[Endothelial progenitor cells in systemic sclerosis: their possible role in angiogenesis]
N Del Papa1, M Cortiana, D P Comina
1Dipartimento di Reumatologia, Istituto Ortopedico G. Pini, Via Pini, 9 - 20122 Milano. delpapa@gpini.it. delpapa@gpini.it
Insights
Circulating endothelial progenitor cells (CEPs) are elevated in systemic sclerosis (SSc) patients, particularly in early disease stages, suggesting a potential re-vascularization effort. Their levels correlate with early SSc, not disease severity or VEGF.
Area of Science:
- Endothelial progenitor cell biology
- Immunology
- Vascular biology
Context:
- Circulating endothelial progenitors (CEPs) are crucial for angiogenesis, migrating to ischemic tissues and differentiating into mature endothelial cells.
- Systemic Sclerosis (SSc) is a condition characterized by fibrosis and vascular abnormalities.
- Understanding CEPs in SSc may offer insights into the body's re-vascularization attempts.
Purpose:
- To investigate the presence and significance of CEPs in the peripheral blood of patients with Systemic Sclerosis (SSc).
- To evaluate the role of CEPs as a potential re-vascularization mechanism in SSc.
- To correlate CEP levels with clinical parameters and growth factor concentrations in SSc patients.
Summary:
- CEPs (defined as CD45 negative, CD34 positive, CD133 positive) were significantly higher in SSc patients compared to healthy controls (HC).
- CEP levels were elevated in early-stage SSc and decreased in later phases, with no correlation to clinical disease parameters or activity scores.
- Plasma vascular endothelial growth factor (VEGF) was higher in SSc patients, but not correlated with CEP numbers.
Impact:
- The findings suggest that hypoxic tissues in SSc may mobilize bone marrow-derived cells, including CEPs, for neovascularization, especially during the early disease stages.
- This study highlights a potential endogenous repair mechanism in SSc, offering avenues for future therapeutic strategies targeting angiogenesis.
- Quantification of CEPs could serve as a biomarker for early-stage SSc and its angiogenic potential.
Background:
Recently, several studies have demonstrated the presence of circulating endothelial progenitors (CEPs) responsible for angiogenesis. Notably, these cells are able to migrate to ischemic tissues and differentiate in situ in mature endothelial cells. Aim of this study was to assess the presence of CEPs in the peripheral blood of patients with Sistemic Sclerosis (SSc) and evaluate their significance as an attempt of re-vascularization
Material And Methods:
Samples of peripheral blood from 40 healthy subjects and 56 patients with SSc were studied. Five-parameter, 3-color flow cytometry was performed with a FACScan. CEPs were defined as CD45 negative, CD34 and CD133 positive. In addition, plasma levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were detected by commercial ELISA (R&D Systems).
Results:
Levels of CEPs (CD133+/CD34+/CD45-) were significantly higher in patients with SSc in comparison to HC (P = 0.01). No correlation was found between CEPs and any clinical parameter of disease neither activity score. CEPs were significantly higher in the group of patients with early disease, while their number decreased in the late phases of disease. Plasma levels of VEGF, but not bFGF, were significantly higher in SSc in comparison to HC (P<0.001) but no correlation was found between VEGF concentrations and CEP number.
Conclusions:
The presence of CEPs in patients with SSc suggest that sclerodermic hypoxic tissues could induce the mobilization of bone-marrow derived cells in an attempt to provided new vessels, in the early phase of the disease, at least.
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