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      Stem/Progenitor Cells, Atherosclerosis and Cardiovascular Regeneration

      research-article
      *
      The Open Cardiovascular Medicine Journal
      Bentham Open
      Stem cells, atherosclerosis, regenerative therapy.

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          Abstract

          Regenerative cell based therapy has potential to become effective adjuvant treatment for patients with atherosclerotic disease. Although data from animal studies support this notion, clinical studies undertaken in patients with acute and chronic coronary artery disease do not conclusively demonstrate benefits of such therapy. There are many questions on the stem cell translational roadmap. The basic mechanisms of stem cell-dependent tissue regeneration are not well understood. There is a debate regarding characterization of specific cell types conferring therapeutic effects. In particular, the role of endothelial progenitor cells as a specific reparative cell subtype is questioned, and the role of myeloid cell linage in fostering of vasculo- and angiogenesis is being increasingly appreciated. Intense discussions surround the place of stem/progenitor cells in atherosclerosis progression, plaque destabilization and vessel remodeling. This paper summarizes the current knowledge on the regenerative stem/progenitor cell definitions, mechanisms of stem cell trafficking, homing and their involvement in atherosclerosis progression.

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          Most cited references68

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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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            Endothelial progenitor cells: characterization and role in vascular biology.

            Infusion of different hematopoietic stem cell populations and ex vivo expanded endothelial progenitor cells augments neovascularization of tissue after ischemia and contributes to reendothelialization after endothelial injury, thereby, providing a novel therapeutic option. However, controversy exists with respect to the identification and the origin of endothelial progenitor cells. Overall, there is consensus that endothelial progenitor cells can derive from the bone marrow and that CD133/VEGFR2 cells represent a population with endothelial progenitor capacity. However, increasing evidence suggests that there are additional bone marrow-derived cell populations (eg, myeloid cells, "side population" cells, and mesenchymal cells) and non-bone marrow-derived cells, which also can give rise to endothelial cells. The characterization of the different progenitor cell populations and their functional properties are discussed. Mobilization and endothelial progenitor cell-mediated neovascularization is critically regulated. Stimulatory (eg, statins and exercise) or inhibitory factors (risk factors for coronary artery disease) modulate progenitor cell levels and, thereby, affect the vascular repair capacity. Moreover, recruitment and incorporation of endothelial progenitor cells requires a coordinated sequence of multistep adhesive and signaling events including adhesion and migration (eg, by integrins), chemoattraction (eg, by SDF-1/CXCR4), and finally the differentiation to endothelial cells. This review summarizes the mechanisms regulating endothelial progenitor cell-mediated neovascularization and reendothelialization.
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              Stem cells, the molecular circuitry of pluripotency and nuclear reprogramming.

              Reprogramming of somatic cells to a pluripotent embryonic stem cell-like state has been achieved by nuclear transplantation of a somatic nucleus into an enucleated egg and most recently by introducing defined transcription factors into somatic cells. Nuclear reprogramming is of great medical interest, as it has the potential to generate a source of patient-specific cells. Here, we review strategies to reprogram somatic cells to a pluripotent embryonic state and discuss our understanding of the molecular mechanisms of reprogramming based on recent insights into the regulatory circuitry of the pluripotent state.
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                Author and article information

                Journal
                Open Cardiovasc Med J
                TOCMJ
                The Open Cardiovascular Medicine Journal
                Bentham Open
                1874-1924
                23 February 2010
                2010
                : 4
                : 97-104
                Affiliations
                []Department of Cardiac and Vascular Surgery, St. George’s University of London, London, UK
                Author notes
                [* ]Address correspondence to this author at the Department of Cardiac and Vascular Surgery, St. George’s University of London, London, UK; Tel: 0044 (0) 20 8725 3946; Fax: 0044 (0) 20 8725 5173; E-mail: dotsenko_2000@ 123456yahoo.com
                Article
                TOCMJ-4-97
                10.2174/1874192401004020097
                2852123
                20386616
                d0c860a3-0794-4473-a0b1-b2e4258e9fa8
                © Olena Dotsenko; Licensee Bentham Open.

                This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                History
                : 18 November 2009
                : 4 December 2009
                : 15 December 2009
                Categories
                Article

                Cardiovascular Medicine
                atherosclerosis,stem cells,regenerative therapy.
                Cardiovascular Medicine
                atherosclerosis, stem cells, regenerative therapy.

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