[Endothelial progenitor cells and atherosclerosis]

Abstract

The integrity and functional activity of the endothelial monolayer play a crucial role in the prevention of atherosclerosis. Extended endothelial cell damage by cardiovascular risk factors can result in endothelial cell apoptosis with loss of the integrity of the endothelium. Endothelial progenitor cells (EPCs) originating from the bone marrow play a significant role in neovascularization of ischemic tissues and in re-endothelialization of injured blood vessels. This may potentially limit atherosclerotic lesion formation. However, risk factors for coronary artery disease such as age and smoking, hypertension, hyperlipidemia and diabetes reduce the number and functional activity of these circulating endothelial progenitor cells, potentially restricting the therapeutic prospective of progenitor cells and limiting the regenerative capacity. The impairment of EPCs by risk factors may contribute to atherogenesis and atherosclerotic disease progression. The article reviews the role of EPCs as markers for atherosclerosis and cardiovascular outcomes and highlights possible novel strategies to interfere with the balance of injury and repair mechanisms.