The purpose of this study was to devise an expanded ischemic flap model and to investigate the role of AMD-3100 (Plerixafor, chemokine receptor 4 inhibitor) in this model by confirming its effect on mobilization of stem cells from the bone marrow. Male Sprague-Dawley rats were used as an animal research model. The mobilization of stem cells from the bone marrow was confirmed in the AMD-3100-treated group. The fractions of endothelial progenitor cells (EPC) and the vascular endothelial growth factor receptor (VEGFR) 2+ cells in the peripheral blood were increased in groups treated with AMD-3100. The expression of vascular endothelial growth factor (VEGF) was increased in response to expansion or AMD injection. The expression of stromal cell derived factor (SDF)-1 and VEGFR2 were increased only in unexpanded flap treated with AMD-3100. Treatment with AMD-3100 increased both the number and area of blood vessels. However, there were no statistically significant differences in the survival area or physiologic microcirculation in rats from the other groups. This endogenous neovascularization induced by AMD-3100 may be a result of the increase in both the area and number of vessels, as well as paracrine augmentation of the expression of VEGF and EPCs. However, the presence of a tissue expander under the flap could block the neovascularization between the flap and the recipient regardless of AMD-3100 treatment and expansion.
Animals ; Anti-HIV Agents/pharmacology ; Bone Marrow Cells/cytology ; Chemokine CXCL12/biosynthesis ; Endothelial Progenitor Cells/*cytology ; Hematopoietic Stem Cells/*cytology ; Heterocyclic Compounds/*pharmacology ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism ; Male ; Neovascularization, Physiologic ; Nitric Oxide Synthase Type III/metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, CXCR4/antagonists & inhibitors ; Surgical Flaps/*blood supply/surgery ; Tissue Expansion/*methods ; Vascular Endothelial Growth Factor A/biosynthesis ; Vascular Endothelial Growth Factor Receptor-2/biosynthesis/metabolism

OBJECTIVETo explore differences in bone marrow angiogenesis seen in aplastic anemia (AA) patients presenting with differential Chinese medicine (CM) syndrome, and to correlate these differences with clinical pathology.

METHODSThirty-five patients were enrolled, including 18 with "yang deficiency syndrome" and 17 with "yin deficiency syndrome." Bone marrow biopsies and serum were collected. Microvessel density (MVD) and positive expression of vascular endothelial-derived growth factor (VEGF) were detected by immunohistochemisty. Hypoxia inducible factor -1α (HIF-1α), and VEGF expression were assayed by enzyme-linked immunoabsorbent assay (ELISA), serum lactate dehydrogenase (LDH) was tested by enzyme method and liquid chip technology was used to detected the expression of interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ and tumor necrosis factor (TNF)-α.

RESULTSCounts for leukocytes, absolute neutrophils and platelets in "yin deficiency syndrome" were lower than those found in "yang deficiency syndrome" (P<0.05). MVD and VEGF expression, and the positive rate of CD34 and VEGF in bone marrow were lower in AA, especially in "yin deficiency syndrome" (P<0.01 or P<0.05). "Yin deficiency syndrome" displayed decreased VEGF and LDH expression, and enhanced expression of HIF-1α as compared to "yang deficiency syndrome" (P<0.05). Levels of IL-4 and IL-6 were higher in AA (P<0.01), but IL-10 was decreased (P<0.05). High TNF-α expression was seen in "yang deficiency syndrome" and IFN-γ expression was decreased in "yin deficiency syndrome" as compared with normals (P <0.01 and P<0.05, respectively).

CONCLUSIONAA patients have lower MVD than normals, especially in "yin deficiency syndrome." MVD might differentially correlate to disease severity, and could be dependent on bone marrow or serum VEGF expression and LDH. Additionally, IL-2, IL-10, IL-4 and IFN-γ were negatively associated while IL-6 and TNF-α were positively associated with MVD.

Adolescent ; Adult ; Aged ; Anemia, Aplastic ; complications ; pathology ; physiopathology ; Bone Marrow ; blood supply ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; blood ; L-Lactate Dehydrogenase ; blood ; Male ; Middle Aged ; Neovascularization, Pathologic ; Vascular Endothelial Growth Factor A ; blood ; Yang Deficiency ; complications ; pathology ; physiopathology ; Yin Deficiency ; complications ; pathology ; physiopathology ; Young Adult

BACKGROUNDRandom flap is one kind of the most widely used skin flaps in reconstructive surgery; however, partial necrosis of its distal end remains a significant problem now. The aim of this study was to evaluate the effect of hypoxia preconditioned bone marrow mesenchymal stem cells (HpBMSCs) transplantation on ultra-long random skin flap survival in rats.

METHODSNormoxic bone marrow mesenchymal stem cells (nBMSCs) were cultured under normoxia (20% O2) and HpBMSCs under hypoxia (1% O2) for 48 hours before transplantation. Thirty Sprague-Dawley rats were randomly divided into control group, nBMSCs group and HpBMSCs group with each consisting of 10 rats. Survival area of ultra-long random skin flap on the dorsal of rats was measured seven days after flap surgery and cell transplantation. Cell survival in vivo, microvessel density and vascular endothelial growth factor (VEGF) were evaluated by histological examination and enzyme-linked immunosorbent assay.

RESULTSCompared with other two groups, flap survival area in HpBMSCs group was significantly larger (P < 0.05). Microvessel density in HpBMSCs group (36.20 ± 8.19) was higher than that in nBMSCs group (30.01 ± 5.68) and control group (17.60 ± 4.19) (P < 0.05). VEGF in HpBMSCs group ((300.05 ± 50.41) pg/g) was higher than those in nBMSCs group ((240.55 ± 33.64) pg/g) and control group ((191.65 ± 32.58) pg/g) (P < 0.05).

CONCLUSIONHpBMSCs transplantation improves ultra-long random skin flap survival via promoting angiogenesis of more survival cells.

Animals ; Bone Marrow Cells ; cytology ; Cell Hypoxia ; physiology ; Cells, Cultured ; Graft Survival ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; cytology ; Rats ; Rats, Sprague-Dawley ; Skin ; blood supply ; Surgical Flaps ; blood supply

OBJECTIVETo evaluate the correlation of venous return disturbance (VRD), bone marrow edema (BME) and the amount of joint fluid with clinical symptoms in osteonecrosis of the femoral head (ONFH).

METHODSTwenty patients (25 hips) with ONFH proved by pathology were parallelly examined by 1.5 T MR and medullograph.

RESULTIn total 25 hips VRD was observed in 16 hips with medullograph and 13 hips with the clinical symptoms (P <0.05). BME was found in 17 with MRI (P <0.01), and the was found in 15 hips with MRI (Spearman=0.949). VRD were found in 16 hydrarthrus.

CONCLUSIONONFH patients with clinical symptoms have VRD, BME and the hydrarthrus. The medullograph is of value in monitoring the development of ONFH.

Adult ; Bone Marrow ; pathology ; physiopathology ; Edema ; pathology ; Female ; Femur Head ; blood supply ; Femur Head Necrosis ; pathology ; physiopathology ; Hip Joint ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Regional Blood Flow ; physiology ; Veins ; physiopathology

OBJECTIVETo investigate the best injection method of the bone marrow mesenchymal stem cells (BM-MSCs) transplantation for the treatment of a rat model with hind limb ischemia.

METHODSTwenty four SD rats with hind limb ischemia were randomly divided into four groups: control group, model group, acupoint BM-MSCs injection group (API group) and thigh muscle BM-MSCs injection group (TMI group). The acupoints of "Sanyinjiao" (SP 6), "Housanli" (ST 36), "Zhaohai" (KI 6), "Huantiao" (GB 30) and "Yanglingquan" (GB 34) were selected for API group, and five non-acupoints were selected on gastrocnemius and adductor of ischemic hind limb for TMI group. Both groups were accepted BM-MSCs transplantion. Model rat with hind limb ischemia was established with the method of blocking the femoral artery and its branches. The changes of blood flow (perfuse unit, PU) was monitored with laser Doppler flowmetry (LDF). In order to describe the visual changes in blood flow, the PU index (PUI) was determined as the ratio of ischemic to non-ischemic hind limb blood perfusion. And also, the levels of VEGF,bFGF in serum were tested to analyze the immunohistochemical expression quantity of VEGF and bFGF.

RESULTSComparing with the model and the TMI groups, the PUI value on 3rd, 14th and 21th days after BM-MSCs transplantation were significantly increased in the API group (P < 0.05, P < 0.01). In contrast to the model group, the VEGF,bFGF levels in serum and the immunohistochemical expression quantity of VEGF and bFGF in the API and TMI groups were significantly increased (all P < 0.01).

CONCLUSIONTransplantation of BM-MSCs through the acupoint can more significantly and quickly increase the blood flow and cause the greater improvement on hind limb ischemia than that of through the way of muscle injection.

Acupuncture Points ; Animals ; Bone Marrow Transplantation ; Disease Models, Animal ; Female ; Humans ; Ischemia ; physiopathology ; therapy ; Lower Extremity ; blood supply ; Male ; Mesenchymal Stem Cell Transplantation ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Regional Blood Flow

Generation of therapeutic angiogenesis to enhance vascularization in the ischemic tissues is a method for treating ischemic tissues in atherosclerotic cardiovascular artery disease. The chemokine stromal cell-derived factor-1 (SDF-1) and its receptor (CXC chemokine receptor 4, CXCR4) play a critical role in the process of post-natal neovascularization. The SDF-1-CXCR4 axis is a potential mechanism for the treatment of ischemic limb. Here, we investigated the role of CXCR4 in bone marrow cells (BMCs) in neovascularization induced by tumor cells and the supernatant of culture media in a murine hind-limb ischemia model which was made by resecting femoral artery and vein. After the injection of mouse melanoma cells B16-F10 (1x10(6) cells in 0.1 mL at the operation day, s.c.) into the abdomen or the cell culture supernatant (0.1 mL/d for 21 d after operation, i.m.) into the ischemic abductor muscle, the CXCR4 positive BMCs were analyzed by flow cytometry. The perfusion of the ischemic limb was evaluated by laser Doppler perfusion imaging (LDPI) on 7, 14 and 21 d after vascular injury operation. Capillary endothelial alkaline phosphatase (AP) was stained to quantify the presence of capillaries, and histological method was used to evaluate the capillary density as a measure of neovascularization in ischemic tissues. The proportions of CXCR4 positive BMCs were notably higher in ischemic limb injected with tumor cells or the supernatant compared to those in the control group (P<0.05). Injection of tumor cells or the supernatant resulted in significantly improved perfusion as measured by LDPI perfusion ratios on 7, 14 and 21 d after femoral artery and vein resection in mice, compared to the controls (P<0.05). Tissue samples harvested from the lower calf muscle at day 21 demonstrated increased capillary densities in mice receiving tumor cells (0.81+/-0.13) or the supernatant (0.63+/-0.05), compared with those in control group (0.44+/-0.09, P<0.05). In conclusion, the injection of B16-F10 tumor cells or the supernatant induces the increase of CXCR4 positive cells in BMCs and the improvement of in vivo neovasculogenesis in mouse ischemic limb.
Animals ; Bone Marrow Cells ; metabolism ; Capillaries ; Cell Culture Techniques ; Chemokine CXCL12 ; metabolism ; Culture Media, Conditioned ; pharmacology ; Disease Models, Animal ; Endothelium, Vascular ; Hindlimb ; blood supply ; Ischemia ; physiopathology ; Melanoma, Experimental ; Mice ; Muscle, Skeletal ; blood supply ; Neovascularization, Physiologic ; Receptors, CXCR4 ; metabolism

Animals ; Apoptosis ; Bone Marrow Cells ; cytology ; Epithelial Cells ; pathology ; Female ; Ischemia ; Kidney ; blood supply ; pathology ; Necrosis ; Proliferating Cell Nuclear Antigen ; analysis ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; pathology ; Stem Cell Transplantation

BACKGROUNDMany treatment options for lower limb ischemia are difficult to apply for the patients with poor arterial outflow or with poor general conditions. The effect of medical treatment alone is far from ideal, especially in patients with diabetic foot. A high level amputation is inevitable in these patients. This study aimed to explore the effect of transplantation of autologous bone marrow mononuclear cells on the treatment of lower limb ischemia and to compare the effect of intra-arterial transplantation with that of intra-muscular transplantation.

METHODSIn this clinical trial, 32 patients with lower limb ischemia were divided into two groups. Group 1 (16 patients with 18 affected limbs) received transplantation of autologous bone marrow mononuclear cells by intra-muscular injection into the affected limbs; and group 2 (16 patients with 17 affected limbs) received transplantation of autologous bone marrow mononuclear cells by intra-arterial injection into the affected limbs. Rest pain, coldness, ankle/brachial index (ABI), claudication, transcutaneous oxygen pressure (tcPO(2)) and angiography (15 limbs of 14 patients) were evaluated before and after the mononuclear cell transplantation to determine the effect of the treatment.

RESULTSTwo patients died from heart failure. The improvement of rest pain was seen in 76.5% (13/17) of group 1 and 93.3% (14/15) of group 2. The improvement of coldness was 100% in both groups. The increase of ABI was 44.4% (8/18) in group 1 and 41.2% (7/17) in group 2. The value of tcPO(2) increased to 20 mmHg or more in 20 limbs. Nine of 15 limbs which underwent angiography showed rich collaterals. Limb salvage rate was 83.3% (15/18) in group 1 and 94.1% (16/17) in group 2. There was no statistically significant difference in the effectiveness of the treatment between the two groups.

CONCLUSIONSTransplantation of autologous bone marrow mononuclear cells is a simple, safe and effective method for the treatment of lower limb ischemia, and the two approaches for the implantation, intra-muscular injection and intra-arterial injection, show similar results.

Aged ; Aged, 80 and over ; Blood Gas Monitoring, Transcutaneous ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; Female ; Humans ; Ischemia ; therapy ; Leg ; blood supply ; Leukocytes, Mononuclear ; transplantation ; Male ; Middle Aged ; Transplantation, Autologous

OBJECTIVETo explore the method for labeling Flk1+ CD31- CD34- human bone marrow mesenchymal stem cells (hBMSCs) with ferumoxide-PLL and evaluate the feasibility of its tracing after transplantation into the brains of Macaca Fascicularis.

METHODSThe hBMSCs were incubated with ferumoxide-PLL. Trypan blue staining, Prussian blue staining, and transmission electron microscope were performed to show intracellular iron, marking efficiency, and the vigor of the labeled cells. After the hBMSCs were transplanted into the brains of cynomolgus monkeys by stereotaxis, magnetic resonance imaging (MRI) was performed to trace the cells in vivo. Cell survival and differentiation were studied with immunohistochemistry, Prussian blue staining, and HE staining.

RESULTSThe marking efficiency of the ferumoxide-PLL was 96%. Iron particles were found intracytoplasmic of the hBMSCs by Prussian blue staining and transmission electron microscopy. The relaxation rates of labeled cells in MRI were 4.4 and 4.2 times higher than those of the unlabeled cells. Hypointensity area was found by MRI three weeks after transplantation. Many hBMSCs and new vessels were found in the transplantation zone by pathological and immunofluorescence methods.

CONCLUSIONSFerumoxide-PLL can effectively label hBMSCs and thus increase its contrast in MRI results. The cells can survive in the brains of cynomolgus monkeys. The labeled hBMSCs can be traced in vivo by MRI.

Animals ; Antigens, CD34 ; analysis ; metabolism ; Bone Marrow Cells ; chemistry ; metabolism ; Bone Marrow Transplantation ; Brain ; blood supply ; metabolism ; Brain Chemistry ; Contrast Media ; chemistry ; Dextrans ; Ferrosoferric Oxide ; chemistry ; Humans ; Macaca fascicularis ; Magnetic Resonance Imaging ; methods ; Magnetite Nanoparticles ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; chemistry ; metabolism ; Platelet Endothelial Cell Adhesion Molecule-1 ; analysis ; metabolism ; Staining and Labeling ; methods ; Vascular Endothelial Growth Factor Receptor-2 ; analysis ; metabolism

OBJECTIVETo investigate the potential effect of homologous bone marrow mesenchymal stem cells (MSCs) on repairing peri-tubular capillary cluster (PTCC), and on improving renal tubular and mesenchymal hypoxia condition.

METHODSMonocyte was purified from bone marrow, amplified and identified as MSCs in vitro. Thirty female Wistar rats were randomly divided into 3 groups, the normal control group (Group A), MSCs transplanted group (Group B) and un-transplanted group (Group C). Rats in Group A was administered with drinking water by gastrogavage for 12 weeks, while those in Group B and C were administered with Aristolochia Decoction for 12 weeks to establish chronic aristolochic acid nephropathy (CAAN) model. At the end of the 12th week, 1 ml of MSCs was injected through caudal vein to the rats in Group B, while to those in Group A and C normal saline was injected instead. Blood, urine and kidney tissue of rats were collected at the end of the 16th week for examination, and their kidney tissue were made into serial section for determining the distribution of Y chromosome and CD34 double positive cells, and the pathological, immunohistochemical changes were observed using Western blotting and RT-PCR, etc.

RESULTSY chromosome and CD34 double positive cells could be seen in MSCs transplanted renal tissue in group B. At the end of the 16th week, the PTCC density in Group C and B was (26.47 +/- 1.56)/ 0.13 mm2 and (5.26 +/- 0.78)/0.13 mm2 respectively, and the IOD value of hypoxia inducible factor-1alpha (HIF-1alpha) in them was (6.74 +/- 0.67) x 10(3) and (25 27 +/- 1.46) x 10(3) respectively, all showing significant difference between the two groups (P < 0.01). The content of CD34 was higher in Group B than that in Group C (P < 0.01).

CONCLUSIONHomologous MSCs can enhance the vascular endothelial cells differentiation to repair the PTCC, thus to improve the renal tubular and mesenchymal hypoxia status.

Animals ; Antigens, CD34 ; biosynthesis ; genetics ; Aristolochic Acids ; Blotting, Western ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; methods ; Capillaries ; abnormalities ; metabolism ; Endothelial Cells ; metabolism ; pathology ; Female ; Immunohistochemistry ; Kidney Diseases ; chemically induced ; pathology ; surgery ; Kidney Tubules ; blood supply ; pathology ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; cytology ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transplantation, Homologous