Publication: Seguridad y eficacia de la inyección transendocárdica de células progenitoras endoteliales autólogas CD 133+ para angiogénesis terapéutica en pacientes sin más opción
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2017-09-06
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Universidad Complutense de Madrid
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Abstract
La cardiopatía isquémica no sólo es la enfermedad cardiovascular con mayor mortalidad en el mundo sino que además determina una extraordinaria morbilidad especialmente cuando degeneran en insuficiencia cardiaca o angina refractaria. Lamentablemente el arsenal terapéutico para estos escenarios es limitado y no son pocos los pacientes que no responden. En este escenario el cardiólogo asiste impotente al progresivo deterioro de la calidad de vida de los pacientes hasta su inexorable final. Por otro lado se genera una gran demanda sanitaria donde la sociedad alienta incansablemente a la comunidad científica a conseguir más y mejores resultados. En este contexto la terapia celular se ha alzado como una terapia prometedora en base a los buenos resultados obtenidos en los estudios experimentales tanto con pequeños como con grandes mamíferos. Los estudios clínicos pioneros fueron realmente ilusionantes pero la consolidación de los mismos en ensayos clínicos de mayor tamaño muestral se enfrentó con incongruencias y limitaciones que han llevado a replantearse hasta los conocimientos más fundamentales. Sin embargo este paso atrás no ha significado un abandono de la terapia, más bien ha permitido que la comunidad científica exija unas bases más robustas, un mejor diseño de los estudios y una homogenización en la forma de evaluar los resultados...
Ischemic heart disease is not only the cardiovascular disease with the highest mortality in the world but also determines an extraordinary morbidity especially related to heart failure or refractory angina. Unfortunately, the therapeutic arsenal for these scenarios is limited and there are many patients who do not respond. Cardiology attends helplessly to the progressive deterioration of the quality of life of patients until its inexorable end. On the other hand it generates a great health demand and society tirelessly encourages the scientific community to achieve more and better treatments. In this context, cell therapy has risen as a promising therapy based on the good results obtained in experimental studies with both small and large mammals. The pioneering clinical studies were really exciting but the results have not been consolidated in clinical trials with larger sample sizes showing inconsistencies and limitations, which make us reconsider even the most basic knowledge. However, this setback has not led to forget the therapy rather it has allowed the scientific community to demand a more robust basis, better study design and homogenization on how to evaluate the results. Takayuki Ashara disclosed in 1997 the existence of endothelial progenitors in peripheral blood. Subsequent studies have confirmed that the bone marrow is the fundamental source of adult endothelial cells. This finding is the scientific pillar of several research works regarding cell therapy in the treatment of tissue ischemia and it is certainly the trail of our work...
Ischemic heart disease is not only the cardiovascular disease with the highest mortality in the world but also determines an extraordinary morbidity especially related to heart failure or refractory angina. Unfortunately, the therapeutic arsenal for these scenarios is limited and there are many patients who do not respond. Cardiology attends helplessly to the progressive deterioration of the quality of life of patients until its inexorable end. On the other hand it generates a great health demand and society tirelessly encourages the scientific community to achieve more and better treatments. In this context, cell therapy has risen as a promising therapy based on the good results obtained in experimental studies with both small and large mammals. The pioneering clinical studies were really exciting but the results have not been consolidated in clinical trials with larger sample sizes showing inconsistencies and limitations, which make us reconsider even the most basic knowledge. However, this setback has not led to forget the therapy rather it has allowed the scientific community to demand a more robust basis, better study design and homogenization on how to evaluate the results. Takayuki Ashara disclosed in 1997 the existence of endothelial progenitors in peripheral blood. Subsequent studies have confirmed that the bone marrow is the fundamental source of adult endothelial cells. This finding is the scientific pillar of several research works regarding cell therapy in the treatment of tissue ischemia and it is certainly the trail of our work...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 26-01-2016