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Vasculogénesis defectuosa en la esclerosis sistémica.

Masataka Kuwana1, Yuka Okazaki, Hidekata Yasuoka

  • 1Institute for Advanced Medical Research Keio University School of Medicine, Tokyo, Japan. kuwanam@sc.itc.keio.ac.jp

Lancet (London, England)
|August 18, 2004
PubMed
Resumen

Los pacientes con esclerosis sistémica tienen menos precursores endoteliales circulantes, lo que afecta la reparación de los vasos sanguíneos. Esto sugiere que la vasculogénesis defectuosa contribuye a su enfermedad vascular y ofrece posibles objetivos terapéuticos.

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Área de la Ciencia:

  • Biología Cardiovascular Biología Cardiovascular
  • Inmunología Inmunología.
  • La Medicina Regenerativa es una Medicina Regenerativa.

Sus antecedentes:

  • La esclerosis sistémica (SSc) se caracteriza por daño vascular, incluida la reducción de la densidad capilar y la obliteración de los vasos.
  • La vasculogénesis, la formación y reparación de los vasos sanguíneos, se basa en los precursores endoteliales circulantes (CEP).
  • La vasculogénesis deteriorada puede ser la base de la patología vascular observada en SSc.

Objetivo del estudio:

  • Para investigar si la vasculogénesis está afectada en pacientes con esclerosis sistémica.
  • Para cuantificar los precursores endoteliales circulantes (CEP) en pacientes con SSc en comparación con los controles.
  • Evaluar el potencial de diferenciación del CEP en SSc.

Principales métodos:

  • CEP cuantificado (CD34+, CD133+, VEGFR2+) en sangre periférica de SSc, artritis reumatoide y grupos de control sanos utilizando citometría de flujo.
  • Factores angiogénicos circulantes medidos a través de ELISA.
  • Capacidad de diferenciación evaluada del CEP por maduración in vitro y expresión del factor von Willebrand.

Principales resultados:

  • Los pacientes con SSc exhibieron números absolutos significativamente más bajos de CEP en comparación con los pacientes con artritis reumatoide y los controles sanos (p <0.0001).
  • Paradójicamente, las concentraciones de factor angiogénico circulante fueron elevadas en pacientes con SSc.
  • La proporción de CEP capaz de diferenciarse en células endoteliales se redujo significativamente en pacientes con SSc (p<0.0001).

Conclusiones:

  • La vasculogénesis defectuosa, indicada por un número reducido y una diferenciación deteriorada de CEP, probablemente contribuye a la vasculopatía observada en la esclerosis sistémica.
  • La vasculogénesis desregulada puede estar implicada en otros trastornos vasculares, incluidos el cáncer y la aterosclerosis.
  • CEP representan un objetivo terapéutico potencial para el manejo de las complicaciones isquémicas en SSc.