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Int J Stem Cells. 2016 May 30;9(1):137-44. doi: 10.15283/ijsc.2016.9.1.137.

Severe Type 2 Diabetes Induces Reversible Modifications of Endothelial Progenitor Cells Which are Ameliorate by Glycemic Control.

International journal of stem cells

Maria Rosaria De Pascale, Giuseppe Bruzzese, Ettore Crimi, Vincenzo Grimaldi, Antonio Liguori, Sergio Brongo, Michelangela Barbieri, Antonietta Picascia, Concetta Schiano, Linda Sommese, Nicola Ferrara, Giuseppe Paolisso, Claudio Napoli

Affiliations

  1. U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria, Second University of Naples.
  2. Division of Cardiology, ASL NA1, Pellegrini Hospital, Naples, Italy.
  3. Department of Anesthesia and Critical Care Medicine, University of Florida, Shands Hospital, Florida, USA.
  4. Department of Medicine and Surgery, Plastic Surgery Unit, University of Salerno, Salerno, Italy.
  5. Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, Second University of Naples, Naples, Italy.
  6. IRCCS Foundation SDN, Naples, Italy.
  7. Geriatrics Medicine, Department of Translational Medical Science, Federico II University of Naples, Naples, Italy.

PMID: 27426095 PMCID: PMC4961113 DOI: 10.15283/ijsc.2016.9.1.137

Abstract

BACKGROUND: Circulating endothelial progenitors cells (EPCs) play a critical role in neovascularization and endothelial repair. There is a growing evidence that hyperglycemia related to Diabetes Mellitus (DM) decreases EPC number and function so promoting vascular complications.

AIM OF THE STUDY: This study investigated whether an intensive glycemic control regimen in Type 2 DM can increase the number of EPCs and restores their function.

METHODS: Sixty-two patients with Type 2 DM were studied. Patients were tested at baseline and after 3 months of an intensive regimen of glycemic control. The Type 2 DM group was compared to control group of subjects without diabetes. Patients with Type 2 DM (mean age 58.2±5.4 years, 25.6% women, disease duration of 15.4±6.3 years) had a baseline HgA1c of 8.7±0.5% and lower EPC levels (CD34+/KDR+) in comparison to healthy controls (p<0.01).

RESULTS: The intensive glycemic control regimen (HgA1c decreased to 6.2±0.3%) was coupled with a significant increase of EPC levels (mean of 18%, p<0.04 vs. baseline) and number of EPCs CFUs (p<0.05 vs. baseline).

CONCLUSION: This study confirms that number and bioactivity of EPCs are reduced in patients with Type 2 DM and, most importantly, that the intensive glycemic control in Type 2 DM promotes EPC improvement both in their number and in bioactivity.

Keywords: Endothelial progenitor cells; Regenerative medicine; Type 2 diabetes; Vascular disease

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