Vascular regeneration therapy: Endothelial progenitor cells for ischemic diseases

Abstract

Since the discovery of circulating endothelial progenitor cells (EPC) in adult human peripheral blood, EPCs are believed to home to sites of neovascularization, where they contribute to vascular regeneration by forming a structural component of capillaries and by secreting angiogenic factors, thereby enhancing vascular and blood flow recovery in ischemic tissue. This therapeutic strategy has been effective in animal models of ischemia, and we and other clinical trials have demonstrated that it was safe and feasible for treatment of critical ischemic limb and cardiovascular diseases. However, the decline of EPCs in the peripheral blood and evidence that several disease states reduced EPC number and/or function have prompted the development of several strategies to overcome these limitations, including the administration of genetically modified EPCs that overexpress angiogenic growth factors. To optimize therapeutic outcomes, investigators must keep refining methods of EPC purification, expansion, and administration, and to develop techniques that overcome the intrinsic decline and phenotypic deficiencies of EPCs. In this chapter, we have illustrated EPC biology and the therapeutic potential of EPCs for vascular regeneration demonstrating our data of clinical study.