期刊
EUROPEAN HEART JOURNAL
卷 41, 期 44, 页码 4271-4282出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehz923
关键词
Stem cells; Outcomes; Biomarkers; Regeneration; Inflammation; Bone marrow; Haematopoiesis; Myelopoiesis
资金
- European Foundation for the Study of Diabetes (EFSD)/Lilly
- Italian Diabetes Society/Lilly
- PRIN 2015 [2015ZTT5KB]
- Cariplo Foundation [2016/0922]
- American Heart Association [19POST34400057, 15SFCRN23910003]
- Abraham J. and Phyllis Katz Foundation
- National Institute of Health [R01HL1379, R00HL1225, 1R61HL138657-02, 1P3 0DK111024-03S1, 5R01HL095479-08, 3RF1AG051633-01S2, 5R01A G042127-06, 2P01HL086773-08, U54AG062334-01]
- The National Institute of Health [1R01HL14120501, 5P01HL101398-02, 1P20HL113451-01, 5P01HL086773-09 1RF 1AG051633-01, R01 NS064162-01, R01 HL89650-01, HL095479-01, 1DP3DK094346-01, 2P01HL086773]
The cardiovascular and haematopoietic systems have fundamental inter-relationships during development, as well as in health and disease of the adult organism. Although haematopoietic stem cells (HSCs) emerge from a specialized haemogenic endothelium in the embryo, persistence of haemangioblasts in adulthood is debated. Rather, the vast majority of circulating stem cells (CSCs) is composed of bone marrow-derived HSCs and the downstream haematopoietic stem/progenitors (HSPCs). A fraction of these cells, known as endothelial progenitor cells (EPCs), has endothelial specification and vascular tropism. In general, the levels of HSCs, HSPCs, and EPCs are considered indicative of the endogenous regenerative capacity of the organism as a whole and, particularly, of the cardiovascular system. In the last two decades, the research on CSCs has focused on their physiologic role in tissue/organ homoeostasis, their potential application in cell therapies, and their use as clinical biomarkers. In this review, we provide background information on the biology of CSCs and discuss in detail the clinical implications of changing CSC levels in patients with cardiovascular risk factors or established cardiovascular disease. Of particular interest is the mounting evidence available in the literature on the close relationships between reduced levels of CSCs and adverse cardiovascular outcomes in different cohorts of patients. We also discuss potential mechanisms that explain this association. Beyond CSCs' ability to participate in cardiovascular repair, levels of CSCs need to be interpreted in the context of the broader connections between haematopoiesis and cardiovascular function, including the role of clonal haematopoiesis and inflammatory myelopoiesis.
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