Endothelial progenitor cells as the target for cardiovascular disease prediction, personalized prevention, and treatments: progressing beyond the state-of-the-art

Abstract

Stimulated by the leading mortalities of cardiovascular diseases (CVDs), various types of cardiovascular biomaterials have been widely investigated in the past few decades. Although great therapeutic effects can be achieved by bare metal stents (BMS) and drug-eluting stents (DES) within months or years, the long-term complications such as late thrombosis and restenosis have limited their further applications. It is well accepted that rapid endothelialization is a promising approach to eliminate these complications. Convincing evidence has shown that endothelial progenitor cells (EPCs) could be mobilized into the damaged vascular sites systemically and achieve endothelial repair in situ, which significantly contributes to the re-endothelialization process. Therefore, how to effectively capture EPCs via specific molecules immobilized on biomaterials is an important point to achieve rapid endothelialization. Further, in the context of predictive, preventive, personalized medicine (PPPM), the abnormal number alteration of EPCs in circulating blood and certain inflammation responses can also serve as important indicators for predicting and preventing early cardiovascular disease. In this contribution, we mainly focused on the following sections: the definition and classification of EPCs, the mechanisms of EPCs in treating CVDs, the potential diagnostic role of EPCs in predicting CVDs, as well as the main strategies for cardiovascular biomaterials to capture EPCs.

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Abbreviations

CVDs:

Cardiovascular diseases

BMS:

Bare metal stents

DES:

drug-eluting stents

EPCs:

Endothelial progenitor cells

PPPM:

Predictive, preventive and personalized medicine

SMCs:

Smooth muscle cells

ISR:

In-stent restenosis

ECS:

Endothelial progenitor cell capturing stent

ECs:

Endothelial cells

CEPCs:

Circulating endothelial progenitor cells

NO:

Nitric oxide

eEPCs:

Early endothelial progenitor cells

lEPCs:

Late endothelial progenitor cells

OECs:

Outgrowth endothelial cells

KDR:

Kinase insert domain receptor

CXCR-1:

Chemokine receptor 1

MMPs:

Matrix metalloproteinase

VEGF:

Vascular endothelial growth factor

cGMP:

Cyclic guanylate monophosphate

Dopa:

Dopamine

SeCA:

Selenocystamine

ECM:

Extracellular matrix

VEGF-R2:

Vascular endothelial growth factor receptor 2

PGI2 :

Prostaglandin I2

PAD:

Peripheral arterial disease

CAD:

Coronary artery disease

GM-CSF:

Granulocyte-macrophage colony-stimulating factor

VE-cadherin+ :

Vascular endothelial-cadherin+

CFU-ECs:

Endothelial cell colony-forming units

CECs:

Circulating endothelial cells

lECs:

Inflammatory endothelial cells

REDV:

Arg-Glu-Asp-Val

PEG:

Polyethylene glycol

vWF:

Von Willebrand factor

SELEX:

Systematic evolution of ligands by exponential enrichment

PPAam:

Plasma polymerized allylamine

RGD:

Arg-Gly-Asp

cRGD:

Cyclic Arg-Gly-Asp

PCL:

Polycaprolactone

PLLA:

Poly (L-lactic acid)

ECFCs:

Endothelial colony forming cells

TPS:

TPSLEQRTVYAK

HCP-1:

Hemocompatible peptide-1

EMF:

External magnetic field

SPION:

Superparamagnetic iron oxide nanoparticles

CA:

Citric acid

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Funding

This research was funded by National Key Research and Development Program of China (2017YFB0702500, 2018YFC1106703 and 2016YFC1102403), and Top Doctor Program of Zhengzhou University (grant number 32210475).

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Kou, F., Zhu, C., Wan, H. et al. Endothelial progenitor cells as the target for cardiovascular disease prediction, personalized prevention, and treatments: progressing beyond the state-of-the-art. EPMA Journal (2020). https://doi.org/10.1007/s13167-020-00223-0

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Keywords

  • Cardiovascular biomaterials
  • Rapid endothelialization
  • Endothelial progenitor cells
  • Endothelial progenitor cell capturing stent
  • Predictive diagnostics
  • Targeted prevention
  • EPC-specific molecules
  • Predictive preventive personalized medicine (PPPM/3PM)