Exercise training increases endothelial progenitor cells and decreases asymmetric dimethylarginine in peripheral arterial disease: A randomized controlled trial
Exercise training increases endothelial progenitor cells and decreases asymmetric dimethylarginine in peripheral arterial disease: A randomized controlled trial
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DOI：
10.1016/j.atherosclerosis.2011.03.018
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发表时间：
2011-07-01
期刊：
影响因子：
5.3
通讯作者：
Steiner, Sabine
中科院分区：
文献类型：
--
作者：
Schlager, Oliver;Giurgea, Aura;Steiner, Sabine
背景：有监督的运动训练（SET）被推荐作为改善伴有间歇性跛行的外周动脉疾病（PAD）患者行走能力的初始治疗方法。假定SET产生有益作用的各种机制，但是关于其对血管生成的影响的数据很少。因此，我们设计了一项前瞻性随机对照试验，研究SET对PAD血管生成和内皮功能标志物的影响。方法：将40例PAD患者随机分为最佳药物治疗组（SET + BMT）和最佳药物治疗组（BMT），分别治疗6个月。内皮祖细胞（EPC）通过全血流式细胞术（CD34+CD133+KDR+共表达）和细胞培养试验（内皮细胞集落形成单位，循环血管生成细胞，迁移试验）在基线，纳入后3,6和12个月进行评估。测定血浆对称二甲基精氨酸（ADMA）、血管内皮生长因子（VEGF）、基质细胞衍生因子-1 （SDF-1）水平及最大步行距离的变化。结果：与BMT组相比，流式细胞术和细胞培养技术测量的EPC在训练后显著增加，ADMA显著降低（p < 0.05）。停止训练6个月后，SET对EPC的有益作用减弱，但与基线和对照组相比，最大步行距离显著提高（p < 0.05）。VEGF和SDF-1血浆水平随时间变化无明显变化。结论：SET增加循环EPC计数，降低ADMA水平，反映血管生成增强和内皮功能改善，可能有助于降低心血管风险。2011爱思唯尔爱尔兰有限公司版权所有。
Background: Supervised exercise training (SET) is recommended as initial treatment to improve walking capacity in peripheral arterial disease (PAD) patients with intermittent claudication. Various mechanisms by which SET yields beneficial effects are postulated, however data regarding its influence on angiogenesis are scarce. Thus, we designed a prospective randomized controlled trial to study the impact of SET on markers of angiogenesis and endothelial function in PAD.Methods: Forty PAD patients were randomized to SET on top of best medical treatment (SET + BMT) for 6 months versus best medical treatment (BMT) only. Endothelial progenitor cells (EPC) were assessed by whole-blood flow cytometry (co-expression of CD34+CD133+KDR+) and cell culture assays (endothelial cell-colony forming units, circulating angiogenic cells, migration assay) at baseline, 3,6 and 12-months after inclusion. Changes of plasma levels of a symmetric dimethylarginine (ADMA), vascular endothelial growth factor (VEGF), stromal cell-derived factor-1 (SDF-1) and maximum walking distance were determined.Results: EPC - measured by flow cytometric and cell culture techniques-increased significantly upon training paralleled by a significant decrease of ADMA when compared to the BMT group (p < 0.05). Six months after training cessation, the beneficial effect of SET on EPC diminished, but maximum walking distance was significantly improved compared to baseline and controls (p < 0.05). No significant changes were observed for VEGF and SDF-1 plasma levels in time course.Conclusions: SET increases circulating EPC counts and decreases ADMA levels reflecting enhanced angiogenesis and improved endothelial function, which might contribute to cardiovascular risk reduction. (C) 2011 Elsevier Ireland Ltd. All rights reserved.