Objective-Emerging evidence suggests that human blood contains bone marrow (BM)-derived endothelial progenitor cells that contribute to postnatal neovascularization. Clinical trials demonstrated that administration of BM-cells can enhance neovascularization. Most studies, however, used crude cell populations. Identifying the role of different cell populations is important for developing improved cellular therapies.
Methods and Results-Effects of the hematopoietic stem cell-containing CD34ϩ cell population on migration, proliferation, differentiation, stimulation of, and participation in capillary-like tubule formation were assessed in an in vitro 3-dimensional matrix model using human microvascular endothelial cells. During movement over the endothelial monolayer, CD34ϩ cells remained stuck at sites of capillary tube formation and time-and dose-dependently formed cell clusters. Immunohistochemistry confirmed homing and proliferation of CD34 ϩ cells in and around capillary sprouts. CD34 ϩ cells were transduced with the LNGFR marker gene to allow tracing. LNGFR gene-transduced CD34 ϩ cells integrated in the tubular structures and stained positive for CD31 and UEA-1. CD34ϩ cells alone stimulated neovascularization by 17%. Coculture with CD34Ϫ cells led to 68% enhancement of neovascularization, whereas CD34 Key Words: angiogenesis Ⅲ nitric oxide, endothelium, vascular type Ⅲ gene therapy Ⅲ peripheral vascular disease T he formation of new capillaries plays a critical role in physiological and pathological processes such as wound healing, ischemia, and tumor growth. It has long been thought that postnatal neovascularization occurred exclusively by migration and proliferation of preexisting endothelial cells (angiogenesis). Increasing evidence indicates that bone marrow (BM)-derived circulating endothelial progenitor cells (EPCs) are also involved in postnatal new vessel formation, 1 a process that, reminiscent of embryonic vessel formation, is termed adult vasculogenesis. 2 The concept of "therapeutic vasculogenesis," administration of adult progenitor cells or progenitor-containing cell populations to stimulate neovascularization, and the potential of progenitor cells to serve as new vehicles for gene therapy have received a lot of scientific attention. Several small clinical trials aimed at therapeutic vasculogenesis by autologous transplantation of BM cells have been performed and improved clinical outcomes in patients with severe chronic limb ischemia or myocardial ischemia have been reported. [3][4][5][6] An important question concerning therapeutic vasculogenesis is, which cell population should be administered? Thus far, most clinical studies have used nonselected BM mononuclear cells; however, administration of such crude cell populations may have unwanted side effects. Recent data suggest that beside EPCs, BM contains other progenitor cells that may contribute to atherosclerosis, 7 whereas hematopoietic cells were reported to have the capacity to produce profibrotic and angiogenic factors. 8,9 Better charact...