Abstract:The development of blood supply is crucial to the growth and progression of breast tumors. However, the contribution and role of endothelial progenitor cells (EPCs) in blood vessel formation in human breast tumors is undefined. Here, we demonstrate for the first time that ~68% of the cells integrated into vasculatures in late stage human breast tumors express CD34 and CD133 (the putative EPC markers). We also demonstrate that metastatic human breast cancer and mouse mammary gland carcinomas (MGCas) aberrantly express granulocyte colony-stimulating factor (G-CSF). Inhibition of the MGCa-derived G-CSF significantly decreased the numbers of EPCs in circulation and tumor vasculatures, as well as microvascular density and growth of transplanted MGCa in mice. These results indicate that EPCs may significantly contribute to blood vessel formation in advanced stage, G-CSF-expressing breast tumors and that patients with G-CSF-producing breast tumors may benefit from angiotherapeutic protocols that inhibit G-CSF-mediated neovascularization.
We established the CoOperative Vascular Intervention Disease (COVID) Team of Greater Philadelphia because national guidelines may not apply to different geographic areas of the United States owing to varying penetrance of the virus. On April 10, 2020, a 10-question survey regarding issues and strategies dealing with COVID-19 was e-mailed to 58 vascular surgeons (VSs) in the Greater Philadelphia area. Fifty-four VSs in 18 surgical groups covering 28 hospitals responded. All groups accepted transfers because of continued availability of intensive care unit beds. Thirteen groups were asked to "redeploy" if the need arose to function outside of the usual duties of a VS. None imposed age restrictions regarding older VSs continuing clinical hospital work. The majority restricted noninvasive vascular laboratory studies to those studies for which findings might mandate intervention within 2 or 3 weeks, restricted dialysis access operations to urgent revisions of arteriovenous fistulas or grafts that were failing or had ulcerations, converted from in-person to telemedicine clinic interactions, and experienced moderate-severe anxiety or fear about personal COVID-19 exposure in the hospital. The majority of VSs in the Philadelphia area dramatically adjusted their clinical practices before the COVID-19 crisis reached peak levels experienced in other metropolitan areas.
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