The prostacyclin analogue iloprost increases circulating endothelial progenitor cells in patients with critical limb ischemia

Rossella Di Stefano; Maria Chiara Barsotti; Elio Melillo; Mariacarla Iorio; Tatiana Santoni; Chiara Armani; Matteo Dell’Omodarme; Chiara Ristori; Raffaele De Caterina; Alberto Balbarini

doi:10.1160/TH07-08-0509

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 100(05): 871-877
DOI: 10.1160/TH07-08-0509

Endothelium and Vascular Development

Schattauer GmbH

The prostacyclin analogue iloprost increases circulating endothelial progenitor cells in patients with critical limb ischemia

Authors

Rossella Di Stefano

¹Angiology Unit, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy

²Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
Maria Chiara Barsotti

²Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
Elio Melillo

¹Angiology Unit, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
Mariacarla Iorio

³Flow Cytometry Section, Immunohaematology, Cisanello Hospital, Pisa, Italy
Tatiana Santoni

²Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
Chiara Armani

²Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
Matteo Dell’Omodarme

⁴Classe di Scienze, Scuola Normale Superiore, INFN, Pisa, Italy
Chiara Ristori

²Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
Raffaele De Caterina

⁵Institute of Cardiology, “G. d’Annunzio” University – Chieti and C.N.R. Institute of Clinical Physiology, Pisa, Italy
Alberto Balbarini

¹Angiology Unit, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy

Abstract

Summary

Patients with critical limb ischemia (CLI) have low levels of endothelial progenitor cells (EPC). Iloprost has been demonstrated to stimulate vascular endothelial growth factor (VEGF) and promote angiogenesis. We investigated the effects of iloprost on EPC levels in vivo in CLI patients. Twenty-three patients with stage III and IV CLI were treated with iloprost for four weeks, improving clinical and instrumental parameters. Mononuclear cells isolated from peripheral blood were cultured to obtain “early” EPC, evaluated counting adherent cells with double positivity for acetylated low-density lipoprotein uptake and Ulex Europaeus lectin at flow cytometry. These cells also co-expressed the monocyte markers CD14 and CD45.Iloprost increased EPC number in the whole patient population: pre-treatment median: 13,812/ml; range: 1,263–83,648/ml; post-treatment median: 23,739/ml; range: 3,385–99,251/ml; p=0.035, irrespective of age, sex, disease stage or atherosclerosis risk factors. In conclusion, iloprost increases EPC number in peripheral blood in vivo. Such an effect may have therapeutic relevance.

Keywords

Endothelial progenitor cells - stem cells - angiogenesis - critical limb ischemia - peripheral arterial disease

Full Text

References

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