Therapeutic approaches in vascular repair induced by adult bone marrow cells and circulating progenitor endothelial cells.

Strong evidence indicates that bone marrow cells (BMCs) can contribute to the healing process of injured vascular system via CXCR4/Thymosin beta4/Integrin alpha4beta1/SDF-1 molecular pathways. We discuss the therapeutic approaches of BMCs and circulating endothelial progenitor cells (EPCs) to restore vascularization. Today some clinical trials employing BMCs in the treatment of peripheral vascular diseases have been completed with encouraging results. When large clinical controlled studies will be completed, the scientific community will evaluate this novel and promising therapeutic approach. Although some basic studies suggest the potential use of adult/somatic stem cell for vascular repair, other stringent data suggest that this potential is dependent also on growth factor synthesis rather than the formation of new arterial vessels. Considering the limitations of adult stem cells especially in elderly subjects, our point of view is that BMCs or exogenous BMC/EPC are candidate for adjunct cell-therapy applications in vascular repair.