Autologous bone marrow mononucleated cell preparation for the clinical treatment of acute myocardial infarction and peripheral arterial disease.

The concept that adult stem/progenitor cells can differentiate into either hematopoietic or nonhematopoietic tissues is supported by a considerable amount of reviewed data (1). Adult mononucleated cells (MNC) containing the stem/ progenitor cell fraction can be isolated from mobilized peripheral blood and bone marrow (BM) tissue by density gradients (2). BM MNC also contain mesenchymal stromal cells (MSC) (3), representing less than 0.1% of the density-gradient selected cells and capable of generating non-hematopoietic tissues (4,5). Endothelial progenitor cells (EPC), with their clonogenic potential, are major contributors to angiogenesis (6). As improved cardiac function depends on revascularization, local BM MNC delivery represents a strategy for supplying the reparative effects of EPC in injured hearts (7). Apart from myocardial and vascular regeneration as mechanisms of stem cell action, other models have been proposed where the transplanted cells could release soluble factors that, acting in a paracrine fashion, would contribute to cardiac repair and regeneration (8 – 10). Clinical applications and eligibility