1
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Li W, Chen L, Mohammad Sajadi S, Baghaei S, Salahshour S. The impact of acute and chronic aerobic and resistance exercise on stem cell mobilization: A review of effects in healthy and diseased individuals across different age groups. Regen Ther 2024; 27:464-481. [PMID: 38745840 PMCID: PMC11091462 DOI: 10.1016/j.reth.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/09/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
Stem cells (SCs) play a crucial role in tissue repair, regeneration, and maintaining physiological homeostasis. Exercise mobilizes and enhances the function of SCs. This review examines the effects of acute and chronic aerobic and resistance exercise on the population of SCs in healthy and diseased individuals across different age groups. Both acute intense exercise and moderate regular training increase circulating precursor cells CD34+ and, in particular, the subset of angiogenic progenitor cells (APCs) CD34+/KDR+. Conversely, chronic exercise training has conflicting effects on circulating CD34+ cells and their function, which are likely influenced by exercise dosage, the health status of the participants, and the methodologies employed. While acute activity promotes transient mobilization, regular exercise often leads to an increased number of progenitors and more sustainable functionality. Short interventions lasting 10-21 days mobilize CD34+/KDR + APCs in sedentary elderly individuals, indicating the inherent capacity of the body to rapidly activate tissue-reparative SCs during activity. However, further investigation is needed to determine the optimal exercise regimens for enhancing SC mobilization, elucidating the underlying mechanisms, and establishing functional benefits for health and disease prevention. Current evidence supports the integration of intense exercise with chronic training in exercise protocols aimed at activating the inherent regenerative potential through SC mobilization. The physical activity promotes endogenous repair processes, and research on exercise protocols that effectively mobilize SCs can provide innovative guidelines designed for lifelong tissue regeneration. An artificial neural network (ANN) was developed to estimate the effects of modifying elderly individuals and implementing chronic resistance exercise on stem cell mobilization and its impact on individuals and exercise. The network's predictions were validated using linear regression and found to be acceptable compared to experimental results.
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Affiliation(s)
- Wei Li
- Department of Sports Medicine, Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Lingzhen Chen
- Department of Sports and Arts, Zhejiang Gongshang University HangZhou College of Commerce, No. 66, South Huancheng Road, Tonglu, Hangzhou, China
| | | | - Sh. Baghaei
- Department of Mechanical Engineering, Khomeinishahr Branch, Islamic Azad University, Iran
| | - Soheil Salahshour
- Faculty of Engineering and Natural Sciences, Istanbul Okan University, Istanbul, Turkey
- Faculty of Engineering and Natural Sciences, Bahcesehir University, Istanbul, Turkey
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, Lebanon
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2
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Liu H, Fang Y, Pan T, Fang G, Liu Y, Jiang X, Chen B, Gu S, Wei Z, Liu P, Fu W, Yang J, Dong Z. Autologous Stem Cells Transplantation for No-Option Angiitis-Induced Critical Limb Ischemia: Recurrence and New Lesion. Stem Cells Transl Med 2022; 11:504-512. [PMID: 35446404 PMCID: PMC9154329 DOI: 10.1093/stcltm/szac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
Although satisfying outcomes have been demonstrated in terms of autologous stem cell transplantation in the treatment of angiitis-induced critical limb ischemia (AICLI), few studies have systematically reported the recurrence conditions. In the current study, we aimed to investigate recurrence conditions of a relatively large AICLI cohort in our center during a long-term follow-up period. From May 2009 to August 2020, 181 patients with AICLI received peripheral blood mononuclear cells (PBMNCs) or purified CD34+ cells (PCCs) transplantation. The main outcomes included recurrence and new lesions. Patient demographic data, ischemic limb characteristics, interventional characteristics, etc., were identified and analyzed. A logistic multivariable regression was performed to identify the independent risk factors for recurrence by a stepwise selection of variables. One hundred forty-eight patients were enrolled in this study. The mean follow-up period was 62.3 ± 37.4 months (range 12-144 months). The 5- and 10-year recurrence-free rates were 88.5% (95% confidence interval [CI] 3.1%-82.6%) and 71.7% (95% CI 7.6%-58.2%), respectively. The 5- and 10-year new lesion-free rates were 93.2% (95% CI 2.2%-89.0%) and 91.7% (95% CI 2.7%-86.6%), respectively. The finding of multiple limbs involved (OR 1.322 95% CI 1.123-12.549, P = .036) and ischemia relief period ≥5 months (OR 3.367 95% CI 1.112-10.192, P = .032) were demonstrated to be independent risk factors for recurrence in patients with AICLI who underwent cell transplantation. For patients with AICLI who responded to cell transplantation, the durability of this therapy was satisfactory, with 5- and 10-year recurrence-free rates of 88.5% and 71.7%, respectively. Multiple limbs involved at admission and ischemia relief period ≥5 months were demonstrated to be independent risk factors for recurrence after transplantation.
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Affiliation(s)
- Hao Liu
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Yuan Fang
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Tianyue Pan
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Gang Fang
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Yifan Liu
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Xiaolang Jiang
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Bin Chen
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Shiyang Gu
- Department of Hematology of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Zheng Wei
- Department of Hematology of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Peng Liu
- Department of Hematology of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Weiguo Fu
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Jue Yang
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
| | - Zhihui Dong
- Department of Vascular Surgery of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- National Clinical Research Center for Interventional Medicine, Shanghai, People’s Republic of China
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3
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Albiero M, D'Anna M, Bonora BM, Zuccolotto G, Rosato A, Giorgio M, Iori E, Avogaro A, Fadini GP. Hematopoietic and Nonhematopoietic p66Shc Differentially Regulates Stem Cell Traffic and Vascular Response to Ischemia in Diabetes. Antioxid Redox Signal 2022; 36:593-607. [PMID: 34538132 DOI: 10.1089/ars.2021.0097] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aims: Peripheral artery disease (PAD) is a severe complication of diabetes, characterized by defective traffic of hematopoietic stem/progenitor cells (HSPCs). We examined the hematopoietic versus nonhematopoietic role of p66Shc in regulating HSPC traffic and blood flow recovery after ischemia in diabetic mice. Results: Using streptozotocin-induced diabetes, chimeric mice with green fluorescent protein (GFP)+ bone marrow (BM), and the hind limb ischemia model, we found that the physiologic mobilization and homing of HSPCs were abolished by diabetes, along with impaired vascular recovery. Hematopoietic deletion of p66Shc, obtained by transplanting p66Shc-/- BM cells into wild-type (Wt) recipients, but not nonhematopoietic deletion, constrained hyperglycemia-induced myelopoiesis, rescued postischemic HSPC mobilization, and improved blood flow recovery in diabetic mice. In Wt diabetic mice transplanted with BM cells from GFP+p66Shc-/- mice, the amount of HSPCs homed to ischemic muscles was greater than in mice transplanted with GFP+p66Shc+/+ cells, with recruited cells displaying higher expression of adhesion molecules and Vegf. In 40 patients with diabetes, p66Shc gene expression in mononuclear cells was correlated with myelopoiesis and elevated in the presence of PAD. In 13 patients with diabetes and PAD, p66Shc expression in HSPC-mobilized peripheral blood cells was inversely correlated with VEGF expression. Innovation: For the first time, we dissect the role of hematopoietic versus nonhematopoietic p66Shc in regulating HSPC traffic and ischemic responses. Conclusion: Hematopoietic deletion of p66Shc was sufficient to rescue HSPC mobilization and homing in diabetes after ischemia and improved blood flow recovery. Inhibiting p66Shc in blood cells may be a novel strategy to counter PAD in diabetes. Antioxid. Redox Signal. 36, 593-607. Clinical Trial No.: NCT02790957.
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Affiliation(s)
- Mattia Albiero
- Department of Medicine, University of Padova, Padova, Italy.,Veneto Institute of Molecular Medicine, Padova, Italy
| | - Marianna D'Anna
- Department of Medicine, University of Padova, Padova, Italy.,Veneto Institute of Molecular Medicine, Padova, Italy
| | - Benedetta Maria Bonora
- Department of Medicine, University of Padova, Padova, Italy.,Veneto Institute of Molecular Medicine, Padova, Italy
| | - Gaia Zuccolotto
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Antonio Rosato
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy.,Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Marco Giorgio
- European Institute of Oncology (IEO), Milan, Italy.,Department of Biomedical Sciences, University of Padova, Padova, Italy
| | | | - Angelo Avogaro
- Department of Medicine, University of Padova, Padova, Italy
| | - Gian Paolo Fadini
- Department of Medicine, University of Padova, Padova, Italy.,Veneto Institute of Molecular Medicine, Padova, Italy
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4
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Liu H, Pan T, Liu Y, Fang Y, Fang G, Jiang X, Chen B, Wei Z, Gu S, Liu P, Fu W, Dong Z. The peripheral blood mononuclear cells versus purified CD34 + cells transplantation in patients with angiitis-induced critical limb ischemia trial: 5-year outcomes and return to work analysis-a randomized single-blinded non-inferiority trial. Stem Cell Res Ther 2022; 13:116. [PMID: 35313967 PMCID: PMC8935813 DOI: 10.1186/s13287-022-02804-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/27/2022] [Indexed: 11/24/2022] Open
Abstract
Backgrounds Patients with AICLI constitute a considerable proportion of NO-CLI patients and cannot be treated with surgical or endovascular treatment. Although cell therapy has shown satisfactory results in treating AICLI, research comparing the efficacy of treatment with the 2 kinds of cell products is rare. The aim of this study was to report the 5-year outcomes of a randomized single-blinded noninferiority trial (Number: NCT 02089828) on peripheral blood mononuclear cells (PBMNCs) and purified CD34+ cells (PCCs) transplantation for treating angiitis-induced critical limb ischemia (AICLI). Methods A randomized single-blinded non-inferiority trial (Number: NCT 02089828) was performed. Fifty patients were randomized 1:1 to the PBMNCs and PCCs groups. Efficacy outcomes, safety outcomes and patients’ work conditions were analyzed. The primary efficacy outcomes included major amputation and total amputation over 60 months. Results During the 60-month follow-up, 1 patient was lost to follow-up, 1 died, and 2 underwent major amputation. The major amputation-free survival rate (MAFS) was 92.0% (95% confidence interval [CI] 82.0%-100.0%) in the PBMNCs group and 91.7% (95% CI 81.3%-100.0%) in the PCCs group (P = 0.980). Compared with the PCCs group, the PBMNCs group had a significantly higher 5-year new lesion-free survival rate (100.0% vs. 83.3% [95% CI 69.7–99.7%], P = 0.039). All patients lost their ability to work before transplantation, and the 5-year cumulative return to work (RTW) rates were 88.0% in the PBMNCs group and 76.0% in the PCCs group (P = 0.085). Conclusion The long-term follow-up outcomes of this trial not only demonstrated similar efficacy and safety for the 2 types of autoimplants but also showed a satisfactory cumulative RTW rate in AICLI patients who underwent cell transplantation. Trial registration: ClinicalTrials.gov, number NCT 02089828. Registered 14 March 2014, https://clinicaltrials.gov/ct2/show/record/NCT02089828.
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Affiliation(s)
- Hao Liu
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Tianyue Pan
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Yifan Liu
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Yuan Fang
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Gang Fang
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Xiaolang Jiang
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Bin Chen
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Zheng Wei
- Departments of Hematology of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shiyang Gu
- Departments of Hematology of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Peng Liu
- Departments of Hematology of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weiguo Fu
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,National Clinical Research Center for Interventional Medicine, Shanghai, China.
| | - Zhihui Dong
- Departments of Vascular Surgery of Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,National Clinical Research Center for Interventional Medicine, Shanghai, China.
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5
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Sun H, Pratt RE, Hodgkinson CP, Dzau VJ. Sequential paracrine mechanisms are necessary for the therapeutic benefits of stem cell therapy. Am J Physiol Cell Physiol 2020; 319:C1141-C1150. [PMID: 33026832 DOI: 10.1152/ajpcell.00516.2019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stem cell injections are an attractive therapeutic tool. It has been demonstrated that injected stem cells promote tissue repair and regeneration via paracrine mechanisms. However, the effects of injected stem cells continue for far longer than they are present. We hypothesized that the effects of injected stem cells are prolonged because of a sequential paracrine relay mechanism. Conditioned media was collected from mesenchymal stem cells (MSCs) after 24 h. This media was then added to RAW264.7. Media was collected from the macrophages after 24 h and was then added to endothelial cells (ECs). This conditioned macrophage media, but not control media, promoted wound healing and induced EC differentiation. Similar results were observed with primary macrophages. To identify the active paracrine factors released by macrophages in response to stimulation by MSC conditioned media we used an antibody array, identifying increased expression of the angiogenesis-related proteins stromal cell-derived factor 1 (SDF1) and plasminogen activator inhibitor-1 (PAI-1). Knockdown of either protein inhibited the ability of conditioned media derived from MSC paracrine factor-stimulated macrophages to induce EC differentiation both in vitro and in vivo. Conditioned media derived from postnatal day 7 (P7) mouse macrophages induced EC differentiation. Moreover, SDF1 and PAI-1 levels were >120 higher in P7 macrophages compared with adult macrophages, suggesting that MSC paracrine factors promote adult macrophages to adopt a juvenile phenotype. These results indicate that MSC paracrine factors induce macrophages to secrete SDF1 and PAI-1, in-turn inducing endothelial cells to differentiate. Identification of a sequential paracrine mechanism opens new therapeutic avenues for stem cell therapy.
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Affiliation(s)
- Hualing Sun
- Mandel Center for Heart and Vascular Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, North Carolina
| | - Richard E Pratt
- Mandel Center for Heart and Vascular Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, North Carolina
| | - Conrad P Hodgkinson
- Mandel Center for Heart and Vascular Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, North Carolina
| | - Victor J Dzau
- Mandel Center for Heart and Vascular Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, North Carolina
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6
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Chen H, Zhang Z, Wang Z, Li Q, Chen H, Guo S, Bao L, Wang Z, Min W, Xiang Q. Stage-specific regulation of Gremlin1 on the differentiation and expansion of human urinary induced pluripotent stem cells into endothelial progenitors. J Cell Mol Med 2020; 24:8018-8030. [PMID: 32468734 PMCID: PMC7348142 DOI: 10.1111/jcmm.15433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/07/2020] [Accepted: 05/07/2020] [Indexed: 12/23/2022] Open
Abstract
Human urinary induced pluripotent stem cells (hUiPSCs) produced from exfoliated renal epithelial cells present in urine may provide a non-invasive source of endothelial progenitors for the treatment of ischaemic diseases. However, their differentiation efficiency is unsatisfactory and the underlying mechanism of differentiation is still unknown. Gremlin1 (GREM1) is an important gene involved in cell differentiation. Therefore, we tried to elucidate the roles of GREM1 during the differentiation and expansion of endothelial progenitors. HUiPSCs were induced into endothelial progenitors by three stages. After differentiation, GREM1 was obviously increased in hUiPSC-induced endothelial progenitors (hUiPSC-EPs). RNA interference (RNAi) was used to silence GREM1 expression in three stages, respectively. We demonstrated a stage-specific effect of GREM1 in decreasing hUiPSC-EP differentiation in the mesoderm induction stage (Stage 1), while increasing differentiation in the endothelial progenitors' induction stage (Stage 2) and expansion stage (Stage 3). Exogenous addition of GREM1 recombinant protein in the endothelial progenitors' expansion stage (Stage 3) promoted the expansion of hUiPSC-EPs although the activation of VEGFR2/Akt or VEGFR2/p42/44MAPK pathway. Our study provided a new non-invasive source for endothelial progenitors, demonstrated critical roles of GREM1 in hUiPSC-EP and afforded a novel strategy to improve stem cell-based therapy for the ischaemic diseases.
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Affiliation(s)
- Haixuan Chen
- Translational Medicine Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhen Zhang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory for Stem Cells and Tissue Engineering, Center for Stem Cell Biology and Tissue Engineering, Ministry of Education, Sun Yat-sen University, Guangzhou, China
| | - Zhecun Wang
- Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Quhuan Li
- Institute of Biomechanics, School of Bioscience and Bioengineering, South China University of Technology, Guangzhou, China
| | - Hui Chen
- Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Song Guo
- Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lin Bao
- Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zheng Wang
- Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, China
| | - Wang Min
- Interdepartmental Program in Vascular Biology and Therapeutics, Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Qiuling Xiang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Key Laboratory for Stem Cells and Tissue Engineering, Center for Stem Cell Biology and Tissue Engineering, Ministry of Education, Sun Yat-sen University, Guangzhou, China
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7
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JIANG ZHIQUN, CHEN YAN, ZENG CHUNHUI, FENG JIUGENG, WAN YILV, WEI MINJUN. RATIONALIZATION OF SURGICAL TREATMENT FOR HEMORRHAGIC MOYAMOYA DISEASE: FROM LABORATORY BENCH RESEARCH, BIOMECHANICS TO META-ANALYSIS. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419500350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background and purpose: Surgery is recommended as the treatment of choice for hemorrhagic Moyamoya disease (MMD). The rationale of surgery and the choice of procedure are poorly understood. The aim of this paper is to present latest evidence, from cellular, biomechanical and population data, surgical treatment options and their effect on the outcome of hemorrhagic MMD. Methods: We systematically reviewed the latest evidence from cellular, biomechanical and populational studies including our own meta-analysis for rationalization of management of MMD. We searched major databases from inception to latest articles available till October 2018. All major breakthroughs including basic research to randomized controlled trials (RCTs) and human case–control studies related to hemorrhagic MMD were included. Our meta-analysis was performed in accordance to the standard Cochrane. Result: Evidence at cellular, biomechanical and RCT levels was presented. For our meta-analysis, we included eight studies, totaling at 632 patients. Our results rationalized the use of surgical methods in support of surgical management of MMD. We showed that surgery in MMD resulted in a significant lower risk of future stroke ([Formula: see text], 95% [Formula: see text]–0.38). Among different surgical methods, the indirect bypass group had a lower risk for sedentary stroke risk reduction compared with the direct bypass group (RR[Formula: see text]=[Formula: see text]3.36, 95% CI[Formula: see text]=[Formula: see text]1.53–7.36). No significant differences were observed in perioperative complications between the two methods. Conclusion: Surgery remains a mainstay for the management of MMD. We concluded that current evidence in biomechanical and our own meta-analysis is in support of surgery being an effective management of hemorrhagic MMD. We deduced insights into research for early detection, characterization and follow up of patients with MMD.
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Affiliation(s)
- ZHI-QUN JIANG
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China
| | - YAN CHEN
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China
| | - CHUN-HUI ZENG
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China
| | - JIU-GENG FENG
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China
| | - YI-LV WAN
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China
| | - MIN-JUN WEI
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China
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8
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Zhang H, Zheng L, Feng L. Epidemiology, diagnosis and treatment of moyamoya disease. Exp Ther Med 2019; 17:1977-1984. [PMID: 30867689 DOI: 10.3892/etm.2019.7198] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/26/2018] [Indexed: 11/06/2022] Open
Abstract
Moyamoya disease (MMD) is a type of chronic cerebrovascular occlusion disease, which frequently occurs in East Asian populations, including pediatric and adult patients, and may lead to ischemic or hemorrhagic stroke, headache, epilepsy or transient ischemic attack. To date, the underlying mechanisms of MMD have remained to be fully elucidated, but certain studies have indicated that genetic factors may be an important component of its development. Cerebral angiography is the best approach for diagnosing MMD. However, with technological advances, non-invasive techniques are increasingly used to accurately evaluate MMD. MMD is commonly treated via surgery, and an increasing number of patients are benefitting from the intra- and extra-cranial revascularization. The present article provides a comprehensive review of MMD on the basis of previous research.
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Affiliation(s)
- Hui Zhang
- Department of Neurosurgery, The First People's Hospital of Jining, Jining, Shandong 272011, P.R. China
| | - Lijian Zheng
- Department of Neurosurgery, The First People's Hospital of Jining, Jining, Shandong 272011, P.R. China
| | - Lei Feng
- Department of Neurosurgery, The First People's Hospital of Jining, Jining, Shandong 272011, P.R. China
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9
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Sánchez-Alonso S, Alcaraz-Serna A, Sánchez-Madrid F, Alfranca A. Extracellular Vesicle-Mediated Immune Regulation of Tissue Remodeling and Angiogenesis After Myocardial Infarction. Front Immunol 2018; 9:2799. [PMID: 30555478 PMCID: PMC6281951 DOI: 10.3389/fimmu.2018.02799] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/13/2018] [Indexed: 12/20/2022] Open
Abstract
Myocardial ischemia-related disorders constitute a major health problem, being a leading cause of death in the world. Upon ischemia, tissue remodeling processes come into play, comprising a series of inter-dependent stages, including inflammation, cell proliferation and repair. Neovessel formation during late phases of remodeling provides oxygen supply, together with cellular and soluble components necessary for an efficient myocardial reconstruction. Immune system plays a central role in processes aimed at repairing ischemic myocardium, mainly in inflammatory and angiogenesis phases. In addition to cellular components and soluble mediators as chemokines and cytokines, the immune system acts in a paracrine fashion through small extracellular vesicles (EVs) release. These vesicular structures participate in multiple biological processes, and transmit information through bioactive cargoes from one cell to another. Cell therapy has been employed in an attempt to improve the outcome of these patients, through the promotion of tissue regeneration and angiogenesis. However, clinical trials have shown variable results, which put into question the actual applicability of cell-based therapies. Paracrine factors secreted by engrafted cells partially mediate tissue repair, and this knowledge has led to the hypothesis that small EVs may become a useful tool for cell-free myocardial infarction therapy. Current small EVs engineering strategies allow delivery of specific content to selected cell types, thus revealing the singular properties of these vesicles for myocardial ischemia treatment.
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Affiliation(s)
- Santiago Sánchez-Alonso
- Immunology Service, Hospital de la Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ana Alcaraz-Serna
- Immunology Service, Hospital de la Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco Sánchez-Madrid
- Immunology Service, Hospital de la Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Vascular Biology and Inflammation, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.,CIBER Cardiovascular, Madrid, Spain
| | - Arantzazu Alfranca
- Immunology Service, Hospital de la Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain.,CIBER Cardiovascular, Madrid, Spain
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10
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Dong Z, Pan T, Fang Y, Wei Z, Gu S, Fang G, Liu Y, Luo Y, Liu H, Zhang T, Hu M, Guo D, Xu X, Chen B, Jiang J, Yang J, Shi Z, Zhu T, Shi Y, Liu P, Fu W. Purified CD34 + cells versus peripheral blood mononuclear cells in the treatment of angiitis-induced no-option critical limb ischaemia: 12-Month results of a prospective randomised single-blinded non-inferiority trial. EBioMedicine 2018; 35:46-57. [PMID: 30172703 PMCID: PMC6156701 DOI: 10.1016/j.ebiom.2018.08.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/15/2018] [Accepted: 08/15/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Peripheral blood mononuclear cells (PBMNCs) and purified CD34+ cells (PCCs) are increasingly being used at treating no-option critical limb ischaemia (NO-CLI). We aimed to compare the efficacies and uncover the advantages associated with each treatment approach. METHODS A randomised single-blinded non-inferiority trial (Number: NCT 02089828) was performed. NO-CLI patients were 1:1 randomised to the PBMNCs and PCCs groups, and compared in relation to safety and efficacy outcomes. The primary efficacy outcomes included major amputation and total amputation over 12 months. The major amputation-free survival (MAFS) and total amputation-free survival (TAFS) rates were calculated. FINDINGS Fifty patients (25 per group, 47 with thromboangiitis obliterans and 3 with other angiitis) were enrolled, with a median follow-up period of 24.5 months (interquartile range: 17-34 months). One patient in the PCCs group was lost at 2 months and one major amputation occurred in the PBMNCs group at 3 months post-transplantation. The total amputation rates at 6 months post-transplantation were 28.0% in the PCCs group and 16.0% in the PBMNCs group (p = 0.343), and remained unchanged at 12 months. The groups did not differ regarding the MAFS and TAFS (Breslow-Wilcoxon test: p = 0.3014 and p = 0.3414). The PCCs group had a significantly higher probability of rest pain relief than the PBMNCs group (Breslow-Wilcoxon test: p = 0.0454). INTERPRETATION PCCs was not inferior to PBMNCs at limb salvage in the treatment of angiitis-induced NO-CLI and appeared to induce earlier ischaemia relief. Each cell type had specific advantages. These outcomes require verification from longer-term trials involving larger numbers of patients. FUND: Training program for outstanding academic leaders of Shanghai health and family planning system (Hundred Talent Program,Grant No. 2018BR40); China National Natural Science Funds (Grant No. 30801122); The excellent core member training programme at Zhongshan Hospital, Fudan University, China (Grant No. 2015ZSYXGG02); and Zhongshan Funds for the Institute of Vascular Surgery, Fudan University, China. CLINICAL TRIAL REGISTRATION This study is registered with ClinicalTrials.gov (NCT 02089828).
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Affiliation(s)
- Zhihui Dong
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China.
| | - Tianyue Pan
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Yuan Fang
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Zheng Wei
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shiyang Gu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Gang Fang
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Yifan Liu
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Yang Luo
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Hao Liu
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Meiyu Hu
- Core Lab of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Daqiao Guo
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Xin Xu
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Bin Chen
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Junhao Jiang
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Jue Yang
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Zhenyu Shi
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Ting Zhu
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Yun Shi
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China
| | - Peng Liu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weiguo Fu
- Department of Vascular Surgery, Zhongshan Hospital, and Institute of Vascular Surgery, Fudan University, Shanghai, China.
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11
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Besnier M, Gasparino S, Vono R, Sangalli E, Facoetti A, Bollati V, Cantone L, Zaccagnini G, Maimone B, Fuschi P, Da Silva D, Schiavulli M, Aday S, Caputo M, Madeddu P, Emanueli C, Martelli F, Spinetti G. miR-210 Enhances the Therapeutic Potential of Bone-Marrow-Derived Circulating Proangiogenic Cells in the Setting of Limb Ischemia. Mol Ther 2018; 26:1694-1705. [PMID: 29908843 DOI: 10.1016/j.ymthe.2018.06.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 06/05/2018] [Accepted: 06/05/2018] [Indexed: 12/28/2022] Open
Abstract
Therapies based on circulating proangiogenic cells (PACs) have shown promise in ischemic disease models but require further optimization to reach the bedside. Ischemia-associated hypoxia robustly increases microRNA-210 (miR-210) expression in several cell types, including endothelial cells (ECs). In ECs, miR-210 represses EphrinA3 (EFNA3), inducing proangiogenic responses. This study provides new mechanistic evidences for a role of miR-210 in PACs. PACs were obtained from either adult peripheral blood or cord blood. miR-210 expression was modulated with either an inhibitory complementary oligonucleotide (anti-miR-210) or a miRNA mimic (pre-miR-210). Scramble and absence of transfection served as controls. As expected, hypoxia increased miR-210 in PACs. In vivo, migration toward and adhesion to the ischemic endothelium facilitate the proangiogenic actions of transplanted PACs. In vitro, PAC migration toward SDF-1α/CXCL12 was impaired by anti-miR-210 and enhanced by pre-miR-210. Moreover, pre-miR-210 increased PAC adhesion to ECs and supported angiogenic responses in co-cultured ECs. These responses were not associated with changes in extracellular miR-210 and were abrogated by lentivirus-mediated EFNA3 overexpression. Finally, ex-vivo pre-miR-210 transfection predisposed PACs to induce post-ischemic therapeutic neovascularization and blood flow recovery in an immunodeficient mouse limb ischemia model. In conclusion, miR-210 modulates PAC functions and improves their therapeutic potential in limb ischemia.
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Affiliation(s)
- Marie Besnier
- Bristol Heart Institute, School of Clinical Science, University of Bristol, Bristol, UK
| | - Stefano Gasparino
- Laboratory of Cardiovascular Research, IRCCS MultiMedica, Milan, Italy
| | - Rosa Vono
- Laboratory of Cardiovascular Research, IRCCS MultiMedica, Milan, Italy
| | - Elena Sangalli
- Laboratory of Cardiovascular Research, IRCCS MultiMedica, Milan, Italy
| | - Amanda Facoetti
- Laboratory of Cardiovascular Research, IRCCS MultiMedica, Milan, Italy
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Cantone
- EPIGET Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Germana Zaccagnini
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato, Italy
| | - Biagina Maimone
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato, Italy
| | - Paola Fuschi
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato, Italy
| | - Daniel Da Silva
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato, Italy
| | - Michele Schiavulli
- AORN Santobono Pausilipon, Transfusion Medicine and Bone Marrow Transplantation Unit-Regional Reference Center for Coagulation Disorders, Napoli, Italy
| | - Sezin Aday
- Bristol Heart Institute, School of Clinical Science, University of Bristol, Bristol, UK
| | - Massimo Caputo
- Bristol Heart Institute, School of Clinical Science, University of Bristol, Bristol, UK
| | - Paolo Madeddu
- Bristol Heart Institute, School of Clinical Science, University of Bristol, Bristol, UK
| | - Costanza Emanueli
- Bristol Heart Institute, School of Clinical Science, University of Bristol, Bristol, UK; National Heart and Lung Institute, Imperial College London, London, UK
| | - Fabio Martelli
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato, Italy.
| | - Gaia Spinetti
- Laboratory of Cardiovascular Research, IRCCS MultiMedica, Milan, Italy.
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12
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Correlation between Therapeutic Efficacy of CD34 + Cell Treatment and Directed In Vivo Angiogenesis in Patients with End-Stage Diffuse Coronary Artery Disease. Stem Cells Int 2018; 2018:9591421. [PMID: 29760742 PMCID: PMC5924973 DOI: 10.1155/2018/9591421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 02/06/2018] [Accepted: 03/04/2018] [Indexed: 11/17/2022] Open
Abstract
Background This study was aimed at testing the association between the therapeutic efficacy of CD34+ cell treatment in patients with end-stage diffuse coronary artery disease as reflected in angiographic grading and results of directed in vivo angiogenesis assay (DIVAA) on their isolated peripheral blood mononuclear cell- (PBMC-) derived endothelial progenitor cells (EPCs). Methods Angiographic grades (0: <5%; 1: 5–35%; 2: 35–75%; 3: >75%) which presented the improvement of vessel density pre- and post-CD34+ treatment were given to 30 patients with end-stage diffuse coronary artery disease having received CD34+ cell treatment. The patients were categorized into low-score group (angiographic grade 0 or 1, n = 12) and high-score group (angiographic grade 2 or 3, n = 18). The percentages of circulating EPCs with KDR+/CD34+/CD45−, CD133+/CD34+/CD45−, and CD34+ were determined in each patient using flow cytometry. PBMC-derived EPCs from all patients were subjected to DIVAA through a 14-day implantation in nude mice. The DIVAA ratio (i.e., mean fluorescent units in angioreactors with EPCs/mean fluorescent units in angioreactors without EPCs) was obtained for each animal with implanted EPCs from each patient. Results and Conclusions The number of EPCs showed no significant difference among the two groups. The DIVAA ratio in the high-score group was significantly higher than that in the low-score group (p = 0.0178). Logistic regression revealed a significant association between the DIVAA ratio and angiographic grading (OR 3.12, 95% CI: 1.14–8.55, p = 0.027). The area under the ROC curve (AUC) was 0.8519 (p = 0.0013). We proposed that DIVAA may be a reliable tool for assessing coronary vascularization after CD34+ cell treatment.
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13
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Berndt R, Hummitzsch L, Heß K, Albrecht M, Zitta K, Rusch R, Sarras B, Bayer A, Cremer J, Faendrich F, Groß J. Allogeneic transplantation of programmable cells of monocytic origin (PCMO) improves angiogenesis and tissue recovery in critical limb ischemia (CLI): a translational approach. Stem Cell Res Ther 2018; 9:117. [PMID: 29703251 PMCID: PMC5921555 DOI: 10.1186/s13287-018-0871-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/18/2018] [Accepted: 04/12/2018] [Indexed: 01/05/2023] Open
Abstract
BACKROUND Employing growth factor-induced partial reprogramming in vitro, peripheral human blood monocytes can acquire a state of plasticity along with expression of various markers of pluripotency. These so-called programmable cells of monocytic origin (PCMO) hold great promise in regenerative therapies. The aim of this translational study was to explore and exploit the functional properties of PCMO for allogeneic cell transplantation therapy in critical limb ischemia (CLI). METHODS Using our previously described differentiation protocol, murine and human monocytes were differentiated into PCMO. We examined paracrine secretion of pro-angiogenic and tissue recovery-associated proteins under hypoxia and induction of angiogenesis by PCMO in vitro. Allogeneic cell transplantation of PCMO was performed in a hind limb ischemia mouse model in comparison to cell transplantation of native monocytes and a placebo group. Moreover, we analyzed retrospectively four healing attempts with PCMO in patients with peripheral artery disease (PAD; Rutherford classification, stage 5 and 6). Statistical analysis was performed by using one-way ANOVA, Tukey's test or the Student's t test, p < 0.05. RESULTS Cell culture experiments revealed good resilience of PCMO under hypoxia, enhanced paracrine release of pro-angiogenic and tissue recovery-associated proteins and induction of angiogenesis in vitro by PCMO. Animal experiments demonstrated significantly enhanced SO2 saturation, blood flow, neoangiogenesis and tissue recovery after treatment with PCMO compared to treatment with native monocytes and placebo. Finally, first therapeutic application of PCMO in humans demonstrated increased vascular collaterals and improved wound healing in patients with chronic CLI without exaggerated immune response, malignant processes or extended infection after 12 months. In all patients minor and/or major amputations of the lower extremity could be avoided. CONCLUSIONS In summary, PCMO improve angiogenesis and tissue recovery in chronic ischemic muscle and first clinical results promise to provide an effective and safe treatment of CLI.
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Affiliation(s)
- Rouven Berndt
- Department of Cardiaovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Hs 18, D-24105, Kiel, Germany.
| | - Lars Hummitzsch
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Katharina Heß
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Martin Albrecht
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Karina Zitta
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Rene Rusch
- Department of Cardiaovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Hs 18, D-24105, Kiel, Germany
| | - Beke Sarras
- Department of Cardiaovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Hs 18, D-24105, Kiel, Germany
| | - Andreas Bayer
- Department of Cardiaovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Hs 18, D-24105, Kiel, Germany
| | - Jochen Cremer
- Department of Cardiaovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Hs 18, D-24105, Kiel, Germany
| | - Fred Faendrich
- Department of Applied Cell Therapy, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Justus Groß
- Department of Cardiaovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Hs 18, D-24105, Kiel, Germany
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14
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Yamamoto S, Muramatsu M, Azuma E, Ikutani M, Nagai Y, Sagara H, Koo BN, Kita S, O'Donnell E, Osawa T, Takahashi H, Takano KI, Dohmoto M, Sugimori M, Usui I, Watanabe Y, Hatakeyama N, Iwamoto T, Komuro I, Takatsu K, Tobe K, Niida S, Matsuda N, Shibuya M, Sasahara M. A subset of cerebrovascular pericytes originates from mature macrophages in the very early phase of vascular development in CNS. Sci Rep 2017. [PMID: 28634350 PMCID: PMC5478595 DOI: 10.1038/s41598-017-03994-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Pericytes are believed to originate from either mesenchymal or neural crest cells. It has recently been reported that pericytes play important roles in the central nervous system (CNS) by regulating blood-brain barrier homeostasis and blood flow at the capillary level. However, the origin of CNS microvascular pericytes and the mechanism of their recruitment remain unknown. Here, we show a new source of cerebrovascular pericytes during neurogenesis. In the CNS of embryonic day 10.5 mouse embryos, CD31+F4/80+ hematopoietic lineage cells were observed in the avascular region around the dorsal midline of the developing midbrain. These cells expressed additional macrophage markers such as CD206 and CD11b. Moreover, the CD31+F4/80+ cells phagocytosed apoptotic cells as functionally matured macrophages, adhered to the newly formed subventricular vascular plexus, and then divided into daughter cells. Eventually, these CD31+F4/80+ cells transdifferentiated into NG2/PDGFRβ/desmin-expressing cerebrovascular pericytes, enwrapping and associating with vascular endothelial cells. These data indicate that a subset of cerebrovascular pericytes derive from mature macrophages in the very early phase of CNS vascular development, which in turn are recruited from sites of embryonic hematopoiesis such as the yolk sac by way of blood flow.
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Affiliation(s)
- Seiji Yamamoto
- Department of Pathology, University of Toyama, Toyama, Japan.
| | - Masashi Muramatsu
- Institute of Resource Development and Analysis, Kumamoto University, Kumamoto, Japan
| | - Erika Azuma
- Department of Pathology, University of Toyama, Toyama, Japan.,Department of Technology Development, Astellas Pharma Tech Co., Ltd., Toyama, Japan
| | - Masashi Ikutani
- Department of Immunobiology and Pharmacological Genetics, University of Toyama, Toyama, Japan
| | - Yoshinori Nagai
- Department of Immunobiology and Pharmacological Genetics, University of Toyama, Toyama, Japan.,JST, PRESTO, Kawaguchi, Saitama, Japan
| | - Hiroshi Sagara
- Medical Proteomics Laboratory, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Bon-Nyeo Koo
- Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.,Laboratory of Stem Cell and Neuro-Vascular Biology, Genetics and Developmental Biology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Maryland, USA
| | - Satomi Kita
- Department of Pharmacology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Erin O'Donnell
- Laboratory of Stem Cell and Neuro-Vascular Biology, Genetics and Developmental Biology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Maryland, USA
| | - Tsuyoshi Osawa
- Laboratry for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Takahashi
- Division for Health Service Promotion, The University of Tokyo, Tokyo, Japan
| | - Ken-Ichi Takano
- Departments of Pharmacology, Weill Cornell Medical College, New York, USA
| | - Mitsuko Dohmoto
- Genome Biotechnology Laboratory, Kanazawa Institute of Technology, Ishikawa, Japan
| | - Michiya Sugimori
- Department of Integrative Neuroscience, University of Toyama, Toyama, Japan
| | - Isao Usui
- First Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Yasuhide Watanabe
- Faculty of Medicine, School of Nursing, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Noboru Hatakeyama
- Department of Anesthesiology, Graduate School of Medicine, Aichi Medical University, Aichi, Japan
| | - Takahiro Iwamoto
- Department of Pharmacology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Kiyoshi Takatsu
- Department of Immunobiology and Pharmacological Genetics, University of Toyama, Toyama, Japan.,Toyama Prefectural Institute for Pharmaceutical Research, Toyama, Japan
| | - Kazuyuki Tobe
- First Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Shumpei Niida
- Medical Genome Center, Center for Geriatrics and Gerontology, Aichi, Japan
| | - Naoyuki Matsuda
- Department of Emergency and Critical Care Medicine, Nagoya University, Nagoya, Japan
| | - Masabumi Shibuya
- Department of Research and Education, Jobu University, Gunma, Japan
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15
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Zhou P, Tan YZ, Wang HJ, Wang GD. Hypoxic preconditioning-induced autophagy enhances survival of engrafted endothelial progenitor cells in ischaemic limb. J Cell Mol Med 2017; 21:2452-2464. [PMID: 28374977 PMCID: PMC5618704 DOI: 10.1111/jcmm.13167] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/17/2017] [Indexed: 01/08/2023] Open
Abstract
Recent clinical studies have suggested that endothelial progenitor cells (EPCs) transplantation provides a modest benefit for treatment of the ischaemic diseases such as limb ischaemia. However, cell‐based therapies have been limited by poor survival of the engrafted cells. This investigation was designed to establish optimal hypoxia preconditioning and evaluate effects of hypoxic preconditioning‐induced autophagy on survival of the engrafted EPCs. Autophagy of CD34+VEGFR‐2+EPCs isolated from rat bone marrow increased after treatment with 1% O2. The number of the apoptotic cells in the hypoxic cells increased significantly after autophagy was inhibited with 3‐methyladenine. According to balance of autophagy and apoptosis, treatment with 1% O2 for 2 hrs was determined as optimal preconditioning for EPC transplantation. To examine survival of the hypoxic cells, the cells were implanted into the ischaemic pouch of the abdominal wall in rats. The number of the survived cells was greater in the hypoxic group. After the cells loaded with fibrin were transplanted with intramuscular injection, blood perfusion, arteriogenesis and angiogenesis in the ischaemic hindlimb were analysed with laser Doppler‐based perfusion measurement, angiogram and the density of the microvessels in histological sections, respectively. Repair of the ischaemic tissue was improved significantly in the hypoxic preconditioning group. Loading the cells with fibrin has cytoprotective effect on survival of the engrafted cells. These results suggest that activation of autophagy with hypoxic preconditioning is an optimizing strategy for EPC therapy of limb ischaemia.
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Affiliation(s)
- Pei Zhou
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
| | - Yu-Zhen Tan
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
| | - Hai-Jie Wang
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
| | - Guo-Dong Wang
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
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16
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Bai YP, Xiao S, Tang YB, Tan Z, Tang H, Ren Z, Zeng H, Yang Z. Shear stress-mediated upregulation of GTP cyclohydrolase/tetrahydrobiopterin pathway ameliorates hypertension-related decline in reendothelialization capacity of endothelial progenitor cells. J Hypertens 2017; 35:784-797. [PMID: 28033126 DOI: 10.1097/hjh.0000000000001216] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Guanosine triphosphate cyclohydrolase/tetrahydrobiopterin (GTPCH)/(BH4) pathway has been proved to regulate the function of endothelial progenitor cells (EPCs) in deoxycorticosterone acetate-salt hypertensive mice, indicating that GTPCH/BH4 pathway may be an important repair target for hypertension-related endothelial injury. Shear stress is an important nonpharmacologic strategy to modulate the function of EPCs. Here, we investigated the effects of laminar shear stress on the GTPCH/BH4 pathway and endothelial repair capacity of circulating EPCs in hypertension. METHOD Laminar shear stress was loaded on the human EPCs from hypertensive patients and normotensive patients. The in-vitro function, in-vivo reendothelialization capacity and GTPCH/BH4 pathway of human EPCs were evaluated. RESULTS Both in-vitro function and reendothelialization capacity of EPCs were lower in hypertensive patients than that in normotensive patients. The GTPCH/BH4 pathway of EPCs was downregulated in hypertensive patients. Shear stress increased in-vitro function and reendothelialization capacity of EPCs from hypertensive patients and normotensive patients. Furthermore, shear stress upregulated the expression of GTPCH I and levels of BH4, nitric oxide, and cGMP of EPCs, and reduced thrombospondin-1 expression. With treatment of GTPCH knockdown or nitroarginine methyl ester inhibition, shear stress-induced increased levels of BH4, nitric oxide and cGMP of EPCs was suppressed. When GTPCH/BH4 pathway of EPCs was blocked, the effects of shear stress on in-vitro function and reendothelialization capacity of EPCs were inhibited. CONCLUSION The study demonstrates for the first time that shear stress-induced upregulation of the GTPCH/BH4 pathway ameliorates hypertension-related decline in endothelial repair capacity of EPCs. These findings provide novel nonpharmacologic therapeutic approach for hypertension-related endothelial repair.
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Affiliation(s)
- Yong-Ping Bai
- aDepartment of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, Hunan bDepartment of Neurology, Sun Yat-Sen Memorial Hospital cDepartment of Pharmacology, Zhongshan School of Medicine dDepartment of Physiology, Zhongshan School of Medicine, Sun Yat-Sen University eSun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine fCenter for Reproductive Medicine, The Sixth Affiliated Hospital gDepartment of Hypertension & Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
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17
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Mathiyalagan P, Liang Y, Kim D, Misener S, Thorne T, Kamide CE, Klyachko E, Losordo DW, Hajjar RJ, Sahoo S. Angiogenic Mechanisms of Human CD34 + Stem Cell Exosomes in the Repair of Ischemic Hindlimb. Circ Res 2017; 120:1466-1476. [PMID: 28298297 DOI: 10.1161/circresaha.116.310557] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 03/04/2017] [Accepted: 03/15/2017] [Indexed: 12/20/2022]
Abstract
RATIONALE Paracrine secretions seem to mediate therapeutic effects of human CD34+ stem cells locally transplanted in patients with myocardial and critical limb ischemia and in animal models. Earlier, we had discovered that paracrine secretion from human CD34+ cells contains proangiogenic, membrane-bound nanovesicles called exosomes (CD34Exo). OBJECTIVE Here, we investigated the mechanisms of CD34Exo-mediated ischemic tissue repair and therapeutic angiogenesis by studying their miRNA content and uptake. METHODS AND RESULTS When injected into mouse ischemic hindlimb tissue, CD34Exo, but not the CD34Exo-depleted conditioned media, mimicked the beneficial activity of their parent cells by improving ischemic limb perfusion, capillary density, motor function, and their amputation. CD34Exo were found to be enriched with proangiogenic miRNAs such as miR-126-3p. Knocking down miR-126-3p from CD34Exo abolished their angiogenic activity and beneficial function both in vitro and in vivo. Interestingly, injection of CD34Exo increased miR-126-3p levels in mouse ischemic limb but did not affect the endogenous synthesis of miR-126-3p, suggesting a direct transfer of stable and functional exosomal miR-126-3p. miR-126-3p enhanced angiogenesis by suppressing the expression of its known target, SPRED1, simultaneously modulating the expression of genes involved in angiogenic pathways such as VEGF (vascular endothelial growth factor), ANG1 (angiopoietin 1), ANG2 (angiopoietin 2), MMP9 (matrix metallopeptidase 9), TSP1 (thrombospondin 1), etc. Interestingly, CD34Exo, when treated to ischemic hindlimbs, were most efficiently internalized by endothelial cells relative to smooth muscle cells and fibroblasts, demonstrating a direct role of stem cell-derived exosomes on mouse endothelium at the cellular level. CONCLUSIONS Collectively, our results have demonstrated a novel mechanism by which cell-free CD34Exo mediates ischemic tissue repair via beneficial angiogenesis. Exosome-shuttled proangiogenic miRNAs may signify amplification of stem cell function and may explain the angiogenic and therapeutic benefits associated with CD34+ stem cell therapy.
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Affiliation(s)
- Prabhu Mathiyalagan
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Yaxuan Liang
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - David Kim
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Sol Misener
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Tina Thorne
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Christine E Kamide
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Ekaterina Klyachko
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Douglas W Losordo
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Roger J Hajjar
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.)
| | - Susmita Sahoo
- From the Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York (P.M., Y.L., D.K., R.J.H., S.S.); Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL (D.K., S.M., T.T., C.E.K., E.K., D.W.L., S.S.); and Caladrius Biosciences, New York (D.W.L.).
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Response to “Comment to the article ‘Diverse contribution of bone marrow-derived late-outgrowth endothelial progenitor cells to vascular repair under pulmonary arterial hypertension and arterial neointimal formation’”. J Mol Cell Cardiol 2017; 103:137-138. [DOI: 10.1016/j.yjmcc.2017.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/17/2017] [Indexed: 11/22/2022]
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Dai X, Yan X, Zeng J, Chen J, Wang Y, Chen J, Li Y, Barati MT, Wintergerst KA, Pan K, Nystoriak MA, Conklin DJ, Rokosh G, Epstein PN, Li X, Tan Y. Elevating CXCR7 Improves Angiogenic Function of EPCs via Akt/GSK-3β/Fyn-Mediated Nrf2 Activation in Diabetic Limb Ischemia. Circ Res 2017; 120:e7-e23. [PMID: 28137917 DOI: 10.1161/circresaha.117.310619] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 11/16/2022]
Abstract
RATIONALE Endothelial progenitor cells (EPCs) respond to stromal cell-derived factor 1 (SDF-1) through chemokine receptors CXCR7 and CXCR4. Whether SDF-1 receptors involves in diabetes mellitus-induced EPCs dysfunction remains unknown. OBJECTIVE To determine the role of SDF-1 receptors in diabetic EPCs dysfunction. METHODS AND RESULTS CXCR7 expression, but not CXCR4 was reduced in EPCs from db/db mice, which coincided with impaired tube formation. Knockdown of CXCR7 impaired tube formation of EPCs from normal mice, whereas upregulation of CXCR7 rescued angiogenic function of EPCs from db/db mice. In normal EPCs treated with oxidized low-density lipoprotein or high glucose also reduced CXCR7 expression, impaired tube formation, and increased oxidative stress and apoptosis. The damaging effects of oxidized low-density lipoprotein or high glucose were markedly reduced by SDF-1 pretreatment in EPCs transduced with CXCR7 lentivirus but not in EPCs transduced with control lentivirus. Most importantly, EPCs transduced with CXCR7 lentivirus were superior to EPCs transduced with control lentivirus for therapy of ischemic limbs in db/db mice. Mechanistic studies demonstrated that oxidized low-density lipoprotein or high glucose inhibited protein kinase B and glycogen synthase kinase-3β phosphorylation, nuclear export of Fyn and nuclear localization of nuclear factor (erythroid-derived 2)-like 2 (Nrf2), blunting Nrf2 downstream target genes heme oxygenase-1, NAD(P)H dehydrogenase (quinone 1) and catalase, and inducing an increase in EPC oxidative stress. This destructive cascade was blocked by SDF-1 treatment in EPCs transduced with CXCR7 lentivirus. Furthermore, inhibition of phosphatidylinositol 3-kinase/protein kinase B prevented SDF-1/CXCR7-mediated Nrf2 activation and blocked angiogenic repair. Moreover, Nrf2 knockdown almost completely abolished the protective effects of SDF-1/CXCR7 on EPC function in vitro and in vivo. CONCLUSIONS Elevated expression of CXCR7 enhances EPC resistance to diabetes mellitus-induced oxidative damage and improves therapeutic efficacy of EPCs in treating diabetic limb ischemia. The benefits of CXCR7 are mediated predominantly by a protein kinase B/glycogen synthase kinase-3β/Fyn pathway via increased activity of Nrf2.
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Affiliation(s)
- Xiaozhen Dai
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Xiaoqing Yan
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Jun Zeng
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Jing Chen
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Yuehui Wang
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Jun Chen
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Yan Li
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Michelle T Barati
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Kupper A Wintergerst
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Kejian Pan
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Matthew A Nystoriak
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Daniel J Conklin
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Gregg Rokosh
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Paul N Epstein
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Xiaokun Li
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.)
| | - Yi Tan
- From the Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences & School of Nursing at the Wenzhou Medical University, Wenzhou, China (X.D., X.Y., Jun Chen, X.L., Y.T.); School of Biomedicine, Chengdu Medical College, China (X.D., K.P.); Department of Pediatrics, Children's Hospital Research Institute, School of Medicine (X.D., J.Z., Jing Chen, Jun Chen, P.N.E., Y.T.), Department of Surgery (Y.L.), Department of Medicine (M.T.B., M.A.N., D.J.C.), Division of Endocrinology, Department of Pediatrics, Wendy L. Novak Diabetes Care Center (K.A.W.), and Diabetes and Obesity Center (D.J.C.), University of Louisville, KY; Departments of Geriatrics, the First Hospital of Jilin University, Changchun, China (Y.W.); and Division of Cardiovascular Disease, University of Alabama at Birmingham (G.R.).
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Patel J, Seppanen EJ, Rodero MP, Wong HY, Donovan P, Neufeld Z, Fisk NM, Francois M, Khosrotehrani K. Functional Definition of Progenitors Versus Mature Endothelial Cells Reveals Key SoxF-Dependent Differentiation Process. Circulation 2016; 135:786-805. [PMID: 27899395 DOI: 10.1161/circulationaha.116.024754] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 11/16/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND During adult life, blood vessel formation is thought to occur via angiogenic processes involving branching from existing vessels. An alternate proposal suggests that neovessels form from endothelial progenitors able to assemble the intimal layers. We here aimed to define vessel-resident endothelial progenitors in vivo in a variety of tissues in physiological and pathological situations such as normal aorta, lungs, and wound healing, tumors, and placenta, as well. METHODS Based on protein expression levels of common endothelial markers using flow cytometry, 3 subpopulations of endothelial cells could be identified among VE-Cadherin+ and CD45- cells. RESULTS Lineage tracing by using Cdh5creERt2/Rosa-YFP reporter strategy demonstrated that the CD31-/loVEGFR2lo/intracellular endothelial population was indeed an endovascular progenitor (EVP) of an intermediate CD31intVEGFR2lo/intracellular transit amplifying (TA) and a definitive differentiated (D) CD31hiVEGFR2hi/extracellular population. EVP cells arose from vascular-resident beds that could not be transferred by bone marrow transplantation. Furthermore, EVP displayed progenitor-like status with a high proportion of cells in a quiescent cell cycle phase as assessed in wounds, tumors, and aorta. Only EVP cells and not TA and D cells had self-renewal capacity as demonstrated by colony-forming capacity in limiting dilution and by transplantation in Matrigel plugs in recipient mice. RNA sequencing revealed prominent gene expression differences between EVP and D cells. In particular, EVP cells highly expressed genes related to progenitor function including Sox9, Il33, Egfr, and Pdfgrα. Conversely, D cells highly expressed genes related to differentiated endothelium including Ets1&2, Gata2, Cd31, Vwf, and Notch. The RNA sequencing also pointed to an essential role of the Sox18 transcription factor. The role of SOX18 in the differentiation process was validated by using lineage-tracing experiments based on Sox18CreERt2/Rosa-YFP mice. Besides, in the absence of functional SOX18/SOXF, EVP progenitors were still present, but TA and D populations were significantly reduced. CONCLUSIONS Our findings support an entirely novel endothelial hierarchy, from EVP to TA to D, as defined by self-renewal, differentiation, and molecular profiling of an endothelial progenitor. This paradigm shift in our understanding of vascular-resident endothelial progenitors in tissue regeneration opens new avenues for better understanding of cardiovascular biology.
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Affiliation(s)
- Jatin Patel
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Elke J Seppanen
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Mathieu P Rodero
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Ho Yi Wong
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Prudence Donovan
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Zoltan Neufeld
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Nicholas M Fisk
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Mathias Francois
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.)
| | - Kiarash Khosrotehrani
- From The University of Queensland, UQ Centre for Clinical Research, Experimental Dermatology Group, Brisbane, QLD, Australia (J.P., E.J.S., M.P.R., H.Y.W., N.M.F., K.K.); The University of Queensland, UQ Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia (P.D., K.K.); The University of Queensland, School of Mathematics and Physics, Brisbane, QLD, Australia (Z.N.); and The University of Queensland, Institute of Molecular Biosciences, Brisbane, QLD, Australia (M.F.).
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21
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Bargehr J, Low L, Cheung C, Bernard WG, Iyer D, Bennett MR, Gambardella L, Sinha S. Embryological Origin of Human Smooth Muscle Cells Influences Their Ability to Support Endothelial Network Formation. Stem Cells Transl Med 2016; 5:946-59. [PMID: 27194743 PMCID: PMC4922852 DOI: 10.5966/sctm.2015-0282] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/15/2016] [Indexed: 01/06/2023] Open
Abstract
UNLABELLED Vascular smooth muscle cells (SMCs) from distinct anatomic locations derive from different embryonic origins. Here we investigated the respective potential of different embryonic origin-specific SMCs derived from human embryonic stem cells (hESCs) to support endothelial network formation in vitro. SMCs of three distinct embryological origins were derived from an mStrawberry-expressing hESC line and were cocultured with green fluorescent protein-expressing human umbilical vein endothelial cells (HUVECs) to investigate the effects of distinct SMC subtypes on endothelial network formation. Quantitative analysis demonstrated that lateral mesoderm (LM)-derived SMCs best supported HUVEC network complexity and survival in three-dimensional coculture in Matrigel. The effects of the LM-derived SMCs on HUVECs were at least in part paracrine in nature. A TaqMan array was performed to identify the possible mediators responsible for the differential effects of the SMC lineages, and a microarray was used to determine lineage-specific angiogenesis gene signatures. Midkine (MDK) was identified as one important mediator for the enhanced vasculogenic potency of LM-derived SMCs. The functional effects of MDK on endothelial network formation were then determined by small interfering RNA-mediated knockdown in SMCs, which resulted in impaired network complexity and survival of LM-derived SMC cocultures. The present study is the first to show that SMCs from distinct embryonic origins differ in their ability to support HUVEC network formation. LM-derived SMCs best supported endothelial cell network complexity and survival in vitro, in part through increased expression of MDK. A lineage-specific approach might be beneficial for vascular tissue engineering and therapeutic revascularization. SIGNIFICANCE Mural cells are essential for the stabilization and maturation of new endothelial cell networks. However, relatively little is known of the effect of the developmental origins of mural cells on their signaling to endothelial cells and how this affects vessel development. The present study demonstrated that human smooth muscle cells (SMCs) from distinct embryonic origins differ in their ability to support endothelial network formation. Lateral mesoderm-derived SMCs best support endothelial cell network complexity and survival in vitro, in part through increased expression of midkine. A lineage-specific approach might be beneficial for vascular tissue engineering and therapeutic revascularization.
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Affiliation(s)
- Johannes Bargehr
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Lucinda Low
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Christine Cheung
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - William G Bernard
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Dharini Iyer
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Martin R Bennett
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Laure Gambardella
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Sanjay Sinha
- The Anne McLaren Laboratory for Regenerative Medicine and Division of Cardiovascular Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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22
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Hodgkinson CP, Bareja A, Gomez JA, Dzau VJ. Emerging Concepts in Paracrine Mechanisms in Regenerative Cardiovascular Medicine and Biology. Circ Res 2016; 118:95-107. [PMID: 26837742 DOI: 10.1161/circresaha.115.305373] [Citation(s) in RCA: 190] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In the past decade, substantial evidence supports the paradigm that stem cells exert their reparative and regenerative effects, in large part, through the release of biologically active molecules acting in a paracrine fashion on resident cells. The data suggest the existence of a tissue microenvironment where stem cell factors influence cell survival, inflammation, angiogenesis, repair, and regeneration in a temporal and spatial manner.
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Affiliation(s)
- Conrad P Hodgkinson
- From the Department of Medicine, Mandel Center for Hypertension Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, NC
| | - Akshay Bareja
- From the Department of Medicine, Mandel Center for Hypertension Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, NC
| | - José A Gomez
- From the Department of Medicine, Mandel Center for Hypertension Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, NC
| | - Victor J Dzau
- From the Department of Medicine, Mandel Center for Hypertension Research and Duke Cardiovascular Research Center, Duke University Medical Center, Durham, NC.
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23
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Zhu J, Song J, Yu L, Zheng H, Zhou B, Weng S, Fu G. Safety and efficacy of autologous thymosin β4 pre-treated endothelial progenitor cell transplantation in patients with acute ST segment elevation myocardial infarction: A pilot study. Cytotherapy 2016; 18:1037-1042. [PMID: 27288307 DOI: 10.1016/j.jcyt.2016.05.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 04/07/2016] [Accepted: 05/10/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Experimental studies and clinical trials suggest that endothelial progenitor cell (EPC) transplantation can repair "broken" heart. However, transplantation of autologous EPCs has numerous limitations, including the limited supply of expanded EPCs, the impaired function and activity of the transplanted cells and so on. Therefore, we investigated the feasibility, safety and initial clinical outcome of autologous thymosin β4 (Tβ4) pre-treated EPC transplantation in patients with acute ST segment elevation myocardial infarction (STEMI). METHODS Ten patients with STEMI were included; they were randomized to 2 groups: EPC transplantation group (control group; n = 5) and Tβ4-pre-treated EPC transplantation group (experimental group; n = 5). EPCs were pre-treated with Tβ4 24 hours before transplantation in experimental group. Cardiac function was evaluated using echocardiography and emission computed tomography, as well as the 6-min walking test before and 6 months after the intervention. RESULTS After 6 months of follow-up, the average 6-min walking distance was increased by 38.2 m (from 263 ± 42 m to 302 ± 34 m) in the control group and 75.7 m (from 264 ± 42 m to 340 ± 44 m) in the experimental group; the average difference of the 6-min walking distance was 37.5 m (95% confidence interval [CI], 28.7-56.3 m; P < 0.01). In addition, the cardiac function in the experimental group was more significantly improved than that of the control group. There were no severe complications related to the procedure in either group during the follow-up. DISCUSSION Our pilot study suggested that Tβ4-optimized EPC transplantation appeared to be feasible and safe, and might have beneficial effects on exercise capacity and left ventricular function in patients with STEMI.
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Affiliation(s)
- Junhui Zhu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jiale Song
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Yu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hao Zheng
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Binquan Zhou
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shaoxiang Weng
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Guosheng Fu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
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24
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Turner EC, Huang CL, Sawhney N, Govindarajan K, Clover AJP, Martin K, Browne TC, Whelan D, Kumar AHS, Mackrill JJ, Wang S, Schmeckpeper J, Stocca A, Pierce WG, Leblond AL, Cai L, O'Sullivan DM, Buneker CK, Choi J, MacSharry J, Ikeda Y, Russell SJ, Caplice NM. A Novel Selectable Islet 1 Positive Progenitor Cell Reprogrammed to Expandable and Functional Smooth Muscle Cells. Stem Cells 2016; 34:1354-68. [PMID: 26840832 DOI: 10.1002/stem.2319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 12/17/2015] [Indexed: 11/08/2022]
Abstract
Disorders affecting smooth muscle structure/function may require technologies that can generate large scale, differentiated and contractile smooth muscle cells (SMC) suitable for cell therapy. To date no clonal precursor population that provides large numbers of differentiated SMC in culture has been identified in a rodent. Identification of such cells may also enhance insight into progenitor cell fate decisions and the relationship between smooth muscle precursors and disease states that implicate differentiated SMC. In this study, we used classic clonal expansion techniques to identify novel self-renewing Islet 1 (Isl-1) positive primitive progenitor cells (PPC) within rat bone marrow that exhibited canonical stem cell markers and preferential differentiation towards a smooth muscle-like fate. We subsequently used molecular tagging to select Isl-1 positive clonal populations from expanded and de novo marrow cell populations. We refer to these previously undescribed cells as the PPC given its stem cell marker profile, and robust self-renewal capacity. PPC could be directly converted into induced smooth muscle cells (iSMC) using single transcription factor (Kruppel-like factor 4) knockdown or transactivator (myocardin) overexpression in contrast to three control cells (HEK 293, endothelial cells and mesenchymal stem cells) where such induction was not possible. iSMC exhibited immuno- and cytoskeletal-phenotype, calcium signaling profile and contractile responses similar to bona fide SMC. Passaged iSMC could be expanded to a scale sufficient for large scale tissue replacement. PPC and reprogramed iSMC so derived may offer future opportunities to investigate molecular, structure/function and cell-based replacement therapy approaches to diverse cardiovascular, respiratory, gastrointestinal, and genitourinary diseases that have as their basis smooth muscle cell functional aberrancy or numerical loss. Stem Cells 2016;34:1354-1368.
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Affiliation(s)
- Elizabeth C Turner
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Chien-Ling Huang
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Neha Sawhney
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Kalaimathi Govindarajan
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Anthony J P Clover
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Kenneth Martin
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Tara C Browne
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Derek Whelan
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Arun H S Kumar
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - John J Mackrill
- Department of Physiology, University College Cork, Biosciences Institute, College Road, Cork, Ireland
| | - Shaohua Wang
- Molecular Medicine Program, Mayo Clinic and Foundation, 200 First St, Rochester, Minnesota, 55905
| | - Jeffrey Schmeckpeper
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Alessia Stocca
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - William G Pierce
- Department of Physiology, University College Cork, Biosciences Institute, College Road, Cork, Ireland
| | - Anne-Laure Leblond
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Liquan Cai
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Donnchadh M O'Sullivan
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Chirlei K Buneker
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - Janet Choi
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
| | - John MacSharry
- Alimentary Pharmabiotic Centre (APC), Biosciences Institute, University College Cork, Cork, Ireland
| | - Yasuhiro Ikeda
- Molecular Medicine Program, Mayo Clinic and Foundation, 200 First St, Rochester, Minnesota, 55905
| | - Stephen J Russell
- Molecular Medicine Program, Mayo Clinic and Foundation, 200 First St, Rochester, Minnesota, 55905
| | - Noel M Caplice
- Centre for Research in Vascular Biology (CRVB), Biosciences Institute, University College Cork, Cork, Ireland
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25
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Bang OY, Fujimura M, Kim SK. The Pathophysiology of Moyamoya Disease: An Update. J Stroke 2016; 18:12-20. [PMID: 26846756 PMCID: PMC4747070 DOI: 10.5853/jos.2015.01760] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 12/25/2015] [Accepted: 12/30/2015] [Indexed: 11/23/2022] Open
Abstract
Moyamoya disease (MMD) is a unique cerebrovascular disease characterized by the progressive stenosis of large intracranial arteries and a hazy network of basal collaterals called moyamoya vessels. Because the etiology of MMD is unknown, its diagnosis is based on characteristic angiographic findings. Re-vascularization techniques (e.g., bypass surgery) are used to restore perfusion, and are the primary treatment for MMD. There is no specific treatment to prevent MMD progression. This review summarizes the recent advances in MMD pathophysiology, including the genetic and circulating factors related to disease development. Genetic and environmental factors may play important roles in the development of the vascular stenosis and aberrant angiogenesis in complex ways. These factors include the related changes in circulating endothelial/smooth muscle progenitor cells, cytokines related to vascular remodeling and angiogenesis, and endothelium, such as caveolin which is a plasma membrane protein. With a better understanding of MMD pathophysiology, nonsurgical approaches targeting MMD pathogenesis may be available to stop or slow the progression of this disease. The possible strategies include targeting growth factors, retinoic acid, caveolin-1, and stem cells.
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Affiliation(s)
- Oh Young Bang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Translational and Stem Cell Research Laboratory on Stroke, Samsung Medical Center, Seoul, Korea
| | - Miki Fujimura
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Seung-Ki Kim
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
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26
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Analysis of the Secretome of Apoptotic Peripheral Blood Mononuclear Cells: Impact of Released Proteins and Exosomes for Tissue Regeneration. Sci Rep 2015; 5:16662. [PMID: 26567861 PMCID: PMC4645175 DOI: 10.1038/srep16662] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/19/2015] [Indexed: 12/12/2022] Open
Abstract
We previously showed that, when peripheral blood mononuclear cells (PBMCs) were stressed with ionizing radiation, they released paracrine factors that showed regenerative capacity in vitro and in vivo. This study aimed to characterize the secretome of PBMCs and to investigate its biologically active components in vitro and vivo. Bioinformatics analysis revealed that irradiated PBMCs differentially expressed genes that encoded secreted proteins. These genes were primarily involved in (a) pro-angiogenic and regenerative pathways and (b) the generation of oxidized phospholipids with known pro-angiogenic and inflammation-modulating properties. Subsequently, in vitro assays showed that the exosome and protein fractions of irradiated and non-irradiated PBMC secretome were the major biological components that enhanced cell mobility; conversely, secreted lipids and microparticles had no effects. We tested a viral-cleared PBMC secretome, prepared according to good manufacturing practice (GMP), in a porcine model of closed chest, acute myocardial infarction. We found that the potency for preventing ventricular remodeling was similar with the GMP-compliant and experimentally-prepared PBMC secretomes. Our results indicate that irradiation modulates the release of proteins, lipid-mediators and extracellular vesicles from human PBMCs. In addition our findings implicate the use of secretome fractions as valuable material for the development of cell-free therapies in regenerative medicine.
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27
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Ikutomi M, Sahara M, Nakajima T, Minami Y, Morita T, Hirata Y, Komuro I, Nakamura F, Sata M. Diverse contribution of bone marrow-derived late-outgrowth endothelial progenitor cells to vascular repair under pulmonary arterial hypertension and arterial neointimal formation. J Mol Cell Cardiol 2015; 86:121-35. [DOI: 10.1016/j.yjmcc.2015.07.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/10/2015] [Accepted: 07/24/2015] [Indexed: 01/29/2023]
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28
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Hu N, Kong LS, Chen H, Li WD, Qian AM, Wang XY, Du XL, Li CL, Yu XB, Li XQ. Autophagy protein 5 enhances the function of rat EPCs and promotes EPCs homing and thrombus recanalization via activating AKT. Thromb Res 2015; 136:642-51. [DOI: 10.1016/j.thromres.2015.06.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 06/18/2015] [Accepted: 06/30/2015] [Indexed: 12/13/2022]
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29
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Odent Grigorescu G, Preda MB, Radu E, Rosca AM, Tutuianu R, Mitroi DN, Simionescu M, Burlacu A. Combinatorial approach for improving the outcome of angiogenic therapy in ischemic tissues. Biomaterials 2015; 60:72-81. [PMID: 25985154 DOI: 10.1016/j.biomaterials.2015.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 05/03/2015] [Indexed: 01/01/2023]
Abstract
Two major populations of endothelial progenitor cells (EPC), namely endothelial colony forming cells (ECFC, or late outgrowth EPC) and circulating angiogenic cells (CAC, or early outgrowth EPC) have been reported to play important roles in vasculogenesis in numerous pathological conditions. However, the poor retention of cells into the ischemic tissue and neovessel fragility are two major flaws that need to be overcome for successful angiogenic therapy. The objective of this study was to explore and exploit the functional properties of EPC populations in order to increase the effectiveness of post-ischemic cell therapy. The results indicate different, still complementary, effects of the two EPC populations on adherence and proliferation of vascular endothelial cells. Matrigel plug assay and mouse hind limb ischemia model showed that concomitant administration of CAC-secreted factors and ECFC resulted in three-fold increase in local cell retention and improved muscle perfusion, vessel maturation and hind limb regeneration, in comparison to either treatment alone. By concluding, factors secreted by CAC co-administered at the time of ECFC transplantation improve tissue regeneration and vascular repair through stabilization of newly-derived blood vessels.
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Affiliation(s)
- G Odent Grigorescu
- Institute of Cellular Biology and Pathology "NicolaeSimionescu", Bucharest, Romania
| | - M B Preda
- Institute of Cellular Biology and Pathology "NicolaeSimionescu", Bucharest, Romania
| | - E Radu
- University Emergency Hospital, Bucharest, Romania
| | - A-M Rosca
- Institute of Cellular Biology and Pathology "NicolaeSimionescu", Bucharest, Romania
| | - R Tutuianu
- Institute of Cellular Biology and Pathology "NicolaeSimionescu", Bucharest, Romania
| | - D N Mitroi
- Institute of Cellular Biology and Pathology "NicolaeSimionescu", Bucharest, Romania
| | - M Simionescu
- Institute of Cellular Biology and Pathology "NicolaeSimionescu", Bucharest, Romania
| | - A Burlacu
- Institute of Cellular Biology and Pathology "NicolaeSimionescu", Bucharest, Romania.
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30
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Cooke JP, Losordo DW. Modulating the vascular response to limb ischemia: angiogenic and cell therapies. Circ Res 2015; 116:1561-78. [PMID: 25908729 PMCID: PMC4869986 DOI: 10.1161/circresaha.115.303565] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 03/31/2015] [Indexed: 12/29/2022]
Abstract
The age-adjusted prevalence of peripheral arterial disease in the US population has been estimated to approach 12%. The clinical consequences of occlusive peripheral arterial disease include pain on walking (claudication), pain at rest, and loss of tissue integrity in the distal limbs; the latter may ultimately lead to amputation of a portion of the lower extremity. Surgical bypass techniques and percutaneous catheter-based interventions may successfully reperfuse the limbs of certain patients with peripheral arterial disease. In many patients, however, the anatomic extent and distribution of arterial occlusion is too severe to permit relief of pain and healing of ischemic ulcers. No effective medical therapy is available for the treatment of such patients, for many of whom amputation represents the only hope for alleviation of symptoms. The ultimate failure of medical treatment and procedural revascularization in significant numbers of patients has led to attempts to develop alternative therapies for ischemic disease. These strategies include administration of angiogenic cytokines, either as recombinant protein or as gene therapy, and more recently, to investigations of stem/progenitor cell therapy. The purpose of this review is to provide an outline of the preclinical basis for angiogenic and stem cell therapies, review the clinical research that has been done, summarize the lessons learned, identify gaps in knowledge, and suggest a course toward successfully addressing an unmet medical need in a large and growing patient population.
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Affiliation(s)
- John P Cooke
- From the Department of Cardiovascular Sciences, Houston Methodist Research Institute, TX (J.P.C.); and NeoStem Inc, New York, NY (D.W.L.).
| | - Douglas W Losordo
- From the Department of Cardiovascular Sciences, Houston Methodist Research Institute, TX (J.P.C.); and NeoStem Inc, New York, NY (D.W.L.).
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31
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Minami Y, Nakajima T, Ikutomi M, Morita T, Komuro I, Sata M, Sahara M. Angiogenic potential of early and late outgrowth endothelial progenitor cells is dependent on the time of emergence. Int J Cardiol 2015; 186:305-14. [PMID: 25838182 DOI: 10.1016/j.ijcard.2015.03.166] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 02/18/2015] [Accepted: 03/16/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Recent studies have suggested that late-outgrowth endothelial progenitor cells (EPCs) derived from human peripheral blood mononuclear cells (hPBMNCs) might have higher angiogenic potential than classically-defined early-outgrowth EPCs (EOCs). However, it still remains unclear which of "so-called" EPC subpopulations defined in a variety of ways has the highest angiogenic potential. METHODS AND RESULTS We classified hPBMNC-derived EPC subpopulations by the time of their emergence in culture. EOCs were defined as attached cells on culture days 3-7. Late-outgrowth EPCs, defined as the cell forming colonies with cobblestone appearance since day 10, were further classified as follows: "moderate"-outgrowth EPCs (MOCs) emerging on days 10-16, "late"-outgrowth EPCs (LOCs) on days 17-23, and "very late"-outgrowth EPCs (VOCs) on days 24-30. Flow cytometry analyses showed the clear differences of hematopoietic/endothelial markers between EOC (CD31(+)VE-cadherin(-)CD34(-)CD14(+)CD45(+)) and LOC (CD31(+)VE-cadherin(+)CD34(+)CD14(-)CD45(-)). We found that LOCs had the highest proliferation and tube formation capabilities in vitro along with the highest expression of angiogenic genes including KDR and eNOS. To investigate the in vivo therapeutic efficacies, each EPC subpopulation was intravenously transplanted into immunocompromised mice (total 4 × 10(5) cells) after unilateral hindlimb ischemia surgery. The LOC-treated mice exhibited significantly-enhanced blood flow recovery (flow ratios of ischemic/non-ischemic leg: 0.99±0.02 [LOC group] versus 0.67 ± 0.07 to 0.78 ± 0.09 [other groups]; P < 0.05) and augmented capillary collateral formation in ischemic leg, which were attributable to their direct engraftment into host angiogenic vessels (approximately 10%) and paracrine effects. CONCLUSION hPBMNC-derived late-outgrowth EPCs emerging on culture days 17-23 are superior to other EPC subpopulations with regard to therapeutic angiogenic potential.
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Affiliation(s)
- Yoshiyasu Minami
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Ischemic Circulatory Physiology, 22nd Century Medical and Research Center, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Ischemic Circulatory Physiology, 22nd Century Medical and Research Center, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masayasu Ikutomi
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Cardiovascular Medicine, Teikyo University Chiba Medical Center, 3426-3 Anegasaki, Ichihara 299-0111, Japan
| | - Toshihiro Morita
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Ischemic Circulatory Physiology, 22nd Century Medical and Research Center, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School of Medicine, 2-10-1 Kuramoto-cho, Tokushima 770-8503, Japan
| | - Makoto Sahara
- Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Medicine-Cardiology/Cell and Molecular Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
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32
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Sirtuins in vascular diseases: Emerging roles and therapeutic potential. Biochim Biophys Acta Mol Basis Dis 2015; 1852:1311-22. [PMID: 25766107 DOI: 10.1016/j.bbadis.2015.03.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/20/2015] [Accepted: 03/04/2015] [Indexed: 11/20/2022]
Abstract
Silent information regulator-2 (Sir-2) proteins, or sirtuins, are a highly conserved protein family of histone deacetylases that promote longevity by mediating many of the beneficial effects of calorie restriction which extends life span and reduces the incidence of cancer, cardiovascular disease (CVD), and diabetes. Here, we review the role of sirtuins (SIRT1-7) in vascular homeostasis and diseases by providing an update on the latest knowledge about their roles in endothelial damage and vascular repair mechanisms. Among all sirtuins, in the light of the numerous functions reported on SIRT1 in the vascular system, herein we discuss its roles not only in the control of endothelial cells (EC) functionality but also in other cell types beyond EC, including endothelial progenitor cells (EPC), smooth muscle cells (SMC), and immune cells. Furthermore, we also provide an update on the growing field of compounds under clinical evaluation for the modulation of SIRT1 which, at the state of the art, represents the most promising target for the development of novel drugs against CVD, especially when concomitant with type 2 diabetes.
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Young PP, Schäfer R. Cell-based therapies for cardiac disease: a cellular therapist's perspective. Transfusion 2015; 55:441-51; quiz 440. [PMID: 25145464 PMCID: PMC5771653 DOI: 10.1111/trf.12826] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/14/2014] [Accepted: 07/14/2014] [Indexed: 12/14/2022]
Abstract
Cell-based therapy is an exciting, promising, and a developing new treatment for cardiac diseases. Stem cell-based therapies have the potential to fundamentally transform the treatment of ischemic cardiac injury and heart failure by achieving what would have been unthinkable only a few years ago-the Holy Grail of myocardial regeneration. Recent therapeutic approaches involve bone marrow (BM)-derived mononuclear cells and their subsets such as mesenchymal stem/stromal cells (MSCs), endothelial progenitor cells as well as adipose tissue-derived MSCs, cardiac tissue-derived stem cells, and cell combinations. Clinical trials employing these cells have demonstrated that cellular therapy is feasible and safe. Regarding delivery methods, the safety of catheter-based, transendocardial and -epicardial stem cell injection has been established. However, the results, while variable, suggest rather modest clinical efficacy overall in both heart failure and ischemic heart disease, such as in acute myocardial infarction. Future studies will focus on determining the most efficacious cell type(s) and/or cell combinations and the most reasonable indications and optimal timing of transplantation, as well as the mechanisms underlying their therapeutic effects. We will review and summarize the clinical trial results to date. In addition, we discuss challenges and operational issues in cell processing for cardiac applications.
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Affiliation(s)
- Pampee P. Young
- Department of Pathology, Microbiology and Immunology, Nashville, Tennessee
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Veterans Affairs, Nashville, Tennessee
| | - Richard Schäfer
- Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Donor Service Baden-Württemberg-Hessen gGmbH, Johann-Wolfgang-Goethe-University Hospital, Frankfurt am Main, Germany
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Umbilical cord blood-derived mesenchymal stem cells: new therapeutic weapons for idiopathic dilated cardiomyopathy? Int J Cardiol 2014; 177:809-18. [PMID: 25305679 DOI: 10.1016/j.ijcard.2014.09.128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/08/2014] [Accepted: 09/23/2014] [Indexed: 02/07/2023]
Abstract
Dilated cardiomyopathy is the most frequent etiology of non-ischemic heart failure. In a majority of cases the causal mechanism is unknown, giving rise to the term 'idiopathic' dilated cardiomyopathy (IDCM). Major pathological derangements include patchy interstitial fibrosis, degenerated cardiomyocytes, and dilatation of the cardiac chambers, but recent evidence suggests that disease progression may also have the signature of cardiac endothelial dysfunction. As we better understand the molecular basis of IDCM, novel therapeutic approaches, mainly gene transfer and cell-based therapies, are being explored. Cells with regenerative potential have been extensively tested in cardiac diseases of ischemic origin in both pre-clinical and clinical settings. However, whether cell therapy has any clinical value in IDCM patients is still being evaluated. This article is a concise summary of cell therapy studies for IDCM, with a focus on recent advances that highlight the vascular potential exhibited by umbilical cord blood-derived mesenchymal stem cells (UCBMSCs). We also provide an overview of cardiac vasculature as a key regulator of subjacent myocardial integrity and function, and discuss the potential mechanisms of UCBMSC amelioration of IDCM myocardium. Consideration of these issues shows that these cells are conceivably new therapeutic agents for this complex and elusive human disorder.
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Yuen DA, Connelly KA, Zhang Y, Advani SL, Thai K, Kabir G, Kepecs D, Spring C, Smith C, Batruch I, Kosanam H, Advani A, Diamandis E, Marsden PA, Gilbert RE. Early outgrowth cells release soluble endocrine antifibrotic factors that reduce progressive organ fibrosis. Stem Cells 2014; 31:2408-19. [PMID: 23922321 DOI: 10.1002/stem.1502] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 06/17/2013] [Accepted: 07/15/2013] [Indexed: 12/13/2022]
Abstract
Adult bone marrow-derived cells can improve organ function in chronic disease models, ostensibly by the release of paracrine factors. It has, however, been difficult to reconcile this prevailing paradigm with the lack of cell retention within injured organs and their rapid migration to the reticuloendothelial system. Here, we provide evidence that the salutary antifibrotic effects of bone marrow-derived early outgrowth cells (EOCs) are more consistent with an endocrine mode of action, demonstrating not only the presence of antifibrotic factors in the plasma of EOC-treated rats but also that EOC conditioned medium (EOC-CM) potently attenuates both TGF-β- and angiotensin II-induced fibroblast collagen production in vitro. To examine the therapeutic relevance of these findings in vivo, 5/6 subtotally nephrectomized rats, a model of chronic kidney and heart failure characterized by progressive fibrosis of both organs, were randomized to receive i.v. injections of EOC-CM, unconditioned medium, or 10(6) EOCs. Rats that received unconditioned medium developed severe kidney injury with cardiac diastolic dysfunction. In comparison, EOC-CM-treated rats demonstrated substantially improved renal and cardiac function and structure, mimicking the changes found in EOC-treated animals. Mass spectrometric analysis of EOC-CM identified proteins that regulate cellular functions implicated in fibrosis. These results indicate that EOCs secrete soluble factor(s) with highly potent antifibrotic activity, that when injected intravenously replicate the salutary effects of the cells themselves. Together, these findings suggest that an endocrine mode of action may underlie the effectiveness of cell therapy in certain settings and portend the possibility for systemic delivery of cell-free therapy.
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Affiliation(s)
- Darren A Yuen
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
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Di Santo S, Seiler S, Fuchs AL, Staudigl J, Widmer HR. The secretome of endothelial progenitor cells promotes brain endothelial cell activity through PI3-kinase and MAP-kinase. PLoS One 2014; 9:e95731. [PMID: 24755675 PMCID: PMC3995762 DOI: 10.1371/journal.pone.0095731] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/31/2014] [Indexed: 11/19/2022] Open
Abstract
Background Angiogenesis and vascular remodelling are crucial events in tissue repair mechanisms promoted by cell transplantation. Current evidence underscores the importance of the soluble factors secreted by stem cells in tissue regeneration. In the present study we investigated the effects of paracrine factors derived from cultured endothelial progenitor cells (EPC) on rat brain endothelial cell properties and addressed the signaling pathways involved. Methods Endothelial cells derived from rat brain (rBCEC4) were incubated with EPC-derived conditioned medium (EPC-CM). The angiogenic response of rBCEC4 to EPC-CM was assessed as effect on cell number, migration and tubular network formation. In addition, we have compared the outcome of the in vitro experiments with the effects on capillary sprouting from rat aortic rings. The specific PI3K/AKT inhibitor LY294002 and the MEK/ERK inhibitor PD98059 were used to study the involvement of these two signaling pathways in the transduction of the angiogenic effects of EPC-CM. Results Viable cell number, migration and tubule network formation were significantly augmented upon incubation with EPC-CM. Similar findings were observed for aortic ring outgrowth with significantly longer sprouts. The EPC-CM-induced activities were significantly reduced by the blockage of the PI3K/AKT and MEK/ERK signaling pathways. Similarly to the outcome of the rBCEC4 experiments, inhibition of the PI3K/AKT and MEK/ERK pathways significantly interfered with capillary sprouting induced by EPC-CM. Conclusion The present study demonstrates that EPC-derived paracrine factors substantially promote the angiogenic response of brain microvascular endothelial cells. In addition, our findings identified the PI3K/AKT and MEK/ERK pathways to play a central role in mediating these effects.
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Affiliation(s)
- Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Anna-Lena Fuchs
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Jennifer Staudigl
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Hans Rudolf Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
- * E-mail:
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Frösen J. Smooth Muscle Cells and the Formation, Degeneration, and Rupture of Saccular Intracranial Aneurysm Wall—a Review of Current Pathophysiological Knowledge. Transl Stroke Res 2014; 5:347-56. [DOI: 10.1007/s12975-014-0340-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/08/2014] [Accepted: 03/11/2014] [Indexed: 10/25/2022]
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Inaba Y, Davidson BP, Kim S, Liu YN, Packwood W, Belcik JT, Xie A, Lindner JR. Echocardiographic evaluation of the effects of stem cell therapy on perfusion and function in ischemic cardiomyopathy. J Am Soc Echocardiogr 2014; 27:192-9. [PMID: 24315764 PMCID: PMC3946830 DOI: 10.1016/j.echo.2013.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Small animal models of ischemic left ventricular (LV) dysfunction are important for the preclinical optimization of stem cell therapy. The aim of this study was to test the hypothesis that temporal changes in LV function and regional perfusion after cell therapy can be assessed in mice using echocardiographic imaging. METHODS Wild-type mice (n = 25) were studied 7 and 28 days after permanent ligation of the left anterior descending coronary artery. Animals were randomized to receive closed-chest ultrasound-guided intramyocardial delivery of saline (n = 13) or 5 × 10(5) multipotential adult progenitor cells (MAPCs; n = 12) on day 7. LV end-diastolic and end-systolic volumes, LV ejection fraction, and stroke volume were measured using high-frequency echocardiography. Multiplanar assessments of perfusion and defect area size were made using myocardial contrast echocardiography. RESULTS Between days 7 and 28, MAPC-treated animals had 40% to 50% reductions in defect size (P < .001) and 20% to 30% increases in total perfusion (P < .01). Perfusion did not change in nontreated controls. Both LV end-diastolic and end-systolic volumes increased between days 7 and 28 in both groups, but LV end-systolic volume increased to a lesser degree in MAPC-treated compared with control mice (+4.2 ± 7.9 vs +19.2 ± 22.0 μL, P < .05). LV ejection fraction increased in the MAPC-treated mice and decreased in control mice (+3.0 ± 4.3% vs -5.6 ± 5.9%, P < .01). There was a significant linear relation between the change in LV ejection fraction and the change in either defect area size or total perfusion. CONCLUSIONS High-frequency echocardiography and myocardial contrast echocardiography in murine models of ischemic LV dysfunction can be used to assess the response to stem cell therapy and to characterize the relationship among spatial flow, ventricular function, and ventricular remodeling.
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Affiliation(s)
- Yoichi Inaba
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Brian P Davidson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Sajeevani Kim
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Ya Ni Liu
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - William Packwood
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - J Todd Belcik
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Aris Xie
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Jonathan R Lindner
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.
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Stewart FA, Seemann I, Hoving S, Russell NS. Understanding radiation-induced cardiovascular damage and strategies for intervention. Clin Oncol (R Coll Radiol) 2013; 25:617-24. [PMID: 23876528 DOI: 10.1016/j.clon.2013.06.012] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/26/2013] [Accepted: 06/30/2013] [Indexed: 12/22/2022]
Abstract
There is a clear association between therapeutic doses of thoracic irradiation and an increased risk of cardiovascular disease (CVD) in cancer survivors, although these effects may take decades to become symptomatic. Long-term survivors of Hodgkin's lymphoma and childhood cancers have two-fold to more than seven-fold increased risks for late cardiac deaths after total tumour doses of 30-40 Gy, given in 2 Gy fractions, where large volumes of heart were included in the field. Increased cardiac mortality is also seen in women irradiated for breast cancer. Breast doses are generally 40-50 Gy in 2 Gy fractions, but only a small part of the heart is included in the treatment fields and mean heart doses rarely exceeded 10-15 Gy, even with older techniques. The relative risks of cardiac mortality (1.1-1.4) are consequently lower than for Hodgkin's lymphoma survivors. Some epidemiological studies show increased risks of cardiac death after accidental or environmental total body exposures to much lower radiation doses. The mechanisms whereby these cardiac effects occur are not fully understood and different mechanisms are probably involved after high therapeutic doses to the heart, or part of the heart, than after low total body exposures. These various mechanisms probably result in different cardiac pathologies, e.g. coronary artery atherosclerosis leading to myocardial infarct, versus microvascular damage and fibrosis leading to congestive heart failure. Experimental studies can help to unravel some of these mechanisms and may identify suitable strategies for managing or inhibiting CVD. In this overview, the main epidemiological and clinical evidence for radiation-induced CVD is summarised. Experimental data shedding light on some of the underlying pathologies and possible targets for intervention are also discussed.
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Affiliation(s)
- F A Stewart
- Division of Biological Stress Response, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Roura S, Gálvez-Montón C, Bayes-Genis A. The challenges for cardiac vascular precursor cell therapy: lessons from a very elusive precursor. J Vasc Res 2013; 50:304-23. [PMID: 23860201 DOI: 10.1159/000353294] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 05/01/2013] [Indexed: 11/19/2022] Open
Abstract
There is compelling evidence that cardiovascular disorders arise and/or progress due mainly to endothelial dysfunction. Novel therapeutic strategies aim to generate new myocardial tissue using cells with regenerative potential, either alone or in combination with biomaterials, cytokines and advanced monitoring devices. Among the human adult progenitor cells used in such methods, those historically termed 'endothelial progenitor cells' show promise for vascular growth and repair. Asahara et al. [Science 1997;275:964-967] initially described putative endothelial cell precursors in 1997. Subsequently, distinct cell populations termed endothelial colony-forming units-Hill, circulating angiogenic cells and endothelial colony-forming cells were identified that varied in terms of phenotype, vascular homeostasis contribution and purity. Notably, most of these cells are not genuine vascular precursor cells belonging to the endothelial lineage. This review provides a broad overview of the main properties of the endothelium, focusing on the basis governing its growth and repair. We discuss efforts to identify true vascular precursors, a matter of debate for the past 15 years, as well as recent methodological advances in identifying new hierarchies of more homogeneous, clonogenic and proliferative vascular endothelial-lineage precursors. Consideration of these issues provides insights that may help develop more effective therapies against human diseases that involve vascular deficits.
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Affiliation(s)
- Santiago Roura
- ICREC Research Program, Health Research Institute Germans Trias i Pujol-IGTP, University Hospital Germans Trias i Pujol, Badalona, Spain.
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Jia X, Lü H, Li C, Feng G, Yao X, Mao L, Ke T, Che Y, Xu Y, Li Z, Kong D. Human embryonic stem cells-derived endothelial cell therapy facilitates kidney regeneration by stimulating renal resident stem cell proliferation in acute kidney injury. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s11434-013-5890-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Liu X, Zhang GX, Zhang XY, Xia WH, Yang Z, Su C, Qiu YX, Xu SY, Zhan H, Tao J. Lacidipine improves endothelial repair capacity of endothelial progenitor cells from patients with essential hypertension. Int J Cardiol 2013; 168:3317-26. [PMID: 23642821 DOI: 10.1016/j.ijcard.2013.04.041] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 02/08/2013] [Accepted: 04/06/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Endothelial progenitor cells (EPCs) play a critical role in maintaining the integrity of vascular endothelium following arterial injury. Lacidipine has a beneficial effect on endothelium of hypertensive patients, but limited data are available on EPCs-mediated endothelial protection. This study tests the hypothesis that lacidipine treatment can improve endothelial repair capacity of EPCs from hypertensive patients through increasing CXC chemokine receptor four (CXCR4) signaling. METHODS In vivo reendothelialization capacity of EPCs from hypertensive patients with or without in vitro lacidipine treatment was examined in a nude mouse model of carotid artery injury. Expression of CXCR4 and alteration in migration and adhesion functions of EPCs were evaluated. RESULTS Basal CXCR4 expression was markedly reduced in EPCs from hypertensive patients compared with normal subjects. In parallel, the phosphorylation of Janus kinase-2 (JAK-2) of EPCs, a CXCR4 downstream signaling, was also significantly decreased. Lacidipine promoted CXCR4/JAK-2 signaling expression of in vitro EPCs. Transplantation of EPCs pretreated with lacidipine significantly accelerated in vivo reendothelialization. The enhanced in vitro function and in vivo reendothelialization capacity of EPCs were inhibited by shRNA-mediated knockdown of CXCR4 expression or pretreatment with JAK-2 inhibitor AG490, respectively. In hypertensive patients, lacidipine treatment for 4 weeks also resulted in an upregulation of CXCR4/JAK-2 signaling of EPCs, which was associated with augmented EPCs-mediated reendothelialization and improved endothelial function. CONCLUSION Deterioration of CXCR4 signaling may lead to impaired EPCs-mediated reendothelialization of hypertensive patients. Lacidipine-modified EPCs via a partially CXCR4 signaling contribute to enhanced endothelial repair capacity in hypertension.
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Affiliation(s)
- Xing Liu
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China; Department of Cardiovascular Disease, The Jiangmen Central Hospital, Jiangmen 529030, China
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Raval Z, Losordo DW. Cell therapy of peripheral arterial disease: from experimental findings to clinical trials. Circ Res 2013; 112:1288-302. [PMID: 23620237 PMCID: PMC3838995 DOI: 10.1161/circresaha.113.300565] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/28/2013] [Indexed: 12/19/2022]
Abstract
The age-adjusted prevalence of peripheral arterial disease in the US population was estimated to approach 12% in 1985, and as the population ages, the overall population having peripheral arterial disease is predicted to rise. The clinical consequences of occlusive peripheral arterial disease include intermittent claudication, that is, pain with walking, and critical limb ischemia (CLI), which includes pain at rest and loss of tissue integrity in the distal limbs, which may ultimately lead to amputation of a portion of the lower extremity. The risk factors for CLI are similar to those linked to coronary artery disease and include advanced age, smoking, diabetes mellitus, hyperlipidemia, and hypertension. The worldwide incidence of CLI was estimated to be 500 to 1000 cases per million people per year in 1991. The prognosis is poor for CLI subjects with advanced limb disease. One study of >400 such subjects in the United Kingdom found that 25% required amputation and 20% (including some subjects who had required amputation) died within 1 year. In the United States, ≈280 lower-limb amputations for ischemic disease are performed per million people each year. The first objective in treating CLI is to increase blood circulation to the affected limb. Theoretically, increased blood flow could be achieved by increasing the number of vessels that supply the ischemic tissue with blood. The use of pharmacological agents to induce new blood vessel growth for the treatment or prevention of pathological clinical conditions has been called therapeutic angiogenesis. Since the identification of the endothelial progenitor cell in 1997 by Asahara and Isner, the field of cell-based therapies for peripheral arterial disease has been in a state of continuous evolution. Here, we review the current state of that field.
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Affiliation(s)
- Zankhana Raval
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Wang HJ, Zhang D, Tan YZ, Li T. Autophagy in endothelial progenitor cells is cytoprotective in hypoxic conditions. Am J Physiol Cell Physiol 2013; 304:C617-26. [DOI: 10.1152/ajpcell.00296.2012] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Endothelial progenitor cells (EPCs) may be incorporated into local vessels to enhance angiogenesis within ischemic tissue. Recently, EPC transplantation has become a potential therapy for improving tissue function in cardiovascular disease. However, the mechanisms of proliferation, differentiation, and survival of EPCs in a hypoxic microenvironment remain unclear. In this study, CD34+VEGFR-2+ EPCs were isolated from mononuclear cells of human umbilical cord blood, and differentiation to endothelial cells was induced with VEGF. When EPC autophagy was inhibited with 3-methyladenine (3-MA) under normoxic conditions, proliferation and viability of the cells were decreased, and the cells failed to differentiate into endothelial cells. Under hypoxic conditions (1% O2), Beclin-1 expression of the cells was upregulated and both MDC-labeled and LC3-positive puncta and autophagic ultrastructures in the cells increased significantly. The number of lysosomes also increased in hypoxia-exposed cells. When autophagy was inhibited with 3-MA under hypoxic conditions, the number of apoptotic cells increased, and the number and size of lysosomes decreased. Conversely, apoptosis of the hypoxic EPCs was reduced when autophagy was induced by pretreatment with rapamycin. These results demonstrate that autophagy is involved in proliferation and differentiation of EPCs. Furthermore, hypoxia activates autophagy, promoting EPC survival by inhibiting apoptosis. Enhancing autophagy with hypoxic preconditioning may be beneficial for survival of the transplanted EPCs in a local hypoxic environment.
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Affiliation(s)
- Hai-Jie Wang
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
| | - Dan Zhang
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
| | - Yu-Zhen Tan
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
| | - Ting Li
- Department of Anatomy, Histology and Embryology, Shanghai Medical School of Fudan University, Shanghai, China
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Abstract
SIGNIFICANCE Proangiogenic therapy appeared a promising strategy for the treatment of patients with acute myocardial infarction (MI), as de novo formation of microvessels, has the potential to salvage ischemic myocardium at early stages after MI, and is also essential to prevent the transition to heart failure through the control of cardiomyocyte hypertrophy and contractility. RECENT ADVANCES Exciting preclinical studies evaluating proangiogenic therapies for MI have prompted the initiation of numerous clinical trials based on protein or gene transfer delivery of growth factors and administration of stem/progenitor cells, mainly from bone marrow origin. Nonetheless, these clinical trials showed mixed results in patients with acute MI. CRITICAL ISSUES Even though methodological caveats, such as way of delivery for angiogenic growth factors (e.g., protein vs. gene transfer) and stem/progenitor cells or isolation/culture procedure for regenerative cells might partially explain the failure of such trials, it appears that delivery of a single growth factor or cell type does not support angiogenesis sufficiently to promote cardiac repair. FUTURE DIRECTIONS Optimization of proangiogenic therapies might include stimulation of both angiogenesis and vessel maturation and/or the use of additional sources of stem/progenitor cells, such as cardiac progenitor cells. Experimental unraveling of the mechanisms of angiogenesis, vessel maturation, and endothelial cell/cardiomyocyte cross talk in the ischemic heart, analysis of emerging pathways, as well as a better understanding of how cardiovascular risk factors impact endogenous and therapeutically stimulated angiogenesis, would undoubtedly pave the way for the development of novel and hopefully efficient angiogenesis targeting therapeutics for the treatment of acute MI.
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Affiliation(s)
- Clement Cochain
- Paris Cardiovascular Research Center, INSERM UMR-S 970, Paris Descartes University, Paris, France
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Role of CX3CR1 receptor in monocyte/macrophage driven neovascularization. PLoS One 2013; 8:e57230. [PMID: 23437346 PMCID: PMC3578809 DOI: 10.1371/journal.pone.0057230] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 01/18/2013] [Indexed: 11/30/2022] Open
Abstract
Monocyte/Macrophages are implicated in initiation of angiogenesis, tissue/organ perfusion and atherosclerosis biology. We recently showed that chemokine receptor CX3CR1 is an essential regulator of monocyte/macrophage derived smooth muscle cell differentiation in the vessel wall after injury. Here we hypothesised the contribution of CX3CR1- CX3CL1 interaction to in vivo neovascularization and studied the functional consequences of genetic and pharmacologic targeting of CX3CR1 in formation, maturation and maintenance of microvascular integrity. Cells functionally deficient in CX3CR1 lacked matrix tunnelling and tubulation capacity in a 3D Matrigel assay. These morphogenic and cytokinetic responses were driven by CX3CL1-CX3CR1 interaction and totally abrogated by a Rho antagonist. To evaluate the role of CX3CR1 system in vivo, Matrigel plugs were implanted in competent CX3CR1+/gfp and functionally deficient CX3CR1gfp/gfp mice. Leaky microvessels (MV) were formed in the Matrigel implanted in CX3CR1gfp/gfp but not in CX3CR1+/gfp mice. In experimental plaque neovascularization immature MV phenotype was observed in CX3CR1gfp/gfp mice, lacking CX3CR1 positive smooth muscle-like cells, extracellular collagen and basement membrane (BM) laminin compared to competent CX3CR1+/gfp mice. This was associated with increased extravasation of platelets into the intima of CX3CR1gfp/gfp but not functionally competent CX3CR1 mice. Pharmacologic targeting using CX3CR1 receptor antagonist in wild type mice resulted in formation of plaque MV with poor BM coverage and a leaky phenotype. Our data indicate a hitherto unrecognised role for functional CX3CR1 in Matrigel and experimental plaque neovascularization in vivo, which may buttress MV collectively in favour of a more stable non-leaky phenotype.
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Shi Q, Cox LA, Hodara V, Wang XL, VandeBerg JL. Repertoire of endothelial progenitor cells mobilized by femoral artery ligation: a nonhuman primate study. J Cell Mol Med 2013; 16:2060-73. [PMID: 22128816 PMCID: PMC3433842 DOI: 10.1111/j.1582-4934.2011.01501.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
To determine in the baboon model the identities and functional characteristics of endothelial progenitor cells (EPCs) mobilized in response to artery ligation, we collected peripheral blood mononuclear cells (PBMNCs) before and 3 days after a segment of femoral artery was removed. Our goal was to find EPC subpopulations with highly regenerative capacity. We identified 12 subpopulations of putative EPCs that were altered >1.75-fold; two subpopulations (CD146+/CD54-/CD45- at 6.63-fold, and CD146+/UEA-1-/CD45- at 12.21-fold) were dramatically elevated. To investigate the regenerative capacity of putative EPCs, we devised a new assay that maximally resembled their in vivo scenario, we purified CD34+ and CD146+ cells and co-cultured them with basal and mobilized PBMNCs; both cell types took up Dil-LDL, but purified CD146+ cells exhibited accelerated differentiation by increasing expression of CD31 and CD144, and by exhibiting more active cord-like structure formation by comparison to the CD34+ subpopulation in a co-culture with mobilized PBMNCs. We demonstrate that ischaemia due to vascular ligation mobilizes multiple types of cells with distinct roles. Baboon CD146+ cells exhibit higher reparative capacity than CD34+ cells, and thus are a potential source for therapeutic application.
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Affiliation(s)
- Qiang Shi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78245-0549, USA.
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Kheirandish-Gozal L, Farré R. The injury theory, endothelial progenitors, and sleep apnea. Am J Respir Crit Care Med 2013; 187:5-7. [PMID: 23281349 DOI: 10.1164/rccm.201210-1950ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Roura S, Bagó JR, Soler-Botija C, Pujal JM, Gálvez-Montón C, Prat-Vidal C, Llucià-Valldeperas A, Blanco J, Bayes-Genis A. Human umbilical cord blood-derived mesenchymal stem cells promote vascular growth in vivo. PLoS One 2012; 7:e49447. [PMID: 23166670 PMCID: PMC3500294 DOI: 10.1371/journal.pone.0049447] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 10/09/2012] [Indexed: 01/01/2023] Open
Abstract
Stem cell therapies are promising strategies to regenerate human injured tissues, including ischemic myocardium. Here, we examined the acquisition of properties associated with vascular growth by human umbilical cord blood-derived mesenchymal stem cells (UCBMSCs), and whether they promoted vascular growth in vivo. UCBMSCs were induced in endothelial cell-specific growth medium (EGM-2) acquiring new cell markers, increased Ac-LDL uptake, and migratory capacity as assessed by qRT-PCR, Western blotting, indirect immunofluorescence, and invasion assays. Angiogenic and vasculogenic potentials could be anticipated by in vitro experiments showing self organization into Matrigel-mediated cell networks, and activation of circulating angiogenic-supportive myeloid cells. In mice, following subcutaneous co-injection with Matrigel, UCBMSCs modified to co-express bioluminescent (luciferases) and fluorescent proteins were demonstrated to participate in the formation of new microvasculature connected with the host circulatory system. Response of UCBMSCs to ischemia was explored in a mouse model of acute myocardial infarction (MI). UCBMSCs transplanted using a fibrin patch survived 4 weeks post-implantation and organized into CD31+network structures above the infarcted myocardium. MI-treated animals showed a reduced infarct scar and a larger vessel-occupied area in comparison with MI-control animals. Taken together, the presented results show that UCBMSCs can be induced in vitro to acquire angiogenic and vasculogenic properties and contribute to vascular growth in vivo.
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Affiliation(s)
- Santiago Roura
- ICREC Research Program, Fundació Institut dInvestigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
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de Mel A, Oh JT, Ramesh B, Seifalian AM. Biofunctionalized quantum dots for live monitoring of stem cells: applications in regenerative medicine. Regen Med 2012; 7:335-47. [PMID: 22594327 DOI: 10.2217/rme.12.21] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AIM This study aimed to live monitor the degree of endothelial progenitor cell (EPC) integration onto tissue-engineering scaffolds by conjugating relevant antibodies to quantum dots (QDs). MATERIALS & METHODS Biocompatible mercaptosuccinic acid-coated QDs were functionalized with two different antibodies to EPC (CD133 with QDs of 640 nm wavelength [λ] and later-stage mature EPCs; and von Willebrand factor with QDs of λ595 and λ555 nm) using conventional carbomide and N-hydroxysuccinimide chemistry. Biofunctionalization was characterized with Fourier-transform infrared spectroscopy. Cell viability assays and gross morphology observations confirmed cytocompatibility and normal patterns of celluar growth. The antigens corresponding to each state of cell maturation were determined using a single excitation at λ488 nm. RESULTS The optimal concentrations of antibody-QD conjugates were biocompatible, hemocompatible and determined the state of EPC transformation to endothelial cells. CONCLUSION Antibody-functionalized QDs suggest new applications in tissue engineering of polymer-based implants where cell integration can potentially be monitored without requiring the sacrifice of implants.
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Affiliation(s)
- Achala de Mel
- UCL Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London, London, UK
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