血管内皮祖细胞与糖尿病微血管病变研究进展

糖尿病微血管病变严重影响了患者生活质量,是患者致死致残主要原因。微血管病变主要表现在视网膜、肾、神经、心肌组织。微血管病变的机制尚未完全清楚,近年越来越多研究发现血管内皮祖细胞(endothelial progenitor cells,EPCs)是该病发病重要原因。EPCs有分化为成熟的内皮细胞并且参与新血管形成和新生的能力。正常情况下内皮损失和EPCs对内皮的修复作用处于动态平衡状态,一旦EPCs受损,内皮损害和修复之间的平衡被打破,内皮层的完整性遭到破坏,必然参与糖尿病血管病变的发生发展。国内外大量研究证明糖尿病合并大血管病变EPCs数目功能改变,而糖尿病合并微血管病变EPCs的怎样变化?本文就EPCs与糖尿病微血管病变的关系进行系统综述。     

高效诱导人胚胎干细胞成为内皮祖细胞

血管的发生和发育不仅对胚胎形成中各器官的发育分化十分重要,并且对成体的创伤修复和生殖功能也具有重要意义．血管内皮细胞是形成心血管封闭管道系统的形态基础,体外多种细胞可经诱导分化产生出内皮祖/内皮细胞(endothelial progenitor/endothelial cells,EPCs/ECs),但是存在一些不足．鉴于人类胚胎干细胞(human embryonic stem cells,hESCs)诱导分化的全能性和长期增殖能力,为EPCs/ECs提供了新的来源．现有文献报道,hESCs诱导分化为EPCs/ECs的比例较低,为了提高该诱导分化效率,我们使用分阶段的二维诱导方法,首先将细胞接种在超纯层纤连蛋白(Matrigel)上,之后通过在不同阶段添加不同的因子,最终获得CD31⁺KDR⁺细胞的比例可以达到16%．进一步内皮诱导分化的结果显示,获得的EPCs/ECs的比例可以达到约32%,这些细胞具有在Matrigel上形成血管样结构的能力,可结合植物凝集素．实时定量PCR的结果显示,诱导分化所得的细胞表达众多内皮相关基因,并且免疫荧光的结果也表明部分细胞表达内皮细胞特异性表面标志CD31．     

糖尿病视网膜病变患者内皮祖细胞的数量变化分析

目的:研究糖尿病视网膜病变患者内皮祖细胞(EPCs)的数量变化,从而探讨内皮祖细胞是否参与了糖尿病微血管病并发症的发生发展。方法:选择与年龄、性别相匹配的患者,共124例,其中健康对照组62例,单纯糖尿病组31例(DM组),糖尿病背景期视网膜病变15例(DM+NPDR组),糖尿病增殖期视网膜病变组16例(DM+PDR组)。采用密度梯度离心法从人外周血分离出单个核细胞,通过流式细胞仪检测内皮祖细胞数量。结果:与健康对照组相比,DM组、DM+NPDR组、DM+PDR组的外周血EPCs的数量明显减少(P0.05)。DM+NPDR组与DM组相比,外周血EPCs数量无统计学差异(P0.05)。DM+PDR组与DM组相比,外周血EPCs数量显著增加(P0.05)。结论:EPCs参与了糖尿病微血管并发症的发生发展,有望在临床治疗中成为潜在的治疗靶点。     

Role of Endothelial Progenitor Cells and Inflammatory Cytokines in Healing of Diabetic Foot Ulcers

Background

To evaluate changes in endothelial progenitor cells (EPCs) and cytokines in patients with diabetic foot ulceration (DFU) in association with wound healing.

Methods

We studied healthy subjects, diabetic patients not at risk of DFU, at risk of DFU and with active DFU. We prospectively followed the DFU patients over a 12-week period. We also investigated similar changes in diabetic rabbit and mouse models of wound healing.

Results

All EPC phenotypes except the kinase insert domain receptor (KDR)⁺CD133⁺ were reduced in the at risk and the DFU groups compared to the controls. There were no major EPC differences between the control and not at risk group, and between the at risk and DFU groups. Serum stromal-cell derived factor-1 (SDF-1) and stem cell factor (SCF) were increased in DFU patients. DFU patients who healed their ulcers had lower CD34⁺KDR⁺ count at visits 3 and 4, serum c-reactive protein (CRP) and granulocyte-macrophage colony-stimulating factor (GM-CSF) at visit 1, interleukin-1 (IL-1) at visits 1 and 4. EPCs tended to be higher in both diabetic animal models when compared to their non-diabetic counterparts both before and ten days after wounding.

Conclusions

Uncomplicated diabetes does not affect EPCs. EPCs are reduced in patients at risk or with DFU while complete wound healing is associated with CD34⁺KDR⁺ reduction, suggesting possible increased homing. Low baseline CRP, IL-1α and GM-CSF serum levels were associated with complete wound healing and may potentially serve as prognostic markers of DFU healing. No animal model alone is representative of the human condition, indicating the need for multiple experimental models.     

内皮祖细胞与血管重新内皮化

血管内皮是循环血液和血管壁组织间的一层天然屏障,在维持血管的正常形态和功能中起重要作用。内皮受损后可引起炎症反应、单核细胞浸润和血管平滑肌细胞增生,促发动脉粥样硬化和再狭窄。因此,直接修复受损血管内皮,促使血管重新内皮化已经成为防止动脉粥样硬化及再狭窄领域的重要课题。大量研究表明,内皮祖细胞(EPC)参与受损血管的重新内皮化。该文就内皮祖细胞的来源、鉴定、参与重新内皮化进行综述。     

Differentiation of Cells in the Hypophysis and in Pancreatic Islets

Deparaffinized, 3-5μ, sections are brought to water, oxidized 3.5 min in an equal-parts mixture of 0.3% H₂SO₄ and 0.3% KMnO₄, and decolorized with 4% K₂S₂O₅. Nuclei are stained with Gomori's (1939) chromium-hematoxylin, and cell granules with Cason's (1950) mixture. The eosinophilic cells of the hypophysis and the alpha cells of pancreatic islets (of Langerhans) stain carmine red; basophilic and beta cells stain dark blue. Heidenhain's _susa is the most suitable fixative for hypophysis, Bouin's fluid for pancreas; but a satisfactory result is obtainable after formalin-sublimate or plain formalin. Besides studying the ratio of the cell types in the hypophysis or in pancreatic islets, it is possible to estimate the granule content of the cells. The method works on human autopsy material provided fixation of hypophysis occurs within 24 hr, and. pancreas, 12 hr post mortem, and it is suitable also for quite fresh organs.     

Differentiation of Cells in the Hypophysis and in Pancreatic Islets

Deparaffinized, 3-5μ, sections are brought to water, oxidized 3.5 min in an equal-parts mixture of 0.3% H₂SO₄ and 0.3% KMnO₄, and decolorized with 4% K₂S₂O₅. Nuclei are stained with Gomori's (1939) chromium-hematoxylin, and cell granules with Cason's (1950) mixture. The eosinophilic cells of the hypophysis and the alpha cells of pancreatic islets (of Langerhans) stain carmine red; basophilic and beta cells stain dark blue. Heidenhain's _susa is the most suitable fixative for hypophysis, Bouin's fluid for pancreas; but a satisfactory result is obtainable after formalin-sublimate or plain formalin. Besides studying the ratio of the cell types in the hypophysis or in pancreatic islets, it is possible to estimate the granule content of the cells. The method works on human autopsy material provided fixation of hypophysis occurs within 24 hr, and. pancreas, 12 hr post mortem, and it is suitable also for quite fresh organs.     

Manganese Supplementation Reduces High Glucose-induced Monocyte Adhesion to Endothelial Cells and Endothelial Dysfunction in Zucker Diabetic Fatty Rats

Endothelial dysfunction is a hallmark of increased vascular inflammation, dyslipidemia, and the development of atherosclerosis in diabetes. Previous studies have reported lower levels of Mn²⁺ in the plasma and lymphocytes of diabetic patients and in the heart and aortic tissue of patients with atherosclerosis. This study examines the hypothesis that Mn²⁺ supplementation can reduce the markers/risk factors of endothelial dysfunction in type 2 diabetes. Human umbilical vein endothelial cells (HUVECs) were cultured with or without Mn²⁺ supplementation and then exposed to high glucose (HG, 25 mm) to mimic diabetic conditions. Mn²⁺ supplementation caused a reduction in monocyte adhesion to HUVECs treated with HG or MCP-1. Mn²⁺ also inhibited ROS levels, MCP-1 secretion, and ICAM-1 up-regulation in HUVECs treated with HG. Silencing studies using siRNA against MnSOD showed that similar results were observed in MnSOD knockdown HUVECs following Mn²⁺ supplementation, suggesting that the effect of manganese on monocyte adhesion to endothelial cells is mediated by ROS and ICAM-1, but not MnSOD. To validate the relevance of our findings in vivo, Zucker diabetic fatty rats were gavaged daily with water (placebo) or MnCl₂ (16 mg/kg of body weight) for 7 weeks. When compared with placebo, Mn²⁺-supplemented rats showed lower blood levels of ICAM-1 (17%, p < 0.04), cholesterol (25%, p < 0.05), and MCP-1 (28%, p = 0.25). These in vitro and in vivo studies demonstrate that Mn²⁺ supplementation can down-regulate ICAM-1 expression and ROS independently of MnSOD, leading to a decrease in monocyte adhesion to endothelial cells, and therefore can lower the risk of endothelial dysfunction in diabetes.     

The Demonstration of Beta Cells in Pancreatic Islets and Their Tumors

The stain is applied routinely to tissues fixed in 10% buffered formalin (pH near 7.0) or in Bouin's fluid. Bring paraffin section to water as usual and mordant 72 hr in 5% CrCl₃ dissolved in 5% acetic acid. Wash in water and in 70% alcohol and stain 6 hr. Formula of staining solution: new fuchsin, 1% in 70% alcohol, 100 ml; HCl, conc., 2 ml and paraldehyde, 2 ml, mixed together and added to the dye solution; let stand 24 hr before use. After staining, wash in running tap water 5-10 min, rinse in distilled water and counterstain if desired. Dehydration in alcohol, clearing and covering completes the process. When the paraldehyde is obtained from a freshly opened bottle, standardized staining times can be used and thus eliminate the necessity of differentiating individual slides. The granules of beta cells stained deep blue to purple and were demonstrated in the pancreatic islet of man, dog, mouse, frog, guinea pig and rabbit.     

内皮祖细胞及其在组织工程中的应用

目前,组织工程化血管的构建和工程化组织器官的血管化因内皮种子细胞的扩增能力不足和生物活性不强而受到限制。内皮祖细胞(EPC)是内皮细胞的前体细胞。出生后,EPC主要存在于骨髓,可向外周血液缓慢释放,参与机体缺血组织的血管重建和损伤血管的重新内皮化。现对EPC的来源、分布、表型特征、动员、分化、归巢、分离、培养与鉴定等生物学特性和EPC在组织工程中的应用进行了全面的综述,并指出目前存在的问题和研究方向。     

血脂康胶囊对高脂模型大鼠EPCs功能的影响

目的:高脂血症可增加心血管事件的发生率,本研究降脂红曲制剂血脂康胶囊对高脂模型大鼠的内皮祖细胞(endothelial progenitor cells,EPCs)生物学功能的影响。方法:给予Wistar大鼠高脂饲料30 d,造成高血脂大鼠模型,灌服血脂康胶囊。密度梯度离心法分别分离正常对照组,高脂模型组和血脂康治疗组大鼠骨髓单核细胞,应用EGM-2MV进行体外培养。以4~6代EPCs为靶细胞。采用Edu标记技术、CCK-8检测法、粘附能力测定试验、改良的Boyden小室、Matrigel法、荧光定量RT-PCR等方法分别检测EPCs增殖、粘附、迁移、体外成血管及单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)等炎性因子的表达。结果:高血脂模型组大鼠EPCs的增殖、粘附、迁移及成血管能力均明显低于对照组,但炎症因子MCP-1表达则高于对照组;与高脂模型组EPCs比较,血脂康可明显促进EPCs的增殖、粘附、迁移及成血管,下调MCP-1的表达。结论:高脂状态下大鼠EPCs的增殖、粘附、迁移及成血管等生物学功能受损,血脂康能调整脂质代谢,改善高脂血症大鼠EPCs功能,从而起到保护血管内皮的功能,减少心血管疾病的发生。     

内皮祖细胞的生物学特性及其临床应用前景

内皮祖细胞（Endothelial Progenitor Cells,EPCs）是内皮细胞（endothelial cells,ECs）的前体细胞,即能分化为成熟ECs的祖细胞,它在血管内皮再生中发挥着重要作用。随着EPCs研究的深入,其在临床诊断、预后判断和各种缺血性疾病的治疗方面将会有广阔的应用前景。然而,关于EPCs的定义、来源、表面标记以及培养鉴定方法目前仍存在争议。     

内皮前体细胞的动员与调节

胚胎发生时期,内皮前体细胞(endothelial progenitor cells,EPCs)参与了原始血管形成的最初过程(血管发生)。已有的证据显示,分化为内皮细胞(endothelial cells,Ecs)的前体也存在于成人中,正常情况下,EPCs停留在成人的骨髓,但是,可以通过细胞因子或血管生成因子信号被动员到循环血,迁移到生理或病理条件下的新血管形成位点,并原位分化成内皮细胞,快速和及时地修复损伤的血管。自源的EPCs原住动员或移植是治疗性血管再生的一个潜在、有效的方法,因此,探究EPCs从骨髓的动员和调节,对血管再生以及修复器官功能具有重要的意义。     

内皮祖细胞的分离培养与鉴定

内皮祖细胞的分离方法有免疫磁珠分离法、淋巴细胞分离液分离法(1.077)和差速贴壁法,这3种方法已被人们广泛使用,均可分离到一定的目的细胞。分离到的目的细胞在培养过程中逐渐分化、成熟、发育为内皮细胞。在内皮细胞和内皮祖细胞的鉴别区分,使用CD34+/CD133+/KDR+鉴定为内皮祖细胞,同时使用内皮祖细胞吞噬D il-ac-LDLFITC-UEA双阳性的方法也可鉴定为内皮祖细胞。     

内皮祖细胞生物学特性及其进展

内皮祖细胞(Endothelial Progenitor Cells,EPCs)是血管内皮细胞的前体细胞,即能分化为成熟血管内皮细胞的祖细胞。随着对EPCs功能和影响其分化、生存、归巢和组织分布因素的了解,EPCs作为临床诊断、预后判断和治疗方法将有广阔的前景。本文就EPCs的的来源,EPCs的分离、培养、鉴定,EPCs的表面标志,EPCs的动员、分化和归巢等生物学特性及其进展展开综述。     

mESC衍生内皮祖细胞定向分化为血管内皮细胞促伤口愈合

缺血性功能障碍是重要的全球健康问题。血管内皮细胞 (vascular endothelial cell, VEC) 在血管生成和创面修复中发挥关键作用,血管重建不足可导致慢性不愈合伤口。因此,了解有效的血管内皮细胞生成策略有助于受损组织中的血管再生。胚胎干细胞 (embryonic stem cell, ESC) 在组织的内皮化研究中应用广泛。内皮祖细胞 (endothelial progenitor cell, EPC) 是血管内皮细胞发育中不可或缺的部分。本研究目的在于找到一种小鼠胚胎干细胞 (mouse embryonic stem cell, mESC) 衍生为内皮祖细胞的快速、易筛选且高重复性的方法,并从内皮祖细胞定向分化中获得存活率高和功能性好的血管内皮细胞。结果表明,胚胎干细胞通过10 ng/mL VEGF和5 ng/mL bFGF定向诱导分化为增殖能力强的“铺路石”样祖细胞。同时,差异贴壁法有助于EPC的筛选。而EPC可诱导3 d的祖细胞高表达CD133和CD34(相对表达量分别为0.88 ± 0.04和2.12 ± 0.02);采用acctuse酶消化祖细胞,并在50 ng/mL VEGF和25 ng/mL bFGF的条件下诱导7 d分化为血管内皮样细胞,该细胞不仅高表达内皮细胞标志基因CD31、CD144、LAMA5、Tek、KDR和vWF,高表达标志蛋白CD31、CD144、LAMA5(相对表达量分别为1.07 ± 0.03、0.60 ± 0.02和0.70 ± 0.02),而且具有良好的迁移、成管和Weibel Palade (W-P) 小体形成能力。随后,将PBS、EPC和VEC分别应用于大小相同的创面治疗,EPC和VEC均能加快组织愈合程度(相对愈合率分别为78.93 ± 75.35%、95.57 ± 83.73%和100.00 ± 0.00%),VEC明显增强了伤口的血管生成能力和炎症反应。该研究初步证实,mESC衍生的EPC定向诱导7 d后可分化为血管内皮细胞。此内皮细胞具有较好的组织修复功能,干细胞促进血管生成的生理途径有望成为组织重塑的新靶点。     

Functional Effects of Adiponectin on Endothelial Progenitor Cells

Adiponectin is an adipokine whose plasma levels are inversely correlated to metabolic syndrome components. Adiponectin protects against atherosclerosis and decreases risks in myocardial infarction. Endothelial progenitor cells (EPCs) are a heterogeneous population of circulating cells involved in vascular repair and neovascularization. EPCs number is reduced in patients with cardiovascular disease. We hypothesize that the positive effects of adiponectin against atherosclerosis are explained in part by its interactions with EPCs. Cells were obtained from healthy volunteers' blood by mononuclear cell isolation and plating on collagen‐coated dishes. Three sub‐populations of EPCs were identified and characterized using flow cytometry. EPCs' expression of adiponectin receptors, AdipoR1, and AdipoR2 was evaluated by quantitative PCR. The effects of recombinant adiponectin on EPCs' susceptibility to apoptosis were assessed. Finally, expression of neutrophil elastase by EPCs and activity of this enzyme on adiponectin processing were assessed. Quantitative PCR analysis of EPCs mRNAs showed that AdipoR1 mRNA is expressed at higher levels than AdipoR2. Expression of AdipoR1 protein was confirmed by western blot. Adiponectin significantly increased survival of two sub‐populations of EPCs in conditions of serum deprivation. Such effect could not be demonstrated in the third EPCs sub‐population. We also demonstrated that EPCs, particularly one sub‐population, express neutrophil elastase. Neutrophil elastase activity was confirmed in EPCs' conditioned media. Adiponectin protects some EPCs sub‐populations against apoptosis and therefore could modulate EPCs ability to induce repair of vascular damage. Neutrophil elastase activity of EPCs could locally modulate adiponectin activity by its involvement in the generation of the globular form of adiponectin.     

A Phloxine-Azure-Hematoxylin Sequence for Differential Staining of Cells in Pancreatic Islets

Sections of 6 μ from tissues fixed in Susa or in Bouin's fluid (without acetic acid) and embedded in paraffin were attached to slides with Mayer's albumen, dried at 37 C for 12 hr, deparaffinized and hydrated. The sections fixed in Susa were transferred to a I₂-K₁ solution (1:2:300 ml of water); rinsed in water, decolorized in 5% Na₂S₂O₃; washed in running water, and rinsed in distilled water. Those fixed in Bouin's were transferred to 80% alcohol until decolorized, then rinsed in distilled water. All sections were stained in 1% aqueous phloxine, 10 min; rinsed in distilled water and transferred to 3% aqueous phosphotungstic acid, 1 min; rinsed in distilled water; stained 0.5 min in 0.05 azure II (Merck), washed in water; and finally, nuclear staining in Weigert's hematoxylin for 1 min was followed by a rinse in distilled water, rapid dehydration through alcohols, clearing in xylene and covering in balsam or a synthetic resin. In the completed stain, islet cells appear as follows: A cells, purple; B cells, weakly violet-blue; D cells, light blue with evident granules; exocrine cells, grayish blue with red granules.     

CXCR2-Dependent Endothelial Progenitor Cell Mobilization in Pancreatic Cancer Growth

Neovascularization is essential for tumor growth. We have previously reported that the chemokine receptor CXCR2 is an important regulator in tumor angiogenesis. Here we report that the mobilization of bone marrow (BM)-derived endothelial progenitor cells (EPCs) is impaired in CXCR2 knockout mice harboring pancreatic cancers. The circulating levels of EPCs (positive for CD34, CD117, CD133, or CD146) are decreased in the bone marrow and/or blood of tumor-bearing CXCR2 knockout mice. CXCR2 gene knockout reduced BM-derived EPC proliferation, differentiation, and vasculogenesis in vitro. EPCs double positive for CD34 and CD133 increased tumor angiogenesis and pancreatic cancer growth in vivo. In addition, CD133(+) and CD146(+) EPCs in human pancreatic cancer are increased compared with normal pancreas tissue. These findings indicate a role of BM-derived EPC in pancreatic cancer growth and provide a cellular mechanism for CXCR2 mediated tumor neovascularization.