Circulating stem/progenitor cells in stable ischemic heart disease and acute coronary syndromes - relevant reparatory mechanism?

Wojciech Wojakowski ^1*, Magda Kucia ², Maciej Kazmierski ¹, Mariusz Z Ratajczak ² and Michal Tendera ¹

¹ III Division of Cardiology, Silesian School of Medicine, Poland
² Stem Cell Biology Program, University of Louisville, United States

^* To whom correspondence should be addressed. E-mail: wojwoj{at}mp.pl.

Accepted 6 February 2007

Abstract

Bone marrow-derived cells which may be involved in the cardiac repair/regeneration after ischemic injury must undergo mobilization into peripheral blood with subsequent homing and engraftment into the target organ. <BR> The mobilization of the heterogenous population of stem/progenitor cells (endothelial progenitors, hematopoietic progenitors, mesenchymal stem cells) in the setting of endothelial injury or myocardial ischemia was described recently. Number of circulating stem/progenitor reflect the endothelial damage and turnover may be a surrogate marker which reflects the burden of cardiovascular risk factors and prognostic marker in stable coronary heart disease as well as acute coronary syndromes. Acute coronary syndromes are associated with increased levels of inflammatory and hematopoietic cytokines which in turn can mobilize the progenitor cells from the bone marrow. Myocardial infarction induces the increase of the number of EPC as well as other less well defined subpopulatons, such as CD34/ c-kit+ and CD34/CXCR4+ cells which may take part in cardiac repair after ischemic injury. This review summarizes the data on mobilization of stem/progenitor cells in acute coronary syndromes. It discusses the cell types, mechanisms of mobilization, homing and engraftment as well as the relevance to clinical outcomes.

Keywords: chemokines, endothelial progenitors, mobilization, myocardial infarction, stem cells

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