Oliveras A, Soler M J, Martínez-Estrada O M, Vázquez S, Marco-Feliu D, Vila J S, Vilaró S, Lloveras J
Nephrology Department, Hospital Universitari del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain.
J Hum Hypertens. 2008 Mar;22(3):183-90. doi: 10.1038/sj.jhh.1002304. Epub 2007 Nov 8.
Circulating endothelial progenitor cells (EPCs) play a key role in the maintenance of endothelial homoeostasis and promote vascular repair. They may also be of predictive value for cardiovascular events. Reduced EPC number and functional activity have been associated with several cardiovascular risk factors, but their relationship with hypertension remains unclear. The objective of this study was to investigate if number and function of circulating EPCs are reduced in patients with refractory hypertension (RHT). Circulating EPCs (CD34+ CD133+/CD45+) were isolated from peripheral blood by flow cytometry in 39 RHT and 30 normotensive controls. EPC number was also determined in vitro after 7 days in culture. After age adjustment, EPC concentration was significantly reduced in RHT as compared with controls (mean (95% CI), 33.8 (18.1-49.6) vs 69.1 (50.7-87.5) EPCs per 10(5) peripheral mononuclear cells (MNCs), respectively; P=0.014). After in vitro culture, EPCs were also reduced in patients as compared with controls (mean (95% CI), 142.3 (49.5-235.0) vs 611.0 (480.2-741.8) EPCs per field, respectively, P<0.001). In multiple linear regression analysis, circulating EPCs were significantly reduced by 56.3% in RHT as compared with control (P=0.006), independently of all other known risk factors. Moreover, RHT had a high independent predictive value for lower EPC proliferation. The number of EPCs per field was reduced by 76.7% in RHT with respect to controls (P<0.001). In summary, the number of circulating EPCs after culture is reduced in patients with RHT, which may be related to the increased rate of endothelial dysfunction, atherosclerotic disease and cardiovascular events observed in this population.
循环内皮祖细胞（EPCs）在维持内皮稳态中起关键作用，并促进血管修复。它们对心血管事件也可能具有预测价值。EPC数量减少和功能活性降低与多种心血管危险因素相关，但其与高血压的关系仍不明确。本研究的目的是调查难治性高血压（RHT）患者循环EPCs的数量和功能是否降低。通过流式细胞术从39例RHT患者和30例血压正常的对照者的外周血中分离循环EPCs（CD34 + CD133 + / CD45 +）。培养7天后还在体外测定EPC数量。年龄调整后，与对照组相比，RHT患者的EPC浓度显著降低（平均值（95％CI），分别为每10（5）个外周单个核细胞（MNCs）中33.8（18.1 - 49.6）个EPC与69.1（50.7 - 87.5）个EPC；P = 0.014）。体外培养后，与对照组相比，患者的EPCs也减少（平均值（95％CI），分别为每视野142.3（49.5 - 235.0）个EPC与611.0（480.2 - 741.8）个EPC，P <0.001）。在多元线性回归分析中，与对照组相比，RHT患者的循环EPCs显著减少56.3％（P = 0.006），独立于所有其他已知危险因素。此外，RHT对较低的EPC增殖具有较高的独立预测价值。与对照组相比，RHT患者每视野EPCs数量减少76.7％（P <0.001）。总之，RHT患者培养后的循环EPCs数量减少，这可能与该人群中观察到的内皮功能障碍、动脉粥样硬化疾病和心血管事件发生率增加有关。
