Role of Endothelial Progenitor Cell Mobilization After Percutaneous Angioplasty Procedure

Abstract

Circulating endothelial progenitor cells (EPCs) are bone marrow-derived cells, contributing to endothelial cell regeneration of injured vessels as well as neovascularization of ischemic lesions. EPC levels and function are inversely correlated with cardiovascular risk factors, can predict the occurrence of adverse events and atherosclerotic disease progression. Ischemia and inflammation are the primary triggers for EPC mobilization and homing, however, vascular trauma, as it occurs during surgical procedures, has been demonstrated to stimulate EPC mobilization even in absence of tissue ischemia. The effect of angioplasty on EPCs is not well defined, mainly because of the different and sometimes contrasting clinical results, due to low numbers of patients enrolled and to lack of standardization in evaluating EPCs. Aim of this review is to report recent results on the effect of EPC mobilization and homing after angioplasty, attempting to summarize them in a comprehensive model. The effect on EPCs of different kind of stents and the potential use of new stents able to attract EPCs will be also described. Results obtained in patients undergoing angioplasty in different vascular districts (coronary, peripheral and carotid) will be shown, together with the correlation between circulating progenitor cells and restenosis.

The promotion of endothelial progenitor cells recruitment by nerve growth factors in tissue-engineered blood vessels

“…During the implantation of endovascular stents, percutaneous transluminal coronary angioplasty (PTCA) tends to damage the vascular endothelium [33]. If EPCs can be mobilized from bone marrow to peripheral blood, homing to the damaged site will repair the injured blood vessel [34].…”

Infections and cardiovascular disease: is Bartonella henselae contributing to this matter?

“…Recent studies also suggest the possibility of using new stents to attract EPCs. The EPC-capturing technology has been shown to promote the arterial healing response by binding circulating EPCs, resulting in the rapid establishment of a functional endothelial monolayer (Aoki et al, 2005;Barsotti et al, 2009).…”

Could Circulating Progenitor Cell Count Be a Barometer for Coronary Artery Disease Progression?

“…Endothelial denuding during PCI in CAD patients acts as a trigger for CPC mobilization into the circulation, activation, and homing to the damaged region requiring repair. 15 Thus monitoring CPC numbers induced by PCI may be helpful for identifying high-risk patients for secondary prevention. However, Arao et al noted no significant change in CPC numbers within the 24 h following elective catheter coronary revascularization with balloon angioplasty or stent placement (bare metal or sirolimus-eluting stent).…”