Endothelial Progenitor Cells Induce Angiogenesis: a Potential Mechanism Underlying Neovascularization in Encephaloduroarteriosynangiosis
- 6 July 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Translational Stroke Research
- Vol. 12 (2), 357-365
- https://doi.org/10.1007/s12975-020-00834-9
Abstract
Encephaloduroarteriosynangiosis (EDAS) is one of the most commonly used indirect vascular reconstruction methods. EDAS aids in the formation of collateral vessels from the extracranial to the intracranial circulation in patients with moyamoya disease (MMD). However, the underlying mechanism of collateral vessel formation is not well understood. Endothelial progenitor cells (EPCs) differentiate to form the vascular endothelial cells and play a very important role in angiogenesis. We designed this prospective clinical trial to investigate the presence of EPCs in patients with MMD and to explore the neovascularization mechanism mediated by the EPCs in EDAS. The patients who were diagnosed with MMD were recruited between February 5, 2017, and January 7, 2018. The blood samples were obtained from an antecubital vein and were analyzed using flow cytometry. EPCs were defined as CD34brCD133+CD45dimKDR+. All the patients enrolled in the study underwent EDAS. Cerebral arteriography was performed 6 months post-EDAS to assess the efficacy of synangiosis. The correlation between EPC count and good collateral circulation was evaluated. Among the 116 patients with MMD enrolled in this study, 73 were women and 43 were men. The average age of the patients was 33.8 ± 15.2 years. The EPC count of the patients with MMD was 0.071% ± 0.050% (expressed as percentage of the peripheral blood mononuclear cells). The EPC count in the good postoperative collateral circulation group was significantly higher (0.085% ± 0.054%) than that in the poor collateral circulation group (0.048% ± 0.034%) (P = 0.000). The age, modified Suzuki-Mugikura grade, and EPC count were significantly correlated with the good collateral circulation post-EDAS in the multivariate analysis (P = 0.018, P = 0.007, and P = 0.003, respectively). The formation of collateral vessels by EDAS is primarily driven by angiogenesis. The EPC count may be the most critical factor for collateral circulation. The therapeutic effect of EDAS is more likely to benefit younger or severe ischemic patients with MMD.Funding Information
- National Natural Science Foundation of China (81571136)
This publication has 46 references indexed in Scilit:
- Guidelines for Diagnosis and Treatment of Moyamoya Disease (Spontaneous Occlusion of the Circle of Willis)Neurologia medico-chirurgica, 2012
- Endothelial Progenitor Cells in Cardiovascular Disease and Chronic Inflammation: from Biomarker to Therapeutic AgentBiomarkers in Medicine, 2011
- Neurosurgical Advances in the Treatment of Moyamoya DiseaseStroke, 2011
- Insights on the Revascularization Mechanism for Treatment of Moyamoya Disease Based on the Histopathologic Concept of Angiogenesis and ArteriogenesisWorld Neurosurgery, 2011
- Clinical and Angiographic Outcomes From Indirect Revascularization Surgery for Moyamoya Disease in Adults and Children: A Review of 63 ProceduresNeurosurgery, 2011
- Role of endothelial progenitor cells during ischemia-induced vasculogenesis and collateral formationMicrovascular Research, 2010
- Moyamoya Disease and Moyamoya SyndromeNew England Journal of Medicine, 2009
- Increased Levels of Circulating Endothelial Progenitor Cells in Patients With Moyamoya DiseaseStroke, 2009
- A protocol for phenotypic detection and enumeration of circulating endothelial cells and circulating progenitor cells in human bloodNature Protocols, 2007
- Surgical Treatment of Moyamoya Disease in Pediatric Patients–Comparison between the Results of Indirect and Direct Revascularization ProceduresNeurosurgery, 1992