Vascular Progenitor Cells in Diabetes Mellitus

Abstract

See related article, pages 1095–1102 Over the centuries, diabetes mellitus–associated ischemic ulcers have driven physicians to continue to improve their skills in healing the ulcers to prevent devastating complications.1 Unfortunately, extremity amputation still remains the outcome in many cases. The recent development of vascular progenitor cell (PC) transplantation aimed at enhancing angiogenesis and wound healing may, however, provide new hope in the treatment of this old ailment.2,3 In this issue of Circulation Research , Barcelos et al show in a murine diabetes mellitus model that topical transplantation of human fetal CD133+ PCs significantly accelerates the healing of skin wounds on ischemic hind limbs.4 Their data suggest that the reparative angiogenesis is mediated by the wingless (Wnt) signaling pathway. The prominin-1 (PROM1)/CD133 gene encodes a pentaspan transmembrane glycoprotein expressed in a variety of stem cells, including hematopoietic stem cells, endothelial PCs (EPCs), and neuronal/glial stem cells.5,6 By suppressing further differentiation, PROM1 helps these cells maintain their stem cell properties. Mutations in PROM1 may result in retinitis pigmentosa,7 and its overexpression is also associated with cancer formation.8 In view of this cancer potential, overstimulation of CD133+ cells may also lead to unwanted consequences. Additionally, that human fetal CD133+ cells are not easily accessible …