Circulating Endothelial Progenitor Cells During Normal Pregnancy and Pre‐Eclampsia

Abstract

In PE, some factors including Ang II and TNF-alpha stimulated EPC proliferation; however, the impairment of EPC mobilization into systemic circulation by serum factors may contribute to insufficient regeneration of EC in disturbed utero-placental circulation of PE.

Circulating endothelial progenitor cells in women with gestational alterations of glucose tolerance

“…Gussin et al 9 and Sugawara et al 10 reported that normal pregnancy is associated with mobilisation of EPCs into the circulation, 9 with an increasing number of colony-forming units as a function of gestational age and serum estradiol levels. 10 A progressive increase with gestational age in the concentration of EPCs during pregnancy in healthy women was also observed by Buemi et al 11 Opposite results were found by Matsubara et al 12 and Savvidou et al, 13 showing that normal singleton and twin pregnancies were associated with a trend of decreasing levels of maternal circulating EPCs with advancing gestation as compared with non-pregnant controls.…”

“…Such results may be of some help in more appropriately framing our findings in the context of EPCs heterogeneity and the apparently conflicting results in the literature regarding changes in EPCs in normal pregnancy. [9][10][11][12][13] In conclusion, we have shown that mild alteration in glucose tolerance during pregnancy is associated with a reduction in the number of circulating EPCs. This finding together with the reported alterations in multiple cardiovascular risk factors previously observed in women with gestational diabetes emphasises the need for careful follow-up in all women with even modest alterations in glucose tolerance.…”

“…7,15,26 In agreement with this interpretation is the reduction in maternal circulating EPCs in pregnant as compared with non-pregnant women previously reported. 12,13 However, the much lower EPC count in pregnant women with impaired glucose tolerance supports an independent metabolic effect and, therefore, the potential implication in increasing vascular risk. With respect to this, it is of interest to note that women with gestational diabetes have endothelial dysfunction, 27 while defects in vascular function 28 and higher intima-media thickness 29 have been reported in women with previous gestational diabetes.…”

“…18 These alterations have been associated with endothelial dysfunction and systemic inflammation, 16 although those findings have not been universally confirmed. 11,12 Gestational diabetes is associated with an increased risk of pre-eclampsia. Yet, only a few studies, to the best of our knowledge, have evaluated the number of circulating EPCs during the third trimester of pregnancy in women with gestational diabetes.…”

Maternal Insulin Therapy Increases Fetal Endothelial Progenitor Cells During Diabetic Pregnancy

“…Recent studies in human pregnancies suggest that a mother's EPCs are involved in the physiologic vascular remodeling of systemic and utero-placental circulation (3,4). Hyperglycemia induces dysfunction and apoptosis of EPCs (5); this may impair the development or maturation of the utero-placental circulation, causing maladaptive responses during diabetic pregnancies.…”