Higher numbers of circulating endothelial progenitor cells in stroke patients with intracranial arterial stenosis

Zhizhong Liu,Fang Fang,Guojun Zhang,Xixiong Kang,Yuetao Ma,Ruimin Wang,Xiurong Ding,Yan Chen

doi:10.1186/1471-2377-13-161

Abstract

BackgroundBone marrow-derived endothelial stem cells participate in vascular repairs. Numbers of circulating endothelial progenitor cells (cEPCs) are associated with atherosclerosis. Fibrinogen plays a key role in atherosclerosis. Objective was to assess if cEPC counts were associated with atherosclerotic intracranial artery stenosis (IAS).MethodsThree hundred subjects (108 patients with stroke and IAS (IAS), 120 control patients with stroke without IAS (CP), and 72 healthy controls (HC)) were retrospectively analyzed. cEPCs were identified and counted by flow cytometry using CD34, CD133 and KDR. Plasma fibrinogen was measured by immunoturbidimetry. cEPC counts were compared between the three groups.ResultscEPC numbers were significantly higher in IAS (0.059 ± 0.031%) than in CP (0.026 ± 0.012%) (P < 0.001) and HC (0.021 ± 0.011%) (P < 0.001), but without difference between CP and HC (P = 0.401). Multiple logistic regression analysis showed that cEPC levels (OR 3.31, 95%CI 1.26-8.87, P = 0.025; IAS vs. CP) were independent markers of IAS after adjustment for hypertension, diabetes and smoking. No significant correlation between cEPC counts and plasma fibrinogen levels was observed (P > 0.05).ConclusioncEPC numbers were associated with degrees of IAS. This measurement may be useful for non-invasive evaluation of atherosclerotic IAS.

Highlights

Bone marrow-derived endothelial stem cells participate in vascular repairs
We hypothesized that there might be a potential association between plasma fibrinogen levels, circulating endothelial progenitor cells (cEPCs) and intracranial artery stenosis (IAS). This present study explored the association between cEPC numbers and IAS, and if there was a correlation between Endothelial progenitor cells (EPC) and fibrinogen levels. cEPCs might be a disease marker in IAS, and may be a treatment target in IAS
Our study showed that serum fibrinogen levels were higher in IAS patients and Control patients (CP) compared with Healthy controls (HC), but that there was no difference between IAS and CP, suggesting that fibrinogen might not be a key factor stimulating cEPCs mobilization in IAS

Summary

Introduction

Bone marrow-derived endothelial stem cells participate in vascular repairs. Numbers of circulating endothelial progenitor cells (cEPCs) are associated with atherosclerosis. Objective was to assess if cEPC counts were associated with atherosclerotic intracranial artery stenosis (IAS). Intracranial arterial stenosis (IAS) is an important cause of stroke. The number of intracranial symptomatic vessels and their stenosis degree is associated with a higher risk of stroke recurrence and other major ischemic events [1,2,3,4]. The mechanisms for atherosclerosis initiation and progression in intracranial large arteries are still ill understood. Intracranial atherosclerosis may be characterized by multiple stenoses of cerebral large arteries, which may result in chronic brain hypoperfusion, responsible for an enhanced angiogenic response [5]. Endothelial repair may be crucial for atherosclerosis progression in intracranial large arteries [6].

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