Circulating Endothelial Progenitor Cells in Type 1 Diabetic Patients: Relation with Patients’ Age and Disease Duration

Abstract

ObjectivesCirculating endothelial progenitor cells (cEPCs) have been reported to be dysfunctional in diabetes mellitus (DM) patients, accounting for the vascular damage and the ensuing high risk for cardiovascular disease (CVD) characteristic of this disease. The aim of the present study was to evaluate the number of circulating cEPCs in type 1 DM (T1DM) patients, without clinical vascular damage, of different ages and with different disease duration.MethodsAn observational, clinical-based prospective study was performed on T1DM patients enrolled in two clinical centers. cEPCs were determined by flow cytometry, determining the number of CD34/CD133/VEGFR2-positive cells within peripheral blood mononuclear cells (PBMCs).ResultsThe number of cEPCs was lower in adult T1DM patients, whilst higher in childhood/young patients, compared to controls of the same age range. When patients were grouped into two age groups (≥ or <20 years) (and categorized on the basis of the duration of the disease), the number of cEPCs in young (<20 years) patients was higher compared with older subjects, regardless of disease duration. A subset of patients with very high cEPCs was identified in the <20 years group.ConclusionThere is an association between the number of cEPCs and patients’ age: childhood/young T1DM patients have significantly higher levels of cEPCs, respect to adult T1DM patients. Such difference is maintained also when the disease lasts for more than 10 years. The very high levels of cEPCs, identified in a subset of childhood/young patients, might protect vessels against endothelial dysfunction and damage. Such protection would be less operative in older subjects, endowed with lower cEPC numbers, in which complications are known to develop more easily.

Circulating endothelial progenitor cells and endothelial cells in moyamoya disease

“…In this study, we found a significant relationship between EPC counts and age. In a study of patients with type 1 diabetes, it was found that younger patients (age < 20 years) had significantly higher circulating EPC counts than adult patients (Arcangeli et al, 2017).…”

“…In a study of patients with type 1 diabetes, it was found that younger patients (age < 20 years) had significantly higher circulating EPC counts than adult patients (Arcangeli et al., 2017). Disease duration has no effect on this finding.…”

Endothelial Progenitor Cells: New Targets for Therapeutics for Inflammatory Conditions With High Cardiovascular Risk

“…Studies have been carried out with MACs also, where young patients with type 1 diabetes mellitus have shown significantly higher levels of MACs compared to adult patients, and where a direct correlation was found between MAC number and disease duration, when greater than 10 years ( 38 ). The authors propose that the high levels of MACs in the young patients might protect vessels against endothelial dysfunction and damage and such protection would be less effective in older subjects, who had lower EPC numbers ( 38 ). In addition, older MACs were shown to be more susceptible to oxidative stress due to reduced activity of antioxidant proteins such as GPX1, thus rendering them vulnerable to apoptosis ( 38 , 39 ).…”

Upregulating CXCR7 Accelerates Endothelial Progenitor Cells Mediated Endothelial Reparation via Activating Akt/Keap-1/Nrf2 Signaling in Diabetes Mellitus

“…DM decreased the number of circulating EPCs and impaired EPCs functional activity [10][11][12], which were associated with the development and poor prognosis of vascular disease [27,28]. The present study revealed the molecular mechanism underlying DM-induced EPCs dysfunction.…”

“…Previous studies demonstrated that endothelial progenitor cells (EPCs) were vital in endothelial reparation [6][7][8][9]. However, DM impaired EPCs function and decreased the circulating EPCs level in either patients or mice with diabetes [10][11][12]. Thus, preventing adverse vascular events was crucial to understanding the potential mechanism underlying EPC dysfunction in DM.…”