title: Effect of intensive glycaemic control on endothelial progenitor cells in patients with long-standing uncontrolled type 2 diabetes.
abstract: OBJECTIVE
  Endothelial progenitor cells (EPCs) have an important role in repair following vascular injury. However, in patients with diabetes, EPC number and function are markedly reduced. It is unclear whether intensive glycaemic control can modify EPC properties in diabetic patients. We aimed to examine whether glycaemic control can improve EPC number and function in patients with long-standing uncontrolled type 2 diabetes.
  
  
  RESULTS
  Thirty-five patients with treated type 2 diabetes and HgA1c ≥ 8.5% were included. Patients were tested at baseline and after 3-4 months of an intensive glycaemic control programme, with the aim of achieving HgA1c of 7%. The diabetes group was compared to 20 patients without diabetes (control). Circulating EPC levels were assessed by flow cytometry for expression of VEGFR2, CD133, and CD34. The capacity of the cells to form colony-forming units (CFUs), and their migration and viability were quantified after 1 week of culture. Patients with diabetes (mean age 61.1 ± 7 years, 28.6% women, disease duration of 19.2 ± 8 years) had a baseline HgA1c of 9.4 ± 0.8%. After the glycaemic control period, HgA1c decreased to 8 ± 0.8%. Circulating EPC levels increased significantly after the intensive control period and reached a level similar to the control group. The number of EPC CFUs also increased significantly after glycaemic control but remained lower than the control group. All EPC functional assays improved following the glycaemic control.
  
  
  CONCLUSIONS
  In patients with uncontrolled long-standing type 2 diabetes, intensive glycaemic control was associated with an increase in the levels of circulating EPCs, and improvement in their functional properties.
authors.affiliation: Tel-Aviv University, Tel-Aviv, Israel The Felsenstein Medical Research Institute, Petah-Tikva, Israel elil@clalit.org.il elev@tmhs.org.
authors.forename: Eli I
authors.initials: EI
authors.lastname: Lev
authors.affiliation: Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Joel
authors.initials: J
authors.lastname: Singer
authors.affiliation: The Felsenstein Medical Research Institute, Petah-Tikva, Israel.
authors.forename: Dorit
authors.initials: D
authors.lastname: Leshem-Lev
authors.affiliation: Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Merav
authors.initials: M
authors.lastname: Rigler
authors.affiliation: The Felsenstein Medical Research Institute, Petah-Tikva, Israel.
authors.forename: Oshrat
authors.initials: O
authors.lastname: Dadush
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Muthiah
authors.initials: M
authors.lastname: Vaduganathan
authors.affiliation: Tel-Aviv University, Tel-Aviv, Israel The Felsenstein Medical Research Institute, Petah-Tikva, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Battler
authors.affiliation: Tel-Aviv University, Tel-Aviv, Israel The Felsenstein Medical Research Institute, Petah-Tikva, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
mesh_terms: D000328:Adult; D000368:Aged; D017209:Apoptosis; D001786:Blood Glucose / Q000378:metabolism*; D002478:Cells, Cultured; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D066026:Endothelial Progenitor Cells / Q000502:physiology*; D004730:Endothelium, Vascular / Q000166:cytology / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D009569:Nitric Oxide; C517652:hemoglobin A1c protein, human
keywords: Diabetes; endothelial progenitor cells; glycaemic control