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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
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.
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.
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