EPCs Role in Cardiovascular Diseases
Endothelial Progenitor Cells Role in Cardiovascular Diseases
Currently, regenerative medicine is on focus with hopes that it can be used in treatment of cardiovascular diseases. The circulating endothelial progenitor cells have been shown to possess an ability to form mature endothelial cells that can be useful in the process of vascular repair as well as neoangiogenesis. In preclinical studies, it has been shown that the circulating endothelial progenitor cells (EPCs) have the potency for cardiovascular regeneration. With this said, it is god to admit that there is still a lot needed to be done in this area to show the effectiveness of the regenerative activities of these EPCs. Here we look at how the EPCs relate to cardiovascular diseases.
Endothelial Progenitor Cells are biomarkers of cardiovascular diseases
Just like other stem cells the circulating endothelial progenitor cells have the ability to proliferate, migrate, and differentiate into mature endothelial cells. First discovered from the human peripheral blood, the EPCs were shown to incorporate into sites of physiological or pathological neovascularization. Ever since the EPCs were discovered, a lot has improved in the understanding of the blood vessel formation. There is a growing body of evidence that EPCs helps in providing postnatal vasculogenesis mechanism for neovascularization and vascular remodeling.
These cells have also been shown to possess diverse physiological functions and helps in the recovery process of myocardial ischemia and infarction, limb ischemia, wound healing, atherosclerosis, endogenous endothelial repair, and tumor vascularization. Earlier clinical trials have proved that EPC therapy is safe and feasible for the treatment of cardiovascular diseases. Plus, the circulating EPCs are also considered as biomarkers for coronary and peripheral artery disease. In spite of the medicinal abilities of these EPCs, there is still a lot to be done in order for the mechanism by which these cells work can be fully understood and be applied.
Despite the haze that still clouds the mechanism with which the EPCs work, it has been shown that EPCs locating to damaged tissues and organs proceeding vascular regeneration do not only help in the formation of the neovasculature but also produce a variety of proangiogenic cytokines and growth factors thus promoting proliferation and migration of pre-existing Endothelial Cells and activating angiogenesis to contribute to vascular regeneration. it is suggested that the EPCs owes their ability to contribute to vascular regeneration to the presence of cytokines and other secreting pro-angiogenic factors in them such as VEGF, stroma derived factor (SDF)-1α, angiopoietin-1 (Ang-1), hepatic growth factor (HGF), insulin-like growth factor (IGF)-1, and eNOS/iNOS (inducible nitric oxide synthase). Thus, EPCs can mediate tissue-protective effects and contribute to neovascularization via direct vasculogenesis in ischemic tissues and indirect production of proangiogenic factors to pre-existing endothelial cells.
Research has shown that there are reduced numbers of EPCs in clinical conditions like diabetes mellitus, heart failure, chronic kidney disease and hypertension. In such conditions these EPCs also become impaired and malfunctioning. It has also been shown that the number of peripheral EPC is significantly reduced and their functions impaired in patients with established coronary artery disease and stroke. In contrast the number of EPCs has been found to be on the increase in patients with acute coronary syndrome such as acute myocardial infarction or unstable angina since they are mobilized from the bone marrow into the bloodstream.
The levels and migratory capacity of EPCs is also highly reduced in those suffering from hypertension with coronary artery disease. Besides, the concentration of circulating EPCs is considerably reduced in refractory hypertension as compared to healthy subjects. Imanishi T and his colleagues reported that EPC senescence is augmented in both experimental hypertensive rats and patients with essential hypertension, which may be related to telomerase inactivation. The team found that the hypertension-induced EPC senescence may affect the process of vascular remodeling.
Another researcher, Delva P in his research; Endothelial progenitor cells in patients with essential hypertension, reported that there was no alteration in the number or functional activity of EPCs in 36 patients with essential hypertension. Some research studies have also demonstrated that the numbers of EPCs are decreased in pulmonary hypertension while others that the number of EPCs are increased or remain normal in pulmonary hypertension. With these available literature that are somehow conflicting there isn’t a clear relationship between EPCs and hypertension
EPCs and Heart Failure
To show the relationship between heart failure and the number of circulating EPCs, Valgimigli M and his counterparts tested the level of EPCs in patients suffering from heart failure and they discovered that EPC mobilization occurred in heart failure and showed a biphasic response, with elevation in early stages while depression in the advanced stages. The increased EPCs was shown as a replication of a functional bone marrow response to diffuse and severe endothelial damage during the early stages of heart failure but an additional and significant increase of tumor necrosis factor (TNF-α) counteracted and overwhelmed the elevation of EPC mobilization in advanced disease phases by exerting a possible suppressive effect on hemopoiesis.
With the above findings, it is clear that there is a relationship between the EPCs and the cardiovascular diseases. For more information about bone marrow transplant and stem cell transplantation, visit www.awaremednetwork.com Dr. Dalal Akoury, a doctor with years of experience in integrative medicine will be able to help. Don’t hesitate to check on http://www.integrativeaddiction2015.com and learn about the upcoming Integrative Addiction Conference 2015. The conference will dwell on unique approaches to telling symptoms of addiction and how to help addicts.
Endothelial Progenitor Cells Role in Cardiovascular Diseases
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