Stem Cells May Avert Amputation
Using a patient's own stem cells, Indiana University doctors are pioneering a new way to prevent amputations in people with severe peripheral arterial disease. Known as PAD, it is a vascular disorder that affects the blood circulation in the feet, legs, kidney, stomach and arms.
In the only study of its kind in the United States, the researchers harvest adult stem cells from the patient's bone marrow and inject them into the diseased leg to prompt the development of new blood vessels and correct the problem. Scientists believe that in healthy patients, stem cells from the bone marrow migrate out to repair organs and arteries when they get injured. Stem cells in people with PAD cannot reach the legs in sufficient numbers to make a difference.
So IU doctors decided to try transporting those potentially healing stem cells from the marrow to the leg for patients with advanced PAD. Although only 10 patients to date have gone through the procedure, the results so far look promising, the researchers say. "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 Murphy, an assistant professor of surgery at Indiana University School of Medicine and the principal investigator of the trial.
About 8 million to 10 million people suffer from PAD, a hardening and clogging of the arteries that can lead to poor circulation, pain, and numbness on the legs and feet.
In about 10 percent of the patients, the disease will eventually become so bad that amputation may be their only standard treatment option, Murphy said.
Currently, angioplasty and/or bypass surgery are the only ways to ward off that eventuality, Murphy said. But not every patient is eligible for one of these procedures. His study offers an alternative to those who have no other choice.
Adriane Pruitt, 23, was one of those patients. About four years ago PAD, which developed after she had a blood clot in her leg, claimed all five toes on her right foot. When she developed a problem in her left leg, the Plainfield mother and dietary aide feared a repeat procedure.
In September, she enrolled in Murphy's trial. Since then, she has had no problems. Her pain disappeared, as did the discoloration and swelling in her foot.
"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."
Eventually Murphy and colleagues hope to enroll 20 patients in the study and follow them for at least a year. Patients have come from New York, Kansas and Miami for the procedure.
Soon Murphy plans to begin a second study on PAD, comparing the efficacy of stem cells isolated from a patient's fat tissue to those that come from the bone marrow.
If either or both techniques prove successful, he said, he wants to explore whether they might also help prevent hardening of the arteries throughout the body.
"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," Murphy said.
