Background-Two types of cells are cultured from the human peripheral blood, early endothelial progenitor cells (EPCs) and outgrowth endothelial cells (OECs), as previously reported. Here, we further characterize these cells, especially with respect to their different origins and functions both in vitro and in vivo. We also investigated whether the combination of these different cell types shows synergism during neovascularization. Methods and Results-Early EPCs were heterogeneously made up of both CD14ϩ monocyte-derived cells, which secrete cytokines, and CD14Ϫ -derived cells, which contain high levels of CD34 ϩ KDR ϩ cells. OECs were cultured almost exclusively from CD14 Ϫ cells, not CD14 ϩ cells, and were distinct from mature endothelial cells in terms of proliferation potential, KDR ϩ expression level, and telomerase activity. A portion of cells from CD14 Ϫ cells and early EPCs produced rapidly proliferating, capillary-forming cells in both the Matrigel plug and the ischemic hind limb similar to OECs. Early EPCs and OECs expressed receptors for vascular endothelial growth factor and interleukin-8, cytokines secreted by early EPCs. There was a differential increase in matrix metalloproteinases (MMPs): MMP-9 in early EPCs and MMP-2 in OECs. In vitro, the angiogenic capability of the 2 cell types was augmented by mutual interaction through cytokines and MMPs. Injection of a mixture of the 2 cells resulted in superior neovascularization in vivo to any single-cell-type transplantation. Conclusions-Distinct origins of the different types of EPCs exist that have different functions in neovascularization.Mixed transplantation of these cells results in synergistic neovascularization through cytokines and MMPs.

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E-selectin plays critical roles in tethering leukocytes to endothelial cells (ECs).We studied the role of E-selectin in endothelial progenitor cell (EPC) homing and vasculogenesis. After ischemia, the expression of E-selectin on ECs peaked 6 to 12 hours and returned to baseline at 24 hours, whereas the level of soluble E-selectin (sE-selectin) in serum increased over 24 hours and remained high at day 7. Mouse bone marrow-derived EPCs expressed not only E-selectin but also its ligand. Homing of circulating EPCs to ischemic limb was significantly impaired in E-selectin knock-out mice, as well as wild-type mice pretreated with blocking antibody against E-selectin, which was rescued by local sE-selectin injection. Mechanism for this is that sE-selectin stimulated not only ECs to express ICAM-1, but also EPCs to secrete interleukin-8 (IL-8), leading to enhanced migration and incorporation to ECs capillary formation. In therapeutic aspect, local treatment with sE-selectin enhanced efficacy of EPC transplantation for vasculogenesis and salvage of ischemic limb. Conversely, when E-selectin was knocked down by E-selectin small interfering RNA, blood flow recovery after EPC transplantation was significantly impaired. But this impaired vasculogenesis was rescued by sE-selectin. In conclusion, these data demonstrate E-selectin is a pivotal molecule for EPCs' homing to ischemic limb and vasculogenesis. IntroductionE-selectin is an inducible cell-adhesion molecule on endothelial cells (ECs), which mediates the binding of the neutrophils and functions as a calcium-dependent lectin. [1][2][3] It consists of 5 components: an amino-terminal "C type" lectin domain critical for ligand interaction, an epidermal growth factor-like domain, 6 complement regulatory repeats, a single transmembrane domain, and a cytoplasmic carboxyl-terminal tail. 4,5 E-selectin mediates adhesive interactions of circulating leukocytes with the vascular endothelium during inflammatory conditions such as rheumatoid arthritis and atherosclerosis. 6,7 It also plays a role in the homing of hematopoietic stem cells, and its constitutive expression on ECs of hematopoietic tissue is essential in the initial step of the homing process. 8,9 In addition, Koch et al have reported that soluble E-selectin (sE-selectin), which is thought to be a cleavage form of membrane-bound E-selectin and therefore lacks the trans-membrane and cytoplasmic domains, induces angiogenesis in the rat cornea and stimulates chemotaxis and tube formation of human dermal microvascular ECs through Src-and phosphatidylinositol 3-kinase-mediated pathways. 10,11 Endothelial progenitor cells (EPCs) have the potential to proliferate and to differentiate into mature ECs. 12 Recent studies in animal and humans suggest the ability of EPCs to home to the areas with reduced oxygen supply and to induce vasculogenesis and angiogenesis. 13,14 Because the number of circulating EPCs may limit the ultimate magnitude of therapeutic angiogenesis, strategy of ex vivo expansion of EPCs harvested from the patient...

Plasma level of NT-proBNP is the most powerful prognostic factor in both HFpEF and HFrEF. Although patients with HFpEF have lower NT-proBNP levels, the prognosis of a patient with HFpEF expected from a given NT-proBNP level is similar with his/her counterpart with HFrEF.

No abstract

Background-Trafficking of transplanted endothelial progenitor cells (EPCs) to an ischemic organ is a critical step in neovascularization. This study was performed to elucidate the molecular mechanism of EPC trafficking in terms of adhesion molecules. Methods and Results-Using murine hindlimb ischemia model, we examined expressions of E-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and platelet-endothelial cell adhesion molecule-1 (PECAM-1) in ischemic muscle by immunofluorescence. ICAM-1 was overexpressed in ischemic muscle compared with nonischemic muscle, whereas expressions of E-selectin, VCAM-1, and PECAM-1 did not show that much difference. ICAM-1 was also upregulated by hypoxia in murine endothelial cells (ECs) as assessed by immunoblot and flow cytometry. EPCs were attached to ECs specifically through ICAM-1/␤-2 integrin interaction in vitro. When EPCs were labeled with fluorescent dye or radioisotope (Tc-99m-HMPAO) and systemically administrated in vivo, EPCs preferentially homed to ischemic muscle. By blocking ICAM-1, EPCs entrapment to ischemic limb in vivo was significantly reduced and neovascularization induced by EPC transplantation was attenuated. Conclusions-ICAM-1 is upregulated by ischemia, and this is closely associated with EPCs entrapment to ischemic limb.Our findings suggest that ICAM-1 expression might be important in regulating the process of neovascularization through its ability to recruit EPCs.

Previously we reported that inhibition of glycogen synthase kinase-3␤ (GSK3␤), a key regulator in many intracellular signaling pathways, enhances the survival and migration of vascular endothelial cells. Here we investigated the effect of inhibition of GSK3␤ activity on the angiogenic function of endothelial progenitor cell (EPC) and demonstrated a new therapeutic angiogenesis strategy using genetically modified EPC. As we previously reported, two biologically distinct types of EPC, spindle-shaped "early EPC" and cobblestone-shaped "late EPC" could be cultivated from human peripheral blood. Catalytically inactive GSK3␤ gene was transduced into both EPC. Inhibition of GSK3␤ signaling pathway led to increased nuclear translocation of ␤-catenin and increased secretion of angiogenic cytokines (vascular endothelial growth factor and interleukin-8). It enhanced the survival and proliferation of early EPC, whereas it promoted the survival and differentiation of late EPC. Transplantation of either of these genetically modified EPC into the ischemic hind limb model of athymic nude mouse significantly improved blood flow, limb salvage, and tissue capillary density compared with nontransduced EPC. Inhibition of GSK3␤ signaling of either of these genetically modified EPC augmented the in vitro and in vivo angiogenic potency of these cell populations. These data provide evidence that GSK3␤ has a key role in the angiogenic properties of EPC. Furthermore, the genetic modification of EPC to alter this signaling step can improve the efficacy of cell-based therapeutic vasculogenesis.

In patients hospitalised for AHF, hyponatraemia on admission is associated with a worse prognosis compared with normonatraemia, irrespective of whether hyponatraemia improves during hospitalisation.