Distinct patterns of circulating endothelial cells in pulmonary hypertension

Abstract

The respective abundance of circulating endothelial cells and endothelial progenitor cells may reflect the balance between vascular injury and repair. As pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) can share features of pulmonary remodelling, we postulated that the two disorders might be associated with different types of pulmonary endothelial dysfunction.We studied 25 consecutive patients undergoing cardiac catheterisation for suspected pulmonary hypertension. Nine patients had PAH, nine had CTEPH, and seven had normal pulmonary arterial pressure and served as controls. Circulating endothelial cells were isolated with CD146-coated beads. CD34+CD133+ cell and endothelial progenitor cell numbers were respectively determined by flow cytometry and cell culture, in peripheral vein and pulmonary artery blood. Plasma levels of soluble vascular endothelial growth factor (VEGF), soluble Eselectin and soluble vascular cell adhesion molecule (sVCAM) were measured by ELISA.No difference in progenitor counts or VEGF levels was found across the three groups. Compared to controls, circulating endothelial cell numbers were significantly increased in PAH but not in CTEPH, in keeping with the elevated soluble E-selectin and sVCAM levels found in PAH alone.In conclusion, PAH, in contrast to CTEPH, is associated with markers of vascular injury (circulating endothelial cells, soluble E-selectin and sVCAM) but not with markers of remodelling (endothelial progenitor cells, CD34+CD133+ cells and VEGF).

Circulating Endothelial Cell Quantification by Microfluidics Chip in Pulmonary Arterial Hypertension

“…In addition, we demonstrated that EPCs correlated with body weight and postmenopausal status in patients with PAH. In our current study, we demonstrate a three-to fivefold increase in CEC counts in patients with PAH compared with control subjects, which is in line with previous reports showing increased CEC numbers in adult PAH (8,10). However, unlike EPCs (5), a correlation between CECs and body weight or age could not be demonstrated.…”

“…CECs are increased in vascular injury-related disorders such as acute myocardial infarction and unstable angina (7). Data on CEC numbers in PAH are sparse and have been gathered in small patient populations only (8)(9)(10)(11).…”

Risk of Major Hemorrhage in Bilateral Lung Transplantation for Chronic Thromboembolic Pulmonary Hypertension: A Case Report*

“…Neovascularity is associated with markers of vascular injury (circulating endothelial cells, soluble E-selectin, and soluble vascular cell adhesion molecules), but not with markers of remodeling (endothelial progenitor cells or vascular endothelial growth factor) [5] with these factors, innumerable neovascular and collateral vessels from bronchial arteries bridge from the thoracic wall to the lungs. During surgery, these abnormal vessels cause extensive bleeding because the vessels become torn off and drawn into the thoracic wall.…”

Advances in Therapeutic Interventions for Patients With Pulmonary Arterial Hypertension

“…Circulating EPCs appear both qualitatively and quantitatively altered in PAH, [151][152][153] but their exact role in pathogenesis remains unclear. A human study of autologous transplantation of ex vivo cultured EPCs has been performed in 31 PAH patients.…”