Publisher Attribution
Cell Transplantation, v. 18, issue 12, p. 1299-1310
Scholar Commons Citation
Hossne, Nelson Americo Jr.; Invitti, Adriana Luckow; Buffolo, Enio; Azevedo, Silvia; Oliveira, Jose Salvador; Stolf, Noedir Groppo; Cruz, L. Eduardo; and Sanberg, Paul R., "Refractory Angina Cell Therapy (ReACT) Involving Autologous Bone Marrow Cells in Patients without Left Ventricular Dysfunction: A Possible Role for Monocytes" (2009). Neurosurgery and Brain Repair Faculty Publications. 63.
https://digitalcommons.usf.edu/nbr_facpub/63
