Thromb Haemost 2008; 100(05): 871-877
DOI: 10.1160/TH07-08-0509
Endothelium and Vascular Development
Schattauer GmbH

The prostacyclin analogue iloprost increases circulating endothelial progenitor cells in patients with critical limb ischemia

Rossella Di Stefano
1   Angiology Unit, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
2   Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
,
Maria Chiara Barsotti
2   Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
,
Elio Melillo
1   Angiology Unit, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
,
Mariacarla Iorio
3   Flow Cytometry Section, Immunohaematology, Cisanello Hospital, Pisa, Italy
,
Tatiana Santoni
2   Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
,
Chiara Armani
2   Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
,
Matteo Dell’Omodarme
4   Classe di Scienze, Scuola Normale Superiore, INFN, Pisa, Italy
,
Chiara Ristori
2   Cardiovascular Research Laboratory, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
,
Raffaele De Caterina
5   Institute of Cardiology, “G. d’Annunzio” University – Chieti and C.N.R. Institute of Clinical Physiology, Pisa, Italy
,
Alberto Balbarini
1   Angiology Unit, Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
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Publikationsverlauf

Received 19. August 2007

Accepted after major revision 12. September 2008

Publikationsdatum:
22. November 2017 (online)

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Summary

Patients with critical limb ischemia (CLI) have low levels of endothelial progenitor cells (EPC). Iloprost has been demonstrated to stimulate vascular endothelial growth factor (VEGF) and promote angiogenesis. We investigated the effects of iloprost on EPC levels in vivo in CLI patients. Twenty-three patients with stage III and IV CLI were treated with iloprost for four weeks, improving clinical and instrumental parameters. Mononuclear cells isolated from peripheral blood were cultured to obtain “early” EPC, evaluated counting adherent cells with double positivity for acetylated low-density lipoprotein uptake and Ulex Europaeus lectin at flow cytometry. These cells also co-expressed the monocyte markers CD14 and CD45.Iloprost increased EPC number in the whole patient population: pre-treatment median: 13,812/ml; range: 1,263–83,648/ml; post-treatment median: 23,739/ml; range: 3,385–99,251/ml; p=0.035, irrespective of age, sex, disease stage or atherosclerosis risk factors. In conclusion, iloprost increases EPC number in peripheral blood in vivo. Such an effect may have therapeutic relevance.