RT Journal Article
SR Electronic
T1 Short- and long-term effects of erythropoietin treatment on endothelial progenitor cell levels in patients with cardiorenal syndrome
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 60
OP 65
DO 10.1136/hrt.2010.194654
VO 97
IS 1
A1 Kim E Jie
A1 Karien van der Putten
A1 Marloes W T Bergevoet
A1 Pieter A Doevendans
A1 Carlo A J M Gaillard
A1 Branko Braam
A1 Marianne C Verhaar
YR 2011
UL http://heart.bmj.com/content/97/1/60.abstract
AB Objective Patients with cardiorenal syndrome (CRS) have high cardiovascular morbidity. Endothelial progenitor cells (EPC) constitute an endogenous vascular repairsystem, protecting against atherosclerosis development. Erythropoietin (EPO) treatment may have beneficial effects by mobilizing EPC from the bonemarrow. Our objective is to determine EPC levels and effects of EPO therapy on EPC levels in CRS patients.Design Open-label randomized trial.Setting Part of the EPOCARES-trial, conducted in Utrecht (Netherlands).Patients Patients with CRS and anaemia and healthy controls were included.Interventions Patients were randomized to receive EPO therapy (50 IU/kg/wk) for 52 weeks or no EPO therapy.Main outcome measures CD34+KDR+-EPC, cultured EPC outgrowth and function at baseline, after 18 days and after 52 weeks.Results Patients showed lower CD34+KDR+-cell numbers compared to controls (6(12) vs. 19(19) cells/105 granulocytes; p=0.010), despite increased levels of stromal cell-derived factor-1α; (3.1(0.8) vs 2.6(0.3) ng/ml; p=0.001). EPC outgrowth and function were not different between patients and controls. EPC levels did not change after 18 days with or without EPO treatment. CD34+KDR+-cells significantly declined after 52 weeks in the non-treated group (p=0.028). Long-term EPO therapy did not significantly affect this reduction in CD34+KDR+-EPC levels.Conclusions CRS patients showed reduced CD34+KDR+-EPC levels compared to controls, consistent with a reduced vascular regenerative potential and despite upregulated SDF-1α levels. Over a one-year follow-up period a marked 68% further reduction in EPC levels was observed in the patient group without EPO treatment. In spite of promising experimental studies, our longitudinal, randomized study did not show significant influence of either short- or long-term EPO therapy on reduced EPC levels in CRS patients.