Improving cardiovascular outcomes in rheumatic diseases: Therapeutic potential of circulating endothelial progenitor cells

John A. Reynolds, Abigail C. Robertson, Ian N. Bruce, M. Yvonne Alexander

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Patients with Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) have a significantly increased risk of cardiovascular disease (CVD). The reason for this is unclear but may be due, at least in part, to the failure of endothelial repair mechanisms. Over the last 15 years there has been much interest in the mechanisms of endothelial renewal and its potential as a therapy for CVD. In the circulation there are two distinct populations of cells; myeloid angiogenic cells (MACs) which augment repair by the paracrine secretion of angiogenic factors, and outgrowth endothelial cells (OECs) which are true endothelial progenitor cells (EPCs) and promote vasculogenesis by differentiating into mature endothelium. There are marked abnormalities in the number and function of these cells in patients with RA and SLE. Inflammatory cytokines including interferon-alpha (IFNα) and tumour-necrosis factor alpha (TNFα) both impair MAC and OEC function ex vivo and may therefore contribute to the CVD risk in these patients. Whilst administration of mononuclear cells, MACs and other progenitors has improved cardiovascular outcomes in the acute setting, this is not a viable option in chronic disease. The pharmacological manipulation of MAC/OEC function in vivo however has the potential to significantly improve endothelial repair and thus reduce CVD in this high risk population. © 2013 Elsevier Inc.
    Original languageEnglish
    Pages (from-to)231-243
    Number of pages12
    JournalPharmacology and Therapeutics
    Volume142
    Issue number2
    DOIs
    Publication statusPublished - 2014

    Keywords

    • Endothelial progenitor cells
    • Myeloid angiogenic cells
    • Outgrowth endothelial cells
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
    • Vascular repair

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