title: Macrophage migration inhibitory factor is a potential inducer of endothelial progenitor cell mobilization after flap operation.
abstract: BACKGROUND
  Endothelial progenitor cells (EPCs) promote angiogenesis and play an important role in tissue revascularization and wound healing. Yet, the exact stimuli and mechanisms for the mobilization remain understood poorly. Macrophage migration inhibitory factor (MIF), which is a structurally unique pleiotropic cytokine, has been suggested to play a role in EPC recruitment and thus was a target of this study.
  
  
  METHODS
  This study included 20 patients who underwent flap operation. Subjects were divided into 3 groups according to the pattern of flap applied. The number of circulating EPCs and serum levels of MIF or CXCL12 were determined at different time intervals. In vitro chemotaxis experiments using Transwell devices were carried out to test whether MIF promotes the chemotactic migration of EPCs. To underscore functionally the chemotactic potential of MIF toward EPCs in flap patients, the chemotactic effects of serum samples from all groups were also examined in the presence and absence of monoclonal anti-macrophage migration inhibitory factor and anti-CXCL12 antibodies on EPC recruitment using in vitro migration chambers.
  
  
  RESULTS
  In flap patients, the number of circulating EPCs and serum levels of MIF but not CXCL12 serum levels were increased markedly compared with preoperative levels at day 1 after operation, especially in the group of free microvascular flaps. Serum levels of CXCL12 in the flap patients were increased only significantly compared with the healthy control group. An analysis between EPCs and MIF revealed a significant correlation, whereas no correlation was observed for CXCL12. MIF exerted a dose-dependent, prochemotactic effect on isolated human EPCs, and serum samples from all flap patients promoted EPC migration. Importantly, this effect was blocked partially by anti-macrophage migration inhibitory factor and to a weaker extent by anti-CXCL12 antibodies.
  
  
  CONCLUSIONS
  We conclude that MIF plays an important role in the mobilization of EPCs, which is dependent on the degree of ischemia. Enhancement by MIF of chemotactic EPCs migration in vitro underpins its proposed in vivo function.
authors.affiliation: Department of Plastic Surgery and Hand Surgery, Burn Center, RWTH Aachen University, Aachen, Germany. gerritgrieb@gmx.de
authors.forename: Gerrit
authors.initials: G
authors.lastname: Grieb
authors.forename: Andrzej
authors.initials: A
authors.lastname: Piatkowski
authors.forename: David
authors.initials: D
authors.lastname: Simons
authors.forename: Nives
authors.initials: N
authors.lastname: Hörmann
authors.forename: Manfred
authors.initials: M
authors.lastname: Dewor
authors.forename: Guy
authors.initials: G
authors.lastname: Steffens
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bernhagen
authors.forename: N
authors.initials: N
authors.lastname: Pallua
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002465:Cell Movement / Q000187:drug effects / Q000502:physiology*; D002478:Cells, Cultured; D054377:Chemokine CXCL12 / Q000097:blood / Q000494:pharmacology; D002633:Chemotaxis / Q000187:drug effects; D042783:Endothelial Cells / Q000166:cytology* / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008263:Macrophage Migration-Inhibitory Factors / Q000494:pharmacology / Q000502:physiology*; D008297:Male; D059630:Mesenchymal Stem Cells / Q000166:cytology* / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000502:physiology; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000502:physiology*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
chemical_list: C515255:CXCL12 protein, human; D054377:Chemokine CXCL12; D008263:Macrophage Migration-Inhibitory Factors