Circulating Vascular Progenitor Cells in Patients With Type 1 Diabetes and Microalbuminuria

Abstract

OBJECTIVEPatients with type 1 diabetes and microalbuminuria are at increased risk of cardiovascular disease (CVD). Abnormalities in vascular progenitor cells, which participate in vascular repair, may be implicated in this susceptibility.RESEARCH DESIGN AND METHODSWe studied the number and function of vascular progenitor cells in 22 type 1 diabetic patients with history of microalbuminuria (MA+) and 22 type 1 diabetic patients without history of microalbuminuria (MA−), of similar age, diabetes duration, glycemic control, renal function, and no history of CVD.RESULTSMA+ patients had lower circulating CD34+ and CD34+/CD133+ cell numbers compared with MA− patients (P < 0.006). In in vitro functional assays, MA+ patients had a significantly lower number of colony-forming units and impaired vascular endothelial growth factor (VEGF)-A–mediated tube formation, when compared with MA− patients (P < 0.01).CONCLUSIONSIn type 1 diabetic patients with microalbuminuria, a marker of microvascular injury and a risk factor for CVD, circulating vascular progenitor cell number is reduced and function is impaired.

Specific Role of Impaired Glucose Metabolism and Diabetes Mellitus in Endothelial Progenitor Cell Characteristics and Function

“…22 Moreover, decreased secretion of NO and vascular endothelial growth factor (VEGF), reduced activity of superoxide dismutase, and impaired function, such as migration and tube formation, are observed in activated late EPCs after exposure to a hyperglycemic condition 23 or advanced glycation end products. 24 Reduced number and function of EPCs are also more prevalent in patients with type 1 and type 2 DM with diabetic nephropathy [25][26][27][28] and macrovascular 26,[29][30][31][32][33] complications and correlate with the degree of atherosclerosis. 34 These observations suggest that the burden of DM-related cardiovascular complications correlates with the number and function of EPCs: alterations in EPCs may contribute to the development and progression of atherosclerosis in patients with DM.…”

Endothelial progenitor cells in diabetes complications

“…Данное исследование подтверждает предположе-ние о негативном влиянии гипергликемии на количество прогениторных клеток. Кроме того, снижение количества и нарушение функции ЭПК наблюдалось при длительном течении СД, наличии микрососудистых [28,29] и макросо-судистых осложнений [30].…”

“…В другом исследовании также показано, что количество циркулиру-ющих CD34+ и CD34+CD133+ клеток ниже у пациентов с МАУ по сравнению с пациентами без МАУ. При анализе культуры обнаружено нарушение функцио нальных свойств клеток в группе больных с МАУ [28].…”

“…Снижение количества клеток коррелирует с наличием МАУ [28] и прогнозирует прогрессирование МАУ [35]. Снижение количества клеток и нарушение их функции коррелируют с наличием МАУ [28].…”

“…Снижение количества клеток и нарушение их функции коррелируют с наличием МАУ [28]. Ретинопатия (при отсутствии макроангиопатии) CD34+CD133+KDR+ CD34+CD45-Снижение количества клеток при непролиферативной ДР и увеличение при пролиферативной ДР [29].…”