Background: Therapeutic angiogenesis induced by the implantation of autologous bone marrow-derived cells has been used for the treatment of ischemic diseases. However, as the outcomes of cell implantation obviously vary among patients, it is essential to identify patients that would benefit the most from this treatment.
Methods and results: We collected clinical and laboratory data from 25 patients scheduled to undergo sternotomy for various surgical procedures. Then, we aspirated bone marrow cells from the sternum during the operation and investigated the cell quality in vitro by cultivation, and their angiogenic potency in vivo using an ischemic limb model of mice. The angiogenic potency of bone marrow cells differed among patients. Aging, renal failure, anemia, and high serum levels of triglyceride, C-reactive protein, interleukin-6, and type I collagen cross-linked N-telopeptide (NTX) significantly correlated with poor angiogenic potency of bone marrow cells. We assigned scores to these risk factors, and found a strong correlation between the risk scores of patients and the angiogenic potency of their bone marrow cells (r=-0.883, P<0.001). These risk scores can predict the angiogenic potency of bone marrow cells for inducing therapeutic angiogenesis with an accuracy of 80%.
Conclusions: We have identified the risk factors related to poor angiogenic potency of bone marrow cells and developed a new scoring system to predict their angiogenic potency for the treatment of ischemic diseases. Our results may help select patients for this treatment in future clinical trials.