title: CD34+ and endothelial progenitor cells in patients with various degrees of congestive heart failure.
abstract: BACKGROUND
  Peripheral blood CD34(+) cells and circulating endothelial progenitor cells (EPCs) increase in myocardial infarction and vascular injuries as a reflection of endothelial damage. Despite the occurrence of endothelial dysfunction in heart failure (HF), no data are available on EPC mobilization in this setting. We investigated the pattern of CD34(+) cells and EPC mobilization during HF and their correlation with the severity and origin of the disease.
  
  
  RESULTS
  Peripheral blood CD34(+) cells (n=91) and EPCs (n=41), assessed both as CD34(+) cells coexpressing AC133 and vascular endothelial growth factor (VEGF) receptor-2 and as endothelial colony-forming units, were studied in HF patients (mean age 67+/-11 years) and 45 gender- and age-matched controls. Tumor necrosis factor-alpha (TNF-alpha) and its receptors (sTNFR-1 and sTNFR-2), VEGF, stromal derived factor-1 (SDF-1), granulocyte-colony stimulating factor (G-CSF), and B-type natriuretic peptide were also measured. CD34(+) cells, EPCs, TNF-alpha and receptors, VEGF, SDF-1, and B-type natriuretic peptide were increased in HF. CD34(+) cells and EPCs were inversely related to functional class and to TNF-alpha, being decreased in New York Heart Association class IV compared with class I and II and controls. No role was found for the origin of the disease.
  
  
  CONCLUSIONS
  CD34(+) cells and EPC mobilization occurs in HF and shows a biphasic response, with elevation and depression in the early and advanced phases, respectively. This could be related to the myelosuppressive role of TNF-alpha.
authors.affiliation: University of Ferrara and Cardiovascular Research Center, Salvatore Maugeri Foundation, IRCCS, Gussago, Italy. vlgmrc@unife.it
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Gian Matteo
authors.initials: GM
authors.lastname: Rigolin
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fucili
authors.forename: Matteo Della
authors.initials: MD
authors.lastname: Porta
authors.forename: Olga
authors.initials: O
authors.lastname: Soukhomovskaia
authors.forename: Patrizia
authors.initials: P
authors.lastname: Malagutti
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Bugli
authors.forename: Letizia Zenone
authors.initials: LZ
authors.lastname: Bragotti
authors.forename: Gloria
authors.initials: G
authors.lastname: Francolini
authors.forename: Endri
authors.initials: E
authors.lastname: Mauro
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Castoldi
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000032:analysis*; D015415:Biomarkers; D054377:Chemokine CXCL12; D019743:Chemokines, CXC / Q000097:blood; D003114:Colony-Forming Units Assay; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood; D006333:Heart Failure / Q000097:blood*; D006412:Hematopoietic Stem Cells / Q000737:chemistry; D006801:Humans; D008297:Male; D059630:Mesenchymal Stem Cells / Q000737:chemistry; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000032:analysis
chemical_list: D018952:Antigens, CD34; D015415:Biomarkers; C515255:CXCL12 protein, human; D054377:Chemokine CXCL12; D019743:Chemokines, CXC; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A; D020097:Natriuretic Peptide, Brain; D016179:Granulocyte Colony-Stimulating Factor; D040301:Vascular Endothelial Growth Factor Receptor-2