Increased circulating endothelial progenitor cells (EPCs) in prepubertal children born prematurely: a possible link
Panagiota Markopoulou1, Eleni Papanikolaou2, Sofia Loukopoulou3
1Neonatal Unit, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Insights
Preterm birth is linked to higher endothelial progenitor cells (EPCs) in children, suggesting potential vascular damage. Maternal gestational diabetes further reduces EPCs, impacting cardiovascular health.
Area of Science:
- Cardiovascular Health
- Neonatal Research
- Endothelial Function
Background:
- Preterm birth can adversely affect long-term cardiovascular health.
- Mechanisms of endothelial dysfunction in preterm individuals are not fully understood.
- Endothelial progenitor cells (EPCs) are crucial for vascular integrity and repair.
Purpose of the Study:
- To investigate circulating endothelial progenitor cell (EPC) levels in prepubertal children born preterm compared to those born at term.
- To explore the association between prematurity, maternal gestational diabetes, and EPC levels.
- To assess cardiovascular risk factors in preterm-born children.
Main Methods:
- Enrolled 136 prepubertal children (63 preterm, 73 term-born controls).
- Measured circulating EPCs (CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim).
- Assessed various cardiovascular risk factors including BMI, blood pressure, lipid profile, and intima-media thickness.
Main Results:
- Preterm-born children had significantly higher levels of both measured EPC types compared to controls.
- Maternal gestational diabetes was associated with significantly lower EPC levels in both the total population and the preterm group.
- Preterm birth correlated with increased cardiovascular risk markers (e.g., higher WHR, SBP, DBP, cIMT, aIMT).
Conclusions:
- Circulating EPCs are elevated in prepubertal children born preterm, indicating potential endothelial damage.
- Maternal gestational diabetes is an independent predictor of reduced EPCs in children.
- These findings highlight the long-term vascular implications of preterm birth and maternal health.
Background:
Endothelial progenitor cells (EPCs) ensure vascular integrity and neovascularization. No studies have investigated EPCs in preterm-born children beyond infancy.
Methods:
One hundred and thirty-six prepubertal children were enrolled: 63 preterm and 73 born at term (controls). Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were measured in preterm-born children compared to controls. Body mass index (BMI), waist-to-hip ratio (WHR), neck circumference, systolic and diastolic blood pressure (SBP and DBP, respectively), fasting glucose, insulin, lipid profile, common carotid and abdominal aortic intima-media thickness (cIMT and aIMT, respectively), endothelium-dependent brachial artery flow-mediated dilation (FMD), and echocardiographic parameters were also assessed.
Results:
Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were significantly higher in preterm-born children compared to controls (p < 0.001 and p < 0.001, respectively). In total study population and in the preterm-born group, EPCs were significantly lower in children born to mothers with gestational diabetes compared to non-diabetic mothers. Prematurity was associated with higher WHR, neck circumference, SBP, DBP, cIMT, aIMT, mean pressure, and velocity of pulmonary artery; the peak velocity of the brachial artery was significantly lower in children born prematurely. In multiple regression analysis, preterm birth and maternal gestational diabetes were recognized as independent predictors of EPCs.
Conclusions:
Circulating EPCs were increased in prepubertal preterm-born children in comparison with peers born full-term. Maternal gestational diabetes was associated with a decrease in EPCs.
Impact:
Mounting evidence supports the adverse effect of prematurity on cardiovascular health. However, the underlying mechanisms that could lead to endothelial dysfunction in preterm-born individuals are not fully understood. Endothelial progenitor cells (EPCs) ensure vascular integrity, normal endothelial function and neovascularization. No studies have investigated the EPCs counts in peripheral blood beyond infancy in children born prematurely. Circulating EPCs were significantly higher in preterm-born prepubertal children compared to controls, thus indicating that prematurity is possibly associated with endothelial damage. In total study population and in the preterm-born group, maternal gestational diabetes was associated with decreased EPCs concentrations.
Related Concept Videos
01:24Regulation of Angiogenesis and Blood Supply
01:07Development of Blood Vessels
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
01:10Mechanism of Angiogenesis