Kalender Günay, Kornberger Angela, Lisy Milan, Beiras-Fernandez Andres, Stock Ulrich A
Deparment of General, Thoracic and Vascular Surgery, Hoechst Hospital.
Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany.
Ther Clin Risk Manag. 2016 Dec 14;12:1841-1847. doi: 10.2147/TCRM.S105280. eCollection 2016.
Endothelial progenitor cells (EPCs) are primitive cells found in the bone marrow and peripheral blood (PB). In particular, the potential of EPCs to differentiate into mature endothelial cells remains of high interest for clinical applications such as bio-functionalized patches for autologous seeding after implantation. The objective of this study was to determine EPCs' kinetics in patients undergoing carotid artery thromboendarterectomy (CTEA) and patch angioplasty.
Twenty CTEA patients were included (15 male, mean age 76 years). PB samples were taken at 1 day preoperatively, and at 1, 3, and 5 days postoperatively. Flow cytometric analysis was performed for CD34, CD133, KDR, and CD45. Expression of KDR, SDF-1α, and G-CSF was analyzed by means of enzyme-linked immunosorbent assay.
Fluorescence-activated cell sorting analysis revealed 0.031%±0.016% (% of PB mononuclear cells) KDR+ cells and 0.052%±0.022% CD45-/CD34+/CD133+ cells, preoperatively. A 33% decrease of CD45-/CD34+/CD133+ cells was observed at day 1 after surgery. However, a relative number (compared to initial preoperative values) of CD45-/CD34+/CD133+ cells was found on day 3 (82%) and on day 5 (94%) postoperatively. More profound upregulated levels of CD45-CD34+/CD133+ cells were observed for diabetic (+47% compared to nondiabetic) and male (+38% compared to female) patients. No significant postoperative time-dependent differences were found in numbers of KDR+ cells and the concentrations of the cytokines KDR and G-CSF. However, the SDF-1α levels decreased significantly on day 1 postoperatively but returned to preoperative levels by day 3.
CTEA results in short-term downregulation of circulating EPCs and SDF-1α levels. Rapid return to baseline levels might indicate participation of EPCs in repair mechanisms following vascular injury.
内皮祖细胞（EPCs）是存在于骨髓和外周血（PB）中的原始细胞。特别是，EPCs分化为成熟内皮细胞的潜力在临床应用中仍备受关注，例如用于植入后自体接种的生物功能化贴片。本研究的目的是确定接受颈动脉血栓内膜切除术（CTEA）和贴片血管成形术患者的EPCs动力学。
纳入20例CTEA患者（15例男性，平均年龄76岁）。术前1天以及术后1、3和5天采集PB样本。对CD34、CD133、KDR和CD45进行流式细胞术分析。通过酶联免疫吸附测定法分析KDR、SDF-1α和G-CSF的表达。
荧光激活细胞分选分析显示，术前KDR+细胞占PB单核细胞的0.031%±0.016%，CD45-/CD34+/CD133+细胞占0.052%±0.022%。术后第1天观察到CD45-/CD34+/CD133+细胞减少了33%。然而，术后第3天（82%）和第5天（94%）发现CD45-/CD34+/CD133+细胞的相对数量（与术前初始值相比）。糖尿病患者（与非糖尿病患者相比增加47%）和男性患者（与女性患者相比增加38%）观察到CD45-CD34+/CD133+细胞上调水平更显著。术后KDR+细胞数量以及细胞因子KDR和G-CSF的浓度未发现明显的术后时间依赖性差异。然而，SDF-1α水平在术后第1天显著下降，但在第3天恢复到术前水平。
CTEA导致循环EPCs和SDF-1α水平短期下调。迅速恢复到基线水平可能表明EPCs参与了血管损伤后的修复机制。
