While it seems like restoring blood flow to an injured leg would be a good thing, it can actually cause additional damage that hinders recovery, researchers say.
Ischemia reperfusion injury affects nearly two million Americans annually with a wide variety of scenarios that temporarily impede blood flow – from traumatic limb injuries, to heart attacks, to donor organs, said Dr. Babak Baban, immunologist at the Medical College of Georgia and College of Dental Medicine at Georgia Regents University.
Restoring blood flow actually heightens inflammation and cell death rather than recovery for many of these patients.
“Think about trying to hold onto a nuclear power plant after you unplug the electricity and cannot pump water to cool it down,” said Dr. Jack Yu, Chief of MCG’s Section of Plastic and Reconstructive Surgery. “All kinds of bad things start happening.”
Baban and Yu are collaborators on a study published in the journal PLOS ONE that shows one way stem cell therapy appears to intervene is with the help of an enzyme also used by a fetus to escape rejection by the mother’s immune system.
Earlier studies indicate stem cells may improve recovery both by enabling new blood vessel growth and by turning down the now-severe inflammation, Baban said. The new study shows that indoleomine 2,3 dioxygenase, or IDO, widely known to dampen the immune response and create tolerance, plays an important role in regulating inflammation in that scenario. Stems cells and numerous other cell types are known to express IDO.
In fact, IDO boosted stem cell efficacy by about a third in their studies in animal models comparing the therapy in normal mice versus mice missing IDO. The researchers documented decreased expression of inflammatory markers, swelling and cell death, which correlate with a shorter, improved recovery (…)
Next steps include seeing if more is better, by giving more stem cells – the researchers only gave one dose in the studies – as well as IDO-enhancing drugs, Baban said. This will include incubating stem cells with IDO, Baban said.
The researchers note that stem cell therapy isn’t yet used to help patients’ injured limbs recover, but is being studied clinically to aid stroke and heart attack recovery at MCG and other centers. Right now, the most physicians can do is restore blood flow and give broad-spectrum antibiotics (…)