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Endothelial progenitor cell number is not decreased in 34 children with Juvenile Dermatomyositis: a pilot study
Dong Xu1,2, Akadia Kacha-Ochana1, Gabrielle A Morgan1
1Cure JM Program of Excellence in Juvenile Myositis Research at Stanley Manne Children's Research Institute of Ann and Robert H., Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Insights
Endothelial progenitor cells (EPC) in children with Juvenile Dermatomyositis (JDM) were found to be within the normal range, similar to healthy controls. These findings suggest a distinct pathophysiology in JDM compared to adult polymyositis.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Vascular Biology
Background:
- Juvenile Dermatomyositis (JDM) is an autoimmune disease affecting children.
- Endothelial progenitor cells (EPCs) play a role in vascular health and repair.
- Understanding EPC levels in JDM may offer insights into disease mechanisms.
Purpose of the Study:
- To determine the number of EPCs in children diagnosed with JDM.
- To compare EPC levels in JDM patients with healthy pediatric controls.
- To investigate correlations between EPC numbers and clinical/demographic factors in JDM.
Main Methods:
- A pilot study involving 34 children with JDM and 13 healthy controls.
- EPC quantification using fluorescence activated cell sorting (FACS).
- Analysis of associations with disease activity scores, duration, genetic polymorphisms, and cardiovascular risk factors.
Main Results:
- EPC numbers in JDM patients were not significantly different from healthy controls.
- No significant association was found between EPC levels and clinical variables or cardiovascular risk factors in JDM.
- EPC levels in JDM were similar to those observed in adults with Dermatomyositis (DM).
Conclusions:
- Children with JDM exhibit normal EPC numbers, comparable to healthy controls and adult DM patients.
- This contrasts with adult polymyositis (PM), where decreased EPCs are noted.
- The findings suggest a potentially different underlying pathophysiology in JDM/DM compared to adult PM.
Objective:
A pilot study to determine endothelial progenitor cells (EPC) number in children with Juvenile Dermatomyositis (JDM).
Methods:
After obtaining informed consent, the EPC number from 34 fasting children with definite/probable JDM at various stages of therapy-initially untreated, active disease on medication and clinically inactive, off medication-was compared with 13 healthy fasting pediatric controls. The EPC number was determined by fluorescence activated cell sorting (FACS), CD34+/VEGFR2+/CD45dim-, and assessed in conjunction with clinical variables: disease activity scores (DAS), duration of untreated disease (DUD), TNF-α allelic polymorphism (A/G) at the promoter region of -308, number of nailfold capillary end row loop (ERL) and von Willebrand factor antigen (vWF:Ag). Correlations of the EPC numbers with the clinical and demographic variables, including DAS Skin (DAS SK), DAS Weakness (DAS WK), DAS Total Score, DUD, Cholesterol, triglycerides, High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL), and ERL were calculated using the Pearson correlation coefficient. Tests of associations of EPC with gender (boy vs girl), TNF-α-308A allele (GA/AA vs GG), vWF:Ag (categorized by specific ABO type) as normal/abnormal were performed, using two-sample T- tests.
Results:
The EPC number for JDM was not significantly different from the healthy controls and was not associated with any of the clinical or cardiovascular risk factors tested.
Conclusion:
The EPC for JDM were in the normal range, similar to adults with DM. These data support the concept that the normal EPC numbers in DM/JDM, irrespective of age, differs from adult PM, where they are decreased, perhaps reflecting a different pathophysiology.
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