Endothelial Progenitor Cells as Biomarkers of Cardiovascular Pathologies: A Narrative Review
Paul Philipp Heinisch1,2,3, Corina Bello3, Maximilian Y Emmert4,5,6
1Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, School of Medicine, Technical University of Munich, 80636 Munich, Germany.
Insights
Endothelial progenitor cells (EPCs) show potential as biomarkers for cardiovascular risk. Further research is needed to define their phenotype and standardize isolation methods for clinical use.
Area of Science:
- Vascular Biology
- Cellular Biology
- Biomarker Discovery
Background:
- Endothelial progenitor cells (EPCs) play a role in maintaining vascular integrity.
- Altered EPC number/function is linked to cardiovascular diseases (CVD) and risk factors.
- Current clinical applicability of EPCs as biomarkers for CVD remains undefined.
Purpose of the Study:
- To discuss the association between EPCs and cardiovascular diseases (CVD).
- To highlight the challenges in assessing endothelial dysfunction in vivo.
- To emphasize the need for standardized EPC definitions and isolation methods for clinical use.
Main Methods:
- Review of existing literature on EPCs, endothelial dysfunction, and CVD.
- Discussion of the heterogeneity of circulating endothelial cells (CECs) and viable EPCs.
- Analysis of challenges in current EPC isolation and characterization techniques.
Main Results:
- EPCs influence vascular endothelium integrity and stability.
- Endothelial dysfunction is a key mechanism in CVD.
- Heterogeneity and senescence of endothelial cells (ECs) and CECs complicate EPC assessment.
Conclusions:
- EPCs hold potential as biomarkers for vascular function and cumulative cardiovascular risk.
- A clear definition of EPC phenotype is crucial for biomarker application.
- Standardization of isolation methods and clinical validation are urgent priorities for EPCs in CVD management.
Abstract:
Endothelial progenitor cells (EPC) may influence the integrity and stability of the vascular endothelium. The association of an altered total EPC number and function with cardiovascular diseases (CVD) and risk factors (CVF) was discussed; however, their role and applicability as biomarkers for clinical purposes have not yet been defined. Endothelial dysfunction is one of the key mechanisms in CVD. The assessment of endothelial dysfunction in vivo remains a major challenge, especially for a clinical evaluation of the need for therapeutic interventions or for primary prevention of CVD. One of the main challenges is the heterogeneity of this particular cell population. Endothelial cells (EC) can become senescent, and the majority of circulating endothelial cells (CEC) show evidence of apoptosis or necrosis. There are a few viable CECs that have properties similar to those of an endothelial progenitor cell. To use EPC levels as a biomarker for vascular function and cumulative cardiovascular risk, a correct definition of their phenotype, as well as an update on the clinical application and practicability of current isolation methods, are an urgent priority.
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