Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Int J Cardiol. 2013 Sep 30;168(2):1070-7. doi: 10.1016/j.ijcard.2012.11.002. Epub 2012 Nov 22.
Circulating endothelial progenitor cells (EPCs) are associated with coronary artery disease (CAD) and predict its outcome. Although the pathophysiology of abdominal aortic aneurysm (AAA) is different, it shares some risk factors with CAD. Therefore, the correlation between EPCs and AAA was investigated.
Seventy-eight subjects (age 77.2 ± 7.8 years) with suspected AAA were prospectively enrolled. Cut-off values (men, 3.5-5.5 cm; women, 3-5 cm) were used to define normal aorta, small AAA, and large AAA on thoraco-abdominal computer tomography. Endothelial function was measured by flow-mediated vasodilation (FMD). Flow cytometry and colony-forming units (CFUs) were used to evaluate circulating EPC numbers. Circulating EPCs were defined as mononuclear cells with low CD45 staining and double-positive staining for KDR, CD34, or CD133. Late out-growth EPCs were cultured from six patients with large AAAs and six age- and sex-matched controls to evaluate proliferation, adhesion, migration, tube formation, and senescence. FMD was significantly lower with large (5.26% ± 3.11%) and small AAAs (6.31% ± 3.66%) than in controls (8.88% ± 4.83%, P=0.008). Both CFUs (normal 38.39 ± 12.99, small AAA 21.22 ± 7.14, large AAA 6.98 ± 1.97; P=0.026) and circulating EPCs (CD34(+)/KDR(+) and CD133(+)/KDR(+)) were significantly fewer in AAA patients than in controls. On multivariate analysis, CFUs and circulating EPCs (CD34(+)/KDR(+)) were independently, inversely correlated to AAA diameter. Proliferation, adhesion, migration, tube formation, and senescence of late EPCs were significantly impaired in AAA patients.
The number and function of EPCs were impaired in AAA patients, suggesting their potential role in AAA.
循环内皮祖细胞（EPCs）与冠状动脉疾病（CAD）相关，并可预测其预后。尽管腹主动脉瘤（AAA）的病理生理学不同，但它与 CAD 有一些共同的危险因素。因此，研究了 EPCs 与 AAA 之间的相关性。
前瞻性纳入 78 名（年龄 77.2±7.8 岁）疑似 AAA 的患者。使用截断值（男性，3.5-5.5cm；女性，3-5cm）在胸腹部计算机断层扫描上定义正常主动脉、小 AAA 和大 AAA。通过血流介导的血管扩张（FMD）测量内皮功能。使用流式细胞术和集落形成单位（CFU）评估循环 EPC 数量。循环 EPCs 定义为低 CD45 染色且 KDR、CD34 或 CD133 双重阳性的单核细胞。从 6 名大 AAA 患者和 6 名年龄和性别匹配的对照中培养晚期外生 EPCs，以评估增殖、黏附、迁移、管形成和衰老。大 AAA（5.26%±3.11%）和小 AAA（6.31%±3.66%）的 FMD 明显低于对照组（8.88%±4.83%，P=0.008）。CFU（正常 38.39±12.99，小 AAA 21.22±7.14，大 AAA 6.98±1.97；P=0.026）和循环 EPCs（CD34(+)/KDR(+)和 CD133(+)/KDR(+））在 AAA 患者中明显少于对照组。多元分析显示，CFU 和循环 EPCs（CD34(+)/KDR(+））与 AAA 直径呈独立负相关。AAA 患者的晚期 EPC 增殖、黏附、迁移、管形成和衰老明显受损。
AAA 患者的 EPC 数量和功能受损，提示其在 AAA 中的潜在作用。
