Clinical research
Age-dependent depression in circulating endothelial progenitor cells inpatients undergoing coronary artery bypass grafting

https://doi.org/10.1016/j.jacc.2003.07.025Get rights and content
Under an Elsevier user license
open archive

Abstract

Objectives

The effect of patient age on circulating endothelial progenitor cells (EPCs) and their mobilization during coronary artery bypass grafting (CABG) was assessed.

Background

The EPCs are able to contribute to reparative neovascularization after tissue ischemia. In experimental models, reparative neovascularization is impaired in senescent animals, but the role of EPCs in this impairment, especially in humans, is unknown.

Methods

In 50 consecutive patients (43 to 80 years old) with stable coronary artery disease undergoing CABG, the numbers of EPCs and the plasma levels of interleukin (IL)-6, IL-8, IL-10, and IL-18, as well as vascular endothelial growth factor (VEGF) and placental growth factor, were determined preoperatively, after coming off bypass, and 6, 12, 24, and 72 h postoperatively.

Results

Preoperative values of EPCs were lowered with increasing age, similar to the lowering of plasma VEGF levels. These age-associated decreases could not be explained by differences in atherosclerotic risk factors or cardiac function. Bypass surgery induced a rapid mobilization in EPCs, IL-6, IL-8, IL-10, and VEGF, with a peak 6 h postoperatively. Persistently lower levels of EPCs and VEGF throughout the observation period were observed in patients >69 years old, which could not be explained by differences in the operative procedure or inflammatory IL activation.

Conclusions

Despite a significant increase in EPCs and release of cytochemokines during CABG, age is a major limiting factor for mobilization of EPCs. Further studies are necessary to improve the strategies for mobilization, ex vivo expansion, and re-transplantation of EPCs in aging patients.

Abbreviations

APC
allophycocyanin
CABG
coronary artery bypass grafting
CAD
coronary artery disease
CPB
cardiopulmonary bypass
EC
endothelial cell
EPC
endothelial progenitor cell
KDR
kinase insert domain containing receptor
IL
interleukin
PlGF
placental growth factor
PTCA
percutaneous transluminal coronary angioplasty
VEGF
vascular endothelial growth factor

Cited by (0)

This work was supported by grants from the German Bundesministerium für Bildung und Forschung, or BMBF (NBL 3, FKZ 3/6) and the Deutsche Forschungsgemeinschaft (SFB 598/B1, A5).