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Pivotal Cytoprotective Mediators and Promising Therapeutic Strategies for Endothelial Progenitor Cell-Based Cardiovascular Regeneration. Stem Cells Int 2016; 2016:8340257. [PMID: 28090210 PMCID: PMC5206447 DOI: 10.1155/2016/8340257] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/11/2016] [Accepted: 10/27/2016] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVDs), including atherosclerosis, stroke, and myocardial infarction, is a major cause of death worldwide. In aspects of cell therapy against CVD, it is generally accepted that endothelial progenitor cells (EPCs) are potent neovascular modulators in ischemic tissues. In response to ischemic injury signals, EPCs located in a bone marrow niche migrate to injury sites and form new vessels by secreting various vasculogenic factors including VEGF, SDF-1, and FGF, as well as by directly differentiating into endothelial cells. Nonetheless, in ischemic tissues, most of engrafted EPCs do not survive under harsh ischemic conditions and nutrient depletion. Therefore, an understanding of diverse EPC-related cytoprotective mediators underlying EPC homeostasis in ischemic tissues may help to overcome current obstacles for EPC-mediated cell therapy for CVDs. Additionally, to enhance EPC's functional capacity at ischemic sites, multiple strategies for cell survival should be considered, that is, preconditioning of EPCs with function-targeting drugs including natural compounds and hormones, virus mediated genetic modification, combined therapy with other stem/progenitor cells, and conglomeration with biomaterials. In this review, we discuss multiple cytoprotective mediators of EPC-based cardiovascular repair and propose promising therapeutic strategies for the treatment of CVDs.
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Challenges and opportunities for stem cell therapy in patients with chronic kidney disease. Kidney Int 2016; 89:767-78. [PMID: 26924058 DOI: 10.1016/j.kint.2015.11.023] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/10/2015] [Accepted: 11/18/2015] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease (CKD) is a global health care burden affecting billions of individuals worldwide. The kidney has limited regenerative capacity from chronic insults, and for the most common causes of CKD, no effective treatment exists to prevent progression to end-stage kidney failure. Therefore, novel interventions, such as regenerative cell-based therapies, need to be developed for CKD. Given the risk of allosensitization, autologous transplantation of cells to boost regenerative potential is preferred. Therefore, verification of cell function and vitality in CKD patients is imperative. Two cell types have been most commonly applied in regenerative medicine. Endothelial progenitor cells contribute to neovasculogenesis primarily through paracrine angiogenic activity and partly by differentiation into mature endothelial cells in situ. Mesenchymal stem cells also exert paracrine effects, including proangiogenic, anti-inflammatory, and antifibrotic activity. However, in CKD, multiple factors may contribute to reduced cell function, including older age, coexisting cardiovascular disease, diabetes, chronic inflammatory states, and uremia, which may limit the effectiveness of an autologous cell-based therapy approach. This Review highlights current knowledge on stem and progenitor cell function and vitality, aspects of the uremic milieu that may serve as a barrier to therapy, and novel methods to improve stem cell function for potential transplantation.
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PIŤHA J, KRÁLOVÁ LESNÁ I, STÁVEK P, MAHROVÁ A, RACEK J, SEKERKOVÁ A, TEPLAN V, ŠTOLLOVÁ M. Effect of Exercise on Markers of Vascular Health in Renal Transplant Recipients. Physiol Res 2015; 64:945-9. [DOI: 10.33549/physiolres.933123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The cornerstone of cardiovascular risk management is lifestyle intervention including exercise which could exert favorable impact also in renal transplant recipients. Nevertheless, reliable assessment of the effect of lifestyle interventions is complicated and the available data in this population are not consistent. The aim of the study was to evaluate the effect of physical activity on selected laboratory markers of vascular health including circulating stem cells, endothelial progenitor cells, microparticles, and plasma asymmetric dimethyl arginine in renal transplant recipients. Nineteen men and 7 women were recruited in 6-month program of standardized and supervised exercise. Control group consisted of 23 men and 13 women of similar age and body mass index not included into the program. One year after the transplantation, the main difference between intervention and control group was found in the change of endothelial progenitor cells (p=0.006). Surprisingly, more favorable change was seen in the control group in which endothelial progenitor cells significantly increased compared to the intervention group. The explanation of this finding might be a chronic activation of reparative mechanisms of vascular system in the population exposed to multiple risk factors which is expressed as relatively increased number of endothelial progenitor cells. Therefore, their decrease induced by exercise might reflect stabilization of these processes.
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Affiliation(s)
- J. PIŤHA
- Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Teplan V, Mahrová A, Králová-Lesná I, Racek J, Valkovský I, Štollová M. Endothelial Progenitor Cells and Asymmetric Dimethylarginine After Renal Transplantation. J Ren Nutr 2015; 25:247-9. [DOI: 10.1053/j.jrn.2014.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 10/29/2014] [Indexed: 01/26/2023] Open
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Teplan V, Králová Lesná I, Piťha J, Mahrová A, Racek J, Valkovský I, Sekerková A, Štollová M. Asymmetric dimethylarginine and endothelial progenitor cells after renal transplantation: the effect of exercise training. Physiol Res 2014; 63:S411-7. [PMID: 25428747 DOI: 10.33549/physiolres.932886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Level of asymmetric dimethylarginine (ADMA) is elevated and endothelial progenitor cells (EPC) and stem cells (SC) are decreased in patients undergoing renal transplantation (Tx) and may contribute to cardiovascular complications. We tested the hypothesis that ADMA, EPC and SC can be influenced with regular physical exercise early after Tx. Blood samples of ADMA, EPC, SC, adipocytokines and metabolic parameters were randomly obtained from 50 transplant patients before and 6 months after exercise program (Group I). Fifty age, sex, HLA typing, duration of dialysis and immunosupression regimen-matched non exercising transplant were examined as controls (Group II). After 6 months, in Group I ADMA decreased (3.50+/-0.45 vs 2.11+/-0.35 micromol/l, P<0.01) and was lower comparing to Group II (P<0.01), SC and EPC also decreased (2816+/-600 vs 2071+/-480 cells/ml resp. 194+/-87 to 125+/-67 cells/ml, P<0.02). Next changes in Group I: adiponectin (P<0.01), leptin (P<0.01), resistin (P<0.02). Visfatin, blood lipids, HbA1c, insulin and blood pressure were also influenced by training program (P<0.05).
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Affiliation(s)
- V Teplan
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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Soriano S, Carmona A, Triviño F, Rodriguez M, Alvarez-Benito M, Martín-Malo A, Alvarez-Lara MA, Ramírez R, Aljama P, Carracedo J. Endothelial damage and vascular calcification in patients with chronic kidney disease. Am J Physiol Renal Physiol 2014; 307:F1302-11. [PMID: 25339701 DOI: 10.1152/ajprenal.00114.2014] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vascular calcification (VC) is a frequent complication of chronic kidney disease (CKD) and is a predictor of cardiovascular morbidity and mortality. In the present study, we investigated the potential involvement of endothelial microparticles (MPs) and endothelial progenitor cells (EPCs) in the generation of VC in CKD patients. The number of circulating EMPs is greater in patients with VC than without VC (307 ± 167 vs. 99 ± 75 EMPs/μl, P < 0.001). The percentage of EPCs is significantly lower in patient with VC than in patients without VC (0.14 ± 0.11% vs. 0.25 ± 0.18%, P = 0.002). The number of EPCs expressing osteocalcin (OCN) was higher in VC patients (349 ± 63 cells/100,000) than in non-VC patients (139 ± 75 cells/100,000, P < 0.01). In vitro, MPs obtained from CKD patients were able to induce OCN expression in EPCs from healthy donors; the increase in OCN expression was more accentuated if MPs were obtained from CKD patients with VC. MPs from CKD patients also induced OCN expression in vascular smooth muscle cells and fibroblasts. In CKD patients, the rise in endothelial MPs associated with a decrease in the number of EPCs, suggesting an imbalance in the processes of endothelial damage and repair in CKD patients, mainly those with VC. Our results suggest that EPCs, through OCN expression, may directly participate in the process of VC.
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Affiliation(s)
- Sagrario Soriano
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; Nephrology Unit, Reina Sofía University Hospital, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and
| | - Andrés Carmona
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; Nephrology Unit, Reina Sofía University Hospital, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and
| | | | - Mariano Rodriguez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; Nephrology Unit, Reina Sofía University Hospital, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and
| | | | - Alejandro Martín-Malo
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; Nephrology Unit, Reina Sofía University Hospital, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and
| | - Maria-Antonia Alvarez-Lara
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; Nephrology Unit, Reina Sofía University Hospital, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and
| | - Rafael Ramírez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and Biologia de Sistemas Department Módulo II-Planta B, Alcala de Henares University, Madrid, Spain
| | - Pedro Aljama
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; Nephrology Unit, Reina Sofía University Hospital, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and
| | - Julia Carracedo
- Instituto Maimónides de Investigación Biomédica de Córdoba, Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain; Nephrology Unit, Reina Sofía University Hospital, Córdoba, Spain; RETICs Red Renal (Instituto de Salud Carlos III), Madrid, Spain; and
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Tillman BW, Yazdani SK, Neff LP, Corriere MA, Christ GJ, Soker S, Atala A, Geary RL, Yoo JJ. Bioengineered vascular access maintains structural integrity in response to arteriovenous flow and repeated needle puncture. J Vasc Surg 2012; 56:783-93. [PMID: 22917043 DOI: 10.1016/j.jvs.2012.02.030] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 02/07/2012] [Accepted: 02/15/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Tissue-engineered blood vessels (TEBV) have been proposed as an alternative to prosthetic grafts for dialysis access. However, arteriovenous (AV) grafts must withstand extreme flow rates and frequent needle trauma. In a proof-of-concept study, we sought to determine whether scaffold-based TEBV could withstand the hemodynamic and mechanical challenges of chronic dialysis access. METHODS TEBV were constructed using decellularized arterial scaffolds seeded with autologous ovine endothelial cells (EC) derived from circulating endothelial progenitor cells (EPC) using a novel high-affinity capture approach. Seeded scaffolds were preconditioned to arterial pressure and flow in a bioreactor for 2 weeks prior to implantation to create carotid artery to jugular vein AV grafts in each animal. TEBV were healed for 1 month before initiating percutaneous needle puncture 3 days/week. TEBV wall geometry and patency were monitored using duplex imaging and were either explanted for histologic analysis at 2 months (n = 5) or followed for up to 6 months until venous outflow stenosis threatened AV graft patency (n = 6). RESULTS Despite high flow, TEBV maintained stable geometry with only modest wall dilation (under 6%) by 4 months after implantation. Needle access was well tolerated with a single puncture site complication, a small pseudoaneurysm, occurring in the late group. Time-to-hemostasis at puncture sites averaged 4 ± 2 minutes. Histologic analysis at 2 months demonstrated repopulation of the outer TEBV wall by host cells and healing of needle punctures by cellular ingrowth and new matrix deposition along the tract. TEBV followed beyond 2 months showed stable wall geometry but, consistent with the primary mode of clinical AV graft failure, all TEBV eventually developed venous anastomotic stenosis (mean, 4.4 ± 0.9 months; range, 3.3-5.6 months postimplantation; n = 6). CONCLUSIONS This pilot study supports the concept of creating dialysis access from scaffold-based autologous TEBV. Engineered AV grafts were created within a clinically relevant time frame and demonstrated stable wall geometry despite high flow and repeated puncture. Cellular ingrowth and puncture site healing may improve wall durability, but venous outflow stenosis remains the primary mode of TEBV graft failure in the ovine model.
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MESH Headings
- Angiography, Digital Subtraction
- Animals
- Arteriovenous Shunt, Surgical/adverse effects
- Arteriovenous Shunt, Surgical/instrumentation
- Bioreactors
- Blood Pressure
- Blood Vessel Prosthesis
- Blood Vessel Prosthesis Implantation/adverse effects
- Blood Vessel Prosthesis Implantation/instrumentation
- Carotid Arteries/diagnostic imaging
- Carotid Arteries/pathology
- Carotid Arteries/physiopathology
- Carotid Arteries/surgery
- Cell Culture Techniques
- Cells, Cultured
- Constriction, Pathologic
- Endothelial Cells/transplantation
- Equipment Failure Analysis
- Feasibility Studies
- Graft Occlusion, Vascular/diagnosis
- Graft Occlusion, Vascular/etiology
- Graft Occlusion, Vascular/physiopathology
- Hemodynamics
- Jugular Veins/diagnostic imaging
- Jugular Veins/pathology
- Jugular Veins/physiopathology
- Jugular Veins/surgery
- Materials Testing
- Models, Animal
- Needles
- Pilot Projects
- Prosthesis Design
- Prosthesis Failure
- Pulsatile Flow
- Punctures
- Regional Blood Flow
- Renal Dialysis
- Sheep
- Stem Cell Transplantation
- Stress, Mechanical
- Time Factors
- Tissue Engineering/methods
- Tissue Scaffolds
- Tomography, X-Ray Computed
- Ultrasonography, Doppler, Color
- Ultrasonography, Doppler, Pulsed
- Vascular Patency
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Affiliation(s)
- Bryan W Tillman
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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Increased cardiovascular risk in rats with primary renal dysfunction; mediating role for vascular endothelial function. Basic Res Cardiol 2012; 107:242. [PMID: 22258067 PMCID: PMC3329880 DOI: 10.1007/s00395-011-0242-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 12/01/2011] [Accepted: 12/23/2011] [Indexed: 11/04/2022]
Abstract
Primary chronic kidney disease is associated with high cardiovascular risk. However, the exact mechanisms behind this cardiorenal interaction remain unclear. We investigated the interaction between heart and kidneys in novel animal model for cardiorenal interaction. Normal Wistar rats and Munich Wistar Fromter rats, spontaneously developing renal dysfunction, were subjected to experimental myocardial infarction to induce cardiac dysfunction (CD) and combined cardiorenal dysfunction (CRD), respectively (N = 5–10). Twelve weeks later, cardiac- and renal parameters were evaluated. Cardiac, but not renal dysfunction was exaggerated in CRD. Accelerated cardiac dysfunction in CRD was indicated by decreased cardiac output (CD 109 ± 10 vs. CRD 79 ± 8 ml/min), diastolic dysfunction (E/e′) (CD 26 ± 2 vs. CRD 50 ± 5) and left ventricular overload (LVEDP CD 10.8 ± 2.8 vs. CRD 21.6 ± 1.7 mmHg). Congestion in CRD was confirmed by increased lung and atrial weights, as well as exaggerated right ventricular hypertrophy. Absence of accelerated renal dysfunction, measured by increased proteinuria, was supported by absence of additional focal glomerulosclerosis or further decline of renal blood flow in CRD. Only advanced peripheral endothelial dysfunction, as found in CRD, appeared to correlate with both renal and cardiac dysfunction parameters. Thus, proteinuric rats with myocardial infarction showed accelerated cardiac but not renal dysfunction. As parameters mimic the cardiorenal syndrome, these rats may provide a clinically relevant model to study increased cardiovascular risk due to renal dysfunction. Peripheral endothelial dysfunction was the only parameter that correlated with both renal and cardiac dysfunction, which may indicate a mediating role in cardiorenal interaction.
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Yang L, Ruan LM, Ye HH, Cui HB, Mu QT, Lou YR, Ji YX, Li WZ, Sun DH, Chen XB. Depression is associated with lower circulating endothelial progenitor cells and increased inflammatory markers. Acta Neuropsychiatr 2011; 23:235-40. [PMID: 25379895 DOI: 10.1111/j.1601-5215.2011.00577.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Yang L, Ruan L-M, Ye H-H, Cui H-B, Mu Q-T, Lou Y-R, Ji Y-X, Li W-Z, Sun D-H, Chen X-B. Depression is associated with lower circulating endothelial progenitor cells and increased inflammatory markers.Objective: To test the hypothesis that depression status in subjects without cardiovascular diseases (CVD) or diabetes is associated with depletion of circulating endothelial progenitor cells (EPCs) and impaired endothelial function.Method: Thirty depressive persons with the first episode of depression (case group) diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and 30 healthy people (control group) were investigated. The depression status was estimated using Hamilton Rating Scale of Depression from which the criteria of depression are determined to be >21 score. EPCs labeled with CD34-ECD, CD133-phycoerythrin and kinase insert domain receptor (KDR)-fluorescein isothiocyanate antibodies were counted by flow cytometry in the peripheral blood of patients and control subjects. Mononuclear cells that were positive for CD34/KDR, CD133/KDR and CD34/CD133/KDR within the lymphocyte population were characterised as different phenotypes of EPCs.Results: There were no significant differences in baseline clinical characteristics between patients and healthy individuals (all p > 0.05). However, patients with depression had significantly lower levels of circulating CD34+CD133+KDR+ EPCs (132.20 ± 17.27 vs. 225.93 ± 9.88, p = 0.000) and endothelial colony-forming units (26.40 ± 3.79 vs. 36.60 ± 2.88, p = 0.000) than that of healthy subjects. Furthermore, CD34+CD133+KDR+ EPCs had a negative correlation with tumour necrosis factor-α (Spearman's ρ = 0.433, p = 0.000) and interleukin-6 (Spearman's ρ = 0.441, p = 0.032).Conclusion: Our result shows that depression was associated with lower levels of circulating EPCs, which may contribute to the development of endothelial dysfunction and atherosclerosis.
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Affiliation(s)
- Lu Yang
- Department of Psychology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Lie-Min Ruan
- Department of Psychology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Hong-Hua Ye
- Department of Cardiology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Han-Bin Cui
- Department of Cardiology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Qi-Tian Mu
- The Stem Cells Transplantation Center, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Yan-Ru Lou
- The Stem Cells Transplantation Center, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Yun-Xin Ji
- Department of Psychology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Wan-Zhen Li
- Department of Psychology, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Ding-He Sun
- The Stem Cells Transplantation Center, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Xiao-Bei Chen
- The Stem Cells Transplantation Center, Ningbo First Hospital, Ningbo, Zhejiang, China
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Wojakowski W, Landmesser U, Bachowski R, Jadczyk T, Tendera M. Mobilization of stem and progenitor cells in cardiovascular diseases. Leukemia 2011; 26:23-33. [DOI: 10.1038/leu.2011.184] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Patschan SA, Patschan D, Temme J, Korsten P, Wessels JT, Koziolek M, Henze E, Müller GA. Endothelial progenitor cells (EPC) in sepsis with acute renal dysfunction (ARD). CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2011; 15:R94. [PMID: 21396100 PMCID: PMC3219359 DOI: 10.1186/cc10100] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Revised: 01/11/2011] [Accepted: 03/11/2011] [Indexed: 12/24/2022]
Abstract
Introduction Sepsis is characterized by systemic microvascular dysfunction. Endothelial progenitor cells (EPCs) are critically involved in maintaining vascular homeostasis under both physiological and pathological conditions. The aim of the present study was to analyze the endothelial progenitor cell system in patients suffering from sepsis with acute renal dysfunction. Methods Patients with newly diagnosed sepsis were recruited from the ICU in a nonrandomized prospective manner. Blood samples were obtained within the first 12 hours after the diagnosis of sepsis. For quantifying endothelial progenitor cells (EPCs), CD133+/Flk-1+ cells were enumerated by cytometric analysis. Analysis of EPC proliferation was performed by a colony-forming units (CFU) assay. Blood concentrations of proangiogenic mediators were measured by ELISA. Acute renal dysfunction was diagnosed according to the Acute Kidney Injury Network (AKIN) criteria. Depending on the overall mean creatinine concentration during the stay at the ICU, patients were either assigned to a 'normal creatinine group' or to a 'high creatinine group'. Survival rates, frequency of dialysis, the simplified acute physiology score (SAPS) II scores, and different laboratory parameters were collected/used for further clinical characterization Results Circulating EPCs were significantly higher in all sepsis patients included in the study as opposed to healthy controls. Patients within the 'high creatinine group' showed an even more pronounced EPC increase. In contrast, EPC proliferation was severely affected in sepsis. Neither total circulating EPCs nor EPC proliferation differed between patients requiring dialysis and patients without renal replacement therapy. Cell numbers and cell proliferation also did not differ between surviving patients and patients with sepsis-related death. Serum levels of vascular endothelial growth factor (VEGF), stromal derived factor-1 (SDF-1), and Angiopoietin-2 were higher in sepsis than in healthy controls. Sepsis patients within the 'high creatinine group' showed significantly higher mean serum levels of uric acid. Conclusions Sepsis significantly affects the endothelial progenitor cell system, as reflected by increased EPC numbers, increased concentrations of proangiogenic mediators, and reduced proliferative capacity of the cells. This occurs independently from the frequency of dialysis and from patient survival. Increased serum levels of uric acid are possibly responsible for stronger EPC mobilization in sepsis patients with higher average creatinine levels.
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Affiliation(s)
- Susann A Patschan
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany.
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12
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Endothelial progenitor cells: novel biomarker and promising cell therapy for cardiovascular disease. Clin Sci (Lond) 2011; 120:263-83. [PMID: 21143202 DOI: 10.1042/cs20100429] [Citation(s) in RCA: 156] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bone-marrow-derived EPCs (endothelial progenitor cells) play an integral role in the regulation and protection of the endothelium, as well as new vessel formation. Peripheral circulating EPC number and function are robust biomarkers of vascular risk for a multitude of diseases, particularly CVD (cardiovascular disease). Importantly, using EPCs as a biomarker is independent of both traditional and non-traditional risk factors (e.g. hypertension, hypercholesterolaemia and C-reactive protein), with infused ex vivo-expanded EPCs showing potential for improved endothelial function and either reducing the risk of events or enhancing recovery from ischaemia. However, as the number of existing cardiovascular risk factors is variable between patients, simple EPC counts do not adequately describe vascular disease risk in all clinical conditions and, as such, the risk of CVD remains. It is likely that this limitation is attributable to variation in the definition of EPCs, as well as a difference in the interaction between EPCs and other cells involved in vascular control such as pericytes, smooth muscle cells and macrophages. For EPCs to be used regularly in clinical practice, agreement on definitions of EPC subtypes is needed, and recognition that function of EPCs (rather than number) may be a better marker of vascular risk in certain CVD risk states. The present review focuses on the identification of measures to improve individual risk stratification and, further, to potentially individualize patient care to address specific EPC functional abnormalities. Herein, we describe that future therapeutic use of EPCs will probably rely on a combination of strategies, including optimization of the function of adjunct cell types to prime tissues for the effect of EPCs.
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Jie KE, Lilien MR, Goossens MHJ, Westerweel PE, Klein MK, Verhaar MC. Reduced endothelial progenitor cells in children with hemodialysis but not predialysis chronic kidney disease. Pediatrics 2010; 126:e990-3. [PMID: 20819900 DOI: 10.1542/peds.2009-3346] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In adults with chronic kidney disease (CKD), reduced levels of vasculoprotective endothelial progenitor cells (EPCs) may contribute to their increased risk of cardiovascular disease. Children with CKD also show signs of cardiovascular disease. However, to our knowledge, there have been no studies on circulating EPC levels in pediatric patients with CKD. We investigated CD34+KDR+ EPC numbers by using flow cytometry in 15 children with predialysis CKD, 13 children on hemodialysis, and 18 age-matched healthy controls. Children on hemodialysis showed 47% reduced EPC levels compared with controls, whereas no significant difference was found for patients with predialysis CKD. Lower EPC levels were found in patients with higher levels of inflammatory marker high-sensitivity C-reactive protein. Our data show, for the first time, that children on hemodialysis have reduced CD34+KDR+ EPC levels, which potentially contributes to their increased cardiovascular risk. In children with predialysis CKD, a decline in renal function was not associated with reduced EPC levels, which may reflect a capacity for preservation of the endogenous repair system during relatively moderate disturbances of the systemic environment.
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Affiliation(s)
- Kim E Jie
- Department of Nephrology and Hypertension, Wilhelmina Children's Hospital, F03.227, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
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Arrigoni FI, Matarin M, Thompson PJ, Michaelides M, McClements ME, Redmond E, Clarke L, Ellins E, Mohamed S, Pavord I, Klein N, Hunt DM, Moore AT, Halcox J, Sisodiya SM. Extended extraocular phenotype of PROM1 mutation in kindreds with known autosomal dominant macular dystrophy. Eur J Hum Genet 2010; 19:131-7. [PMID: 20859302 DOI: 10.1038/ejhg.2010.147] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Mutations in prominin 1 (PROM1) have been shown to result in retinitis pigmentosa, macular degeneration and cone-rod dystrophy. Because of the putative role of PROM1 in hippocampal neurogenesis, we examined two kindreds with the same R373C PROM1 missense mutation using our established paradigm to study brain structure and function. As the protein encoded by PROM1, known as CD133, is used to identify stem/progenitor cells that can be found in peripheral blood and reflect endothelial reparatory mechanisms, other parameters were subsequently examined that included measures of vascular function, endothelial function and angiogenic capacity. We found that aspects of endothelial function assayed ex vivo were abnormal in patients with the R373C PROM1 mutation, with impaired adhesion capacity and higher levels of cellular damage. We also noted renal infections, haematuria and recurrent miscarriages possibly reflecting consequences of abnormal tubular modelling. Further studies are needed to confirm these findings.
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Jie KE, Zaikova MA, Bergevoet MWT, Westerweel PE, Rastmanesh M, Blankestijn PJ, Boer WH, Braam B, Verhaar MC. Progenitor cells and vascular function are impaired in patients with chronic kidney disease. Nephrol Dial Transplant 2010; 25:1875-82. [PMID: 20083473 DOI: 10.1093/ndt/gfp749] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Endothelial dysfunction contributes to accelerated atherosclerosis in chronic kidney disease (CKD). Bone marrow-derived endothelial progenitor cells (EPC) constitute an endogenous vascular repair system protecting against atherosclerosis. Smooth muscle progenitor cells (SPC) may stimulate atherosclerosis development. We hypothesized that an imbalance in EPC and SPC occurs in CKD, which may contribute to the increased cardiovascular disease (CVD) risk. METHODS EPC and SPC outgrowth from mononuclear cells (MNC), EPC migratory function and circulating CD34(+)KDR(+)-EPC were measured in 49 patients with varying degrees of CKD on regular therapy and 33 healthy volunteers. Renal function, CKD cause, CVD history and endothelial dysfunction parameters were determined as factors of influence on progenitor cells. RESULTS Patients had reduced EPC outgrowth compared to controls [9 (2-22) vs 12 (1-38) cells/10(3) MNC, P = 0.026], independent of CKD cause and degree, whereas SPC outgrowth levels were higher in patients with more impaired kidney function (r = -0.397, P = 0.008). Patients had lower CD34(+)KDR(+)-EPC compared to controls [9 (0-52) vs 19 (4-110) cells/10(5) granulocytes, P = 0.004]. CVD history and increased endothelial dysfunction markers were related to lower EPC levels. Progenitor cell outgrowth was shifted towards SPC with progression of endothelial damage. Reduction in EPC could not be attributed to decreases in progenitor cell-mobilizing factors SDF-1 alpha and VEGF as levels increased with progressive kidney and endothelial dysfunction, while EPC remained low. CONCLUSIONS Our data suggest that, already in mild CKD, EPC-mediated endogenous vascular regeneration is impaired, while SPC levels increase with declining kidney function.
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Affiliation(s)
- Kim E Jie
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
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16
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Thacker SG, Duquaine D, Park J, Kaplan MJ. Lupus-prone New Zealand Black/New Zealand White F1 mice display endothelial dysfunction and abnormal phenotype and function of endothelial progenitor cells. Lupus 2010; 19:288-99. [PMID: 20068018 DOI: 10.1177/0961203309353773] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patients with systemic lupus erythematosus (SLE) have an impairment in phenotype and function of endothelial progenitor cells (EPCs) which is mediated by interferon alpha (IFN-alpha). We assessed whether murine lupus models also exhibit vasculogenesis abnormalities and their potential association with endothelial dysfunction. Phenotype and function of EPCs and type I IFN gene signatures in EPC compartments were assessed in female New Zealand Black/New Zealand White F(1) (NZB/W), B6.MRL-Fas(lpr)/J (B6/lpr) and control mice. Thoracic aorta endothelial and smooth muscle function were measured in response to acetylcholine or sodium nitropruside, respectively. NZB/W mice displayed reduced numbers, increased apoptosis and impaired function of EPCs. These abnormalities correlated with significant decreases in endothelium-dependent vasomotor responses and with increased type I IFN signatures in EPC compartments. In contrast, B6/lpr mice showed improvement in endothelium-dependent and endothelial-independent responses, no abnormalities in EPC phenotype or function and downregulation of type I IFN signatures in EPC compartments. These results indicate that NZB/W mice represent a good model to study the mechanisms leading to endothelial dysfunction and abnormal vasculogenesis in lupus. These results further support the hypothesis that type I IFNs may play an important role in premature vascular damage and, potentially, atherosclerosis development in SLE.
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Affiliation(s)
- S G Thacker
- Division of Rheumatology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109-5680, USA
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17
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Sipos PI, Crocker IP, Hubel CA, Baker PN. Endothelial progenitor cells: their potential in the placental vasculature and related complications. Placenta 2009; 31:1-10. [PMID: 19917514 DOI: 10.1016/j.placenta.2009.10.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 09/23/2009] [Accepted: 10/12/2009] [Indexed: 02/04/2023]
Abstract
Endothelial progenitor cells (EPCs) have received significant attention in recent times. A role for EPCs has been suggested in a range of pathologies and some recent studies of EPCs in pregnancy have been published. This review provides a guide to the confusing field of EPCs. Attention is paid to their phenotyping, as although elementary this remains a highly debated topic. The current understanding of different subtypes and physiological role of EPCs in the placenta, fetus and adult are also considered. An overview is given as to role of EPC's in the pathophysiology of different disease states and the possible therapeutic and diagnostic applications expected from EPC-related research in obstetrics.
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Affiliation(s)
- P I Sipos
- Maternal and Fetal Health Research Group, The University of Manchester, Research Floor, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
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18
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Avogaro A, Fadini GP. Role of endothelial progenitor cells in diabetes mellitus. Expert Rev Endocrinol Metab 2009; 4:575-589. [PMID: 30780783 DOI: 10.1586/eem.09.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Endothelial progenitor cells (EPCs) are bone marrow-derived cells involved in endothelial healing and angiogenesis. EPCs are considered an integrated component of the cardiovascular system, which promotes vascular health. Derangement of EPC biology in diabetes has been hailed as a novel concept in the pathogenesis of micro- and macro-vascular complications. Additionally, EPCs are considered to be disease biomarkers, as they provide an index of cardiovascular risk. The mechanisms leading to EPC dysfunction in diabetes may include defective mobilization from bone marrow to peripheral blood and reduced half-life. Hyperglycemia is considered the major determinant of microvascular complications, while other mechanisms concur to increase the risk of cardiovascular disease in diabetic patients. EPCs may represent a novel pathophysiological connection to understand development and progression of diabetic complications.
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Affiliation(s)
- Angelo Avogaro
- a Dipartimento di Medicina Clinica e Sperimentale, Cattedra di Malattie del Metabolismo, Università di Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Gian Paolo Fadini
- b Dipartimento di Medicina clinica e Sperimentale, Cattedra di Malattie del Metabolismo, Università di Padova, Via Giustiniani 2, 35128 Padova, Italy.
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19
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Abstract
Rheumatic disease is characterized by inflammation and endothelial dysfunction, which contribute to accelerated atherosclerosis. Circulating endothelial progenitor cells (EPCs) can restore dysfunctional endothelium and thereby protect against atherosclerotic vascular disease. The number and function of EPCs are, however, affected in rheumatic diseases such as psoriatic arthritis, rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and antineutrophil cytoplasmic autoantibody-associated vasculitis. rheumatic disease is often characterized by decreased numbers, and impaired function, of EPCs, although numbers of these cells might increase during the initial years of systemic sclerosis. Pioneering studies show that EPC dysfunction might be improved with pharmacological treatment. How best to restore EPC function, and whether achieving this aim can prevent long-term cardiovascular complications in rheumatic disease, remain to be established.
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20
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Miller TW, Isenberg JS, Roberts DD. Molecular regulation of tumor angiogenesis and perfusion via redox signaling. Chem Rev 2009; 109:3099-124. [PMID: 19374334 PMCID: PMC2801866 DOI: 10.1021/cr8005125] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - David D. Roberts
- To whom correspondence should be addressed: NIH, Building 10, Room 2A33, 10 Center Dr, MSC1500, Bethesda, Maryland 20892,
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21
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Dome P, Teleki Z, Rihmer Z, Peter L, Dobos J, Kenessey I, Tovari J, Timar J, Paku S, Kovacs G, Dome B. Circulating endothelial progenitor cells and depression: a possible novel link between heart and soul. Mol Psychiatry 2009; 14:523-31. [PMID: 18180758 DOI: 10.1038/sj.mp.4002138] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although depression is known to be an independent risk factor for cardiovascular disorders, the mechanisms behind this connection are not well understood. However, the reduction in the number of endothelial progenitor cells (EPCs) in patients with cardiovascular risk factors has led us to hypothesize that depression influences the number of EPCs. EPCs labeled with CD34, CD133 and vascular endothelial growth factor receptor-2 (VEGFR2) antibodies were counted by flow cytometry in the peripheral blood (PB) of 33 patients with a current episode of major depression and of 16 control subjects. Mature (CD34+/VEGFR2+) and immature (CD133+/VEGFR2+) EPC counts were decreased in patients (vs controls; P<0.01 for both comparisons), and there was a significant inverse relationship between EPC levels and the severity of depressive symptoms (P<0.01 for both EPC phenotypes). Additionally, we assayed the plasma levels of VEGF, C-reactive protein (CRP) and tumor necrosis factor (TNF)-alpha and observed significantly elevated TNF-alpha concentrations in patients (vs controls; P<0.05) and, moreover, a significant inverse correlation between TNF-alpha and EPC levels (P<0.05). Moreover, by means of a quantitative RT-PCR approach, we measured CD34, CD133 and VEGFR2 mRNA levels of PB samples and found a net trend toward a decrease in all the investigated EPC-specific mRNA levels in patients as compared with controls. However, statistical significance was reached only for VEGFR2 and CD133 levels (P<0.01 for both markers). This is the first paper that demonstrates evidence of decreased numbers of circulating EPCs in patients with a current episode of major depression.
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Affiliation(s)
- P Dome
- Fifth Department of Psychiatry, National Institute of Psychiatry and Neurology, Budapest, Hungary
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22
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Metsuyanim S, Levy R, Davidovits M, Dekel B. Molecular evaluation of circulating endothelial progenitor cells in children undergoing hemodialysis and after kidney transplantation. Pediatr Res 2009; 65:221-5. [PMID: 18852688 DOI: 10.1203/pdr.0b013e3181903909] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Increased risk of cardiovascular disease in end-stage renal disease (ESRD) has been explained by accelerated atherosclerosis and impaired angiogenesis, in which endothelial progenitor cells (EPC) may play key roles. Circulating cells with endothelial progenitor phenotype have not been evaluated in children with ESRD. Using a quantitative reverse transcriptase polymerase chain reaction (RT-PCR) approach, we measured endothelial-specific and progenitor-associated genes VE-cadherin (VE-C), CD146, CD31, tyrosine-protein kinase receptor (Tie-2), Flk1, CD133, and growth factors promoting EPC function, vascular endothelial growth factor (VEGF), erythropoietin (EPO), and stromal cell-derived factor-1 (SDF-1) in the blood of pediatric patients undergoing hemodialysis and after transplantation. Patients' metabolic parameters were correlated with EPC marker gene levels. Compared with controls, circulating VE-cadherin, CD146, Flk1, VEGF, and EPO RNA levels were decreased in ESRD and normalized in transplanted patients. Levels of VE-cadherin, which were the most significantly reduced in ESRD (p = 0.001) inversely correlated in all of the patient population with serum urea and creatinine concentration, whereas among the ESRD group showed an inverse correlation with diastolic blood pressure (BP), interventricular septum thickness (IVST), and left ventricular mass index. Pediatric ESRD patients may have lower angiogenic potential and increased cardiovascular morbidity, because of decreased expression of circulating endothelial cell specific transcripts. Prospective studies are required to link this expression pattern and its restoration in transplanted patients to cardiovascular outcome.
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Affiliation(s)
- Sally Metsuyanim
- Department of Pediatrics and the Pediatric Stem Cell Research Institute, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
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23
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Dome B, Dobos J, Tovari J, Paku S, Kovacs G, Ostoros G, Timar J. Circulating bone marrow-derived endothelial progenitor cells: characterization, mobilization, and therapeutic considerations in malignant disease. Cytometry A 2008; 73:186-93. [PMID: 18000872 DOI: 10.1002/cyto.a.20480] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Until recently, tumor vascularization was thought to occur exclusively through angiogenesis. However, recent studies using different animal models of cancer suggested the importance of bone marrow-derived endothelial progenitor cells (EPCs) (i.e. postnatal vasculogenesis) in tumor vascularization and growth. EPCs are present in the peripheral blood, their levels are increased in response to certain signals/cytokines, and they home into the neovascular bed of malignant tissues. Furthermore, at the clinical level, evidence is emerging that changes in EPC levels might predict the efficacy of anticancer drug combinations that include antiangiogenic agents. On the basis of these observations, EPCs have attractive potential diagnostic and therapeutic applications for malignant diseases. In this paper, we review biological features of EPCs and speculate on the utility of these progenitor cells for medical oncology.
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Affiliation(s)
- Balazs Dome
- Department of Tumor Biology, National Koranyi Institute of Pulmonology, Budapest, Hungary
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24
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Rafii DC, Psaila B, Butler J, Jin DK, Lyden D. Regulation of vasculogenesis by platelet-mediated recruitment of bone marrow-derived cells. Arterioscler Thromb Vasc Biol 2007; 28:217-22. [PMID: 18096826 DOI: 10.1161/atvbaha.107.151159] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bone marrow-derived cells contribute to physiological and pathological vascular remodeling throughout ontogenesis and adult life. During tissue regeneration and tumor growth, the release of cytokines and chemokines mediates the recruitment of hematopoietic and endothelial progenitor cells that contribute to the assembly of neovessels. Current evidence implies that platelets contribute structurally and instructively to vascular remodeling. Platelets adhere almost immediately to exposed or activated endothelium, and they are major storage and delivery vehicles for pro- and antiangiogenic growth factors including VEGF-A and thrombospondin (TSP), and cytokines and chemokines, such as stromal-derived factor 1 (SDF-1). By site-specific deployment of these factors, platelets orchestrate the local angiogenic stimulus within a tissue and direct the recruitment and differentiation of circulating bone marrow-derived cells. These insights have profound clinical implications; inhibition of platelet-deployed growth factors or their receptors may be an effective strategy to block tumor growth, whereas activation of these pathways may be used to accelerate revascularization and tissue regeneration.
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Affiliation(s)
- Daniel C Rafii
- Weill Cornell Medical College, Department of Pediatrics, New York, NY 10021, USA
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25
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Westerweel PE, Hoefer IE, Blankestijn PJ, de Bree P, Groeneveld D, van Oostrom O, Braam B, Koomans HA, Verhaar MC. End-stage renal disease causes an imbalance between endothelial and smooth muscle progenitor cells. Am J Physiol Renal Physiol 2007; 292:F1132-40. [PMID: 17200161 DOI: 10.1152/ajprenal.00163.2006] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Patients with end-stage renal disease (ESRD) on hemodialysis have an increased risk of cardiovascular disease (CVD). Circulating endothelial progenitor cells (EPC) contribute to vascular regeneration and repair, thereby protecting against CVD. However, circulating smooth muscle progenitor cells (SPC) may contribute to adverse vascular remodeling. We hypothesized that an imbalance occurs between EPC and SPC in ESRD patients and sampled progenitor cells from 45 ESRD patients receiving regular treatment. Our study is the first to show reduced numbers of CD34+KDR+ hematopoietic stem cell (HSC)-derived EPC (type I EPC). Furthermore, monocyte-derived EPC cultured from mononuclear cells (type II EPC) were reduced in number and had a reduced capacity to stimulate endothelial cell angiogenesis. In contrast, SPC outgrowth was unaffected. In vitro incubation with uremic serum impaired type II EPC outgrowth from healthy donor mononuclear cells and did not influence SPC outgrowth. The hemodialysis procedure itself induced HSC apoptosis and caused an acute depletion of circulating EPC. Taken together, the decreased number and impaired function of EPC are compatible with impaired endogenous vascular repair in hemodialysis patients, whereas the unaffected SPC numbers suggest that the potential of progenitor cells to contribute to adverse remodeling is retained. This EPC-SPC imbalance may contribute to the acceleration of CVD in ESRD patients and could offer novel therapeutic targets.
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Affiliation(s)
- Peter E Westerweel
- Dept. of Vascular Medicine, F02.126, Univ. Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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26
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Kaplan RN, Psaila B, Lyden D. Niche-to-niche migration of bone-marrow-derived cells. Trends Mol Med 2007; 13:72-81. [PMID: 17197241 DOI: 10.1016/j.molmed.2006.12.003] [Citation(s) in RCA: 175] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2006] [Revised: 11/24/2006] [Accepted: 12/18/2006] [Indexed: 02/06/2023]
Abstract
During ontogenesis, haematopoietic stem cells (HSCs) relocate between extra-embryonic and embryonic compartments. Similarly, site-specific homing of HSCs is ongoing during adulthood. With the expanding knowledge of HSC physiology, a new paradigm emerges in which HSCs and haematopoietic progenitor cells (HPCs) migrate to defined microenvironments within the bone marrow (BM) and to 'activated' or 'inducible' niches elsewhere. Here, we summarize current understanding of HSC niche characteristics, and the physiological and pathological mechanisms that guide HSC homing both within the BM and to distant niches in the periphery, promoting new vessel growth in tumours and ischaemia. Recent observations suggest that features of the HSC niche might also be recapitulated in pre-metastatic sites. Clusters of BM-derived HPCs promote invasion of disseminating cancer cells. Clear clinical benefits can be foreseen by modulating HSCs and their microenvironments, in promoting tissue regeneration, and inhibiting tumourigenesis and cancer metastasis.
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Affiliation(s)
- Rosandra N Kaplan
- Department of Pediatrics, Weill College of Medicine at Cornell University and Memorial Sloan-Kettering Cancer Center, New York, NY10021, USA
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27
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Herbrig K, Gebler K, Oelschlaegel U, Pistrosch F, Foerster S, Wagner A, Gross P, Passauer J. Kidney transplantation substantially improves endothelial progenitor cell dysfunction in patients with end-stage renal disease. Am J Transplant 2006; 6:2922-8. [PMID: 17061996 DOI: 10.1111/j.1600-6143.2006.01555.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Endothelial progenitor cells (EPC) are involved in endothelial repair and maintenance. Dysfunction of EPC may contribute to accelerated arteriosclerosis in chronic kidney disease. Kidney transplantation (KTx) improves both survival and endothelial function of dialysis patients. In a prospective study, we tested to which extent KTx changes EPC biology. We studied number and function (migratory activity, adhesion to extracellular matrix proteins and to mature endothelial cells [EC]) of EPC in 20 patients during dialysis and 3, 6, 9 and 12 months after KTx. Twenty-two healthy volunteers served as matched controls. Circulating precursor populations were measured by flow cytometric analysis. Cytokines relevant for EPC mobilization were monitored. Compared to the dialysis state, KTx increased the migration of EPC to approximately 2-fold. Adhesion to fibronectin and to collagen type IV was significantly increased after KTx. An improved adhesion rate of EPC to mature EC was observed. The number of EPC decreased. The amount of precursor populations showed no difference compared to the pretransplant state. Our study shows an improved function of EPC after KTx. This finding indicates an improved potential for endothelial repair which in turn may contribute to enhanced endothelial function and reduced cardiovascular morbidity after KTx.
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Affiliation(s)
- K Herbrig
- Nephrology, Department of Internal Medicine III, Technical University of Dresden, Dresden, Germany.
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