Linc today 2018 thursday

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6  February 2018  LINC TODAY  Thursday

Focus session: Pioneering techniques for critical limb ischaemia and “no option patients”  Technical Forum  Thursday  13:30

Stem cell angiogenesis: showing promise


igrid Nikol (Asklepios Klinik St. Georg, Hamburg, Germany) presents on the current developments in cell and gene therapy during this afternoon’s Focus Session on ‘no option’ CLI patients. Dr Nikol will present the design of the PACE study, the randomised, double-blind, multicentre, placebo-controlled, parallel-group phase III study to evaluate the efficacy, tolerability and safety of intramuscular injections of PLX-PAD (placentalderived adherent stromal cells) for the treatment of patients with critical limb isch“Many colleagues still emia (CLI) with minor tissue believe in autologous cells, loss who are unsuitable for and do not know about this revascularization.1 PACE is 2015 metaanalysis.” an EU-sponsored Horizon Sigrid Nikol 2020 project. The study is presently in the early stages be more immunologically comof randomisation. patible, other issues have proved Dr Nikol has previously conducted research in angiogenesis problematic. Referring to work by Hill et al. wherein increased gene therapy2, a field she has now deems “dead”. “All the cardiovascular risk was associatlast trials were, as far as I know, ed with depletion of progenitor prematurely ended. Last year cells3, Dr Nikol said: “It has been there was still one large trial re- shown that cells taken from cruiting, but that has also been older organisms produce less ended prematurely.” growth factors, and the number Efforts are now planted firmly of available cells is lower.” in the cell therapy realm, specifiMost published work to date cally using allogeneic placental has been carried out using cells. While cells derived from autologous cells derived from patients themselves are likely to blood or bone marrow. While a

2015 meta-analysis on all available randomised, placebo-controlled4 demonstrated no advantage of bone marrow-derived stem cell therapy on the primary outcome measures of amputation, survival, and amputationfree survival in patients with CLI, the authors concluded that more sophisticated cell therapy strategies should be explored in future randomised trials.4 Presently, a number of trials continue to explore both autologous bone-marrow and allogeneic stem cell therapy for peripheral artery disease. “Many colleagues still believe in autologous cells, and Continued on page 7