Mudyanadzo Tatenda A
Surgery, University of South Alabama, Mobile, USA.
Cureus. 2018 Sep 21;10(9):e3342. doi: 10.7759/cureus.3342.
Cardiovascular disease is cited as the underlying cause of death in one out of every three deaths within the United States; this burden on the health care system percolates down to affect patients on an individual level. In part, the problem arises from the low regenerative capacity of cardiovascular system cells, for example, cardiac myocytes, and from oxidative stressors to the human body. Endothelial progenitor cells (EPCs) are a type of stem cell, and various clinical conditions including hypertension and renal failure underlie their dysfunction. EPCs are classified as either early or late outgrowth endothelial progenitor cells depending on the time they appear in circulation and at the site of injury after an inciting event. Their function is paracrine through the release of cytokines, growth factors and chemokines such as interleukin-6 and vascular endothelial growth factor, and they are involved in transdifferentiation into vascular smooth muscle cells and potentially cardiac myocytes. They are beneficial to the modification of cardiovascular cell apoptosis, fibrosis, and contractility. In times of stress, the normal function of endothelial progenitor cells is altered; this creates a maladaptive cycle where stress and failed coping mechanisms enhance each other toward the culmination of cardiovascular disease. The development of the cardiovascular system follows gastrulation in the embryonic period, and the cells that form the system are derived from the mesoderm; being mesoderm, the vascular cells exhibit heterogeneity in their origin and function. The need to understand the molecular and cellular regulatory pathways during development can amalgamate efforts of endothelial cell and cardiovascular system pathophysiology for the advancement of patient cardiovascular reserve and function.
在美国，每三例死亡中就有一例被认为是心血管疾病作为根本死因；这种对医疗保健系统的负担会向下渗透，在个体层面影响患者。部分问题源于心血管系统细胞（例如心肌细胞）的低再生能力以及人体所面临的氧化应激源。内皮祖细胞（EPCs）是一种干细胞，包括高血压和肾衰竭在内的各种临床病症是其功能障碍的基础。根据它们在循环系统以及激发事件后损伤部位出现的时间，EPCs被分为早期或晚期内皮祖细胞。它们通过释放细胞因子、生长因子和趋化因子（如白细胞介素 - 6和血管内皮生长因子）发挥旁分泌功能，并且参与向血管平滑肌细胞甚至可能向心肌细胞的转分化。它们对改善心血管细胞凋亡、纤维化和收缩性有益。在应激状态下，内皮祖细胞的正常功能会发生改变；这会形成一个适应不良的循环，即应激和应对机制失效相互促进，直至心血管疾病的发生。心血管系统的发育在胚胎期遵循原肠胚形成过程，形成该系统的细胞源自中胚层；作为中胚层细胞，血管细胞在起源和功能上表现出异质性。理解发育过程中的分子和细胞调节途径有助于整合内皮细胞和心血管系统病理生理学方面的研究工作，以提高患者的心血管储备和功能。
