Endothelial Progenitor Cells: A Review of Molecular Mechanisms in the Pathogenesis and Endovascular Treatment of Intracranial Aneurysms

• Published in: Neuromolecular medicine Vol. 26; no. 1; p. 25
• Main Authors: Ramirez-Velandia, Felipe, Mensah, Emmanuel, Salih, Mira, Wadhwa, Aryan, Young, Michael, Muram, Sandeep, Taussky, Philipp, Ogilvy, Christopher S.
• Format: Journal Article
• Language: English
• Published: New York Springer US 17.06.2024; Springer Nature B.V
• Subjects: 1-Phosphatidylinositol 3-kinase; Aneurysm; Aneurysms; Angiogenesis; Animals; Biomedical and Life Sciences; Biomedicine; Bone marrow; Cardiovascular system; CD34 antigen; Cell Differentiation; Comorbidity; Embolization; Embolization, Therapeutic; Endothelial cells; Endothelial Progenitor Cells - physiology; Endothelial Progenitor Cells - transplantation; Endovascular coiling; Endovascular Procedures - methods; Growth factors; Humans; Internal Medicine; Intracranial Aneurysm - therapy; Kinases; MAP kinase; Matrix metalloproteinase; Microenvironments; Molecular modelling; Neovascularization, Pathologic; Neovascularization, Physiologic; Neurology; Neurosciences; Pathogenesis; Progenitor cells; Review; Signal Transduction; Therapeutic targets; Vascular diseases; Intracranial aneurysms; Flow diversion; Pathogenesis; Coiling; Endovascular procedures; Endothelial progenitor cells
• ISSN: 1535-1084; 1559-1174; 1559-1174
• DOI: 10.1007/s12017-024-08791-4

This comprehensive review explores the multifaceted role of endothelial progenitor cells (EPCs) in vascular diseases, focusing on their involvement in the pathogenesis and their contributions to enhancing the efficacy of endovascular treatments for intracranial aneurysms (IAs). Initially discovered as CD34 +  bone marrow-derived cells implicated in angiogenesis, EPCs have been linked to vascular repair, vasculogenesis, and angiogenic microenvironments. The origin and differentiation of EPCs have been subject to debate, challenging the conventional notion of bone marrow origin. Quantification methods, including CD34 +  , CD133 +  , and various assays, reveal the influence of factors, like age, gender, and comorbidities on EPC levels. Cellular mechanisms highlight the interplay between bone marrow and angiogenic microenvironments, involving growth factors, matrix metalloproteinases, and signaling pathways, such as phosphatidylinositol-3-kinase (PI3K) and mitogen-activated protein kinase (MAPK). In the context of the pathogenesis of IAs, EPCs play a role in maintaining vascular integrity by replacing injured and dysfunctional endothelial cells. Recent research has also suggested the therapeutic potential of EPCs after coil embolization and flow diversion, and this has led the development of device surface modifications aimed to enhance endothelialization. The comprehensive insights underscore the importance of further research on EPCs as both therapeutic targets and biomarkers in IAs.