Association between endothelial progenitor cell depletion in blood and mild-to-moderate renal insufficiency in stable angina

Surdacki, Andrzej; Marewicz, Ewa; Wieteska, Ewa; Szastak, Grzegorz; Rakowski, Tomasz; Wieczorek-Surdacka, Ewa; Dudek, Dariusz; Pryjma, J; Dubiel, Jacek S.

doi:10.1093/ndt/gfm943

Cited by 22 publications

(27 citation statements)

References 69 publications

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“…This is in contrast with a study of Surdacki et al [42] in patients with mild-to-moderate renal insufficiency and angina, in which an inverse relation between homocystein levels and circulating EPC was reported. One explanation could be the overall higher cardiovascular risk score of the patients from the latter study in which differences in EPC counts might have become more pronounced.…”

Section: Homocysteincontrasting

confidence: 99%

Current perspective of pathophysiological and interventional effects on endothelial progenitor cell biology: Focus on Pi3K/AKT/eNOS pathway

Everaert¹,

Craenenbroeck²,

Hoymans³

et al. 2010

International Journal of Cardiology

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Section: Homocysteincontrasting

confidence: 99%

Current perspective of pathophysiological and interventional effects on endothelial progenitor cell biology: Focus on Pi3K/AKT/eNOS pathway

Everaert¹,

Craenenbroeck²,

Hoymans³

et al. 2010

International Journal of Cardiology

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“…Published data have provided evidence for both mechanisms [17]. Most interesting among these data is the evidence that endothelial progenitor cells (EPCs) have a phenotype that drives their potency for neovascularization [19,20,21,22]. …”

Section: Discussionmentioning

confidence: 99%

Intracoronary Autologous CD34+ Stem Cell Therapy for Intractable Angina

et al. 2010

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Background/Objectives: A large number of patients with coronary artery disease experience angina that is not suitable for revascularization and is refractory to conventional medical therapy. Laboratory and preclinical studies have provided evidence for the safety and potential efficacy of autologous CD34+ stem cell therapies as treatment for angina. Clinical studies investigating intramyocardial transplantation of autologous CD34+ stem cells by catheter injection for patients with refractory angina show that this is safe and feasible. It remains unclear whether intracoronary infusion of CD34+ stem cells exerts beneficial effects in patients with angina as well. We addressed this question with a controlled clinical trial by enrolling 112 patients with refractory angina. Previous trials have investigated the safety and beneficial effects of CD34+ cells isolated from granulocyte colony-stimulating factor-mobilized peripheral blood; in our trial, we isolated CD34+ cells directly from the patient’s bone marrow. Methods: One hundred and twelve patients with diffuse triple-vessel disease and Canadian Cardiovascular Society class III or IV angina were enrolled in a double-blind, randomized (1:1), placebo-controlled study. Patients received optimal medical treatment but were not candidates for mechanical revascularization (percutaneous coronary intervention or coronary artery bypass grafting). Fifty-six patients (27 women and 29 men aged 42–80 years) were enrolled in the treatment group, and 56 patients (28 women and 28 men aged 43–80 years) who received optimal medical treatment and intracoronary saline injections were enrolled in the placebo control group. Bone marrow was collected from all enrolled patients at a volume of 120–150 ml each in both groups. Selections of CD34+ cells were performed by a CE-marked device approved by the Security, Food and Drug Administration of China. Coronary angiography had been performed before enrollment in this study. Results: No myocardial infarction was observed during intracoronary infusion. The intracoronary infusion of cells or saline did not result in cardiac enzyme elevation, cardiac perforation or pericardial effusion. No arrhythmia, such as ventricular tachycardia or ventricular fibrillation, was induced by intracoronary infusion. No serious adverse events occurred in either group. The reduction in the frequency of angina episodes per week 3 and 6 months after infusion was significantly higher in the treatment group (–14.6 ± 4.8 at 3 months and –15.6 ± 4.0 at 6 months) than in the control group (–4.5 ± 0.3 and –3.0 ± 1.2, respectively; p < 0.01). Other efficacy parameters such as nitroglycerine usage, exercise time and the Canadian Cardiovascular Society class also showed an improvement in the treatment group compared to the control group. A significant improvement in myocardial perfusion was noted in the treatment group compared to the control group, as measured by single-photon emission computed tomography. Conclusions: This randomized trial investigating intracoronary infusi...

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“…The effects of immunosuppressive therapy and former exposure to long-term dialysis treatment complicate interpretation of these findings. Surdacki et al [25] studied a very specific population of patients with stable angina and severe angiographic CAD with strict criteria on medication use and comorbidity. They found lower CD34 + KDR + -EPC counts in patients with impaired kidney function within their selected population.…”

Section: Discussionmentioning

confidence: 99%

Progenitor cells and vascular function are impaired in patients with chronic kidney disease

Jie

Зайкова

Bergevoet

et al. 2010

Nephrology Dialysis Transplantation

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Background. Endothelial dysfunction contributes to accelerated atherosclerosis in chronic kidney disease (CKD). Bone marrow-derived endothelial progenitor cells (EPC) constitute an endogenous vascular repair system protecting against atherosclerosis. Smooth muscle progenitor cells (SPC) may stimulate atherosclerosis development. We hypothesized that an imbalance in EPC and SPC occurs in CKD, which may contribute to the increased cardiovascular disease (CVD) risk. Methods. EPC and SPC outgrowth from mononuclear cells (MNC), EPC migratory function and circulating CD34+ KDR + -EPC were measured in 49 patients with varying degrees of CKD on regular therapy and 33 healthy volunteers. Renal function, CKD cause, CVD history and endothelial dysfunction parameters were determined as factors of influence on progenitor cells. Results. Patients had reduced EPC outgrowth compared to controls [9 (2-22) vs 12 (1-38) cells/10 3 MNC, P = 0.026], independent of CKD cause and degree, whereas SPC outgrowth levels were higher in patients with more impaired kidney function (r = −0.397, P = 0.008). Patients had lower CD34 + KDR + -EPC compared to controls [9 (0-52) vs 19 (4-110) cells/10 5 granulocytes, P = 0.004]. CVD history and increased endothelial dysfunction markers were related to lower EPC levels. Progenitor cell outgrowth was shifted towards SPC with progression of endothelial damage. Reduction in EPC could not be attributed to decreases in progenitor cell-mobilizing factors SDF-1α and VEGF as levels increased with progressive kidney and endothelial dysfunction, while EPC remained low. Conclusions. Our data suggest that, already in mild CKD, EPC-mediated endogenous vascular regeneration is impaired, while SPC levels increase with declining kidney function.

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Association between endothelial progenitor cell depletion in blood and mild-to-moderate renal insufficiency in stable angina

Cited by 22 publications

References 69 publications

Current perspective of pathophysiological and interventional effects on endothelial progenitor cell biology: Focus on Pi3K/AKT/eNOS pathway

Current perspective of pathophysiological and interventional effects on endothelial progenitor cell biology: Focus on Pi3K/AKT/eNOS pathway

Intracoronary Autologous CD34+ Stem Cell Therapy for Intractable Angina

Progenitor cells and vascular function are impaired in patients with chronic kidney disease

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