Circulating endothelial cells in cardiovascular disease
Christopher J Boos1, Gregory Y H Lip, Andrew D Blann
1Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, United Kingdom.
Insights
Quantifying circulating endothelial cells (CECs) in blood offers a new way to assess endothelial damage. Elevated CEC levels indicate cardiovascular disease risk and predict adverse outcomes after myocardial infarction.
Area of Science:
- Cardiovascular Research
- Endothelial Cell Biology
- Biomarker Discovery
Background:
- Circulating endothelial cells (CECs) are mature cells detaching from blood vessel linings due to injury.
- Endothelial progenitor cells (EPCs) are distinct bone marrow-derived cells involved in vascular repair.
- Assessing endothelial health is crucial for understanding and managing cardiovascular diseases.
Purpose of the Study:
- To provide an overview of the pathophysiology of CECs in cardiovascular disease.
- To compare CECs with EPCs.
- To highlight the clinical relevance of CEC quantification.
Main Methods:
- Quantification of CECs using immunomagnetic bead separation and fluorescence microscopy.
- CEC enumeration via flow cytometry.
- Review of recent studies on CECs in various cardiovascular conditions.
Main Results:
- Increased CEC numbers are observed in cardiovascular diseases like myocardial infarction, stroke, and diabetes.
- CEC levels remain unchanged in conditions such as stable hypertension and atrial fibrillation.
- CEC quantification post-myocardial infarction predicts major adverse coronary events and mortality.
Conclusions:
- CEC quantification is a developing, reproducible method for assessing endothelial damage.
- Elevated CECs are linked to cardiovascular disease and its risk factors.
- CEC levels serve as a prognostic indicator for adverse cardiovascular events.
Abstract:
Quantification of circulating endothelial cells (CECs) in peripheral blood is developing as a novel and reproducible method of assessing endothelial damage/dysfunction. The CECs are thought to be mature cells that have detached from the intimal monolayer in response to endothelial injury and are a different cell population to endothelial progenitor cells (EPCs). The EPCs are nonleukocytes derived from the bone marrow that are believed to have proliferative potential and may be important in vascular regeneration. Currently accepted methods of CEC quantification include the use of immunomagnetic bead separation (with cell counting under fluorescence microscopy) and flow cytometry. Several recent studies have shown increased numbers of CECs in cardiovascular disease and its risk factors, such as unstable angina, acute myocardial infarction, stroke, diabetes mellitus, and critical limb ischemia, but no change in stable intermittent claudication, essential hypertension, or atrial fibrillation. Furthermore, CEC quantification at 48 h after acute myocardial infarction has been shown to be an accurate predictor of major adverse coronary events and death at both 1 month and 1 year. This article presents an overview of the pathophysiology of CECs in the setting of cardiovascular disease and a brief comparison with EPCs.
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