Abstract: A method of treating cardiac or myocardial conditions comprises the administration of an effective amount of autologous bone marrow. The bone marrow may optionally be stimulated and/or administered in combination with a pharmaceutical drug, protein, gene or other factor or therapy that may enhance bone marrow production of angiogenic growth factors and/or promote endothelial cell proliferation or migration or blood vessel formation.

Abstract: A therapeutic composition is provided that comprises a cell-free conditioned medium containing mixed secretion products of isolated angiogenic progenitor cells obtained from bone marrow, peripheral blood, or adipose tissue. The composition may additionally contain angiogenesis-promoting proteins obtained by transfecting the progenitors cells in culture with an angiogenesis promoting transgene. The composition is useful to promote angiogenesis when introduced into or adjacent to an ischemic site in a patient, such as in myocardium or peripheral limb. Methods are also provided for utilizing such cell-free conditioned medium to deliver angiogenesis-promoting proteins to a patient. The cell-free conditioned medium can also be injected into the blood stream for delivery to the ischemic tissue. The cells can derive from either an autologous or allogenic source and can be lyophilized or frozen for storage.

Abstract: Methods are provided for promoting formation of collateral blood supply at an ischemic site in tissue by culturing early attaching cells derived from growth of bone marrow aspirate in vitro, collecting early attaching cells produced by the bone marrow culture and injecting conditioned medium produced by culture of the early attaching cells into an ischemic site in heart or limb. The preferred early attaching cells for use in the invention methods are marrow-derived stromal cells. Any donor's bone marrow can be used in preparation of the conditioned medium. Optionally, the early attaching cells can be transfected with an angiogenesis promoting transgene encoding hypoxia inducing factor 1 alpha, a fibroblast growth factor and/or a nitric oxide synthase. Conditioned media containing angiogenic cytokines produced such cells are also provided for injection into tissue, such as heart or peripheral limb muscle, requiring formation of collateral blood supply.

Abstract: A flexible tissue injection catheter is used to accomplish injections at a precisely controlled depth of precisely controlled volumes of a therapeutic or diagnostic agent into an interior body cavity, such as the epicardium or myocardium of the heart. In one embodiment, the invention method includes repeated injections at spaced intervals along the myocardium or epicardium of sterile fluid containing autologous bone marrow aspirate to promote angiogenesis. For myocardial injection, depth penetration is controlled by using a catheter that allows the operator to control depth penetration by means of an adjustable needle stop attached to the catheter handle. In another embodiment depth penetration during epicardial injections is controlled by use of an injection catheter having an operator-controlled adjustable needle stop that produces a sensible signal, such as a visible or audible signal, marking each increment of needle tip exposed by operation of the adjustable needle stop.

Abstract: The invention tissue injection catheters are designed to facilitate injection of a therapeutic or diagnostic agent to an interior body cavity, especially the myocardium or epicardium of the heart with precisely controlled depth penetration. The invention injection catheters, which include mechanisms for precisely controlling the length of needle tip exposed for tissue penetration, are designed to be used in an assemblage with a sterile container and delivery actuator for reinjection of autologous cell-containing fluids, such as autologous bone marrow aspirate. In preferred embodiments, the assemblage is designed to be hand-held. When used in such an assemblage, the invention catheters are particularly useful as a gene delivery device to effect angiogenesis of ischemic areas of the heart.

Abstract: The invention provides systems containing a sterile container for aspiration, filtering, treating and reinjection into a subject of a bodily fluid in a sterile environment. The systems are particularly designed to facilitate transfection of cells within the sterile container by gene therapy molecules and reinjection of the transfected cells into the donor at controlled depth in precisely controlled volumes such as is useful for revascularization of ischemic cardiac tissue. For injection, a pressure actuator, preferably hand-held, applies force to liquids held within the sterile container in precisely controlled increments, thereby expressing liquids through a hollow needle or injection catheter in precisely controlled microvolumes. The invention systems include a hand-held injection device with audible cues that correspond to an operator-selected injection volume and/or audible cues that correspond to needle penetration depth selected by the operator.

Abstract: Methods for aspiration and filtering of a bodily fluid containing undesired components are provided and for treatment of the bodily fluids in a sterile environment in preparation for reinjection of treated aspirate into a donor subject. The invention methods are particularly designed to facilitate transfection of aspirated cells with angiogenesis promoting molecules without danger to the technician or the donor prior to reinjection of the treated cells, either percutaneously or via a surgical opening via a catheter or injection needle. A pressure actuator attached to the sterile container is used to express treated fluids in precisely controlled volumes. The invention methods include delivery of treated fluids using a hand-held device with audible cues that correspond to an operator-selected injection volume and/or audible cues that correspond to needle penetration depth selected by the operator.