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Cellular Therapy for Stroke and CNS Injuries pp 109–123Cite as

The Role of Endothelial Progenitor Cells in Stroke

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Part of the book series: Springer Series in Translational Stroke Research ((SSTSR))

Abstract

Stroke is a devastating disease that is a leading cause of death and disability in developed countries. However, therapeutic options are notably limited, so is mandatory to investigate repairing processes after stroke in order to develop therapeutic strategies able to promote brain repair processes. In this context, therapeutic angiogenesis and vasculogenesis hold promise to improve the prognosis of patients with stroke. In this regard, it is well established that circulating endothelial progenitor cells (EPCs) have been suggested to be a marker of vascular risk and endothelial function. Moreover, low EPC number has been found in patients with cerebrovascular diseases. Besides, EPC levels have been associated with good neurological and functional outcome as well as reduced infarct growth in patients with acute ischemic stroke. Finally, experimental and clinical studies indicate that EPC might mediate endothelial cell regeneration and neovascularization. Therefore, EPC-based therapy could be an excellent therapeutic option in stroke. Currently, clinical trials for evaluating EPC treatment in ischemic stroke are ongoing. In this chapter, we discuss the present status of knowledge about the possible therapeutic role of EPCs in stroke, molecular mechanisms, and the future perspectives and strategies for their use in clinical practice.

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Abbreviations

Ang-1:

Angiopoietin 1

Cdc42:

Cell division control protein 42 homolog

CFU-EC:

Early outgrowth colony forming unit-endothelial cell

eF2:

Elongation factor 2

Enos:

Endothelial nitric oxide synthase

EPCs:

Endothelial progenitor cells

EPO:

Erythropoietin

G-CSF:

Granulocyte colony-stimulating factor

ERp29:

Endoplasmic reticulum protein 29

HIF-1:

Hypoxia-inducible factor 1

HSP-72:

72 kilodalton heat shock protein

ICH:

Intracerebral hemorrhage

IGF-1:

Insulin-like growth factor 1

IS:

Ischemic stroke

mKitL:

membrane bound Kit ligand

MMP-9:

Matrix metalloproteinase 9

NO:

Nitric oxide

PRDX1:

Peroxiredoxin 1

r-tPA:

Recombinant tissue plasminogen activator

SCF:

Stem cell factor

SDF-1α:

stromal cell-derived factor 1α

VEGF:

Vascular endothelial growth factor

VEGFR2:

Vascular endothelial growth factor receptor 2

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Authors and Affiliations

  1. Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, c/ Travesa da Choupana s/n, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, 15706, Santiago de Compostela, Spain

    Tomás Sobrino, Francisco Campos & Prof. José Castillo

Authors
  1. Tomás Sobrino
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  2. Francisco Campos
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  3. Prof. José Castillo
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Corresponding author

Correspondence to José Castillo .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, SUNY Upstate Medical College, Syracuse, New York, USA

    Li-Ru Zhao

  2. Loma Linda University School of Medicine Depts of Physiology, Loma Linda, California, USA

    John H. Zhang

Conclusions

Conclusions

In brief, in response to stimuli such as stroke , EPCs are mobilized from bone marrow to peripheral blood and may participate in endothelial cell repair-regeneration and in tissue neovascularization processes. In this context, experimental and human studies have shown that neovascularization is present in the adult brain exposed to ischemia and that EPCs participate in cerebral neovascularization processes. Finally, we and others have observed that a higher increment in the number of circulating EPCs is associated with a better outcome in patients with stroke. Taken together, these findings suggest that EPCs may mediate neurorepair processes after stroke, and that exogenous supplementation or endogenous stimulation of EPCs have a great therapeutic potential for stroke. However, larger clinical trials are needed to evaluate the safety and efficacy of EPC transplantation for treating stroke. Furthermore, how to improve the strategies in order to maximize the endogenous stimulation of EPCs deserves also further studies.

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Sobrino, T., Campos, F., Castillo, J. (2015). The Role of Endothelial Progenitor Cells in Stroke. In: Zhao, LR., Zhang, J. (eds) Cellular Therapy for Stroke and CNS Injuries. Springer Series in Translational Stroke Research. Springer, Cham. https://doi.org/10.1007/978-3-319-11481-1_6

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  • DOI: https://doi.org/10.1007/978-3-319-11481-1_6

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