Bone Marrow Resident and Circulating Progenitor Cells in Patients Undergoing Cardiac Surgery
Bone Marrow Resident and Circulating Progenitor Cells in Patients Undergoing Cardiac Surgery
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DOI：
10.1016/j.athoracsur.2010.08.033
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发表时间：
2010-11-01
影响因子：
4.6
通讯作者：
Jahangiri, Marjan
中科院分区：
文献类型：
--
作者：
Dotsenko, Olena;Xiao, Qingzhong;Jahangiri, Marjan
背景。手术血运重建引起的血管创伤刺激造血和非造血祖细胞的动员。然而，尚不清楚动员的祖细胞是否具有功能活性并参与外周归巢。我们尚未发现有关骨髓对血运重建手术的反应的可用临床研究。方法。这是一项对 76 名接受选择性冠状动脉搭桥手术的患者进行的观察性前瞻性研究。在基线、手术结束时和术后 24 小时收集骨髓抽吸物和血样（仅血样）。通过流式细胞术测量CD34+、CD34+CD133+和CD34+CXCR4+祖细胞计数、CXCR4+单核细胞计数和CD34+细胞上的CXCR4表达。通过克隆形成和迁移测定在体外研究祖细胞功能。结果。作为对冠状动脉血运重建的反应，CD34+祖细胞被动员起来，具有增强的迁移和克隆形成功能。术后24小时外周血CD34+CXCR4+亚群及CD34+细胞CXCR4表达显着升高。在多变量模型中，手术结束时动员的祖细胞上的 CXCR4 表达与骨髓驻留 CD34+ 细胞上的基线 CXCR4 表达以及体外循环持续时间独立相关。手术结束时，CD34+骨髓细胞上CXCR4的表达显着下降，表明最活跃的表达CXCR4的祖细胞进入外周循环。结论。冠状动脉搭桥手术与功能活跃的祖细胞的骨髓释放有关。需要进一步的研究来验证动员的祖细胞是否参与受损组织的再生。 (Ann Thorac Surg 2010;90:1944-51) (C) 2010，胸外科医师协会
Background. Vascular trauma induced by surgical revascularization stimulates mobilization of hematopoietic and nonhematopoietic progenitor cells. However, it is not clear whether mobilized progenitors are functionally active and participate in peripheral homing. We have found no clinical studies available regarding the reaction of bone marrow to surgical revascularization.Methods. This was an observational prospective study of 76 patients undergoing elective coronary artery bypass graft surgery. Bone marrow aspirates and blood samples were collected at baseline, at the end of surgery, and 24 hours postoperatively (blood samples only). The CD34+, CD34+CD133+, and CD34+CXCR4+ progenitor cell counts, CXCR4+ mononuclear cell counts, and CXCR4 expression on CD34+ cells were measured by flow cytometry. Progenitor cell functions were studied in vitro by clonogenic and migration assays.Results. In response to coronary revascularization there was mobilization of CD34+ progenitors, having increased migratory and clonogenic function. The CD34+ CXCR4+ subsets and CXCR4 expression on CD34+ cells in peripheral blood increased significantly 24 hours postoperatively. The CXCR4 expression on mobilized progenitors at the end of surgery was independently related to baseline CXCR4 expression on bone marrow resident CD34+ cells and duration of cardiopulmonary bypass in a multivariate model. At the end of surgery there was a significant fall in the expression of CXCR4 on CD34+ bone marrow cells, suggesting egress into peripheral circulation of the most active CXCR4-expressing progenitors.Conclusions. Coronary artery bypass graft surgery is associated with bone marrow release of functionally active progenitor cells. Further studies are needed to verify whether mobilized progenitors participate in regeneration of injured tissues. (Ann Thorac Surg 2010;90:1944-51) (C) 2010 by The Society of Thoracic Surgeons