Stem cells in treatment of lower extremity ulcers.

Применение клеточных технологий в лечении трофических язв
Turlybek Tuganbekov 1, Manarbek Askarov 2, Nurlan Ashimov 3, Dana Saipiyeva 4
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1 Surgical Diseases Department, Astana Medical University
2 Centre of Cell Technologies and Transplantation, National Scientific Medical Centre
3 Docent of Surgical Diseases Department, Astana Medical University
4 Astana Medical University
J CLIN MED KAZ, Volume 4, Issue 30, pp. 14-20.
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Therapy of lower extremity ulcers remains one of the biggest challenges in the contemporary surgical world. Failure to guarantee stable results with traditional techniques has forced to seek for alternative ways. Various clinical and experimental studies speak for effectiveness of stem cells transplantation in the treatment of leg ulcers and complicated wounds due to their multifactorial impact on regeneration aspects such as cell proliferation, extracellular matrix synthesis, growth factors release, neovascularisation and angiogenesis. Moreover, stem cells can differentiate into skin and vascular components themselves. Stimulation of angiogenesis appears to be a key aspect in the wounds regeneration where microcirculation is affected, therefore effect of stem cell therapy on this primary pathogenetic mechanism allows to consider stem cells in conjunction with the basic therapy of underlying condition an effective alternative for the traditional therapy. The article highlights etiology and pathogenesis of lower extremity ulcers, the main treatment techniques and their brief description. A separate attention is given to the types and characteristics of stem cells and growth factors as well as their effects on healing of low extremities ulcers. Advantages and limitations of stem cell therapy are also discussed.

Трофикалық жараны емдеу жəне жараның ұзақ уақыт бойы жазылмауы заманауи хирургия саласының басты мəселесі болып отыр. Дəстүрлі терапияны (емді) қолданудағы тұрақты əсердің болмауынан емдеудің басқа амал -тəсілдерін іздеуге тура келеді. Түрлі клиникалық жəне ғылыми зерттеулердің нəтижесі трофикалық жаралардың жазылуындағы өзекті жасушалардың трансплантациялау əсерінің жасушалар профилерациясы, экстрацеллюлярлық матриксінің жинақталуы, өсу (даму) қабілетінің шектелуіне, неоваскуляризациялану мен ангиогенездену сияқты регенарция əрекеттеріне əкеліп соғады, сонымен қатар, өзекті жасушалар өздігімен тері жəне көк тамырлар жасушаларына саралануы (ауысуы) мүмкін. Ангиогенездің стимуляциясы (қоздыруы) жара жазылуының негізгі аспектісі ретінде танылады, яғни оның пайда болуы нəтижесінде микроциркуляцияның бұзылу əрекеті байқалады, оның салдарынан негізі патогенетикалық механизмге өзекті жасушалардың əсер етуі дəстүрлі емдеуге жаңа тиімді тəсіл болып танылатын эритроптық емдеумен қабысудың жасушалық терапиясын қарастыруға болады. Мақалада трофикалық жаралардың этиологиясы мен патогенезі суреттеліп, заманауи емдік жолдарының қысқаша шолу жолдары келтіріледі. Ерекше назарды өзекті жасушалардың түрі мен ерекшелігіне, өсу факторына аударуға болады, сонымен бірге трофикалық жаралар - ды емдеуде олардың тигізер əсері сөз етіледі. Жасушалық терапияның (емнің) шектеуі мен басымдығы талқыланады.


Tuganbekov T, Askarov M, Ashimov N, Saipiyeva D. Stem cells in treatment of lower extremity ulcers.. Journal of Clinical Medicine of Kazakhstan. 2013;4(30):14-20.


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