Abstract
The fetoplacental circulation plays a key role in both short- and long-term outcomes, and aberrant flow indices as manifested by abnormal fetal Doppler velocimetry within this compartment have been associated with significant adverse consequences. These include fetal growth restriction, which often coexists with preeclampsia, and long-lasting medical issues as a result of both the underlying pathology and prematurity such as bronchopulmonary dysplasia, chronic lung disease, and neurodevelopmental delay. Furthermore, it is also clear that exposure to an abnormal in utero environment increases risk for long-term, adulthood issues such as cardiovascular disease. Endothelial progenitor cells (EPCs) have been implicated in vasculogenesis and angiogenesis, and they have been isolated from both human placenta and umbilical cord blood. This review outlines the extensive nomenclature of EPCs, summarizes existing literature surrounding human placental and umbilical cord blood EPCs, explores their potential role in pregnancy complications and adverse perinatal outcome, and highlights key areas where future investigations are needed.
Highlights
Of the three main components that shape placental function—the maternal uteroplacental circulation, placental trophoblast, and fetoplacental blood flow—it is the fetoplacental circulation that has been clinically demonstrated to be most highly related to adverse perintal outcome
Endothelial progenitor cells (EPCs) have been isolated from the human placenta and umbilical cord blood, and in comparison to those derived from adult peripheral blood mononuclear cells (PBMNCs), demonstrate unique features such as enhanced proliferative and clonogenic potential
They demonstrated an endothelial cell-like phenotype, with the ability to produce nitric oxide in response to acetylcholine and vascular endothelial growth factor. These cells were incorporated into foci of neovascularization in a rabbit model of unilateral hindlimb ischemia. These investigators concluded that PBMNCs isolated with anti-CD34 or anti-Flk-1 were able to differentiate into endothelial cells, and this method of isolation and identification became the standard for assessing EPCs
Summary
Of the three main components that shape placental function—the maternal uteroplacental circulation, placental trophoblast, and fetoplacental blood flow—it is the fetoplacental circulation that has been clinically demonstrated to be most highly related to adverse perintal outcome. Even if a growth-restricted fetus emerges from the perinatal and early childhood periods without adverse consequences, multiple lines of evidence suggest that they remain at increased risk for long-term, adulthood issues such as cardiovascular disease [3,4,5]. From a structural perspective, scanning electron microscopy, stereological analysis, and mathematical modeling suggest that FGR placentas demonstrate impaired placental vascular angiogenesis [6,7,8]. This is just one condition in which the fetoplacental vasculature is impaired, it highlights the importance of this compartment in pregnancy and long-term outcome
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
