Circulating Endothelial Progenitor Cells, Vascular Function, and Cardiovascular Risk
Jonathan M. Hill, M.R.C.P., Gloria Zalos, R.N., Julian P.J. Halcox, M.R.C.P., William H. Schenke, B.A., Myron A. Waclawiw, Ph.D., Arshed A. Quyyumi, M.D., and Toren Finkel, M.D., Ph.D.
Background Cardiovascular risk factors contribute to atherogenesisby inducing endothelial-cell injury and dysfunction. We hypothesizedthat endothelial progenitor cells derived from bone marrow havea role in ongoing endothelial repair and that impaired mobilizationor depletion of these cells contributes to endothelial dysfunctionand cardiovascular disease progression.
Methods We measured the number of colony-forming units of endothelialprogenitor cells in peripheral-blood samples from 45 men (mean[±SE] age, 50±2 years). The subjects had variousdegrees of cardiovascular risk but no history of cardiovasculardisease. Endothelium-dependent and endothelium-independent functionwas assessed by high-resolution ultrasonography of the brachialartery.
Results We observed a strong correlation between the numberof circulating endothelial progenitor cells and the subjects'combined Framingham risk factor score (r=0.47, P=0.001).Measurement of flow-mediated brachial-artery reactivity alsorevealed a significant relation between endothelial functionand the number of progenitor cells (r=0.59, P<0.001). Indeed,the levels of circulating endothelial progenitor cells werea better predictor of vascular reactivity than was the presenceor absence of conventional risk factors. In addition, endothelialprogenitor cells from subjects at high risk for cardiovascularevents had higher rates of in vitro senescence than cells fromsubjects at low risk.
Conclusions In healthy men, levels of endothelial progenitorcells may be a surrogate biologic marker for vascular functionand cumulative cardiovascular risk. These findings suggest thatendothelial injury in the absence of sufficient circulatingprogenitor cells may affect the progression of cardiovasculardisease.
Source Information
From the Cardiovascular Branch (J.M.H., G.Z., J.P.J.H., W.H.S., T.F.) and the Office of Biostatistics Research (M.A.W.), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.; and Emory University Hospital, Atlanta (A.A.Q.).
Address reprint requests to Dr. Finkel at the Cardiovascular Branch, NIH, Bldg. 10/6N-240, 10 Center Dr., Bethesda, MD 20892-1622, or at finkelt{at}nih.gov.
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