Progenitor cell mobilisation is associated with erythropoietin serum level increase in patients with acute myocardial infarction and angina pectoris

Introduction: Bone marrow derived stem cells have the capacity to home infarcted heart tissue, and promote cardiac repair as shown in experimental data in animal models. So we addressed the question wether progenitor cells that have been shown to differentiate into endothelial cells and cardiomyocytes in vitro and in vivo are mobilized in peripheral blood (PB) in patients with coronary heart disease (CHD) and determined growth factor serum levels.

Methods: PB was taken from 16 pts. with acute myocardial infarction (AMI), 8 pts. with angina pectoris (AP) an 10 pts. without CHD who underwent cornary angiogram (control) and analysed with FACS analysis (percent/1 million cells). Epo serum levels were determined with ELISA technique (mU/ml). Samples were drawn at time point (TP) 1 (day 1–3 after ischemic event) and time point (TP) 2 (day 4–8).

Results: The mean values of CD34+, CD117+ and CD133+ cells were all elevated in pts. with either AMI or AP compared to the control group. Pts. with AMI had significantly more elevated CD117+ and CD34+ progenitor cells in PB compared to pts. with AP. Epo was significantly elevated in pts. with AP and AMI.

• CD34 (AMI/AP/control): TP1 0.21/0.19/0.10; TP2 0.31/0.27/0.12 (%/1million)

• CD117 (AMI/AP/control): TP1 0.09/0.05/0.06; TP2 0.30/0.05/0.06

• CD133 (AMI/AP/control): TP1 0.20/0.21/0.11; TP2 0.19/0.11/0.10

• Epo (AMI/AP/control): TP1 34.0/24.0/9.0; TP2 30.0/27.5/8.2 (mU/ml)

Conclusion: Pts. with AMI have increased CD34+, CD117+ and CD133+ precursor cell mobilisation after ischemic events. Cardiomyocyte necrosis is a stimulus for progenitor cell mobilisation and Epo may play a role in its regulation.