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. 2014 Dec 2;15(1):82.
doi: 10.1186/1129-2377-15-82.

Reduced circulating endothelial progenitor cells in reversible cerebral vasoconstriction syndrome

Shih-Pin Chen, Yen-Feng Wang, Po-Hsun Huang, Chin-Wen Chi, Jong-Ling Fuh  1 , Shuu-Jiun Wang
Affiliations

Reduced circulating endothelial progenitor cells in reversible cerebral vasoconstriction syndrome

Shih-Pin Chen et al. J Headache Pain. .

Abstract

Background: The pathophysiology of reversible cerebral vasoconstriction syndrome (RCVS) remains elusive. Endothelial dysfunction might play a role, but direct evidence is lacking. This study aimed to explore whether patients with RCVS have a reduced level of circulating circulating endothelial progenitor cells (EPCs) to repair the dysfunctional endothelial vasomotor control.

Methods: We prospectively recruited 24 patients with RCVS within one month of disease onset and 24 healthy age- and sex-matched controls. Flow cytometry was used to quantify the numbers of circulating EPCs, defined as KDR+CD133+, CD34+CD133+, and CD34+KDR+ double-positive mononuclear cells. The Lindegaard index, an index of vasoconstriction, was calculated by measuring the mean flow velocity of middle cerebral arteries and distal extracranial internal carotid arteries via color-coded sonography on the same day as blood drawing. A Lindegaard index of 2 was chosen as the cutoff value for significant vasoconstriction of middle cerebral arteries based on our previous study.

Results: Patients with RCVS had a reduced number of CD34+KDR+ cells (0.009 ± 0.006% vs. 0.014 ± 0.010%, p = 0.031) but not KDR+CD133+ cells or CD34+CD133+ EPCs, in comparison with controls. The number of CD34+KDR+ cells was inversely correlated with the Lindegaard index (rs = -0.418, p = 0.047). Of note, compared to controls, patients with a Lindegaard index > 2 (n = 13) had a reduced number of CD34+KDR+ cells (0.007 ± 0.005% vs. 0.014 ± 0.010%, p = 0.010), but those with a Lindegaard index ≤ 2 did not.

Conclusions: Patients with RCVS had reduced circulating CD34+KDR+ EPCs, which were correlated with the severity of vasoconstriction. Endothelial dysfunction might contribute to the pathogenesis of RCVS.

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Figures

Figure 1
Figure 1
Comparison of the numbers of endothelial progenitor cells between patients with reversible cerebral vasoconstriction syndrome and controls. (column: mean, error bars: standard errors). RCVS: reversible cerebral vasoconstriction syndrome; LI: Lindegaard index.
Figure 2
Figure 2
Correlation between the numbers of CD34 + KDR + endothelial progenitor cells and Lindegaard index.
See this image and copyright information in PMC

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