Effect of intensive multifactorial treatment on vascular progenitor cells in hypertensive patients

Abstract

BackgroundMost hypertensive patients, despite a proper control of their cardiovascular risk factors, have cardiovascular complications, evidencing the importance of controlling and/or reversing target-organ damage. In this sense, endothelial dysfunction has been associated with the presence of cardiovascular risk factors and related cardiovascular outcomes. Since hypertension often clusters with other risk factors such as dyslipemia, diabetes and obesity, in this study we have investigated the effect of intensive multifactorial treatment on circulating vascular progenitor cell levels on high-risk hypertensive patients.DesignWe included108 hypertensive patients receiving intensive multifactorial pharmacologic treatment and dietary recommendations targeting blood pressure, dyslipemia, hyperglycemia and weight for 12 months. After the treatment period, blood samples were collected and circulating levels of endothelial (CD34+/KDR+, CD34+/VE-cadherin+) and smooth muscle (CD14+/endoglin+) progenitor cells were identified by flow cytometry. Additionally, plasma concentration of vascular endothelial growth factor (VEGF) was determined by ELISA.ResultsMost hypertensive patients (61±12 years, 47% men) showed cardiovascular parameters within normal ranges at baseline. Moreover, body mass index and the majority of the biochemical parameters (systolic and diastolic blood pressure, fasting glucose, total cholesterol, HDL-c, LDL-c, creatinine and hs-CRP) significantly decreased overtime. After 12 months of intensive treatment, CD34+/KDR+ and CD14+/endoglin+ levels did not change, but CD34+/VE-cadherin+ cells increased significantly at month 12 [0.9(0.05–0.14)% vs 0.05(0.02–0.09)% P<0.05]. However, VEGF plasma concentration decreased significantly overtime [89.1(53.9–218.7) vs [66.2(47.5–104.6) pg/mL, P<0.05].ConclusionsLong-term intensive treatment in hypertensive patients further improves cardiovascular risk and increases circulating EPCs, suggesting that these cells could be a therapeutic target.

Mobilization of progenitor cells and vessel healing after implantation of SYNERGY in acute coronary syndrome

“…In the present study, we used flow cytometric marker CD34+/KDR+ cells, in addition to CD34+/CD133+/CD45 null cells, both of which abundantly include EPC lineage 16 , 17 . As a result, a stronger mobilization of both CD34+/CD133+/CD45 null cells and CD34+/KDR+ cells was induced at early stage in the SYNERGY group, compared with the PROMUS group, possibly associated with more favorable vessel healing at late stage after the SNYERGY stent implantation.…”

“…We measured circulating CD34 +/CD133 +/CD45 null and CD34 +/kinase insert domain receptor (KDR)+ progenitor cells as EPC linage, using flow cytometry based on a previously described method 16 , 17 with minor modifications. In brief, EDTA-treated peripheral blood (3 ml) was incubated with test reagent or control reagent.…”

Mobilization of Progenitor Cells and Vessel Healing After Implantation of Synergytm in Acute Coronary Syndrome

“…20,21 In the present study, we used ow cytometric marker CD34+/KDR + cells, in addition to CD34+/CD133+/CD45 null cells, both of which abundantly include EPC lineage. 5,6 As a result, SNYERGY™ stent induced stronger mobilization of both CD34+/CD133+/CD45 null cells and CD34+/KDR + cells at early stage, compared with PROMUS PREMIER™ stent, possibly associated with more favorable vessel healing at late stage after the SNYERGY™ stent implantation. The result of correlation between percent change in CD34+/KDR + cells at early stage and OCT-based neointimal thickness at late stage indicates that CD34+/KDR + cells might predict wound healing response at the stent-injured vessel sites.…”

“…We measured circulating CD34+/CD133+/CD45 null and CD34+/kinase insert domain receptor (KDR) + progenitor cells as EPC linage, using ow cytometry based on a previously described method 5,6 with minor modi cations. In brief, EDTA-treated peripheral blood (3 ml) was incubated with test reagent or control reagent.…”

“…The CD34+/CD133+/CD45 null cells signi cantly increased on the day 7 in the SYNERGY group [to 84 (52-117) cell/1⋅10 6 WBCs, P < 0.0001], while it did not change in the PROMUS group [to 67 (43-114) cell/1⋅106 WBCs]. The CD34+/KDR + cells also signi cantly increased on the day 7 in the SYNERGY group [to 10 (5-16) cell/2⋅10 5 MNCs, P < 0.0001], while it increased less signi cantly [to 8 (4-13) cell/2⋅10 5 MNCs, P < 0.05] in the PROMUS group.…”