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Autologous bone marrow mononuclear cells (BM-MNCs) are an investigational cell therapy developed by Dr. Michael P. Murphy at the Indiana University School of Medicine for the treatment of limb-threatening ischemia (critical limb ischemia). The therapy involves harvesting bone marrow from the patient's iliac crest and concentrating the mononuclear cell fraction, which contains a heterogeneous population of hematopoietic stem cells, mesenchymal stem cells, and endothelial progenitor cells. These cells are then injected intramuscularly into the ischemic leg muscle. The therapeutic mechanism is primarily paracrine-mediated; the injected cells release a variety of pro-angiogenic growth factors and cytokines, including vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF). These signals stimulate angiogenesis (the formation of new blood vessels) and arteriogenesis (the expansion of existing vessels), thereby improving blood flow to the ischemic limb and reducing the risk of amputation in patients with severe peripheral vascular disease who have no other revascularization options.
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