Diabetic man hopes study on stem cells saves his leg.

Plain Dealer, The (Cleveland, OH) - Monday, April 27, 2009 Author: Harlan Spector, Plain Dealer Reporter
It starts with a blister or sore on the foot. An ulcer forms. Infection sets in. Flesh dies and turns black. Then doctors have little choice but to amputate.

  It happens to tens of thousands of diabetics every year in the United States. Raymond Culberston's turn may be coming.

  Like many with complications from diabetes, the Canton retiree has poor blood flow to his legs and feet. Uncontrolled blood sugar has damaged the small blood vessels and turned a blister caused by a rubbing shoe into a limb-threatening wound. Culberston smokes, too, which puts diabetics on the fast track to vessel disease and amputation.

  Culberston's only hope is an experimental stem - cell treatment that doctors hope will grow new vessels in his left leg so that his wounds can heal.

  Stem cells extracted from our bodies are being studied for all kinds of treatments, from regenerating nerves to mending damaged heart muscle.

  Doctors at University Hospitals Case Medical Center hope in this case that stem cells strained from Culberston's blood will help his foot.

  He recently underwent a series of injections in his leg. But because it is a blind study – meaning that for research purposes the therapy is compared to a sham treatment – neither Culberston nor his doctors know whether he received stem cells or a saline solution.

  "The leg, they've been talking about taking it off. That's the next thing after this," Culberston said, lying in a recovery room.

  Dr. Marco Costa of UH said he is optimistic the study will show benefit, based on previous success using stem cells to treat damaged coronary blood vessels.

  "It's a very serious social problem because of the number of diabetic patients that exist," Costa said. "There are lots of patients suffering with ulcers on the foot, and they don't get medical care."

   Suffering is the appropriate term, said Culberston. He has turned to stronger painkillers as his wounds worsened in recent years.

  "The pain is something else," he said. "Now I'm on morphine two times a day, but it's working."

  Results from the study may take months. Doctors said stem - cell therapy - if that's what he received and not a placebo - might not spare Culberston from amputation. But they hoped it would improve circulation so that he can walk on the leg.

  It also could result in a less severe amputation.

  So far, only 24 patients are enrolled in the study nationally, and Culberston is the only one in Ohio, Costa said.

  "We have high expectations that this might be the future therapy for these patients," he said.

Caption: LYNN ISCHAY THE PLAIN DEALER Raymond Culberston, 66, is undergoing experimental stem - cell therapy in hopes of restoring circulation in his left leg. LYNN ISCHAY THE PLAIN DEALER Dr. John Blebea, chief of the division of vascular and endovascular surgery at University Hospitals, examines the damaged foot of Ray Culberston. Stacey Mazzurco, a registered nurse of cardiovascular medicine, stands by to receive the stemcells that will be injected into Culberston's leg.