Effect of targeted therapy on circulating progenitor cells in precapillary pulmonary hypertension

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• 作者：Jé ; ssica Garcí ; a-Lucio ; BsC^a ; Olga Tura-Ceide ; PhD^a ; ^b ; ^{tura@clinic.ub.es} ; Roberto del Pozo ; MD^a ; Isabel Blanco ; MD^a ; ^b ; Sandra Pizarro ; MD^a ; Elisabet Ferrer ; PhD^a ; Marta Dí ; ez ; PhD^a ; Nú ; ria Coll-Bonfill ; BsC^a ; Lucilla Piccari ; MD^a ; Ví ; ctor I. Peinado ; PhD^a ; ^b ; Joan Albert Barberà ; MD^a ; ^b
• 关键词：Circulating progenitor cells ; Treatment-naï ; ve patients ; PAH-targeted therapy
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：238-243
• 全文大小：655 K
• 卷排序：228

文摘

Endothelial dysfunction is key in the development of pulmonary hypertension (PH) and is associated with reduced number of circulating progenitor cells. Studies to date evaluating levels of circulating progenitor cells in PH have provided conflicting results. Current treatment of pulmonary arterial hypertension (PAH) and medical treatment of chronic thromboembolic pulmonary hypertension (CTEPH) targets endothelium dependent signalling pathways. The effect of PAH-targeted therapy on circulating progenitor cells has not been clearly established.ObjectivesTo investigate whether levels of circulating progenitor cells in treatment-naïve patients with PAH or CTEPH differ from healthy subjects and to assess the effect of PAH-targeted therapy on the circulating levels of these progenitors.MethodsThirty controls, 33 PAH and 11 CTEPH treatment-naïve patients were studied. Eighteen patients with PAH and 9 with CTEPH were re-evaluated 6–12 months after starting PAH-targeted therapy. Levels of progenitors were measured by flow cytometry as CD45+ CD34+ and CD45+ CD34+ CD133+ cells.ResultsCompared with controls, the number of circulating progenitor cells was reduced in PAH but not in CTEPH. After 6–12 months of treatment, levels of circulating progenitors increased in PAH and remained unchanged in CTEPH. Patients with lower exercise tolerance presented lower levels of circulating progenitors. No other relation was found between levels of progenitors and clinical or hemodynamic parameters.ConclusionsPatients with PAH, but not those with CTEPH, present reduced levels of circulating progenitor cells. PAH-targeted therapy increases levels of progenitors in PAH but not in CTEPH, suggesting different involvement of progenitor cells in the pathobiology of these pulmonary hypertensive disorders.