心肌梗死后影响CD34+和CD133+祖细胞自发动员的因素。
Factors influencing spontaneous mobilization of CD34+ and CD133+ progenitor cells after myocardial infarction.
作者信息
Turan R G, Brehm M, Koestering M, Tobias Z, Bartsch T, Steiner S, Picard F, Ebner P, Schannwell C M, Strauer B E
机构信息
Laboratory of Stem Cell Transplantation and Molecular Cardiology, Division of Cardiology, Pneumology and Angiology, Heinrich-Heine-University, Moorenstrasse 6, Duesseldorf, Germany.
出版信息
Eur J Clin Invest. 2007 Nov;37(11):842-51. doi: 10.1111/j.1365-2362.2007.01876.x.
BACKGROUND
Bone marrow-derived circulating progenitor cells (BM-CPCs) are mobilized into adult peripheral blood (PB) during acute myocardial infarction (AMI) and may contribute to the regeneration of infarcted myocardium. The purpose of the present study is to determine whether mobilization of BM-CPCs into PB depends on cardiovascular risk factors (CVRFs), age of patients, infarct associated inflammatory markers, and left ventricular function after AMI.
MATERIALS AND METHODS
Peripheral blood concentrations of CD34/45(+) and CD133/45(+) BM-CPCs were measured by flow cytometry in 44 patients after AMI and in 16 subjects with atypical chest pain acting as controls.
RESULTS
Mobilization of CD34/45(+) and CD133/45(+) BM-CPCs on day 1 after AMI showed significant negative correlation with age, the number of CVRFs, infarct size, creatine phosphokinase peak in bivariate as well as in multivariate analyses. We additionally found a positive correlation of CD34/45(+) and CD133/45(+) BM-CPCs mobilization on day 1 after AMI with global ejection fraction (EF) in bivariate analysis but could not confirm this in multivariate analysis. Elevated of C-reactive protein (CRP) and leukocyte levels on day 1 after AMI were significantly associated with decreased concentrations of CD34/45(+) BM-CPCs. The concentrations of CD34/45(+) and CD133/45(+) BM-CPCs significantly increased in AMI patients, with the peak on day 7 as compared to the control group.
CONCLUSIONS
The mobilization of CD34/45(+) and CD133/45(+) BM-CPCs into the PB depends on many factors, i.e. the number of CVRFs, age, infarct size and inflammatory markers of patients. Most importantly, the severity of the circulatory dysfunction and the amount of necrotic myocardial tissue are the main determinants. Moreover, this spontaneous mobilization of BM-CPCs may serve as a very important surrogate for infarct size as well as for global EF and it may determine the regenerative potency after AMI.
背景
急性心肌梗死（AMI）期间，骨髓来源的循环祖细胞（BM-CPCs）会动员至成年外周血（PB）中，可能有助于梗死心肌的再生。本研究旨在确定BM-CPCs动员至PB是否取决于心血管危险因素（CVRFs）、患者年龄、梗死相关炎症标志物以及AMI后的左心室功能。
材料与方法
采用流式细胞术检测44例AMI患者及16例以非典型胸痛为对照的受试者外周血中CD34/45(+)和CD133/45(+) BM-CPCs的浓度。
结果
在双变量及多变量分析中，AMI后第1天CD34/45(+)和CD133/45(+) BM-CPCs的动员与年龄、CVRFs数量、梗死面积、肌酸磷酸激酶峰值呈显著负相关。我们还发现，在双变量分析中，AMI后第1天CD34/45(+)和CD133/45(+) BM-CPCs的动员与整体射血分数（EF）呈正相关，但在多变量分析中未得到证实。AMI后第1天C反应蛋白（CRP）和白细胞水平升高与CD34/45(+) BM-CPCs浓度降低显著相关。与对照组相比，AMI患者中CD34/45(+)和CD133/45(+) BM-CPCs的浓度显著升高，在第7天达到峰值。
结论
CD34/45(+)和CD133/45(+) BM-CPCs动员至PB取决于多种因素，即CVRFs数量、年龄、梗死面积和患者的炎症标志物。最重要的是，循环功能障碍的严重程度和坏死心肌组织的量是主要决定因素。此外，BM-CPCs的这种自发动员可能是梗死面积以及整体EF的非常重要的替代指标，并且可能决定AMI后的再生能力。
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