Hsu Shan-Ling, Yin Tsung-Cheng, Shao Pei-Lin, Chen Kuan-Hung, Wu Re-Wen, Chen Chien-Chang, Lin Pao-Yuan, Chung Sheng-Ying, Sheu Jiunn-Jye, Sung Pei-Hsun, Chen Chen-Yu, Wang Ching-Jen, Yip Hon-Kan, Lee Mel S
Department of Orthopedics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung 83301, Taiwan.
Department of Nursing, Asia University Taichung 41354, Taiwan.
Am J Transl Res. 2019 Apr 15;11(4):1948-1964. eCollection 2019.
We tested the hypothesis that hyperbaric oxygen (HBO) (100% oxygen/2.4 atmospheres) facilitated the effect of autologous endothelial progenitor cell (EPC) therapy on restoring the blood flow in rat critical-limb ischemia (CLI). Adult-male-SD rats (n = 8/each group) were categorized into group 1 [sham control (SC)], group 2 (CLI-treated with culture medium), group 3 [CLI-intermittent HBO (3 h/day for 5 consecutive days after CLI), group 4 (CLI-EPC/2.0 × 10 cells), and group 5 (CLI-HBO-EPC). By day 5 after CLI, flow cytometry showed that the circulating EPC (Sca-1/CD31+/C-kit/CD31+/CD34+) levels were highest in group 5 and lowest in group 2 (all < 0.001). By day 14, laser Doppler demonstrated that the ratio of blood flow (i.e., CLI to normal hind-limb) was highest in group 1, lowest in group 2 and significantly higher in group 5 than in groups 3 and 4 (all < 0.0001). The protein expressions of endothelial-cell biomarkers (CD31/vWF/eNOS), and numbers of endothelial-cell markers (CD31+/vWF+) and small vessels exhibited a similar pattern to blood-flow ratio among five groups, whereas the angiogenesis parameters in protein (CXCR4/SDF-1α/HIF-1α/VEGF) and cellular (HIF-1α/SDF-1α/CXCR4+) levels were progressively increased from groups 1 to 5 (all < 0.0001). The protein expression of apoptotic (mitochondrial-Bax/cleaved-capspase-3/PARP), fibrotic (p-Smad3/TGF-ß) and mitochondrial-damaged (cytosolic-cytochrome C) exhibited an opposite pattern, whereas the protein expressions of anti-fibrotic (BMP-2/p-Smad1/5) and mitochondrial integrity (mitochondrial-cytochrome C) exhibited an identical pattern of ratio of blood flow among the five groups (all < 0.0001). Combined HBO-EPC therapy is superior to either one alone in improving ischemia in rodent CLI.
高压氧(HBO)(100%氧气/2.4个大气压)可促进自体内皮祖细胞(EPC)疗法对恢复大鼠严重肢体缺血(CLI)血流的作用。成年雄性SD大鼠(每组n = 8只)被分为1组[假手术对照组(SC)]、2组(CLI用培养基治疗)、3组[CLI-间歇性HBO(CLI后连续5天每天3小时)]、4组(CLI-EPC/2.0×10个细胞)和5组(CLI-HBO-EPC)。CLI后第5天,流式细胞术显示循环EPC(Sca-1/CD31+/C-kit/CD31+/CD34+)水平在5组中最高,在2组中最低(均<0.001)。到第14天,激光多普勒显示血流量比值(即CLI与正常后肢的比值)在1组中最高,在组中最低,且5组明显高于3组和4组(均<0.0001)。内皮细胞生物标志物(CD31/vWF/eNOS)的蛋白表达、内皮细胞标志物(CD31+/vWF+)数量和小血管在五组中的表现与血流量比值相似,而蛋白水平(CXCR4/SDF-1α/HIF-1α/VEGF)和细胞水平(HIF-1α/SDF-1α/CXCR4+)的血管生成参数从1组到5组逐渐增加(均<0.0001)。凋亡相关(线粒体Bax/裂解的半胱天冬酶-3/PARP)、纤维化相关(p-Smad3/TGF-β)和线粒体损伤相关(胞浆细胞色素C)的蛋白表达呈现相反模式,而抗纤维化(BMP-2/p-Smad1/5)和线粒体完整性相关(线粒体细胞色素C)的蛋白表达在五组中呈现与血流量比值相同的模式(均<0.0001)。在改善啮齿动物CLI缺血方面,联合HBO-EPC疗法优于单独的任何一种疗法。