Endogenous vascular repair system in cardiovascular disease: The role of endothelial progenitor cells

Abstract

BackgroundCardiovascular (CV) disease has been considered as the first global leading cause of premature death in last decades. Vascular complications close correspond to development of endothelial dysfunction, microvascular inflammation, accelerating atherosclerosis, coagulopathy, and thrombosis, in pathogenesis of which altered vascular reparation is core player and possible target for further treatment strategy. AimsThe aim of the review is: to summarize knowledge regarding the role of endothelial progenitor cells (EPCs) as a core component of endogenous vascular repair system in CV disease. MethodsThis is a descriptive review based on evidence of pre-clinical and clinical studies published within last decade. ResultsThe review is reported that developing of CV disease associates with lowered number and impaired function of circulating EPCs, which play a pivotal role in endogenous reparation of vasculature and restore endothelial function after various injuries on the vessels. EPCs could be modified by several stimuli including epigenetic factors and thereby they are failed completely restoring vascular structure and endothelial function. However, there is unclear whether EPC dysfunction is just a whiteness of the evolution of CV disease or it could be a trigger of CV disease manifestation in the vulnerable population. ConclusionEPCs are novel biological marker of impaired vascular reparation and CV risk with predictive value. Large clinical trials are required to justify number and function of EPCs as independent prognosticator of CV risk.

Extracellular Endothelial Cell-Derived Vesicles: Emerging Role in Cardiac and Vascular Remodeling in Heart Failure

“…This process is under strong epigenetic control and circulating EVs originated from activated and apoptotic endothelial cells and their precursors are able to regulate the repair of tissues such as endothelium and vasculature myocardium through attraction of cells with high innate ability to post-natal transformation (87,88). Finally, increased levels of extracellular activated endothelial cell-derived vesicles characterize a tendency in endogenous repair systems to restore the integrity and function of target organs including the endothelium, myocardium, kidney, and brain (89). Previous clinical studies have shown that the number of circulating EVs produced by progenitor precursors of endothelial cells or mature endothelial cells declines depending on the severity of HF, and patients with HFrEF had significantly lowered levels of EVs when compared with patients with HFpEF (90)(91)(92).…”

Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers

“…Additional factor that is involved onto a development of late adverse remodelling is epigenetically mediating disturbance of endogenous vascular repair system [32,33]. It has been found that altered vascular repair has maintained vasoconstriction and vascular dysfunction that accelerated atherosclerosis and supported hibernation in the grey zone around myocardial infarction.…”

“…Cells. Mononuclears (MPCs) and endothelial progenitor cells (EPCs) are essential components of endogenous vascular repair system that is activated as a result of several triggers, such as ischemia/hypoxia, inflammation, shear stress, thrombosis, infiltration of lipids, direct injury of vasculature, and endothelium [32].…”

Targeting the Endothelium to Achieve Cardioprotection

“…They are the primary endogenous vascular repair system, and their dysfunction and low levels are associated with the progression of CVD ( Haider et al, 2017 ). Circulating EPC level rise in post-MI patients ( Shintani et al, 2001 ), and this is associated with their vascular reparative role and, therefore, its cardioprotective role ( Berezin, 2019 ). Stem/progenitor cell-based therapy has been extensively studied for angio-myogenic repair of the ischemic heart.…”