Arterial homeostasis, inflammation, and erythropoietic growth factors.
A neurohumoral link between kidneys and the heart has been established, particularly in the context of hypertension and cardiomyopathy. Beyond this neuro-endocrine pathway, another connecting system theoretically recruits growth factors that are selectively produced by the kidneys and have the ability to promote a distant reaction at the level of bone marrow. This reaction differentiates and circulates vascular progenitor cells capable of repairing the injured cardiovascular system. Reducing injuries (prevention) stabilizes disease processes by reducing tissue damage and destruction but the gradual degradation of the body's natural repair mechanisms eventually allows progressive reactivation of disease processes. In this light, a focus on tissue repair rather than injury prevention may hold the key to controlling chronic heart diseases. This article examines the medical therapies, including recombinant human erythropoietin, that have been shown to improve the function and survival of endothelial progenitor cells and promote the healing of damaged tissue.
Goldschmidt-Clermont
Pascal J
PJ
Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Diehl
Anna Mae
AM
D004730:Endothelium, Vascular / Q000503:physiopathology; D004921:Erythropoietin / Q000502:physiology*; D006133:Growth Substances / Q000502:physiology*; D006331:Heart Diseases / Q000503:physiopathology*; D006706:Homeostasis; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D013234:Stem Cells / Q000502:physiology
D006133:Growth Substances; D004921:Erythropoietin