内皮祖细胞与冠心病

内皮祖细胞是内皮细胞的前体细胞,近年研究表明它在冠心病的发生、发展中扮演了重要角色。本文就冠心病患者内皮祖细胞数量、功能的改变及内皮祖细胞在冠心病的治疗应用等方面研究进展作一综述。     

外周血中的内皮细胞与冠心病

外周血的成熟内皮细胞及内皮祖细胞与冠心病具有密切的关系，本文就外周血中成熟内皮细胞及内皮祖细胞数量改变与冠心病发病、治疗和预后等方面研究进展作一综述。     

雌激素与冠心病——通过内皮祖细胞发挥有益作用

内皮祖细胞是血管内皮细胞的前体细胞,目前较多研究提示其在冠心病中的治疗作用。雌激素可能影响冠心病的病理生理过程和预后,但其益处仍未得到肯定。已经有较多证据显示雌激素可通过促进内皮祖细胞的动员、增殖、归巢、分化并减少其凋亡,从而增加内皮修复和血管新生,最终达到减轻心脏缺血性损伤,改善心脏功能的作用。由于内皮祖细胞的长期作用仍缺乏研究,而通过内皮祖细胞对冠心病发挥影响也很可能仅是雌激素的部分作用,雌激素在冠心病的预防和治疗方面的益处依然需要更多的研究以证实。     

他汀类药物与内皮祖细胞

内皮祖细胞是来源于骨髓可分化为内皮细胞的一群细胞,在组织缺血及血管损伤时动员入血,参与微血管的生成及血管内皮的修复。有研究表明循环内皮祖细胞的数量和功能与冠心病危险因子呈负相关,提示循环内皮祖细胞有作为心血管疾病预后评估工具的应用前景。他汀类药物除了调节血脂的作用外,在血脂正常的动物模型中也发现能增加内皮祖细胞数量及增强内皮祖细胞功能,他汀类药物的这种作用可能是其临床上治疗冠心病获益的机制之一。     

血管内皮祖细胞与冠心病的研究进展

内皮祖细胞是内皮细胞的前体细胞,近年研究表明它与冠心病密切相关.现就其与冠心病发生与发展的关系,及其在冠心病治疗中的作用作一综述.     

未来治疗的新领域——内皮祖细胞

内皮祖细胞来源于骨髓,可分化为成熟有功能的内皮细胞.大量试验证实冠心病和心力衰竭患者内皮祖细胞数量减低,外周循环内皮祖细胞功能受损,许多因素可影响内皮祖细胞的数量及功能.因此,药物动员内皮祖细胞或使其功能正常化有望改善心血管病患者的预后.现总结近来关于影响内皮祖细胞因素的研究,有助于探索未来治疗的新领域.     

循环内皮祖细胞在原发性高血压与动脉粥样硬化中的作用

内皮祖细胞(endothelial progenitor cells,EPCs)是来源于骨髓而存在于外周血的单核干细胞,具有分化为成熟内皮细胞功能,参与了内皮损伤修复、血管新生和血管形成等过程,有学者提议用循环内皮祖细胞数量代替C反应蛋白作为新一代预测冠心病的工具.本文主要讨论内皮祖细胞的特性及其在原发性高血压与动脉粥样硬化中的作用.     

内皮祖细胞与冠心病的研究新进展

冠心病是严重危害人类健康的常见病,其发病机制主要是“内皮损伤反应”。内皮祖细胞（endothelial progenitor cells,EPCs）是血管内皮细胞（endothelial cells,ECs）的前体细胞,参与人胚胎血管生成,促进出生后内皮损伤的修复和缺血组织的血管新生,维护血管内皮的完整性及功能。     

基因修饰内皮祖细胞在动脉粥样硬化中的应用

内皮祖细胞是能分化为内皮细胞的前体细胞,动物及临床试验证实移植内皮祖细胞有益于治疗动脉粥样硬化。在病理状态下内皮祖细胞的功能受损,限制了其应用。通过基因修饰技术可以改善EPCs的功能并提高其移植效率,为动脉粥样硬化性疾病的细胞疗法提供了新的治疗策略。     

内皮祖细胞的动员及其在治疗缺血性心肌病中的应用

内皮祖细胞是一类能分化成血管内皮细胞的前体细胞,在成人血管发生中起着重要作用。从骨髓动员内皮祖细胞,增加循环内皮祖细胞的数量,对治疗缺血性心肌病有重要的临床意义。     

血管内皮祖细胞与冠状动脉硬化性心脏病危险因素的研究现状

内皮祖细胞是血管内皮细胞的前体,它不仅参与胚胎时期的血管生成,而且对出生后微血管新生、损伤血管内皮修复和功能维持中仍然有重要的作用。新近研究表明,内皮祖细胞与冠状动脉硬化性心脏病密切相关,与冠状动脉硬化性心脏病危险因素呈反向线形关系。本文就其与炎症因子、高同型半胱氨酸、血管紧张素Ⅱ、尿酸作一综述。     

内皮祖细胞在心血管疾病的研究进展

内皮细胞的脱失和功能障碍是心血管疾病中的突出特征。血管内皮祖细胞起源于骨髓,对于缺血组织的血管新生和损伤血管的复内皮化起着很重要的作用。现主要综述内皮祖细胞在心血管疾病中的应用及存在问题。     

The number of endothelial progenitor cell colonies in the blood is increased in patients with angiographically significant coronary artery disease.

OBJECTIVES: The objective of this study was to determine whether the number of endothelial progenitor cells (EPCs) and circulating angiogenic cells (CACs) in peripheral blood was associated with the presence and severity of coronary artery disease (CAD) in patients undergoing coronary angiography. BACKGROUND: Previous studies have suggested an inverse relationship between levels of circulating EPCs/CACs and the presence of CAD or cardiovascular risk factors, whereas other studies have observed increased numbers of EPCs in the setting of acute ischemia. However, the criteria used to identify specific angiogenic cell subpopulations and methods of evaluating CAD varied in these studies. In the present study, we used rigorous criteria to identify EPCs and CACs in the blood of patients undergoing coronary angiography. METHODS: The number of EPCs and CACs were measured in the blood of 48 patients undergoing coronary angiography. Patients with acute coronary syndromes were excluded. RESULTS: Compared with patients without angiographically significant CAD, the number of EPCs was increased (1.11 +/- 2.50 vs. 4.01 +/- 3.70 colonies/well, p = 0.004) and the number of CACs trended higher (175 +/- 137 vs. 250 +/- 160 cells per mm(2), p = 0.09) among patients with significant CAD. The highest levels of EPCs were isolated from patients subsequently selected for revascularization (5.03 +/- 4.10 colonies/well). CONCLUSIONS: In patients referred for coronary angiography, higher numbers of EPCs, and a trend toward higher numbers of CACs, were associated with the presence of significant CAD, and EPC number correlated with maximum angiographic stenosis severity. Endothelial progenitor cell levels were highest in patients with CAD selected for revascularization.     

冠心病干细胞移植疗法种子细胞体外诱导分化的实验研究

目的　为探讨冠心病的干细胞移植疗法提供理想的种子细胞来源。方法　收集健康成人骨髓 ,通过Ficoll离心法获得骨髓单个核细胞 ,置于纤维连接蛋白预衬的DMEM培养基中 ,用血管内皮生长因子 (vascularendothelialgrowthfactor,VEGF)和碱性成纤维细胞生长因子 (basicfibroblastgrowthfactor,bFGF)加以诱导 ,并通过荧光显微镜和免疫组织化学方法对诱导后的细胞进行形态学观察和鉴定。结果　在VEGF、bFGF等诱导因子存在的条件下 ,骨髓单个核细胞分化成为内皮祖细胞 ,倒置荧光微镜下呈典型的“纺锤样”梭形细胞 ,单层细胞贴壁生长融合时呈铺路石样排列 ,免疫组织化学示vWF抗体染色阳性 ,CD34抗体染色阳性。结论　成人骨髓单个核细胞在特定条件下可诱导分化成为内皮祖细胞 ,此细胞可作为冠心病干细胞移植疗法的种子细胞。     

Role of inflammation and oxidative stress in endothelial progenitor cell function and mobilization: therapeutic implications for cardiovascular diseases

Endothelial progenitor cells (EPCs) are mobilized from the bone marrow into the peripheral circulation, home to sites of injury, and incorporate into foci of neovascularization, thereby improving blood flow and tissue recovery. Patients with cardiovascular diseases, including coronary artery disease, heart failure, hypertension, and diabetes, have been shown to exhibit reduced number and functional capacity of EPCs. Considerable evidence indicates that EPCs constitute an important endogenous system to maintain endothelial integrity and vascular homeostasis, while reduced number of EPCs has recently been shown to predict future cardiovascular events. Thus, enhancement of EPCs could be of potential benefit for individuals with cardiovascular diseases. The interplay between inflammation and oxidative stress is involved in the initiation, progression, and complications of cardiovascular diseases. Emerging evidence from in vitro and clinical studies suggests that inflammatory and oxidative changes influence EPC mobilization. Drugs with anti-inflammatory and antioxidant properties, currently administered to patients with cardiovascular diseases, such as statins, have been demonstrated to exert beneficial effects on EPC biology. A better understanding of the inflammatory and oxidative mechanisms leading to the numerical and functional impairment of EPCs would provide additional insight into the pathogenesis of cardiovascular disease and create novel therapeutic targets.     

急性心肌梗塞循环内皮祖细胞与冠状动脉病变严重程度的分析

目的：研究急性心肌梗塞（AMI）患者外周血中内皮祖细胞（EPCs）的水平与冠状动脉病变程度之间的关系。方法：选取55例AMI患者,以定量冠状动脉造影评估冠状动脉的血管狭窄程度,同时选取30名冠状动脉造影阴性的患者为对照组。所有患者均在入院后即刻[AMI发病平均时间（2．5±1．5）h],第24h、48h、72h、7d、14d及一个月时采血,以CD133作为EPCs标记物,用流式细胞仪检测患者外周血中CD133标记细胞数量。结果：AMI组患者及对照组均有EPCs（CD133）的表达,AMI患者EPCs数目明显低于非冠心病患者（P〈0．05）。多支病变者较单支病变者有降低趋势,但无显著性差异（P〉0．05）。EPCs数目和Gensini评分呈明显负相关（n=55,r=-0．619,P〈0．05）。结论：急性心肌梗塞患者EPCs数目和冠状动脉病变程度有关。     

内皮祖细胞与缺血性脑血管病

内皮祖细胞(endothelial progenitor cell,EPC)是一种具有分化和增殖能力的内皮前体细胞,在～定条件下能被动员到缺血组织参与损伤血管的修复和血管新生,被视为血管修复能力的标志.近年来的研究表明,EPC数量的变化在脑缺血的发生和预后中起着重要作用,EPC可能作为一种潜在的治疗策略被应用于缺血性脑血管病.文章就EPC在缺血性脑血管病中的应用进展进行了综述.     

Endothelial progenitor cells: a promising therapeutic alternative for cardiovascular disease

The integrity and functional activity of the endothelial monolayer play a critical role in preventing atherosclerotic disease progression. Endothelial cell (EC) damage by atherosclerosis risk factors can result in EC apoptosis with loss of the integrity of the endothelium. Thus, approaches to repair the injured vessels with the goal of regenerating ECs have been tested in preclinical experimental models and in clinical studies. Indeed, endothelial progenitor cells (EPCs) originating from the bone marrow have been shown to incorporate into sites of neovascularization and home to sites of endothelial denudation. These cells may provide an endogenous repair mechanism to counteract ongoing risk factor-induced endothelial injury and to replace dysfunctional endothelium. Risk factors for coronary artery disease, such as age, smoking, hypertension, hyperlipidemia, and diabetes, however, reduce the number and functional activity of circulating EPCs, potentially restricting the therapeutic prospective of progenitor cells and limiting the regenerative capacity. Furthermore, the impairment of EPCs by risk factors may contribute to atherogenesis and atherosclerotic disease progression. The article reviews the role of EPCs in atherogenesis and in predicting cardiovascular outcomes, and highlights the potential challenges in developing therapeutic strategies aiming to interfere with the balance of injury and repair mechanisms.     

Circulating endothelial and progenitor cells:Evidence from acute and long-term exercise effects

Circulating bone-marrow-derived cells,named endothelial progenitor cells(EPCs),are capable of maintaining,generating,and replacing terminally differentiated cells within their own specific tissue as a consequence of physiological cell turnover or tissue damage due to injury.Endothelium maintenance and restoration of normal endothelial cell function is guaranteed by a complex physiological procedure in which EPCs play a significant role.Decreased number of peripheral blood EPCs has been associated with endothelial dysfunction and high cardiovascular risk.In this review,we initially report current knowledge with regard to the role of EPCs in healthy subjects and the clinical value of EPCs in different disease populations such as arterial hypertension,obstructive sleep-apnea syndrome,obesity,diabetes mellitus,peripheral arterial disease,coronary artery disease,pulmonary hypertension,and heart failure.Recent studies have introduced the novel concept that physical activity,either performed as a single exercise session or performed as part of an exercise training program,results in a significant increase of circulating EPCs.In the second part of this review we provide preliminary evidence from recent studies investigating the effects of acute and long-term exercise in healthy subjects and athletes as well as in disease populations.