Endothelial Progenitor Cells as Prognostic Markers of Preterm Birth-Associated Complications

Abstract

Preterm birth is associated with alteration of the vascular tree that can result in disease states such as bronchopulmonary dysplasia and retinopathy of prematurity during the neonatal period and emphysema and hypertension in adulthood. Studies have suggested a potential role for endothelial progenitor cells in the pathophysiology of prematurity‐related complications involving blood vessels; however, this knowledge has never been synthesized. We conducted a systematic review of the published data to examine the characteristics of endothelial progenitor cells in relation to preterm birth in humans. Preterm infants compared with term controls displayed similar or increased circulating/cord blood endothelial progenitor cell counts. However, the preterm endothelial progenitor cells were more vulnerable to exogenous factors such as oxidative stress. A reduced number, in particular of endothelial colony‐forming cells, was associated with bronchopulmonary dysplasia. No studies have examined endothelial progenitor cells beyond the neonatal period. These findings could prove useful in the identification of biomarkers for prognostication or therapeutic strategies for vascular‐related diseases in preterm‐born individuals. Stem Cells Translational Medicine 2017;6:7–13

Biogenesis of Pro-senescent Microparticles by Endothelial Colony Forming Cells from Premature Neonates is driven by SIRT1-Dependent Epigenetic Regulation of MKK6

“…Endothelial Colony Forming Cells (ECFC) are a relevant subset of endothelial progenitor cells that mainly reside in vessel wall, circulate at low frequency in the blood, and support vascular repair and de novo vessel formation 7 – 9 . A growing body of evidence supports their role as potential biomarkers and therapeutic targets in PT birth 5 , 10 , 11 . Among the factors that can alter cord blood ECFC functions in premature neonates, we recently demonstrated the involvement of accelerated senescence driven by sirtuin-1 (SIRT1) deficiency, which determines their vasculogenic defects 12 .…”

Stem cell biology and regenerative medicine for neonatal lung diseases

“…Conversely, another study reported impaired cord blood ECFC self-renewal, in vivo vasculogenesis, and response to vascular endothelial growth factor from CDH infants compared with healthy term infants (46). Together with other studies using EPCs as biomarkers for neonatal complications, these observations highlight the need for larger sample sizes on clearly defined EPCs to provide more robust data (47). Overall, these findings provided sufficient rationale to test the therapeutic potential of ECFCs and MACs in animal models.…”

Endothelial Colony‐Forming Cells in Young Adults Born Preterm: A Novel Link Between Neonatal Complications and Adult Risks for Cardiovascular Disease

“…In the cord blood of preterm infants, EPC counts have been shown to be either similar to or increased versus full‐term infants, but studies of ECFC subtype proliferation and vessel formation have yielded contradictory results 54. Cord blood ECFC from preterm infants were shown to be particularly vulnerable to oxidant conditions (such as hyperoxia) with drastically impaired growth potential, disrupted nitric oxide/vascular endothelial growth factor signaling, accelerated cell senescence, as well as increased oxidative stress status 16, 17, 55.…”