Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2012, vol. 21, nr 2, March-April, p. 249–254

Publication type: review article

Language: English

Endothelial Progenitor Cells in Diabetic Foot Syndrome

Śródbłonkowe komórki progenitorowe w zespole stopy cukrzycowej

Ewelina Drela1,, Katarzyna Stankowska1,, Arleta Kulwas1,, Danuta Rość1,

1 Department of Pathophysiology, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, Poland

Abstract

In the late 20th century endothelial progenitor cells (EPCs) were discovered and identified as cells capable of differentiating into endothelial cells. Antigens characteristic of endothelial cells and hematopoietic cells are located on their surface. EPCs can proliferate, adhere, migrate and have the specific ability to form vascular structure, and they have a wide range of roles: They participate in maintaining hemostasis, and play an important part in the processes of vasculogenesis and angiogenesis. They are sources of angiogenic factors, especially vascular endothelial growth factor (VEGF). EPCs exist in bone marrow, from which they are recruited into circulation in response to specific stimuli. Tissue ischemia is thought to be the strongest inductor of EPC mobilization. Local ischemia accompanies many pathological states, including diabetic foot syndrome (DFS). Impaired angiogenesis – in which EPCs participate – is typical of DFS. An analysis of the available literature indicates that in diabetic patients the number of EPCs declines and their functioning is impaired. Endothelial progenitor cells are crucial to vasculogenesis and angiogenesis during ischemic neovascularization. The pathomechanisms underlying impaired angiogenesis in patients with DFS is complicated, but the discovery of EPCs has shed new light on the pathogenesis of many diseases, including diabetes foot syndrome.

Streszczenie

Śródbłonkowe komórki progenitorowe (EPCs – endothelial progenitor cells) zostały odkryte jako komórki wykazujące zdolność do różnicowania w komórki śródbłonka. Na swej powierzchni mają antygeny charakterystyczne zarówno dla komórek śródbłonka, jak i komórek hematopoetycznych. EPCs wykazują cechy proliferacji, adhezji, migracji oraz posiadają swoistą zdolność tworzenia struktur naczyniowych. Wachlarz ról pełnionych przez EPCs jest szeroki: biorą udział w utrzymaniu hemostazy, odgrywają istotną rolę w procesach waskulogenezy i angiogenezy. Są źródłem czynników angiogennych, zwłaszcza naczyniowo śródbłonkowego czynnika wzrostu (VEGF – vascular endothelial growth factor). EPCs egzystują w szpiku kostnym, skąd są rekrutowane do krążenia pod wpływem określonych bodźców. Za najsilniejszy czynnik mobilizujący EPCs do krwi krążącej jest uważane niedotlenienie tkanek. Miejscowa hipoksja towarzyszy wielu patologicznym stanom, w tym zespołowi stopy cukrzycowej (DFS – diabetic foot syndrome). DFS charakteryzuje się nieprawidłową angiogenezą, w której biorą udział EPCs. Z analizy dostępnej literatury wynika, iż liczba EPCs u pacjentów z cukrzycą jest zmniejszona oraz obserwuje się upośledzenie ich funkcji. Śródbłonkowe komórki progenitorowe są kluczowym elementem w budowaniu naczyń krwionośnych podczas neowaskularyzacji indukowanej niedotlenieniem. Patomechanizm leżący u podłoża nieprawidłowej angiogenezy u pacjentów z DFS jest skomplikowany, a odkrycie EPCs rzuciło nowe światło na patogenezę wielu schorzeń, w tym zespołu stopy cukrzycowej.

Key words

endothelial progenitor cells, diabetic foot syndrome

Słowa kluczowe

śródbłonkowe komórki progenitorowe, zespół stopy cukrzycowej

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