Summary
Clinical medicine has been revolutionized by the impact of cellular and molecular
biology in the past 30 years. This article focuses on a novel approach, whereby the
clinically proven and important concept of patient or organ stress testing is being
applied to cellular models, thereby developing and validating novel quantitative molecular
and cellular stress tests. One example is monocyte chemotaxis analysis, whereby circulating
monocytes freshly isolated from peripheral blood are being tested for their migratory
responsiveness towards relevant biological stimuli such as growth factors or chemokines.
These stimuli are relevant for recruiting monocytes to sites of local inflammation
such as during wound healing or arteriogenesis, i.e. growth of collateral arteries.
Initial clinical studies to validate “ligand-induced monocyte chemotaxis” indicate
that this parameter is impaired in the presence of various cardiovascular risk factors
including diabetes mellitus, hypercholesterolemia or smoking. In addition, there is
proof of concept that impaired monocyte chemotaxis is reversible as shown for anti-oxidants
in smokers. Moreover, the parameter “ligand-induced monocyte chemotaxis” is of great
relevance for basic science (including Molecular Cell Biology) as unravelling the
underlying molecular mechanisms of cellular dysfunction will certainly stimulate our
understanding of the molecular basis of cellular function. This article highlights
the concept of stress testing in modern medicine. Cellular stress testing is introduced
as a novel and intriguing approach, which was developed as bedside-to-bench. Future
prospective clinical trials will have to validate the predictive value of cellular
stress testing.
Keywords Monocytes - chemotaxis - functional cell testing - functional cellular diagnostics
- stress test for vascular cells
