title: Endothelial differentiation of diabetic adipose-derived stem cells.
abstract: BACKGROUND
  Diabetic (DM) patients frequently lack autologous vascular tissue required for revascularization procedures and dialysis access creation. We have developed a tissue-engineered graft that uses adipose-derived stem cells (ASC) as endothelial cell substitutes. Here, we compare DM versus nondiabetic (NDM) ASC in terms of isolation efficiency, proliferation, commitment toward endothelial lineage, and seeding onto the luminal surface of a graft.
  
  
  METHODS
  ASC were isolated from liposuction specimens of vascular surgery patients. Proliferation was assessed by constructing growth curves over 14 d. ASC were differentiated in endothelial growth medium (EGM2). Endothelial commitment was assessed by measuring endothelial cell-specific gene expression (CD31, von Willebrand factor) and by cord formation on Matrigel. Finally, ASC were seeded onto a vascular scaffold, flow conditioned, and imaged with confocal microscopy.
  
  
  RESULTS
  Diabetes did not alter ASC isolation efficiency (224,028 ± 20,231 cells/g adipose for DM (n = 53) versus 259,345 ± 15,441 cells/g adipose for NDM (n = 145; P = 0.21). Growth curves for DM (n = 6) and NDM (n = 6) also appeared similar. After culture in EGM2, upregulation of CD31 and von Willebrand factor message was observed in NDM; these markers were found within the primary cultures of DM but no upregulation was observed after culture in EGM2. Both groups exhibited similar cord formation on Matrigel and retention to vascular scaffolds.
  
  
  CONCLUSIONS
  Isolation and proliferation studies suggest that adipose is a promising source of stem cells for tissue engineering in the DM population. The angiogenic potential of DM ASC appears intact; however, differences in acquisition of endothelial cell markers suggest that differentiation may be inhibited or delayed by diabetes.
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Policha
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Lily
authors.initials: L
authors.lastname: Chang
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lamb
authors.affiliation: Department of Surgery, Cooper Medical School of Rowan University, Camden, New Jersey.
authors.forename: Thomas
authors.initials: T
authors.lastname: Tulenko
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Electronic address: paul.dimuzio@jefferson.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: DiMuzio
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000328:Adult; D053687:Adult Stem Cells / Q000166:cytology*; D015415:Biomarkers; D001807:Blood Vessel Prosthesis; D002102:Cadaver; D002454:Cell Differentiation; D019070:Cell Lineage; D049109:Cell Proliferation; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D042783:Endothelial Cells / Q000166:cytology*; D005260:Female; D006801:Humans; D015187:Lipectomy; D008297:Male; D018919:Neovascularization, Physiologic
chemical_list: D015415:Biomarkers
keywords: Adipose-derived stem cells; Diabetes; Endothelium; Vascular tissue-engineering