Age-dependent depression in circulating endothelial progenitor cells in patients undergoing coronary artery bypass grafting
Age-dependent depression in circulating endothelial progenitor cells in patients undergoing coronary artery bypass grafting
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DOI：
10.1016/j.jacc.2003.07.025
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发表时间：
2003-12-17
影响因子：
24
通讯作者：
Simm, A
中科院分区：
文献类型：
--
作者：
Scheubel, RJ;Zorn, H;Simm, A
目的探讨冠状动脉旁路移植术(CABG)患者年龄对循环内皮祖细胞(EPC)及其动员的影响。背景：EPC在组织缺血后修复新生血管中起重要作用。在实验模型中，老年动物的修复性新生血管受到损害，但内皮祖细胞在这种损害中的作用尚不清楚，尤其是在人类中。方法连续50例接受冠状动脉旁路移植术的稳定性冠状动脉疾病患者，在术前、术后6、12、24和72小时测定内皮细胞的数量和血浆白介素6、8、10、18以及血管内皮生长因子和胎盘生长因子的水平。这些与年龄相关的下降不能用动脉粥样硬化危险因素或心功能的差异来解释。体外循环术后EPC、IL-6、1L-8、1L-10和血管内皮生长因子迅速动员，6h达高峰。在整个观察期内，69岁患者的EPC和血管内皮生长因子水平持续降低，这不能用手术方式或炎性IL激活的差异来解释。结论尽管CABG期间EPC显著增加和细胞趋化因子的释放，但年龄是EPC动员的主要限制因素。需要进一步的研究来改进老年患者内皮祖细胞的动员、体外扩增和重新移植的策略。(J Am Coll心脏ol 2003；42：2073-80)(C)2003，由美国心脏病学会基金会主办。
OBJECTIVESThe effect of patient age on circulating endothelial progenitor cells (EPCs) and their mobilization during coronary artery bypass grafting (CABG) was assessed.BACKGROUNDThe EPCs are able to contribute to reparative neovascularization after tissue ischemia. In experimental models, reparative neovascularization is impaired in senescent animals, but the role of EPCs in this impairment, especially in humans, is unknown.METHODSIn 50 consecutive patients (43 to 80 years old) with stable coronary artery disease undergoing CABG, the numbers of EPCs and the plasma levels of interleukin (IL)-6, IL-8, IL-10, and IL-18, as well as vascular endothelial growth factor (VEGF) and placental growth factor, were determined preoperatively, after coming off bypass, and 6, 12, 24, and 72 h postoperatively.RESULTSPreoperative values of EPCs were lowered with increasing age, similar to the lowering of plasma VEGF levels. These age-associated decreases could not be explained by differences in atherosclerotic risk factors or cardiac function. Bypass surgery induced a rapid mobilization in EPCs, IL-6, 1L-8, 1L-10, and VEGF, with a peak 6 h postoperatively. Persistently lower levels of EPCs and VEGF throughout the observation period were observed in patients > 69 years old, which could not be explained by differences in the operative procedure or inflammatory IL activation.CONCLUSIONSDespite a significant increase in EPCs and release of cytochemokines during CABG, age is a major limiting factor for mobilization of EPCs. Further studies are necessary to improve the strategies for mobilization, ex vivo expansion, and re-transplantation of EPCs in aging patients. (J Am Coll Cardiol 2003;42:2073-80) (C) 2003 by the American College of Cardiology Foundation.