HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 292/4/F1132    most recent 00163.2006v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Westerweel, P. E. Articles by Verhaar, M. C. Search for Related Content PubMed PubMed Citation Articles by Westerweel, P. E. Articles by Verhaar, M. C.

End-stage renal disease causes an imbalance between endothelial and smooth muscle progenitor cells

Departments of ¹Vascular Medicine, ²Experimental Cardiology, and ³Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands

Submitted 12 May 2006 ; accepted in final form 27 December 2006

Patients with end-stage renal disease (ESRD) on hemodialysis have an increased risk of cardiovascular disease (CVD). Circulating endothelial progenitor cells (EPC) contribute to vascular regeneration and repair, thereby protecting against CVD. However, circulating smooth muscle progenitor cells (SPC) may contribute to adverse vascular remodeling. We hypothesized that an imbalance occurs between EPC and SPC in ESRD patients and sampled progenitor cells from 45 ESRD patients receiving regular treatment. Our study is the first to show reduced numbers of CD34+KDR+ hematopoietic stem cell (HSC)-derived EPC (type I EPC). Furthermore, monocyte-derived EPC cultured from mononuclear cells (type II EPC) were reduced in number and had a reduced capacity to stimulate endothelial cell angiogenesis. In contrast, SPC outgrowth was unaffected. In vitro incubation with uremic serum impaired type II EPC outgrowth from healthy donor mononuclear cells and did not influence SPC outgrowth. The hemodialysis procedure itself induced HSC apoptosis and caused an acute depletion of circulating EPC. Taken together, the decreased number and impaired function of EPC are compatible with impaired endogenous vascular repair in hemodialysis patients, whereas the unaffected SPC numbers suggest that the potential of progenitor cells to contribute to adverse remodeling is retained. This EPC-SPC imbalance may contribute to the acceleration of CVD in ESRD patients and could offer novel therapeutic targets.

endothelial progenitor cells; cardiovascular disease; hemodialysis

This article has been cited by other articles:

				P. E. Westerweel, F. L.J. Visseren, G. R. Hajer, J. K. Olijhoek, I. E. Hoefer, P. de Bree, S. Rafii, P. A. Doevendans, and M. C. Verhaar Endothelial progenitor cell levels in obese men with the metabolic syndrome and the effect of simvastatin monotherapy vs. simvastatin/ezetimibe combination therapy Eur. Heart J., November 2, 2008; 29(22): 2808 - 2817. [Abstract] [Full Text] [PDF]

				D. Hughes, A. A. Fu, A. Puggioni, J. F. Glockner, B. Anwer, A. M. McGuire, D. Mukhopadhyay, and S. Misra Adventitial transplantation of blood outgrowth endothelial cells in porcine haemodialysis grafts alleviates hypoxia and decreases neointimal proliferation through a matrix metalloproteinase-9-mediated pathway--a pilot study Nephrol. Dial. Transplant., September 11, 2008; (2008) gfn433v1. [Abstract] [Full Text] [PDF]

				P. Stenvinkel, J. J. Carrero, J. Axelsson, B. Lindholm, O. Heimburger, and Z. Massy Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient: How Do New Pieces Fit into the Uremic Puzzle? Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 505 - 521. [Abstract] [Full Text] [PDF]

				Y. Diao, S. Guthrie, S.-L. Xia, X. Ouyang, L. Zhang, J. Xue, P. Lee, M. Grant, E. Scott, and M. S. Segal Long-Term Engraftment of Bone Marrow-Derived Cells in the Intimal Hyperplasia Lesion of Autologous Vein Grafts Am. J. Pathol., March 1, 2008; 172(3): 839 - 848. [Abstract] [Full Text] [PDF]

				J. Tongers and D. W. Losordo Frontiers in Nephrology: The Evolving Therapeutic Applications of Endothelial Progenitor Cells J. Am. Soc. Nephrol., November 1, 2007; 18(11): 2843 - 2852. [Abstract] [Full Text] [PDF]

				O. van Oostrom, M. Nieuwdorp, P.E. Westerweel, I.E. Hoefer, R. Basser, E.S.G. Stroes, and M.C. Verhaar Reconstituted HDL Increases Circulating Endothelial Progenitor Cells in Patients With Type 2 Diabetes Arterioscler. Thromb. Vasc. Biol., August 1, 2007; 27(8): 1864 - 1865. [Full Text] [PDF]