Decreased number and impaired angiogenic function of endothelial progenitor cells in patients with chronic renal failure.
OBJECTIVE
Increased risk of cardiovascular disease in patients with chronic renal failure (CRF) has been explained by accelerated atherosclerosis and impaired angiogenesis, in which endothelial progenitor cells (EPCs) may play key roles. We hypothesized that altered EPC biology may contribute to the pathophysiology of CRF.


RESULTS
EPCs were isolated from CRF patients on maintenance hemodialysis (n=44) and from a normal control group (n=30). CRF patients showed markedly decreased numbers of EPC (44.6%) and colonies (75.3%) when compared with the controls (P<0.001). These findings were corroborated by 30.5% decrease in EPC migratory function in response to vascular endothelial growth factor (VEGF) (P=0.040) and 48.8% decrease in EPC incorporation into human umbilical vein endothelial cells (HUVEC) (P<0.001). In addition, Framingham's risk factor score of both CRF (r=-0.461, P=0.010) and normal group (r=-0.367, P=0.016) significantly correlated with the numbers of EPC. Indeed, the number of circulating EPC was significantly lower in CRF patients than in normal group under the same burden of risk factors (P<0.001). A significant correlation was also observed between dialysis dose (Kt/V) and EPC incorporation into HUVEC (r=0.427, P=0.004).


CONCLUSIONS
EPC biology, which is critical for neovascularization and the maintenance of vascular function, is altered in CRF. Our data strongly suggest that dysfunction of circulating EPC has a role in the progression of cardiovascular disease in patients with CRF.
Choi
Jin-Ho
JH
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Koung Li
KL
Huh
Wooseong
W
Kim
Beom
B
Byun
Jonghoe
J
Suh
Wonhee
W
Sung
Jidong
J
Jeon
Eun-Seok
ES
Oh
Ha-Young
HY
Kim
Duk-Kyung
DK
D000368:Aged; D002452:Cell Count; D019070:Cell Lineage; D002465:Cell Movement; D002478:Cells, Cultured / Q000473:pathology; D003094:Collagen; D003114:Colony-Forming Units Assay; D003327:Coronary Disease / Q000453:epidemiology; D004338:Drug Combinations; D042783:Endothelial Cells / Q000473:pathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D007797:Laminin; D008297:Male; D059630:Mesenchymal Stem Cells / Q000187:drug effects / Q000473:pathology*; D008875:Middle Aged; D009024:Morphogenesis; D009389:Neovascularization, Pathologic / Q000503:physiopathology*; D011509:Proteoglycans; D006435:Renal Dialysis; D012307:Risk Factors; D042461:Vascular Endothelial Growth Factor A / Q000494:pharmacology
D004338:Drug Combinations; D007797:Laminin; D011509:Proteoglycans; D042461:Vascular Endothelial Growth Factor A; C059485:matrigel; D003094:Collagen