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


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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Fig. 1
Fig. 2



Cardiovascular diseases


Bare metal stents


drug-eluting stents


Endothelial progenitor cells


Predictive, preventive and personalized medicine


Smooth muscle cells


In-stent restenosis


Endothelial progenitor cell capturing stent


Endothelial cells


Circulating endothelial progenitor cells


Nitric oxide


Early endothelial progenitor cells


Late endothelial progenitor cells


Outgrowth endothelial cells


Kinase insert domain receptor


Chemokine receptor 1


Matrix metalloproteinase


Vascular endothelial growth factor


Cyclic guanylate monophosphate






Extracellular matrix


Vascular endothelial growth factor receptor 2

PGI2 :

Prostaglandin I2


Peripheral arterial disease


Coronary artery disease


Granulocyte-macrophage colony-stimulating factor

VE-cadherin+ :

Vascular endothelial-cadherin+


Endothelial cell colony-forming units


Circulating endothelial cells


Inflammatory endothelial cells




Polyethylene glycol


Von Willebrand factor


Systematic evolution of ligands by exponential enrichment


Plasma polymerized allylamine




Cyclic Arg-Gly-Asp




Poly (L-lactic acid)


Endothelial colony forming cells




Hemocompatible peptide-1


External magnetic field


Superparamagnetic iron oxide nanoparticles


Citric acid


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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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  • 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)