Bone marrow-derived endothelial progenitor cells participate in the initiation of moyamoya disease
Taku Sugiyama1, Satoshi Kuroda, Naoki Nakayama
1Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo.
Abstract:
The mechanisms through which moyamoya disease occurs and progresses remain unknown. Recent studies have indicated the involvement of circulating endothelial progenitor cells (EPCs) in the development of moyamoya disease. This study directly investigated the participation of EPCs in moyamoya disease, using specimens of the supraclinoid internal carotid artery collected from two adult patients. The specimens were stained with primary antibodies against CD34, CD133, and vascular endothelial growth factor receptor-2 (VEGFR2) to localize the circulating EPCs in the thickened intima of occlusive arterial lesion. The CD34- and VEGFR2-positive cells were densely found in the thickened intima of occlusive arterial lesion, particularly clustered in the superficial layer of thickened intima. However, the number of CD34- and CD133-positive cells was very small. The CD34-positive cells also expressed von Willebrand factor on the surface of thickened intima and were also positive for α-smooth muscle actin in the deeper layer. These findings suggest that circulating EPCs may be involved in the development of occlusive arterial lesion in moyamoya disease.
Insights
Moyamoya disease progression is unclear. This study found that circulating endothelial progenitor cells (EPCs) may contribute to the arterial blockages characteristic of this condition.
Area of Science:
- Neurology
- Vascular Biology
- Cell Biology
Background:
- The underlying mechanisms of moyamoya disease pathogenesis remain largely unknown.
- Emerging evidence suggests a role for circulating endothelial progenitor cells (EPCs) in moyamoya disease development.
- This study aimed to directly investigate the presence and role of EPCs in moyamoya disease lesions.
Observation:
- Supraclinoid internal carotid artery specimens from two adult moyamoya disease patients were analyzed.
- Immunohistochemistry was performed using antibodies for CD34, CD133, and VEGFR2 to identify EPCs.
- EPC markers were localized within the thickened intima of the occlusive arterial lesions.
Findings:
- CD34- and VEGFR2-positive cells were abundant in the thickened intima, especially in superficial layers.
- A small number of CD34- and CD133-positive cells were observed.
- CD34-positive cells expressed von Willebrand factor and α-smooth muscle actin, indicating potential differentiation.
Implications:
- These findings suggest that circulating EPCs are involved in the formation of occlusive arterial lesions in moyamoya disease.
- Understanding the role of EPCs could lead to novel therapeutic strategies for moyamoya disease.
- Further research is warranted to elucidate the precise mechanisms of EPC involvement.
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