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      Impairment of circulating endothelial progenitors in Down syndrome

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          Abstract

          Background

          Pathological angiogenesis represents a critical issue in the progression of many diseases. Down syndrome is postulated to be a systemic anti-angiogenesis disease model, possibly due to increased expression of anti-angiogenic regulators on chromosome 21. The aim of our study was to elucidate some features of circulating endothelial progenitor cells in the context of this syndrome.

          Methods

          Circulating endothelial progenitors of Down syndrome affected individuals were isolated, in vitro cultured and analyzed by confocal and transmission electron microscopy. ELISA was performed to measure SDF-1α plasma levels in Down syndrome and euploid individuals. Moreover, qRT-PCR was used to quantify expression levels of CXCL12 gene and of its receptor in progenitor cells. The functional impairment of Down progenitors was evaluated through their susceptibility to hydroperoxide-induced oxidative stress with BODIPY assay and the major vulnerability to the infection with human pathogens. The differential expression of crucial genes in Down progenitor cells was evaluated by microarray analysis.

          Results

          We detected a marked decrease of progenitors' number in young Down individuals compared to euploid, cell size increase and some major detrimental morphological changes. Moreover, Down syndrome patients also exhibited decreased SDF-1α plasma levels and their progenitors had a reduced expression of SDF-1α encoding gene and of its membrane receptor. We further demonstrated that their progenitor cells are more susceptible to hydroperoxide-induced oxidative stress and infection with Bartonella henselae. Further, we observed that most of the differentially expressed genes belong to angiogenesis, immune response and inflammation pathways, and that infected progenitors with trisomy 21 have a more pronounced perturbation of immune response genes than infected euploid cells.

          Conclusions

          Our data provide evidences for a reduced number and altered morphology of endothelial progenitor cells in Down syndrome, also showing the higher susceptibility to oxidative stress and to pathogen infection compared to euploid cells, thereby confirming the angiogenesis and immune response deficit observed in Down syndrome individuals.

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          Most cited references52

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          Angiogenesis: an organizing principle for drug discovery?

          Angiogenesis--the process of new blood-vessel growth--has an essential role in development, reproduction and repair. However, pathological angiogenesis occurs not only in tumour formation, but also in a range of non-neoplastic diseases that could be classed together as 'angiogenesis-dependent diseases'. By viewing the process of angiogenesis as an 'organizing principle' in biology, intriguing insights into the molecular mechanisms of seemingly unrelated phenomena might be gained. This has important consequences for the clinical use of angiogenesis inhibitors and for drug discovery, not only for optimizing the treatment of cancer, but possibly also for developing therapeutic approaches for various diseases that are otherwise unrelated to each other.
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            Number and migratory activity of circulating endothelial progenitor cells inversely correlate with risk factors for coronary artery disease.

            Recent studies provide increasing evidence that postnatal neovascularization involves bone marrow-derived circulating endothelial progenitor cells (EPCs). The regulation of EPCs in patients with coronary artery disease (CAD) is unclear at present. Therefore, we determined the number and functional activity of EPCs in 45 patients with CAD and 15 healthy volunteers. The numbers of isolated EPCs and circulating CD34/kinase insert domain receptor (KDR)-positive precursor cells were significantly reduced in patients with CAD by approximately 40% and 48%, respectively. To determine the influence of atherosclerotic risk factors, a risk factor score including age, sex, hypertension, diabetes, smoking, positive family history of CAD, and LDL cholesterol levels was used. The number of risk factors was significantly correlated with a reduction of EPC levels (R=-0.394, P=0.002) and CD34-/KDR-positive cells (R=-0.537, P<0.001). Analysis of the individual risk factors demonstrated that smokers had significantly reduced levels of EPCs (P<0.001) and CD34-/KDR-positive cells (P=0.003). Moreover, a positive family history of CAD was associated with reduced CD34-/KDR-positive cells (P=0.011). Most importantly, EPCs isolated from patients with CAD also revealed an impaired migratory response, which was inversely correlated with the number of risk factors (R=-0.484, P=0.002). By multivariate analysis, hypertension was identified as a major independent predictor for impaired EPC migration (P=0.043). The present study demonstrates that patients with CAD revealed reduced levels and functional impairment of EPCs, which correlated with risk factors for CAD. Given the important role of EPCs for neovascularization of ischemic tissue, the decrease of EPC numbers and activity may contribute to impaired vascularization in patients with CAD. The full text of this article is available at http://www.circresaha.org.
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              Identifying biological themes within lists of genes with EASE.

              EASE is a customizable software application for rapid biological interpretation of gene lists that result from the analysis of microarray, proteomics, SAGE and other high-throughput genomic data. The biological themes returned by EASE recapitulate manually determined themes in previously published gene lists and are robust to varying methods of normalization, intensity calculation and statistical selection of genes. EASE is a powerful tool for rapidly converting the results of functional genomics studies from 'genes' to 'themes'.
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                Author and article information

                Journal
                BMC Med Genomics
                BMC Medical Genomics
                BioMed Central
                1755-8794
                2010
                13 September 2010
                : 3
                : 40
                Affiliations
                [1 ]Institute of Genetics and Biophysics ''A. Buzzati-Traverso'', IGB-CNR, Naples, Italy
                [2 ]Section of Microbiology, Department of Experimental Medicine, 1st School of Medicine, Second University of Naples, Naples, Italy
                [3 ]Department of General Pathology and Excellence Research Center on Cardiovascular Diseases, 1st School of Medicine, Second University of Naples, Naples, Italy
                [4 ]IRCCS Fondazione SDN, Naples, Italy
                [5 ]Istituto per le Applicazioni del Calcolo, "Mauro Picone", CNR, Naples, Italy
                [6 ]Department of Biological Science, University of Naples "Federico II", Naples, Italy
                [7 ]Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
                [8 ]IRCCS Multimedica, Milan, Italy
                [9 ]Department of Biochemistry and Medical Biotechnology, University of Naples "Federico II", Naples, Italy
                [10 ]Institute of General Pathology, Section of Clinical Pathology, Faculty of Medicine, University of Milan, Milan, Italy
                [11 ]Cardiology Department of Second University of Naples, "Monaldi Hospital", Naples, Italy
                [12 ]Department of Cellular and Molecular Biology and Pathology "L. Califano" and School of Biotechnological Sciences, University of Naples "Federico II", Naples, Italy
                Article
                1755-8794-3-40
                10.1186/1755-8794-3-40
                2949777
                20836844
                734209e7-7c6e-40e7-a711-eb957904b60b
                Copyright ©2010 Costa et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 February 2010
                : 13 September 2010
                Categories
                Research Article

                Genetics
                Genetics

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