Endothelial Progenitor Cells Biology Research Articles

Endothelial Progenitor Cells Bind and Inhibit Platelet Function and Thrombus Formation

Interactions of endothelial progenitor cells (EPCs) with vascular and blood cells contribute to vascular homeostasis. Although platelets promote the homing of EPCs to sites of vascular injury and their differentiation into endothelial cells, the functional consequences of such interactions on platelets remain unknown. Herein, we addressed the interactions between EPCs and platelets and their impact on platelet function and thrombus formation. Cultured on fibronectin in conditioned media, human peripheral blood mononuclear cells differentiated, within 10 days of culture, into EPCs, which uptake acetylated low-density lipoprotein, bind ulex-lectin, lack monocyte/leukocyte markers (CD14, P-selectin glycoprotein ligand-1, L-selectin), express progenitor/endothelial markers (CD34, vascular endothelial growth factor receptor-2, von Willebrand factor, and vascular endothelial cadherin), and proliferate in culture. These EPCs bound activated platelets via CD62P and inhibited its translocation, glycoprotein IIb/IIIa activation, aggregation, and adhesion to collagen, mainly via prostacyclin secretion. Indeed, this was associated with upregulation of cyclooxygenase-2 and inducible nitric oxide synthase. However, the effects on platelets in vitro were reversed by cyclooxygenase and cyclooxygenase-2 inhibition but not by nitric oxide or inducible nitric oxide synthase inhibition. Moreover, in a ferric chloride-induced murine arterial thrombosis model, injection of EPCs led to their incorporation into sites of injury and impaired thrombus formation, leading to an incomplete occlusion with 50% residual flow. Peripheral blood mononuclear cell-derived EPCs bind platelets via CD62P and inhibit platelet activation, aggregation, adhesion to collagen, and thrombus formation, predominantly via upregulation of cyclooxygenase-2 and secretion of prostacyclin. These findings add new insights into the biology of EPCs and define their potential roles in regulating platelet function and thrombosis.

Role of endothelial progenitor cells in diabetes mellitus

Endothelial progenitor cells (EPCs) are bone marrow-derived cells involved in endothelial healing and angiogenesis. EPCs are considered an integrated component of the cardiovascular system, which promotes vascular health. Derangement of EPC biology in diabetes has been hailed as a novel concept in the pathogenesis of micro- and macro-vascular complications. Additionally, EPCs are considered to be disease biomarkers, as they provide an index of cardiovascular risk. The mechanisms leading to EPC dysfunction in diabetes may include defective mobilization from bone marrow to peripheral blood and reduced half-life. Hyperglycemia is considered the major determinant of microvascular complications, while other mechanisms concur to increase the risk of cardiovascular disease in diabetic patients. EPCs may represent a novel pathophysiological connection to understand development and progression of diabetic complications.

Decreased in the number and function of circulation endothelial progenitor cells in patients with avascular necrosis of the femoral head

Introduction Once non-traumatic avascular necrosis of the femoral head (ANFH) happened, vascular impairment and feeble collateral circulation are followed by poor outcomes. Circulating endothelial progenitor cells (EPCs) may substantially contribute to vascular homeostasis such as vascular repair and new blood vessel growth. We investigated whether abnormalities in EPCs levels and functions are present in ANFH patients. Methods 54 ANFH patients were enrolled, including steroid-induced ( n = 21), alcohol-induced ( n = 15) and idiopathic ANFH ( n = 18), and 30 healthy subjects as control (HC). The numbers of circulation EPCs were determined by fluorescence-activated cell-sorting (FACS) analysis. EPCs cultured from peripheral blood mononuclear cells on fibronectin to induce the expression of receptors for acetylated low-density lipoprotein and ulex-lectin. EPCs colony-forming units (CFUs) were observed from 54 patients and 30 healthy controls. Migratory capacity to chemo-attractants (vascular endothelial growth factor) cellular senescence levels and in vitro angiogenesis ability were assessed in age-matched subjects ( n = 10 per groups). Results Mean numbers of circulating EPC were 1460 ± 265 cells/ml in HC, 545 ± 177 in ANFH, ( P < 0.001). Mean numbers of CFUs were 26.2 ± 6.2 in HC, 19.6 ± 7.7 in ANFH,( P < 0.001). Although there were not significant differences in circulating EPC and CFUs among the steroid-induced, alcohol-induced or idiopathic three groups, all these risk factors contributed to the decreased circulating EPCs numbers and CFUs. In addition, EPCs from ANFH patients showed reduced migratory capacity and increased cellular senescence compared with EPCs from normal subjects, furthermore the ability of angiogenesis in vitro was also impaired. Conclusion Circulating endothelial progenitor cells (EPCs) numbers and functions are reduced in ANFH patients, suggesting that risk factors of ANFH may alter EPCs biology in angiogenesis and vascular repair.

Effects of androgens on endothelial progenitor cellsin vitroandin vivo

The beneficial or detrimental effects of androgens on the cardiovascular system are debated. Endothelial progenitor cells are bone-marrow-derived cells involved in endothelial healing and angiogenesis, which promote cardiovascular health. Oestrogens are potent stimulators of endothelial progenitor cells, and previous findings have indicated that androgens may improve the biology of these cells as well. In the present study, we show that testosterone and its active metabolite dihydrotestosterone exert no effects on the expansion and function of late endothelial progenitors isolated from the peripheral blood of healthy human adult males, whereas they positively modulate early ‘monocytic’ endothelial progenitor cells. In parallel, we show that castration in rats is followed by a decrease in circulating endothelial progenitor cells, but that testosterone and dihydrotestosterone replacement fails to restore endothelial progenitor cells towards normal levels. This is associated with persistently low oestrogen levels after androgen replacement in castrated rats. In a sample of 62 healthy middle-aged men, we show that circulating endothelial progenitor cell levels are more directly associated with oestradiol, rather than with testosterone, concentrations. In conclusion, our results collectively demonstrate that androgens exert no direct effects on endothelial progenitor cell biology in vitro and in vivo.

Levels of circulating endothelial progenitor cells are related to uremic toxins and vascular injury in hemodialysis patients.

Patients suffering from chronic kidney diseases (CKD) exhibit cardiovascular diseases and profound endothelial dysfunction. CKD patients have reduced numbers of endothelial progenitor cells, but little is known about the factors influencing these numbers. Among these factors, we hypothesized that uremic toxins and vascular injury affect endothelial progenitor cells. Thirty-eight hemodialysis patients were investigated and compared with 21 healthy controls. CD34+CD133+ immature progenitors, CD34+KDR+ endothelial progenitors cells (EPC) and myeloid EPC (mEPC) were counted in peripheral blood. Levels of uremic toxins beta(2)-microglobulin, indole-3 acetic acid, indoxylsulfate, p-cresylsulfate and homocysteine were measured. Vascular injury was assessed in hemodialysis (HD) patients by measuring aortic pulse wave velocity and plasma levels of endothelial microparticles. In vitro experiments were performed to study the effect of uremic toxins on apoptosis of progenitor cells. CD34+CD133+ immature progenitor cell number was negatively correlated with the levels of uremic toxins beta(2)-microglobulin and indole-3 acetic acid. In vitro, indole-3 acetic acid induced apoptosis of CD133+ cells. These data indicate uremic toxins have a deleterious role on progenitor cells, early in the differentiation process. Moreover, mEPC number was positively correlated with markers of vascular injury-pulse wave velocity and endothelial microparticle levels. This suggests that vascular lesions could stimulate progenitor cell mobilization, even in a context of reduced EPC induced by CKD. In conclusion, uremic toxins and vascular injury appear to affect endothelial progenitor cell biology in CKD.

Endothelial progenitor cells and their potential clinical implication in cardiovascular disorders

Risk factors associated with cardiovascular diseases reduce the availability of endothelial progenitor cells (EPC) by affecting their mobilization and integration into injured vascular sites. The existence of a bone marrow reservoir of EPC has attracted interest, especially as target for therapeutic intervention in different pathological settings. Among the cardiovascular risk factors, hypertension has been shown to be a strongest predictor of EPC migratory impairment. However, at present, data concerning EPC biology are still limited. In this article we provide an overview of data relevant to their potential clinical implications in cardiovascular disorders. In addition, the recent advances in understanding the role of EPC in the pathophysiology of hypertension are discussed.

Pivotal Role of Lnk Adaptor Protein in Endothelial Progenitor Cell Biology for Vascular Regeneration

Despite the fact that endothelial progenitor cells (EPCs) are important for postnatal neovascularization, their origins, differentiation, and modulators are not clear. Here, we demonstrate that Lnk, a negative regulator of hematopoietic stem cell proliferation, controls endothelial commitment of c-kit(+)/Sca-1(+)/Lineage(-) (KSL) subpopulations of bone marrow cells. The results of EPC colony-forming assays reveal that small (primitive) EPC colony formation by CD34(-) KSLs and large (definitive) EPC colony formation by CD34((dim)) KSLs are more robust in lnk(-/-) mice. In hindlimb ischemia, perfusion recovery is augmented in lnk(-/-) mice through enhanced proliferation and mobilization of EPCs via c-Kit/stem cell factor. We found that Lnk-deficient EPCs are more potent actors than resident cells in hindlimb perfusion recovery and ischemic neovascularization, mainly via the activity of bone marrow-EPCs. Similarly, lnk(-/-) mice show augmented retinal neovascularization and astrocyte network maturation without an increase in indicators of pathogenic angiogenesis in an in vivo model of retinopathy. Taken together, our results provide strong evidence that Lnk regulates bone marrow-EPC kinetics in vascular regeneration. Selective targeting of Lnk may be a safe and effective strategy to augment therapeutic neovascularization by EPC transplantation.

Wild-type apo A-I and apo A-IMilano gene transfer reduce native and transplant arteriosclerosis to a similar extent

Apolipoprotein (apo) A-I(Milano) is an apo A-I mutant characterized by a cysteine for arginine substitution at position 173. Apo A-I(Milano) carriers have much less atherosclerosis than expected from their low plasma high-density lipoprotein cholesterol levels, suggesting that this mutant may have superior atheroprotective properties. Here, we compare the effect of hepatocyte-directed gene transfer of wild-type human apo A-I and human apo A-I(Milano) on endothelial progenitor cell (EPC) biology and on the progression of native atherosclerosis and allograft vasculopathy in C57BL/6 apo E(-/-) mice. Human apo A-I and apo A-I(Milano) transfer resulted in an equivalent increase of EPC number and function as well as EPC incorporation and endothelial regeneration in allografts and inhibited the progression of native atherosclerosis and allograft vasculopathy to a similar extent. In conclusion, the current head-to-head comparison indicates that human apo A-I(Milano) transfer is not superior compared to wild-type human apo A-I transfer.

Oxidative Stress Impairs Endothelial Progenitor Cell Function

Circulating endothelial progenitor cells (EPCs) in adult human peripheral blood were identified in 1997. Since their original identification, EPCs have been extensively studied as biomarkers to assess the risk of cardiovascular disease in human subjects and as a potential cell therapeutic for vascular regeneration. EPCs are exposed to oxidative stress during vascular injury as residents of blood vessel walls or as circulating cells homing to sites of neovascularization. Given the links between oxidative injury, endothelial cell dysfunction, and vascular disease, recent investigation has focused on the responses of EPCs to oxidant stress and the molecular mechanisms that control redox regulation in these specialized cells. In this review, we discuss the various cell and flow-cytometric techniques used to define and isolate EPCs from circulating blood and the current human and mouse genetic data, which offer insights into redox control in EPC biology and angiogenesis. Finally, we review how EPC responses to oxidant stress may be a critical determinant in maintaining the integrity and function of the cardiovascular system and how perturbations of redox control in EPCs may lead to various human diseases.

Abstract 3752: Mineralocorticoid Receptor Antagonism Prevents Aldosterone Mediated Dysfunction of Human Endothelial Progenitor Cells in Vitro, in Vivo and in Patients

Hyperaldosteronism has been associated with vascular injury. Bone marrow derived endothelial progenitor cells (EPC) play an important role in endothelial repair and vascular homeostasis. We therefore examined the effects of aldosterone and its blockade by the mineralocorticoid receptor (MR) antagonist eplerenone on EPC number and function in vitro , in vivo and a clinical trial . EPCs expressed the MR at the gene and protein level. Aldosterone treatment of human EPC led to a translocation of the MR into the nucleus and impaired multiple cellular functions, such as differentiation, migration, proliferation and incorporation in vascular networks. Impaired EPC function was rescued by pharmacological antagonism or genetic ablation of the MR. Aldosterone increased the intracellular production of reactive oxygen species (ROS), which was attenuated by MR blockade. Aldosterone-mediated increase of ROS was mainly protein kinase A-dependent and resulted in cAMP activation with subsequent impairment of EPC migration. Chronic aldosterone infusion in mice (implanted minipumps, 50mg/kg/d for 14d) impaired EPC functionality and resulted in endothelial dysfunction. MR antagonism prevented those effects. In patients with hyperaldosteronism, EPC displayed reduced migratory potential compared with age-matched healthy controls. Impaired function of EPC from patients with hyperaldosteronism significantly correlated with endothelial dysfunction assessed by peripheral arterial tonometry. Importantly, MR antagonism in patients with hyperaldosteronism improved EPC as well as endothelial function. EPC function is impaired in hyperaldosteronism by increased intracellular ROS production and cAMP activation. Beneficial effects of MR antagonists in cardiovascular disease prevention and therapy especially during hyperaldosteronism may be mediated in part by improved EPC biology.

Abstract 1963: Endothelial Cell-Derived Microparticles Interact with Regenerating Cells and Transfer Biological Information

Apoptosis of endothelial cells (ECs) leads to the development of endothelial dysfunction, which itself is strongly associated with poor cardiovascular prognosis. EC apoptosis can be quantified using flow-cytometry-based enumeration of circulating EC-derived microparticles (EMP) within peripheral blood. Bone marrow-derived endothelial progenitor cells (EPC) contribute to EC regeneration and are an important predictor for cardiovascular mortality. We postulate that EC apoptosis with concomitant release of EMP is an important signal for regenerating cells to initiate EC repair. EMP were generated from human coronary arterial endothelial cells (HCAEC). Proteomic analysis showed that the identified proteins represent cytoskeleton/cytoskeleton-binding proteins, proteins involved in intracellular transport/signalling, and protein folding. In addition, proteins related to apoptosis, proliferation, and migration were identified. HCAEC/EPC were able to incorporate EMP in an annexin I/ phosphatidylserine receptor-dependent way. Incubation of mononuclear cells with EMP lead to an enhanced conversion into early outgrowth EPC. EMP co-incubation also changed the phenotype of cultivated Langerhans-like dendritic cells into an immature phenotype. Co-cultivation of ECs and EPC with EMP prevented TNF-alpha induced cell apoptosis. Migration of EPC was enhanced in response to EMP. Finally, we measured EPC liberation from bone marrow into peripheral blood. Intravenous treatment of C57bl6 mice with EMP enhanced the number of sca-1/flk-1 positive EPC within peripheral blood compared to control. The number of CD31+/Annexin+ EMP and CD34 + /KDR + EPC was determined in 40 patients with coronary artery disease. The number of circulating EMP correlated with EPC function (p&lt;0.001, r=0.601). EMP and EPC seem to substantially interact in an annexin I/PSR dependent way. EMP influence EPC biology in vitro and induces EPC mobilization in vivo. We speculate that the described interaction of EMP with EPC enhance the homing process of EPC within the area of EC damage.

Role of integrin-linked kinase for functional capacity of endothelial progenitor cells in patients with stable coronary artery disease

Number and function of endothelial progenitor cells (EPCs) are down-regulated in patients with coronary artery disease (CAD). Integrin-linked kinase (ILK) is a signal and adaptor protein that regulates survival of mature endothelial cells and vascular development.Here we show that EPC dysfunction in patients with CAD is paralleled by down-regulation of ILK while restoration of ILK expression rescues the migratory defect of CAD-EPCs. Human EPCs transduced with dominant-negative ILK (DN-ILK) display significantly reduced expression of CD34+/VEGFR-2+, DiI-Ac-LDL uptake, and Ulex europaeus lectin binding. Mechanistically, DN-ILK-transfected EPCs are characterized by decreased proliferation, while proliferation is increased in wild-type ILK-transfected EPCs. These effects are paralleled by changes in cyclin D1 expression, colony forming units, and cytoskeletal rearrangement. Functionally, ILK is necessary and sufficient for SDF-1-triggered migration and adhesion in EPCs.These data extend current knowledge about the role of ILK in EPC biology and implicate ILK as a therapeutic target in CAD.

High‐density lipoprotein exerts vasculoprotection via endothelial progenitor cells

Endothelial progenitor cells (EPC) enhance endothelial cell repair, improve endothelial dysfunction and are a predictor for cardiovascular mortality. High-density lipoprotein (HDL) cholesterol levels inversely correlate with cardiovascular events and have vasculoprotective effects. Here we postulate that HDL influences EPC biology. HDL and EPC were isolated according to standard procedures. Differentiation of mononuclear cells into DiLDL/lectin positive cells was enhanced after HDL treatment compared to vehicle. HDL was able to inhibit apoptosis (TUNEL assay, annexin V staining) while proliferation (BrdU incorporation) of early outgrowth colonies after extended cell cultivation (14 days) was increased. Flow chamber experiments revealed an improved adhesion of HDL pre-incubated EPC on human coronary artery endothelial cells (HCAEC) compared to vehicle while HDL treatment of HCAEC prevented adhesion of inflammatory cells. Flow cytometry demonstrated an up-regulation of β2- and α4-integrins on HDL pre-incubated EPC. Blocking experiments revealed a unique role of β2-integrin in EPC adhesion. Treatment of wild-type mice with recombinant HDL after endothelial denudation resulted in enhanced re-endothelialization compared to vehicle. Finally, in patients with coronary artery disease a correlation between circulating EPC and HDL concentrations was demonstrated. We provide evidence that HDL mediates important vasculoprotective action via the improvement of function of circulating EPC.

Endothelial Progenitor Cells and Angiogenesis Join the PPARty

See related article, pages 80–88 Peroxisome proliferator-activated receptors (PPARs) are ligand-inducible transcription factors that belong to the nuclear hormone receptor superfamily.1 In mammals, the PPAR family consists of 3 subtypes of proteins encoded by separate genes: PPARα (NR1C1), PPARγ (NR1C3), and PPARδ (also known as β or NR1C2).2 They act as heterodimers with the retinoid X receptor and regulate gene transcription by binding to specific response elements in the promoter of the target genes.3 The classical biological activity of PPARα is the regulation of the rate of fatty acid uptake and their esterification into triglyceride or oxidation,4–7 whereas PPARγ is classically involved in adipocyte differentiation, regulation of fat storage, and maintenance of glucose homeostasis.5 The physiological functions of PPARδ are instead still unclear, although it is known that this receptor contributes to an inflammatory switch through its association and disassociation with transcriptional repressors.8 The clinical importance of PPARs originates with fibrates and thiazolidinediones (TZDs), which respectively act on PPARα and PPARγ and are used to ameliorate hyperlipidemia and hyperglycemia in subjects with type 2 diabetes mellitus (T2DM). Fibrates, such as gemfibrozil, clofibrate, fenofibrate, and bezofibrate, are drugs that effectively reduce triglycerides (TG) and free …

The Role of Neuregulin/erbB Signaling in Endothelial Progenitor Cell Biology

Neuregulin (NRG) is a ligand for the erbB3 and erbB4 members of the EGF family receptors, and is known to activate signaling pathways that mediate proliferation, survival, migration and differentiation in various cell types. Stimuli such as exercise and ischemia‐reperfusion, which induce NRG shedding also induce endothelial progenitor cell (EPC) mobilization and recruitment. We hypothesized that NRG signaling may a play role in EPC mobilization and homing.Using western blot and immunostaining, we found that a murine embryonic endothelial progenitor cell line expresses NRG ligand and the ErbB‐2, 3 and 4 receptors. Treatment with recombinant NRG led to ErbB2/B3 phosphorylation as well as downstream Akt and endothelial nitric oxide synthase phosphorylation. NRG activated signaling was blocked by the ErbB receptor inhibitors AG1478 and Lapatanib. To examine the role of NRG/ErbB signaling in EPC biology we performed a matrigel angiogenesis assay. In contrast to mature rat cardiac microvascular endothelial cells (CMEC), EPC's in 3 dimensional monoculture do not form microvessel networks. However when EPC's are co‐cultured with CMEC's in matrigel, EPC's incorporate into the developing microvessel network within 24 hrs. This effect was completely inhibited by the erbB receptor inhibitor AG1478.These results support a role for Neuregulin/ErbB signaling in EPC recruitment. A clearer understanding of what role NRG signaling may play in EPC biology has important implications for cardiovascular biology, as well as the pathophysiology of cardiac dysfunction seen in the setting of erbB2 targeted cancer therapeutics.

Circulating Endothelial Progenitor Cells in Cerebrovascular Disease

Stroke is associated with high disability and mortality burdens worldwide, but there are few effective and widely available therapies. There is therefore a need to develop treatments that promote the repair and regeneration of ischemic brain tissue. In this regard, a population of adult stem cells-called endothelial progenitor cells (EPCs)-has been identified in peripheral blood that could provide novel approaches in regenerative medicine for curing patients with acute ischemic stroke. There is accumulating evidence that EPCs can repair damaged endothelia and attenuate the development and progression of atherosclerosis. Also, EPCs can be recruited in response to acute ischemic events and participate in reparative vasculogenesis. Most studies related to EPCs have involved patients with cardiovascular diseases, and there is emerging evidence that EPCs represent a risk marker and a potential therapeutic agent in cerebrovascular disease. Here we review the characteristics and biology of EPCs in cerebrovascular disease and discuss the challenges that must be addressed to clarify the role and therapeutic applicability of EPCs in cerebrovascular disease.

Progenitor cells and vascular disease

Vascular progenitor cells have been the focus of much attention in recent years; both from the point of view of their pathophysiological roles and their potential as therapeutic agents. However, there is as yet no definitive description of either endothelial or vascular smooth muscle progenitor cells. Cells with the ability to differentiate into mature endothelial and vascular smooth muscle reportedly reside within a number of different tissues, including bone marrow, spleen, cardiac muscle, skeletal muscle and adipose tissue. Within these niches, vascular progenitor cells remain quiescent, until mobilized in response to injury or disease. Once mobilized, these progenitor cells enter the circulation and migrate to sites of damage, where they contribute to the remodelling process. It is generally perceived that endothelial progenitors are reparative, acting to restore vascular homeostasis, while smooth muscle progenitors contribute to pathological changes. Indeed, the number of circulating endothelial progenitor cells inversely correlates with exposure to cardiovascular risk factors and numbers of animal models and human studies have demonstrated therapeutic roles for endothelial progenitor cells, which can be enhanced by manipulating them to overexpress vasculo-protective genes. It remains to be determined whether smooth muscle progenitor cells, which are less well studied than their endothelial counterparts, can likewise be manipulated to achieve therapeutic benefit. This review outlines our current understanding of endothelial and smooth muscle progenitor cell biology, their roles in vascular disease and their potential as therapeutic agents.

Endothelial progenitor cell therapy for the treatment of coronary disease, acute MI, and pulmonary arterial hypertension: Current perspectives

Since their identification in 1997, bone marrow derived endothelial progenitor cells (EPCs) have been studied for their role in the endogenous maintenance and repair of endothelium and their potential regenerative capacity beyond the endothelium. In particular, EPCs have been tested in cell therapy approaches with the aim of developing novel therapies for conditions currently lacking effective treatment options. In this review, we discuss the scientific background and clinical experience using EPC delivery or mobilization for the treatment of post-angioplasty restenosis, acute myocardial infarction and pulmonary arterial hypertension. Although these approaches are safe, efficacy has yet to be proven in large randomized clinical trials. Unfortunately, the biology of EPCs is still poorly understood. The success of future clinical trials depends on a better understanding of EPC biology and intelligent design.

Reconstituted HDL Increases Circulating Endothelial Progenitor Cells in Patients With Type 2 Diabetes

Recent articles in this journal suggest a new role for HDL in endothelial progenitor cell (EPC)-mediated endothelial repair.1,2 We investigated the effect of increasing HDL levels by systemic infusion of reconstituted HDL (rHDL)3 on EPC availability in patients with type 2 diabetes (DM2). Patients with DM2 have reduced availability and impaired function of EPCs,4 indicative of impaired vascular repair.5 Our data show for the first time that a beneficial effect of increasing HDL levels on EPC biology also occurs in humans. Seven patients with uncomplicated DM2 (age 53.6±3.0years; 3 females/4 males; glycosylated hemoglobin A1c 7.1±0.3%) were included in the study. The institutional review board approved the study, and all subjects gave written informed consent. Patients used only metformin. They had mild dyslipidemia (total …

Endothelial progenitor cells for postnatal vasculogenesis

Bone marrow-derived endothelial progenitor cells (EPCs) are present in the systemic circulation, are augmented in response to certain cytokines and/or tissue ischemia, and are home to--as well as incorporate into--sites of neovascularization. On the basis of these aspects, EPCs have attractive potential therapeutic applications for cardiovascular ischemic diseases as a novel cell-based strategy, mainly via a vasculogenesis mechanism. This review provides an update of the biology of EPCs, as well as highlighting the potential use of these cells for therapeutic regeneration.