RESUMO
To determine whether the presence of ischemic heart disease (IHD) per se, or rather the co-presence of heart failure (HF), is the primum movens for less effective stem cell products in autologous stem cell therapy, we assessed numbers and function of bone marrow (BM)-derived progenitor cells in patients with coronary artery disease (n = 17), HF due to ischemic cardiomyopathy (n = 8), non-ischemic HF (n = 7), and control subjects (n = 11). Myeloid and erythroid differentiation capacity of BM-derived mononuclear cells was impaired in patients with underlying IHD but not with non-ischemic HF. Migration capacity decreased with increasing IHD severity. Hence, IHD, with or without associated cardiomyopathy, is an important determinant of progenitor cell function. No depletion of hematopoietic and endothelial progenitor cells (EPC) within the BM was observed, while circulating EPC numbers were increased in the presence of IHD, suggesting active recruitment. The observed myelosuppression was not driven by inflammation and thus other mechanisms are at play.
Assuntos
Células da Medula Óssea/patologia , Cardiomiopatias/patologia , Doença da Artéria Coronariana/patologia , Células Progenitoras Endoteliais/patologia , Células-Tronco Hematopoéticas/patologia , Isquemia Miocárdica/patologia , Adulto , Idoso , Fosfatase Alcalina/metabolismo , Proteínas Angiogênicas/genética , Proteínas Angiogênicas/metabolismo , Biomarcadores/sangue , Células da Medula Óssea/metabolismo , Cardiomiopatias/metabolismo , Estudos de Casos e Controles , Diferenciação Celular , Movimento Celular , Células Cultivadas , Doença da Artéria Coronariana/metabolismo , Citocinas/genética , Citocinas/metabolismo , Células Progenitoras Endoteliais/metabolismo , Feminino , Células-Tronco Hematopoéticas/metabolismo , Humanos , Mediadores da Inflamação/metabolismo , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/metabolismo , Fenótipo , Receptores de Citocinas/genética , Receptores de Citocinas/metabolismoRESUMO
BACKGROUND: Clinical studies reporting immediate loading of endosseous implants for edentulous cases and for fixed partial restorations have been well documented with satisfactory survival rates. Implants with a recently developed, nanometer-scale surface topography (NanoTite, BIOMET 3i, Palm Beach Gardens, FL, USA), created by discrete crystalline depositions (DCD) of calcium phosphate nano-crystals onto a dual acid-etched (DAE) surface, show enhanced early fixation in preclinical studies when compared with DAE-surfaced implants. These outcomes suggest DCD-surfaced implants may be advantageous for immediate loading approaches. OBJECTIVE: The aim of this prospective, multicenter, observational study is to report clinical outcomes for DCD-surfaced implants placed in immediate functional support of single- and multi-unit restorations according to an immediate loading protocol. MATERIALS AND METHODS: One hundred eighty-five patients enrolled at 15 international study centers received a total of 335 implants supporting 216 immediate provisionalizations consisting of 128 single-tooth restorations and 88 fixed restorations. Of the 335 implants, 77% are located in posterior and 23% in anterior regions with 55.5% of the total in mandibles and 44.5% in maxillae. Patients were evaluated for implant mobility, gingival health, symptomatology, and radiographic outcomes. RESULTS: At the time of this 1-year interim report, a total of 17 failures have been observed in 11 patients, yielding a cumulative survival rate of 94.9%. CONCLUSION: Relative to other prospective, multicenter studies of immediately loaded implants with various surface enhancements, NanoTite implants perform comparatively well when immediately provisionalized with single-tooth and fixed restorations.