title: Severe Type 2 Diabetes Induces Reversible Modifications of Endothelial Progenitor Cells Which are Ameliorate by Glycemic Control.
abstract: BACKGROUND
  Circulating endothelial progenitors cells (EPCs) play a critical role in neovascularization and endothelial repair. There is a growing evidence that hyperglycemia related to Diabetes Mellitus (DM) decreases EPC number and function so promoting vascular complications.
  
  
  OBJECTIVE
  This study investigated whether an intensive glycemic control regimen in Type 2 DM can increase the number of EPCs and restores their function.
  
  
  METHODS
  Sixty-two patients with Type 2 DM were studied. Patients were tested at baseline and after 3 months of an intensive regimen of glycemic control. The Type 2 DM group was compared to control group of subjects without diabetes. Patients with Type 2 DM (mean age 58.2±5.4 years, 25.6% women, disease duration of 15.4±6.3 years) had a baseline HgA1c of 8.7±0.5% and lower EPC levels (CD34+/KDR+) in comparison to healthy controls (p<0.01).
  
  
  RESULTS
  The intensive glycemic control regimen (HgA1c decreased to 6.2±0.3%) was coupled with a significant increase of EPC levels (mean of 18%, p<0.04 vs. baseline) and number of EPCs CFUs (p<0.05 vs. baseline).
  
  
  CONCLUSIONS
  This study confirms that number and bioactivity of EPCs are reduced in patients with Type 2 DM and, most importantly, that the intensive glycemic control in Type 2 DM promotes EPC improvement both in their number and in bioactivity.
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria, Second University of Naples.
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: De Pascale
authors.affiliation: Division of Cardiology, ASL NA1, Pellegrini Hospital, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bruzzese
authors.affiliation: Department of Anesthesia and Critical Care Medicine, University of Florida, Shands Hospital, Florida, USA.
authors.forename: Ettore
authors.initials: E
authors.lastname: Crimi
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria, Second University of Naples.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Grimaldi
authors.affiliation: Division of Cardiology, ASL NA1, Pellegrini Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Liguori
authors.affiliation: Department of Medicine and Surgery, Plastic Surgery Unit, University of Salerno, Salerno, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Brongo
authors.affiliation: Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, Second University of Naples, Naples, Italy.
authors.forename: Michelangela
authors.initials: M
authors.lastname: Barbieri
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria, Second University of Naples.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Picascia
authors.affiliation: IRCCS Foundation SDN, Naples, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Schiano
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria, Second University of Naples.
authors.forename: Linda
authors.initials: L
authors.lastname: Sommese
authors.affiliation: Geriatrics Medicine, Department of Translational Medical Science, Federico II University of Naples, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
authors.affiliation: Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, Second University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paolisso
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria, Second University of Naples.|Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, Second University of Naples, Naples, Italy.|IRCCS Foundation SDN, Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Napoli
keywords: Endothelial progenitor cells; Regenerative medicine; Type 2 diabetes; Vascular disease