Gollie Jared M, Sen Sabyasachi
Research & Development, VA Medical Center, Washington, DC 20422, USA.
Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, DC 20037, USA.
Rev Cardiovasc Med. 2022 Dec 2;23(12):396. doi: 10.31083/j.rcm2312396.
Noncommunicable chronic diseases, such as obesity, cardiovascular disease (CVD), and type 2 diabetes (T2D), pose significant health challenges globally. Important advances have been made in the understanding of the pathophysiologal mechanisms and treatment of noncommunicable diseases in recent years. Lack of physical activity is a primary contributor to many noncommunicable diseases including metabolic syndrome, T2D, CVD, and obesity. Certain diabetes medications and non-pharmaceutical interventions, such as physical activity and exercise, are shown to be effective in decreasing the CVD risks associated with heart disease, stroke, obesity, prediabetes, and T2D. The ability to measure and analyze circulating adult stem cells (ASCs) has gained particular interest due to their potential to identify at-risk individuals and implications in various therapeutics. Therefore, the purpose of this narrative review is to (1) provide an overview of ASCs; specifically endothelial progenitor cells (EPCs) and mesenchymal stromal cells (MSCs), (2) describe the responses of these cells to acute and chronic exercise, and (3) highlight the potential effect of exercise on EPCs and MSCs in aging and disease. EPCs are circulating cells, abundantly available in peripheral blood, bone marrow, and umbilical cord, and are defined by cell surface markers such as CD34. EPCs are expected to play an important role in angiogenesis and neovascularization and have been implicated in the treatment of CVD. MSCs are essential for maintaining tissue and organ homeostasis. MSCs are defined as multipotent heterogeneous cells that can proliferate as plastic-adherent cells, have fibroblast-like morphology, form colonies , and can differentiate into ostyeoblasts, adipocytes, chondroblasts, and myoblasts. In the presence of aging and disease, EPCs and MSCs decrease in quantity and functional capacity. Importantly, exercise facilitates EPC differentiation and production from bone marrow and also helps to promote migration and homing to the hypoxic and damaged tissue which in turn improve angiogenesis and vasculogenesis. Similarly, exercise stimulates increases in proliferation and migratory activity of MSCs. Despite the reported benefits of exercise on EPC and MSC number and function, little is known regarding the optimal exercise prescription for aging and clinical populations. Moreover, the interactions between medications and exercise on EPCs and MSCs is currently unclear. Use of ASCs as a biomarker have the potential to revolutionize the management of patients with a variety of metabolic and obesity related disorders and also pro-inflammatory diseases. Further investigation of clinical entities are urgently needed to understand the implications of interventions such as exercise, diet, and various medications on EPC and MSC quantity and function in aging and clinical populations.
肥胖、心血管疾病（CVD）和2型糖尿病（T2D）等非传染性慢性病在全球范围内构成了重大的健康挑战。近年来，在非传染性疾病的病理生理机制理解和治疗方面取得了重要进展。缺乏身体活动是包括代谢综合征、T2D、CVD和肥胖在内的许多非传染性疾病的主要促成因素。某些糖尿病药物和非药物干预措施，如身体活动和运动，已被证明能有效降低与心脏病、中风、肥胖、糖尿病前期和T2D相关的心血管疾病风险。由于循环成人干细胞（ASC）在识别高危个体方面的潜力及其在各种治疗中的意义，对其进行测量和分析的能力引起了特别关注。因此，本叙述性综述的目的是：（1）概述ASC，特别是内皮祖细胞（EPC）和间充质基质细胞（MSC）；（2）描述这些细胞对急性和慢性运动的反应；（3）强调运动对衰老和疾病中EPC和MSC的潜在影响。EPC是循环细胞，在外周血、骨髓和脐带中大量存在，并由细胞表面标志物如CD34定义。EPC有望在血管生成和新生血管形成中发挥重要作用，并已被用于CVD的治疗。MSC对维持组织和器官的稳态至关重要。MSC被定义为多能异质性细胞，可作为贴壁细胞增殖，具有成纤维细胞样形态，形成集落，并可分化为成骨细胞、脂肪细胞、软骨细胞和平滑肌细胞。在衰老和疾病状态下，EPC和MSC的数量和功能能力会下降。重要的是，运动促进EPC从骨髓的分化和产生，还有助于促进其向缺氧和受损组织的迁移和归巢，进而改善血管生成和血管发生。同样，运动刺激MSC的增殖和迁移活性增加。尽管有报道称运动对EPC和MSC的数量及功能有益，但对于衰老和临床人群的最佳运动处方知之甚少。此外，目前尚不清楚药物与运动对EPC和MSC的相互作用。将ASC用作生物标志物有可能彻底改变对患有各种代谢和肥胖相关疾病以及炎症性疾病患者的管理。迫切需要对临床实体进行进一步研究，以了解运动、饮食和各种药物等干预措施对衰老和临床人群中EPC和MSC数量及功能的影响。
