Therapeutic revascularisation of ischaemic tissue: the opportunities and challenges for therapy using vascular stem/progenitor cells

Abstract

Ischaemia-related diseases such as peripheral artery disease and coronary heart disease constitute a major issue in medicine as they affect millions of individuals each year and represent a considerable economic burden to healthcare systems. If the underlying ischaemia is not sufficiently resolved it can lead to tissue damage, with subsequent cell death. Treating such diseases remains difficult and several strategies have been used to stimulate the growth of blood vessels and promote regeneration of ischaemic tissues, such as the use of recombinant proteins and gene therapy. Although these approaches remain promising, they have limitations and results from clinical trials using these methods have had limited success. Recently, there has been growing interest in the therapeutic potential of using a cell-based approach to treat vasodegenerative disorders. In vascular medicine, various stem cells and adult progenitors have been highlighted as having a vasoreparative role in ischaemic tissues. This review will examine the clinical potential of several stem and progenitor cells that may be utilised to regenerate defunct or damaged vasculature and restore blood flow to the ischaemic tissue. In particular, we focus on the therapeutic potential of endothelial progenitor cells as an exciting new option for the treatment of ischaemic diseases.

Generation and Culture of Blood Outgrowth Endothelial Cells from Human Peripheral Blood

“…These applications include both endothelial cell transplantation to promote neovascularization (see 12 and references therein), as well as the generation of induced for autologous cell therapies. BOECs reprogram faster and with a higher efficiency than skin fibroblasts.…”

The real face of endothelial progenitor cells – Circulating angiogenic cells as endothelial prognostic marker?

“…231 The phenotypic overlap between EPC and monocytic cells was 232 even more pronounced in case of cells cultured in vitro [13]. It [71]. Moreover, as these cells are 276 linked to macrophages, they may be highly plastic and therefore 277 could contribute to inflammatory responses by paracrine effects 278 [71].…”

“…It [71]. Moreover, as these cells are 276 linked to macrophages, they may be highly plastic and therefore 277 could contribute to inflammatory responses by paracrine effects 278 [71]. Although this cell population was called by O'Neill et al [71] 279 myeloid angiogenic cells (MACs), it, in fact, represented CACs.…”

“…On the other hand, the outgrowth EPCs or ECFCs have higher 289 proliferative potential, more closely resemble ECs and appear to 290 structurally contribute to neovessels [20,22,71,[74][75][76]. However, 291…”

“…Moreover, as these cells are 276 linked to macrophages, they may be highly plastic and therefore 277 could contribute to inflammatory responses by paracrine effects 278 [71]. Although this cell population was called by O'Neill et al [71] 279 myeloid angiogenic cells (MACs), it, in fact, represented CACs. 280 Summarizing the current knowledge, early EPCs are a 281 heterogeneous population originating from myeloid hematopoi-282 etic cells, which share features with immune cells and have a paracrine effect on angiogenic processes [72,73].…”