Int J Stem Cells.  2022 May;15(2):136-143. 10.15283/ijsc21027.

Evaluation of Circulating Endothelial Progenitor Cells in Abdominal Aortic Aneurysms after Endovascular Aneurysm Repair

• Wu W
• Zhang J
• Shao L
• Huang H
• Meng Q
• Shen Z
• Teng X

• KMID: 2529785
• DOI: http://doi.org/10.15283/ijsc21027

Abstract

Background and Objectives
Circulating endothelial progenitor cells (EPCs) participate in vascular repair and predict cardiovascular outcomes. The aim of this study was to investigate the correlation between EPCs and abdominal aortic aneurysms (AAAs).
Methods and Results
Patients (age 67±9.41 years) suffering from AAAs (aortic diameters 58.09±11.24 mm) were prospectively enrolled in this study. All patients received endovascular aneurysm repair (EVAR). Blood samples were taken preoperatively and 14 days after surgery from patients with aortic aneurysms. Samples were also obtained from age-matched control subjects. Circulating EPCs were defined as those cells that were double positive for CD34 and CD309. Rat models of AAA formation were generated by the peri-adventitial elastase application of either saline solution (control; n=10), or porcine pancreatic elastase (PPE; n=14). The aortas were analyzed using an ultrasonic video system and immunohistochemistry. The levels of CD34^＋/CD309^＋ cells in the peripheral blood mononuclear cell populations were measured by flow cytometry. The baseline numbers of circulating EPCs (CD34^＋/CD309^＋) in the peripheral blood were significantly smaller in AAA patients compared with control subjects. The number of EPCs doubled by the 14th day after EVAR. A total of 78.57% of rats in the PPE group (11/14) formed AAAs (dilation ratio ＞150%). The numbers of EPCs from defined AAA rats were significantly decreased compared with the control group.
Conclusions
EPC levels may be useful for monitoring abdominal aorta aneurysms and rise after EVAR in patients with aortic aneurysms, and might contribute to the rapid endothelialization of vessels.

Keyword

Abdominal aortic aneurysms; Endothelial progenitor cells; Endovascular aneurysm repair; Porcine pancreatic elastase

Figure

• 

  Fig. 1 Circulating levels of EPCs in the peripheral blood from subjects. (A) Circulating numbers of EPCs waswere measured in different groups by flow cytometry. (B) Percentage of circulating CD34＋/CD309＋ cells in patients with abdominal aortic aneurysms compared to age-matched con-trols. *p<0.05, vs. Con. #p<0.05, vs. AAA before EVAR.

• 

  Fig. 2 Aneurysm formation after peri-adventitial elastase application. (A) Characteristic morphology of the abdominal aorta. (Left) One abdominal aortic aneurysm is shown from the Control group. (Middle) An aorta at the end of 5th week after PPE application. (Right) Morphology of a separated abdominal aorta. (B) Changes in the aortic diameter above baseline and post-operatively. (C) The dilation ratios of the abdominal aorta followed for 5 weeks. An aneurysm was defined as an increase in the aortic diameter by ≥ 50% above baseline. *p<0.05, vs. Con.

• 

  Fig. 3 Histological sections of abdominal aorta. (A) Hematoxylin and eosin staining of the aorta. (B) Verhoeff-Van Gieson (VVG) staining of elastic fibers in aneurysm sections. (C) Immunofluorescence of abdominal aorta sections labeled with antibodies to detect CD34 (red) and CD309 (green). The white arrow indicates CD34＋/CD309＋ cells colocalizing as orange.

• 

  Fig. 4 Circulating levels of EPCs in AAA rats. (A) Circulating numbers of EPCs in different groups by flow cytometry. (B) Percentage of circulating CD34＋/CD309＋ cells in rats with abdominal aortic aneurysms compared with controls. *p<0.05, vs. Con.

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