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Imbalance of circulating endothelial cells and progenitors in idiopathic pulmonary fibrosis

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Abstract

Background

Fibrogenesis during idiopathic pulmonary fibrosis (IPF) is strongly associated with abnormal vascular remodeling. Respective abundance of circulating endothelial cells (CEC) and endothelial progenitor cells (EPC) might reflect the balance between vascular injury and repair and potentially serve as biomarkers of the disease.

Objectives and Methods

We postulated that CEC and EPC subtypes might be differently modulated in IPF. Sixty-four consecutive patients with newly diagnosed IPF were prospectively enrolled and compared to thirteen healthy volunteers. CEC were counted with immunomagnetic CD146-coated beads; progenitors CD34+45dim/CD34+133+/CD34+KDR+were assessed through flow cytometry and EPC (colony-forming-units-Endothelial Cells, CFU-EC, and endothelial colonies forming cells, ECFC) were quantified by cell culture assays.

Results

IPF patients were characterized by a marked increase in CEC associated to an EPC defect: both CD34+KDR+ cells and CFU-EC were decreased versus controls. Moreover, in IPF subjects with a low diffusing capacity of the lung for carbon monoxide (DLCO) < 40 %, CFU-EC and ECFC were higher compared to those with DLCO > 40 %. Finally, ECFC were negatively correlated with DLCO. During an 18 month follow up, CEC levels increased in patients with exacerbation, including those who died during follow up. Finally, ECFC from patients with exacerbation proliferative potential was strongly increased.

Conclusion

IPF is basically associated with both a vascular injury and a repair defect. This study highlights an adaptative process of EPC mobilization in the most severe forms of IPF, that could reflect enhanced homing to the pulmonary vasculature, which clinical consequences remain to be determined.

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Acknowledgments

We thank maternity department of Begin hospitals for providing us cord blood. Umbilical cord bloods were collected from consenting mothers. The study was approved by local ethics committee of “Hôpital des Instructions et des Armées de Begin (France) (201008043234797) and protocol conformed to ethical guidelines of Declaration of Helsinki. We received research grants from the Chancellerie des Universités, Paris, France (Leg Poix).

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Authors and Affiliations

  1. Hematology Department, European Georges Pompidou Hospital, Université Paris Descartes, 20 rue Leblanc, 75015, Paris, France

    David M. Smadja

  2. Inserm UMRS 765, Faculté de Pharmacie, Paris, France

    David M. Smadja, Laetitia Mauge, Clément d’Audigier, Pascale Gaussem & Dominique Israel-Biet

  3. AP-HP, Hôpital Européen Georges Pompidou, Service d`Hématologie Biologique, Paris, France

    David M. Smadja, Laetitia Mauge, Clément d’Audigier, Sébastien Bertil & Pascale Gaussem

  4. Vascular Biology Program and Surgery Department, Children`s Hospital, Harvard Medical School, Boston, MA, USA

    David M. Smadja

  5. AP-HP, Hôpital Avicenne, Service de Pneumologie, Bobigny, France

    Hilario Nunes, Zohra Carton & Dominique Valeyre

  6. Pneumology Department, European Georges Pompidou Hospital, Université Paris Descartes, Sorbonne Paris Cité, 20 rue Leblanc, 75015, Paris, France

    Karine Juvin & Dominique Israel-Biet

  7. AP-HP, Hôpital Bichat, Service de Pneumologie, Paris, France

    Raphael Borie & Bruno Crestani

  8. AP-HP, Hôpital Européen Georges Pompidou, Centre d’investigation clinique Inserm Centre, 9201, Paris, France

    Anne Blanchard

  9. Hematology Department, European Georges Pompidou Hospital, Université Paris Descartes, Sorbonne Paris Cité, 20 rue Leblanc, 75015, Paris, France

    Laetitia Mauge, Clément d’Audigier & Pascale Gaussem

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  1. David M. Smadja
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Correspondence to David M. Smadja.

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Smadja, D.M., Mauge, L., Nunes, H. et al. Imbalance of circulating endothelial cells and progenitors in idiopathic pulmonary fibrosis. Angiogenesis 16, 147–157 (2013). https://doi.org/10.1007/s10456-012-9306-9

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