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Stem Cell Reviews and Reports

, Volume 15, Issue 2, pp 157–165 | Cite as

Endothelial Progenitor Cells Biology in Diabetes Mellitus and Peripheral Arterial Disease and their Therapeutic Potential

  • Anna Pyšná
  • Robert Bém
  • Andrea Němcová
  • Vladimíra Fejfarová
  • Alexandra Jirkovská
  • Jitka Hazdrová
  • Edward B. Jude
  • Michal DubskýEmail author
Article
  • 339 Downloads

Abstract

Endothelial progenitors are a population of cells with the inherent capacity to differentiate into mature endothelial cells and proangiogenic paracrine action. These characteristics have led to extensive studies being performed and tested in the treatment of tissue ischemia. The natural course of diabetes mellitus (DM) results in multiple areas of vascular damage. Thus endothelial progenitor cells‘(EPCs) beneficial potential is particularly desirable in diabetic patients. In this review, we summarize contemporary knowledge of EPC biology in DM. It has been shown that EPC functions are considerably impaired by DM. The presence of peripheral arterial disease (PAD) seems to further exacerbate the deficiencies of EPCs. However, studies examining EPC counts in PAD and DM observed disparate results, which can be due to a lack of consensus on precise EPC immunotype used in the different studies. Nevertheless, the results of EPC-based autologous cell therapy (ACT) are promising. In addition, EPCs have been shown to bean independent predictor of cardiovascular risk and diabetic foot ulcer healing.

Keywords

Autologous cell therapy Diabetes mellitus Endothelial progenitor cells Peripheral arterial disease Vascular repair 

Abbreviations

ACT

Autologous cell therapy

AGEs

Advanced glycation products

BM

Bone-marrow

BM-MNC

Bone-marrow mononuclear cells

CAD

Coronary artery disease

CPC

Circulating progenitor cells

CLI

Critical limb ischemia

DM

Diabetes mellitus

DN

Diabetic neuropathy

DR

Diabetic retinopathy

ECFCs

Endothelial colony-forming cells

eNOS

Endothelial nitric oxide synthase

Epo

Erythropoietin

ECM

Extracellular matrix

EPC

Endothelial progenitor cell

FGF

Fibroblast growth factor receptor

G-CSF

Granulocyte colony-stimulating factor

HIF-1

Hypoxia-inducible factor-1

KDR

Kinase insert domain receptor

MAC

Myeloid angiogenic cell

MMP-9

Matrix metalloproteinase-9

MNC

Mononuclear cells

OCN

Osteocalcin

PAD

Peripheral arterial disease

PB-MNC

Peripheral blood mononuclear cells

SDF -1

Stromal cell-derived factor-1

T1DM

Type 1 diabetes mellitus

T2DM

Type 2 diabetes mellitus

UCB

Umbilical cord blood

VEGF

Vascular endothelial growth factor

VEGFR2

Vascular endothelial growth factor receptor 2

vWF

Von Willebrand factor

Notes

Acknowledgements

This work was supported by Ministry of Health of the Czech Republic [grant number 16-27262A], by the conceptual development of research organization [Institute for Clinical and Experimental Medicine – IKEM, IN 00023001] and by Czech Science Foundation (GA ČR) [grant number 14-03540S]. All rights reserved.

Compliance with Ethical Standards

Conflicts of Interest

No potential conflicts of interest relevant to this article were reported.

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Authors and Affiliations

  1. 1.Institute for Clinical and Experimental MedicinePragueCzech Republic
  2. 2.Diabetes CentreTameside Hospital NHS Foundation Trust and University of ManchesterLancashireUK

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