冠心病患者内皮祖细胞变化与冠状动脉病变的相关性

目的观察冠心病患者外周血中提取的内皮祖细胞的细胞形态、数量、集落数与正常对照组的区别。并研究冠心病患者冠状动脉狭窄的不同范围和程度与内皮祖细胞数量变化的相关性。方法选择冠心病患者57例和对照组30例,从外周血获取单个核细胞,体外培养后进行细胞分析和计数。并分析冠状动脉狭窄的不同范围和程度,患者内皮祖细胞数量和成集落数量的区别,并进行相关分析。结果 (1)冠心病患者外周血内皮祖细胞数量(23.1±1.8比56.7±2.4)和细胞集落数(14.7±2.5比24.2±1.7)较对照组明显减少;(2)随着冠状动脉狭窄范围的扩大和狭窄程度的加重,内皮祖细胞的数量和活性明显下降。结论冠心病患者外周血内皮祖细胞的数量和成集落的数量明显降低;冠心病患者外周血内皮祖细胞的数量与冠状动脉病变的范围和狭窄程度呈负相关。     

下肢动脉硬化性闭塞症患者外周血内皮祖细胞数量和功能的变化

目的 研究下肢动脉硬化性闭塞症患者外周血内皮祖细胞数量及其功能的改变.方法 入选对象60例分为实验组(n=30)和对照组(n=30).密度梯度法分离人外周血单个核细胞,诱导分化培养7天后,荧光染色和流式细胞术鉴定贴壁细胞为内皮祖细胞.采用吉姆萨染色法计算细胞个数、集落数目,MTT比色法、改良Boyden小室及黏附能力实验测定内皮祖细胞增殖、迁移和黏附能力.结果 下肢动脉硬化性闭塞症患者外周血内皮祖细胞数量较对照组(27.2±3.6:52.6±5.9,细胞/×200倍视野,P<0.05)减少,集落个数较对照组(16.6±4.8:22.3±4.9,集落/×40倍视野,P<0.05)也减少,而且增殖能力 (0.193±0.064:0.243±0.078,P<0.05)、迁移能力(12.1±2.7:17.8±4.2,细胞/×200倍视野,P<0.05)、黏附能力(47.3±4.3:51.9±3.7,细胞/×200倍视野,P<0.05)受损.结论 下肢动脉硬化性闭塞症患者外周血内皮祖细胞数量减少,生物学功能减退.     

冠心病患者外周血晚期内皮祖细胞集落数量与功能的变化

目的探讨冠心病患者外周血晚期内皮祖细胞集落数量和功能的变化。方法入选研究对象54例,分成冠心病组(n=27)和对照组(n=27)。密度梯度离心法从外周血中获得单个核细胞,体外培养扩增21天后鉴定内皮祖细胞,计数晚期集落数量,分别用MTT比色法、改良的Boyden小室法和HFN培养板测定晚期内皮祖细胞的增殖、迁移和黏附功能。结果冠心病组内皮祖细胞晚期集落数量(2.5±1.2)与对照组(3.8±1.6)相比,明显减少(P<0.05);增殖、迁移和黏附能力与对照组比较(分别为0.324±0.024比0.433±0.064,9.9±2.5比13.9±4.1,21.3±5.1比31.0±7.1)显著降低(P<0.05)。结论冠心病患者晚期内皮祖细胞的数量减少,功能受损。     

冠心病患者内皮祖细胞tPA和PAI表达的变化

目的探讨冠心病患者外周血中内皮祖细胞(EPC)的变化及其组织型纤溶酶原激活物(tPA)和纤溶酶原激活剂抑制剂(PAI)的表达。方法选择冠心病患者57例和对照组30例,提取内皮祖细胞进行数量和细胞集落的比较。利用ELISA法和底物发光法检测EPC分泌tPA和PAI的浓度和活性;用RT-PCR法检测EPC的tPA和PAI mRNA表达。结果冠心病患者EPC数量较对照组明显减少(23.1±1.8比56.7±2.4,P<0.05),形成细胞集落数(14.7±2.5比24.2±1.7,P<0.05)、细胞增殖能力也明显降低,冠心病患者EPC的tPA表达较对照组下降,PAI表达增强。结论冠心病患者外周血EPC数量减少和功能障碍可能在疾病的发生发展中起作用。     

急性心肌梗死伴2型糖尿病患者内皮祖细胞动员障碍

目的观察急性心肌梗死伴2型糖尿病患者血浆缺血相关因子血管内皮生长因子和基质细胞衍生因子水平,骨髓内皮祖细胞动员是否存在障碍,以及基质细胞衍生因子、血管内皮生长因子-内皮祖细胞动员通路是否存在异常。方法采用密度梯度离心法分离外周血单个核细胞,用流式细胞仪检测急性心肌梗死后不同时间点(1、3、5、7、14和28天)外周血CD45-/low /CD34 /CD133 /KDR 早期内皮祖细胞数量。酶联免疫吸附法检测血浆中血管内皮生长因子、基质细胞衍生因子以及高敏C反应蛋白的浓度。结果急性心肌梗死伴2型糖尿病患者外周血内皮祖细胞动员高峰(第7天)较急性心肌梗死非糖尿病患者(第5天)延迟且显著减少[(140±48)/106比(246±100)/106,P<0.05]。糖尿病组血浆血管内皮生长因子(第5天:277±95ng/L比168±35ng/L,P<0.05)、基质细胞衍生因子(第5天:3835±402ng/L比3287±384ng/L,P<0.05)以及高敏C反应蛋白(第3天:55.55±14.88mg/L比36.92±14.83mg/L,P<0.05)在高峰点的水平显著高于非糖尿病组。结论糖尿病患者心肌梗死后组织缺血程度较重,但组织缺血后基质细胞衍生因子、血管内皮生长因子-内皮祖细胞动员通路存在障碍,这可能是糖尿病患者缺血后血管新生功能障碍,发生急性心肌梗死后预后较差的原因之一。     

不同剂量的阿托伐他汀对心肌损伤大鼠内皮祖细胞动员及血管内皮功能的影响

目的观察不同剂量的阿托伐他汀对心肌损伤后大鼠骨髓和外周血内皮祖细胞动员及血管内皮功能的影响。方法S-D大鼠背部皮肤多点注射异丙肾上腺素(5mg/kg)制造心肌损伤模型后,随机分为生理盐水对照组和不同剂量的阿托伐他汀组[5、10、20、40及80mg/(kg.d)]。4周后,流式细胞仪检测大鼠外周血CD34 和血管内皮生长因子受体2 双阳性细胞数。骨髓和外周血单个核细胞于M199培养基培养,FITC标记的异凝集素和DiI标记的乙酰化低密度脂蛋白染色双阳性细胞为正在分化的内皮祖细胞,倒置荧光显微镜计数3个随机高倍视野数。阿托伐他汀灌胃3天后测定血清一氧化氮浓度。结果阿托伐他汀各剂量组骨髓培养内皮祖细胞均较对照组明显增加(P<0.05),其中40mg/(kg.d)组内皮祖细胞数量最多,较对照组增加了2.4倍(P<0.05),80mg/(kg.d)组与40mg/(kg.d)组比较稍有下降,但无统计学差异;阿托伐他汀组外周血培养内皮祖细胞较对照组明显增加,40mg/(kg.d)组增加最明显(P<0.05);心肌损伤后外周血CD34 /血管内皮生长因子受体2 细胞较损伤前增加(P<0.05),其中80mg/(kg.d)组最明显,较对照组增加了4.18倍(P<0.05),40mg/(kg.d)组与80mg/(kg.d)组无统计学差异;阿托伐他汀各剂量组血清一氧化氮浓度较对照组明显增加,其中80mg/(kg.d)组增加最明显,并随剂量增加一氧化氮浓度增加。结论阿托伐他汀具有显著的剂量依赖性骨髓动员、促进外周血中内皮祖细胞迁移、改善血管内皮功能的作用。     

体外制备的晚期糖基化终产物对内皮祖细胞数量的影响

目的观察体外制备的晚期糖基化终产物对内皮祖细胞数量的影响。方法人血清白蛋白与葡萄糖共同孵育90d后,行Bradford检测法蛋白定量和荧光值测定。从正常成人外周血中分离提取单个核细胞,培养7d后,流式细胞仪鉴定细胞表型,分别加入浓度为2mg/L、20mg/L和200mg/L的晚期糖基化终产物并设置对照组,干预不同的时间(0h、24h、48h和72h),200倍光学显微镜下随机取10个视野计数。结果该方法制备的晚期糖基化终产物具有荧光性。细胞培养7d,CD34/CD133/KDR单克隆抗体流式细胞仪鉴定细胞,结果发现表达KDR达78.60%±2.20%、CD34为8.60%±2.00%和CD1332.80%±0.60%,提示大部分细胞为内皮祖细胞。以不同时间(0h、24h、48h和72h)和浓度(2mg/L、20mg/L和200mg/L)晚期糖基化终产物干预内皮祖细胞生长,对比0h组每个视野下细胞数量(186.0±6.7),干预24h细胞数量减少(146.67±4.98),72h降至最低(73.67±3.76)(P<0.001),呈现明显的时间效应(r=0.9658,P<0.01);终浓度为2mg/L或20mg/L晚期糖基化终产物干预内皮祖细胞72h后,与同时培养72h的对照组无显著差异(P>0.05),但随着浓度加大,浓度效明显(r=0.9988,P<0.01)。结论此方法制备的晚期糖基化终产物符合文献所述的特性,晚期糖基化终产物能抑制内皮祖细胞生长,具有时间效应和浓度效应。     

C反应蛋白对外周血内皮祖细胞数量及功能的影响

目的研究C反应蛋白对人外周血内皮祖细胞数量及功能的影响。方法从外周血中分离出单个核细胞,体外培养7天,在贴壁细胞中加入不同浓度的C反应蛋白(1 mg/L、2.5 mg/L和5.0 mg/L)作用不同时间(24 h、48 h和72 h),用四唑盐比色试验(MTT)和细胞集落形成单位计数的方法评价C反应蛋白对内皮祖细胞增殖的影响;采用趋化试验评价不同浓度的C反应蛋白对血管内皮生长因子诱导的内皮祖细胞趋化能力的影响;检测细胞上清中一氧化氮的浓度变化;逆转录—聚合酶链式反应检测细胞内皮源性一氧化氮合酶表达强度变化。结果C反应蛋白减少内皮祖细胞的集落形成单位数量及抑制内皮祖细胞的增殖能力;随着C反应蛋白浓度的增加,内皮祖细胞的趋化能力受到抑制;同样细胞分泌的一氧化氮减少,内皮源性一氧化氮合酶表达减弱。结论C反应蛋白可能通过抑制内皮祖细胞的增殖和趋化能力促进内皮功能不全的发展。     

叶酸对老年冠心病患者外周血内皮祖细胞数量及功能的影响

目的探讨老年冠心病患者口服叶酸治疗对外周血内皮祖细胞(EPCs)数量及功能的影响。方法选择初次诊断为冠心病的老年患者60例,随机分为治疗组和对照组,每组30例,在规范的冠心病二级预防基础上,治疗组给予叶酸5 mg/d口服,对照组口服安慰剂。在入院时、服药4 w及8 w时检测两组患者的同型半胱氨酸(Hcy)和血流介导的内皮舒张功能(FMD)水平,并利用外周血分离单个核细胞进行体外诱导培养,分别观察其集落形成、增殖及迁移能力。结果 Di L-ac LDL(红色)和FITC-UEA-1(绿色)染色双阳性的细胞可鉴定为EPCs。与对照组比较,治疗组治疗8 w EPCs数量、迁移及增殖能力显著增高[(67.70±4.09)个vs(48.92±3.55)个,(34.03±3.43)%vs(27.54±4.24)%,(0.67±0.04)%vs(0.54±0.04)%,P<0.05],FMD水平显著增高[(7.63±1.67)%vs(5.36±1.33)%,P<0.05],Hcy水平显著降低[(10.37±0.84)μmol/L vs(12.23±0.74)μmol/L,P<0.05]。EPCs数量、迁移、增殖能力与Hcy水平呈负相关(r=-0.668,P<0.05;r=-0.657,P<0.05;r=-0.775,P<0.05),FMD水平与Hcy水平呈负相关(r=-0.718,P<0.05)。结论老年冠心病患者口服叶酸可增高外周血EPCs的数量、迁移及增殖能力,改善血流介导的FMD,这可能与叶酸降低Hcy水平有关。     

肾毒性物质对甲酚抑制内皮祖细胞增殖和eNOS磷酸化

目的:观察对甲酚对人外周血晚期内皮祖细胞(EPCs)的体外增殖和内皮一氧化氮合酶(eNOS)活性的影响.方法:用密度梯度离心法分离健康成人外周血中的单个核细胞,在含有血管内皮生长因子等的培养基中培养.通过形态学、免疫荧光、流式细胞分析鉴定细胞,在贴壁细胞中加入不同浓度对甲酚,用细胞计数和集落生成实验法评价对甲酚对EPC...     

2型糖尿病外周血内皮祖细胞的诱导分化及影响因素的研究

目的观察2型糖尿病（T2DM）外周血内皮祖细胞（endothelial progenitor cell，EPC）在体外的分化增殖能力及影响因素。方法取20例T2DM无并发症患者、19例T2DM合并血管并发症患者和21例对照人群外周血EPC培养，观察细胞形态学变化并计数，用流式细胞仪检测贴壁细胞的特异性标志。结果糖尿病血管并发症组培养获得的EPC和EPC集落低于糖尿病无并发症组（P〈0．05）和对照组（P〈0．01）。EPC数量与SBP及FPG呈负相关（R=-0.266，P〈0.05；R=-0.619，P〈0．01），糖尿病人EPC集落生成数量与HbA1C水平呈负相关（R=-0．749，P〈0.05），与糖尿病病程年呈负相关（R=-0.406，P〈0．01）。结论FPG和SBP与EPC的增殖分化有关，T2DM外周血EPC数目减少，与HbA1c、SBP及病程相关。     

The comparison of EPC count and function in the situation of vascular repair at early and late stage

To investigate the relationship between the changes in the number and function of the late endothelial progenitor cells (EPC) in peripheral blood and the carotid artery stenosis. 60 cases were selected and were divided into the carotid artery stenosis group of 40 cases (mild stenosis in 20 cases, moderate/severe stenosis in 20 cases), normal control group of 20 cases with the global cerebral angiography. Extracted the blood of femoral artery from the patients during the global cerebral angiography, mononuclear cells were isolated from peripheral blood by density-gradient centrifugation and were cultured to 21 days when they were identified as late endothelial progenitor cells, counted the colony numbers of late EPC. Then the proliferation, migration and adherentce ability of late EPC were determined by the MTT assay, modified Boyden and the HFN culturing plates. The amount of the late EPC colonies(34.30 ± 4.90, 25.38 ± 6.33) were significantly reduced in the patients with carotid artery stenosis compared with the control group (46.00 ± 5.64) (P < 0.05); the function of proliferation, migration, adhesion of the late EPC in patiens with cerebral artery stenosis were significantly lower (P < 0.05), the number and function of late EPC decreased with the worsening of vascular stenosis (P < 0.05). The number of EPC in peripheral blood of patients with the carotid artery stenosis decreased, the function was impaired, and number and function changes of late EPC were negatively correlated with the degree of carotid artery stenosis.     

Exposure to platelets promotes functional properties of endothelial progenitor cells

Recent evidence indicates that endothelial progenitor cells (EPCs) have an important role in the process of repair following vascular injury, and that platelets mediate their recruitment to sites of injury. Platelets and EPCs can interact and bind directly. However, there is limited information on the effect of platelets on EPC function following this interaction. We, therefore, aimed to assess the in vitro effect of platelets on functional properties of EPCs. Human EPCs were isolated from donated Buffy coats and purified on a magnetic separation column specific for CD133. They were incubated either on fibronectin matrix, or co-incubated with washed platelets (isolated from healthy volunteers), for 7 days. Number of EPC colony forming units (CFU) was quantified, and endothelial cell lineage confirmed by immunostaining. Functional properties of the cultured cells were evaluated by MTT—proliferation assay and migration assay using the Boyden chamber. Co-incubation of EPCs with platelets compared to incubation of EPCs alone (on fibronectin matrix) resulted in higher number of CFUs after 7 days (6.5 ± 1.3 vs. 3.5 ± 0.5 CFUs/well, respectively, P = 0.005). In addition, co-incubation of EPCs with platelets versus EPCs alone was associated with higher proportion of living cells, by the MTT assay (0.2 ± 0.01 vs. 0.12 ± 0.04 MTT 570 nm respectively, P = 0.003), and higher number of migrated EPCs, assessed by the migration assay (1400 ± 212 vs. 580 ± 180 migrated cells/2000 cells, respectively, P < 0.0001). In vitro exposure to platelets promotes the capacity of EPCs to form colonies, proliferate and migrate. Therefore, the interaction with platelets appears to augment EPC functional properties.     

Impaired progenitor cell activity in age-related endothelial dysfunction

OBJECTIVES: We investigated whether human age-related endothelial dysfunction is accompanied by quantitative and qualitative alterations of the endothelial progenitor cell (EPC) pool. BACKGROUND: Circulating progenitor cells with an endothelial phenotype contribute to the regeneration and repair of the vessel wall. An association between the loss of endothelial integrity and EPC modification may provide a background to study the mechanistic nature of such age-related vascular changes. METHODS: In 20 old and young healthy individuals (61 +/- 2 years and 25 +/- 1 year, respectively) without major cardiovascular risk factors, endothelial function, defined by flow-mediated dilation of the brachial artery via ultrasound, as well as the number and function of EPCs isolated from peripheral blood, were determined. RESULTS: Older subjects had significantly impaired endothelium-dependent dilation of brachial artery (flow-mediated dilation [FMD] 5.2 +/- 0.5% vs. 7.1 +/- 0.6%; p < 0.05). Endothelium-independent dilation after glycerol trinitrate (GTN) was not different, but the FMD/GTN ratio was significantly lower in old subjects (49 +/- 4% vs. 37 +/- 3%; p < 0.05), suggesting endothelial dysfunction. There were no differences in the numbers of circulating EPCs, defined as CD34/KDR or CD133/KDR double-positive cells in peripheral blood. In contrast, lower survival (39 +/- 6 cells/mm(2) vs. 65 +/- 11 cells/mm(2); p < 0.05), migration (80 +/- 12 vs. 157 +/- 16 cells/mm(2); p < 0.01), and proliferation (0.20 +/- 0.04 cpm vs. 0.44 +/- 0.07 cpm; p < 0.05) implicate functional impairment of EPCs from old subjects. The FMD correlated univariately with EPC migration (r = 0.52, p < 0.05) and EPC proliferation (r = 0.49, p < 0.05). Multivariate analysis showed that both functional features represent independent predictors of endothelial function. CONCLUSIONS: Maintenance of vascular homeostasis by EPCs may be attenuated with age based on functional deficits rather than depletion of CD34/KDR or CD133/KDR cells.     

2型糖尿病外周血内皮祖细胞增殖、分化及细胞周期变化

目的观察2型糖尿病（T2DM）患者外周血内皮祖细胞（EPC）增殖、分化能力及细胞周期分布。方法T2DM患者（DM组）和非T2DM患者（Con组）各20例，离心法获取外周血单个核细胞，培养7天后，鉴定EPC，检测EPC增殖能力、EPC分化及细胞周期分布。结果DM组外周血EPC数量及增殖能力明显降低；EPC数量、增殖能力与HbA1c水平和DM病程呈负相关；EPC表达CD14^＋、CD64^＋明显高于Con组，而表达vWF^＋明显低于Con组；EPC在S期的比例明显减少，在G0／G1期的比例增高。结论T2DM患者外周血EPC数量减少、增殖能力受损、向内皮细胞系分化减少。     

A deleterious effect of aspirin on the antithrombotic properties of endothelial cells is not observed with platelets previously exposed to aspirin: studies in a flow system

We have explored both the independent and combined effects of aspirin on cultured endothelial cells and platelets, and its influence on platelet deposition onto an extracellular matrix. Blood was circulated through a flat perfusion chamber with two coverslips placed sequentially with respect to blood flow. The first coverslip (upstream) was covered with a cultured endothelial cell monolayer, and the second (downstream) coated with extracellular matrix obtained after endothelial cell removal. Platelet interaction was measured on the second coverslip. Treatment of endothelial cells on the first coverslip with 100 μM aspirin strongly reduced 6-keto-PGF_1a levels recovered in the perfusates (118.3 ± 35.8 vs 1038.0 ± 308.5 pg/ml) and significantly increased platelet deposition on the downstream coverslip (% covered surface: 38.6 ± 6.4% vs 14.6 ± 1.8%; P < 0.001). Increased platelet deposition (% covered surface: 24.9 f 3.1%; P < 0.01) was observed in perfusions performed with blood containing aspirinized platelets, in the presence of intact endothelial cells. Treatment with aspirin of both platelets and endothelial cells had no additional effect on platelet adherence. Pretreatment of cultured endothelial cells with aspirin did not influence the adhesive properties of their underlying extracellular matrix. Our results indicate that, although endothelial cell cyclooxygenase is important in regulating platelet adhesion, its blockade seemed to have minimal effect on platelet deposition once platelet-cyclooxygenase was already inhibited.     

Functional impairment of hematopoietic progenitor cells in patients with coronary heart disease

The circulating form of endothelial progenitors cells (EPCs) are derived from bone marrow (BM)-derived hematopoietic stem cells (HSCs). Enhanced mobilization of EPCs was shown to be linked to cardiac diseases. This study investigated whether reduced EPC levels in advanced coronary heart disease (CHD) are secondary to a functional exhaustion of HSCs in the BM or to reduced mobilization. Number and functional properties of EPCs were assessed in 15 healthy controls, and 40 patients with CHD. The colony-forming unit (CFU) capacity of BM-derived mononuclear cells and the CD34+ HSC number were examined in four healthy volunteers, and 15 CHD patients. EPC number was reduced in CHD patients (P < 0.01 vs. controls). Moreover, the migratory capacity was significantly impaired in EPCs of CHD patients (P < 0.05 vs. controls). On multivariate analysis, CHD was an independent predictor of functional EPC impairment. CFUs were reduced in CHD patients (59.6 +/- 21.2 vs. 75.4 +/- 25.8 in controls, P < 0.05). CHD was also predictor of impaired CFU capacity. In this small clinical study, CHD is associated with selective impairment of HSC function in the BM and in the peripheral blood, which may contribute to impairment of cardiac function.     

C反应蛋白对外周血内皮祖细胞数量及功能的影响

目的研究C反应蛋白对人外周血内皮祖细胞数量及功能的影响。方法从外周血中分离出单个核细胞，体外培养7天，在贴壁细胞中加入不同浓度的C反应蛋白（1mg／L、2．5mg／L和5．0mg／L）作用不同时间（24h、48h和72h），用四唑盐比色试验（MI]r）和细胞集落形成单位计数的方法评价C反应蛋白对内皮祖细胞增殖的影响；采用趋化试验评价不同浓度的C反应蛋白对血管内皮生长因子诱导的内皮祖细胞趋化能力的影响；检测细胞上清中一氧化氯的浓度变化；逆转录-聚合酶链式反应检测细胞内皮源性一氧化氮合酶表达强度变化。结果C反应蛋白减少内皮祖细胞的集落形成单位数量及抑制内皮祖细胞的增殖能力；随着C反应蛋白浓度的增加，内皮祖细胞的趋化能力受到抑制；同样细胞分泌的一氧化氮减少，内皮源性一氧化氮合酶表达减弱。结论C反应蛋白可能通过押制内皮祖细胞的增殖和趋化能力促进内皮功能不全的发展。