Department of Clinical and Experimental Medicine, Division of Metabolic Diseases, University of Padova, Medical School, Padova, Italy.
Diabetes Obes Metab. 2010 Jul;12(7):570-83. doi: 10.1111/j.1463-1326.2010.01210.x.
Diabetes mellitus increases cardiovascular risk through its negative impact on vascular endothelium. Although glucotoxicity and lipotoxicity account for endothelial cell damage, endothelial repair is also affected by diabetes. Endothelial progenitor cells (EPCs) are involved in the maintenance of endothelial homoeostasis and in the process of new vessel formation. For these reasons, EPCs are thought to have a protective impact within the cardiovascular system. In addition, EPCs appear to modulate the functioning of other organs, providing neurotropic signals and promoting repair of the glomerular endothelium. The exact mechanisms by which EPCs provide cardiovascular protection are unknown and the definition of EPCs is not standardized. Notwithstanding these limitations, the literature consistently indicates that EPCs are altered in type 1 and type 2 diabetes and in virtually all diabetic complications. Moreover, experimental models suggest that EPC-based therapies might help prevent or reverse the features of end-organ complications. This identifies EPCs as having a novel pathogenic role in diabetes and being a potential therapeutic target. Several ways of favourably modulating EPCs have been identified, including lifestyle intervention, commonly used medications and cell-based approaches. Herein, we provide a comprehensive overview of EPC pathophysiology and the potential for EPC modulation in diabetes.
糖尿病通过对血管内皮的负面影响增加心血管风险。虽然糖毒性和脂毒性导致内皮细胞损伤，但内皮修复也受到糖尿病的影响。内皮祖细胞（EPCs）参与维持内皮稳态和新血管形成过程。出于这些原因，EPCs 被认为在心血管系统中具有保护作用。此外，EPCs 似乎调节其他器官的功能，提供神经营养信号并促进肾小球内皮的修复。EPC 提供心血管保护的确切机制尚不清楚，并且 EPC 的定义尚未标准化。尽管存在这些局限性，但文献一致表明，1 型和 2 型糖尿病以及几乎所有糖尿病并发症中 EPC 都会发生改变。此外，实验模型表明，基于 EPC 的治疗可能有助于预防或逆转终末器官并发症的特征。这表明 EPC 在糖尿病中具有新的致病作用，是潜在的治疗靶点。已经确定了几种有利调节 EPC 的方法，包括生活方式干预、常用药物和基于细胞的方法。本文全面概述了 EPC 的病理生理学以及糖尿病中 EPC 调节的潜力。
