Adult Stem Cells Help to Prevent Amputation

By Shari Rudavsky, Indy Star, July 11, 2006

Peripheral arterial disease, recognized as PAD, is a vascular disorder that affects the blood circulation in the arms, legs, feet, stomach, and kidneys. Normally a disease that requires amputation of the affected body part, Indiana University doctors are pioneering a novel method to prevent and avert such permanent treatment using a patient’s own stem cells.

The researchers at IU harvest adult stem cells from the patient’s bone marrow, inject the cells into the diseased leg, and thus encourage the development of new blood vessels and correct the problem. The study conducted by scientists at IU is the only one of its kind in the United States.

According to scientists, in patients that are healthy, stem cells from the bone marrow migrate out of the tissue to repair arteries and organs when they are injured. For individuals afflicted with PAD, stem cells cannot reach the injured tissue in numbers that make a difference.

Thus, in patients suffering from advanced PAD, doctors at IU decided to try transporting the healing stem cells from the marrow to the leg.

The results look hopeful even though to date, only 10 patients have gone through the procedure.

"The information that we're getting from this study is telling us this therapy does indeed work, and we're learning more and more about how to isolate this information," said Dr. Michael, an assistant professor of surgery at Indiana University School of Medicine and the principal investigator of the trial.

PAD, a hardening and clogging of the arteries that can lead to poor circulation, pain, and numbness on the legs and feet, afflicts between 8 and 10 million people. In about 10 percent of the patients, PAD symptoms become so bad that amputation may be the only standard treatment option available stated Murphy.

Other present methods of treatment include angioplasty and/or bypass surgery to avoid the eventuality of amputation, but the downside is that not every individual patient is suitable for one of these procedures.

Michael’s study offers an option to those individuals where amputation is the only choice left.

Four years ago, 23 year old mother and dietary aide Adriane lost all five toes on her right foot after PAD developed when she had a blood clot in her leg. When PAD caused difficulty in her other leg, Adriane feared another amputation.

After registering in Michael’s trial in September, she has no problems. The discolorations and swelling in her foot, the pain, all of these disappeared.

"Now I can do everything I want," she said. "I was worried, because I had been there before and I knew what the outcome was in the end. I was worried I would have to go through something like that again."

The eventual goal is to enroll 20 patients in the study and conduct follow-ups for at least one year following treatment. Michael and his colleagues have had patients come from Miami, Kansas, and New York for the procedure.

A second study on PAD has been planned where the efficacy of stem cells isolated from a patient’s fat tissue will be compared to those cells that come from bone marrow. Michael also planned an exploration into whether they might also avoid hardening of arteries, not just in PAD, but throughout the body. The exploration would begin once either or both of the techniques for treating PAD are confirmed a success.

"We're hoping to expand this information to rebuilding the heart after a heart attack, the brain after a stroke, and maybe even the kidney or liver with the complications of diabetes," Michael said.