Number and function of endothelial progenitor cells as a marker of severity for diabetic vasculopathy
Gian Paolo Fadini1, Saverio Sartore, Mattia Albiero
1Department of Clinical and Experimental Medicine, Division of Metabolic Diseases, University of Padova, School of Medicine, Italy.
Insights
Endothelial progenitor cells (EPCs) are reduced and impaired in type 2 diabetes patients with peripheral arterial disease (PAD). Lower EPC levels correlate with PAD severity, suggesting EPC dysregulation in diabetic vasculopathy.
Area of Science:
- Vascular Biology
- Diabetes Complications
- Cellular Biology
Background:
- Peripheral arterial disease (PAD) is a serious complication of diabetes.
- Endothelial progenitor cells (EPCs) are crucial for vascular repair and homeostasis.
- Impaired EPCs may contribute to the development of diabetic vasculopathy.
Purpose of the Study:
- To investigate the correlation between the number and function of EPCs and PAD severity in type 2 diabetic patients.
- To elucidate the role of EPC dysregulation in the pathogenesis of diabetic vasculopathy.
Main Methods:
- Quantified circulating EPCs (defined by CD34, CD133, KDR expression) using flow cytometry in 127 diabetic patients.
- Assessed PAD severity through carotid atherosclerosis and clinical stage of leg atherosclerosis obliterans.
- Evaluated EPC clonogenic and adhesion capacity in vitro.
Main Results:
- Diabetic patients with PAD showed a 53% reduction in circulating EPCs compared to non-PAD patients.
- EPC levels negatively correlated with carotid stenosis degree and leg claudication stage.
- Cultured EPCs from diabetic patients with PAD exhibited significantly lower clonogenic and adhesion capacity.
Conclusions:
- Reduced EPC number and impaired function are associated with PAD severity in type 2 diabetes.
- EPC dysregulation plays a significant role in the pathogenesis of diabetic vasculopathy.
- EPC count may serve as a novel biomarker for peripheral atherosclerosis in diabetic individuals.
Objective:
Peripheral arterial disease (PAD) is a threatening complication of diabetes. As endothelial progenitor cells (EPCs) are involved in neovasculogenesis and maintenance of vascular homeostasis, their impairment may have a role in the pathogenesis of diabetic vasculopathy. This study aimed to establish whether number and function of EPCs correlate with PAD severity in type 2 diabetic patients.
Methods And Results:
EPCs were defined by the expression of CD34, CD133 and KDR, and quantified by flow cytometry in 127 diabetic patients with and without PAD. PAD severity has been assessed as carotid atherosclerosis and clinical stage of leg atherosclerosis obliterans. Diabetic patients with PAD displayed a significant 53% reduction in circulating EPCs versus non-PAD patients, and EPC levels were negatively correlated with the degree of carotid stenosis and the stage of leg claudication. Moreover, the clonogenic and adhesion capacity of cultured EPCs were significantly lower in diabetic patients with PAD versus patients without.
Conclusions:
This study demonstrates that EPC decrease is related to PAD severity and that EPC function is altered in diabetic subjects with PAD, strengthening the pathogenetic role of EPC dysregulation in diabetic vasculopathy. EPC count may be considered a novel biological marker of peripheral atherosclerosis in diabetes.
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