Circulating Endothelial Progenitor Cells in Type 1 Diabetic Patients: Relation with Patients' Age and Disease
Adolfo Arcangeli1, Elena Lastraioli2, Barbara Piccini3
1Diabetology Unit, Prato Hospital, Prato, Italy.
Insights
Childhood/young type 1 diabetes patients have higher circulating endothelial progenitor cells (cEPCs) than adults. These elevated cEPC levels may offer vascular protection in younger individuals with type 1 diabetes mellitus (T1DM).
Area of Science:
- Cardiovascular Research
- Endocrinology
- Immunology
Background:
- Diabetes mellitus (DM) is linked to endothelial dysfunction and increased cardiovascular disease (CVD) risk.
- Circulating endothelial progenitor cells (cEPCs) play a role in vascular repair and are reportedly dysfunctional in DM patients.
- Understanding cEPC levels in type 1 DM (T1DM) is crucial for assessing vascular health, especially in different age groups.
Purpose of the Study:
- To evaluate the number of circulating cEPCs in type 1 DM patients across various ages and disease durations.
- To investigate potential age-related differences in cEPC levels among T1DM patients without clinical vascular damage.
Main Methods:
- An observational, prospective clinical study involving T1DM patients from two centers.
- Quantification of cEPCs using flow cytometry, specifically identifying CD34/CD133/VEGFR2-positive cells within peripheral blood mononuclear cells (PBMCs).
Main Results:
- cEPC counts were lower in adult T1DM patients but higher in childhood/young T1DM patients compared to age-matched controls.
- Younger T1DM patients (<20 years) exhibited higher cEPC numbers than older patients, irrespective of disease duration.
- A subset of young T1DM patients presented with notably elevated cEPC levels.
Conclusions:
- A significant association exists between cEPC levels and age in T1DM patients, with younger individuals showing higher counts.
- Elevated cEPCs in young T1DM patients may confer protection against endothelial dysfunction and vascular damage.
- Lower cEPC levels in adult T1DM patients might correlate with a reduced capacity for vascular protection and a higher susceptibility to complications.
Objectives:
Circulating endothelial progenitor cells (cEPCs) have been reported to be dysfunctional in diabetes mellitus (DM) patients, accounting for the vascular damage and the ensuing high risk for cardiovascular disease (CVD) characteristic of this disease. The aim of the present study was to evaluate the number of circulating cEPCs in type 1 DM (T1DM) patients, without clinical vascular damage, of different ages and with different disease duration.
Methods:
An observational, clinical-based prospective study was performed on T1DM patients enrolled in two clinical centers. cEPCs were determined by flow cytometry, determining the number of CD34/CD133/VEGFR2-positive cells within peripheral blood mononuclear cells (PBMCs).
Results:
The number of cEPCs was lower in adult T1DM patients, whilst higher in childhood/young patients, compared to controls of the same age range. When patients were grouped into two age groups (≥ or <20 years) (and categorized on the basis of the duration of the disease), the number of cEPCs in young (<20 years) patients was higher compared with older subjects, regardless of disease duration. A subset of patients with very high cEPCs was identified in the <20 years group.
Conclusion:
There is an association between the number of cEPCs and patients' age: childhood/young T1DM patients have significantly higher levels of cEPCs, respect to adult T1DM patients. Such difference is maintained also when the disease lasts for more than 10 years. The very high levels of cEPCs, identified in a subset of childhood/young patients, might protect vessels against endothelial dysfunction and damage. Such protection would be less operative in older subjects, endowed with lower cEPC numbers, in which complications are known to develop more easily.
More Related Videos
Related Concept Videos
Peripheral Artery Disease I: Introduction
Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Diabetes: Symptoms, Diagnosis, and Complications


