doi: 10.1161/01.CIR.0000074242.66719.4A
(Circulation. 2003;107:3093.)
© 2003 American Heart Association, Inc.
Brief Review: From Bench to Bedside |
Endothelial Progenitor Cells
New Hope for a Broken Heart
From the Divisions of Cardiology (D.J.S., M.J.B.K.) and Cardiac Surgery (P.E.S., P.W.M.F., R.D.W., S.V.), University of Toronto, Toronto, Ontario, Canada.
Correspondence to Subodh Verma, MD, PhD, Division of Cardiac Surgery, Toronto General Hospital, 14EN-215, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4. E-mail subodh.verma@sympatico.ca
Key Words: endothelium • cells • ischemia • revascularization
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Mr S. is a 62-year-old restaurant owner who has had recurrent stable angina that has not improved despite maximal medical therapy and an earlier coronary bypass. On angiography, Mr S. has diffusely diseased coronary vessels and is no longer considered a candidate for further direct revascularization. An alternative treatment strategy for revascularizing ischemic tissue is therefore required. One potential strategy, therapeutic neovascularization, aims to promote the formation of natural bypasses or collaterals within the ischemic tissue by harvesting the potential of endothelial progenitor cells (EPCs). This From Bench to Bedside article will explore the current concept of an EPC, the role EPCs play in neovascularization, the strategies used to maximize EPC number and function, the experimental and clinical evidence supporting EPC utility, and the future direction of EPC research.
See p 2995
What Are EPCs?
Progenitor cells are primitive bone marrow (BM) cells that have the capacity to proliferate, migrate, and differentiate into various mature cell types. EPCs, in particular, possess the ability to mature into the cells that line the lumen of blood vessels.1 The first evidence indicating the presence of EPCs in the adult circulation emerged when mononuclear blood cells from healthy human volunteers were shown to acquire an endothelial cell–like phenotype in vitro and to incorporate into capillaries in vivo.2 These putative EPCs were characterized via expression of CD34 and vascular endothelial growth factor receptor-2 (VEGFR-2), 2 antigens shared by embryonic endothelial progenitors, and hematopoietic stem cells (HSCs). Subsequent studies confirmed that CD34+ cells isolated from BM or umbilical cord
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