Centro Hospitalar e Universitário de Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, Portugal; Centro Neurociências e Biologia Celular, Coimbra, Portugal.
Centro Neurociências e Biologia Celular, Coimbra, Portugal.
J Neurol Sci. 2018 Feb 15;385:119-125. doi: 10.1016/j.jns.2017.12.028. Epub 2017 Dec 24.
Endothelial Progenitor Cells (EPCs) are a circulating stem cell population with in vivo capacity of promoting angiogenesis after ischemic events. Despite the promising preclinical data, their potential integration with reperfusion therapies and hemodynamic evolution of stroke patients is still unknown. Our aim was to determine the association of EPCs with acute, subacute and chronic hemodynamic features.
In this prospective study, we included consecutive patients with ages between 18 and 80years and non-lacunar ischemic stroke within the territory of a middle cerebral artery. All patients were subject to hemodynamic evaluation by ultrasound at baseline, seven days and three months. We quantified cerebral blood flow (CBF) and assessed early recanalization and collateral flow. Hemorrhagic transformation was graded in Magnetic Resonance imaging performed at seven days. EPCs were isolated from peripheral venous blood collected in the first 24h and seven days, counted and submitted to functional in vitro tests.
We included 45 patients with a median age of 70±10years. The angiogenic and migratory capacities of EPCs were associated with increased collateral flow in the acute stage and day seven CBF, without statistically significant associations with recanalization nor haemorrhagic transformation. The number of EPCs was not associated with any hemodynamic variable.
The functional properties of EPCs are associated with acute and subacute stroke hemodynamics, with no effect on haemorrhagic transformation.
内皮祖细胞（EPCs）是一种循环的干细胞群体，具有在缺血事件后促进血管生成的体内能力。尽管有很有前景的临床前数据，但它们与再灌注治疗和中风患者的血液动力学演变的潜在整合仍然未知。我们的目的是确定 EPCs 与急性、亚急性和慢性血液动力学特征的关系。
在这项前瞻性研究中，我们纳入了年龄在 18 至 80 岁之间且大脑中动脉区域内发生非腔隙性缺血性中风的连续患者。所有患者均在基线、第 7 天和第 3 个月通过超声进行血液动力学评估。我们量化了脑血流（CBF），并评估了早期再通和侧支循环。在第 7 天进行的磁共振成像中对出血性转化进行分级。在发病后的前 24 小时和第 7 天采集外周静脉血，分离出 EPCs 并进行计数，并进行功能体外测试。
我们纳入了 45 名年龄中位数为 70±10 岁的患者。EPCs 的血管生成和迁移能力与急性和第 7 天 CBF 的侧支循环增加有关，但与再通或出血性转化没有统计学上的显著关联。EPCs 的数量与任何血液动力学变量均无关联。
EPCs 的功能特性与急性和亚急性中风的血液动力学有关，与出血性转化无关。
