Circulating endothelial and endothelial progenitor cells are a promising marker of endothelial damage and endothelial regeneration potential. However, their quantification is difficult due to their rareness in the peripheral blood. The most commonly used methods for their identification are immunomagnetic separation and flow cytometry. An advantage of flow cytometry is that a large number of cells can be analysed in a relatively short time in addition to the fact that a combination of various cell markers can be used at the same time. This is important, because we do not have marker that is completely specific for circulating endothelial and endothelial progenitor cells. In order to identify these cells in the peripheral blood by flow cytometry, we developed a protocol for their determination, where an isotype control was used to eliminate nonspecific events. The absolute number was determined with double counting method. Circulating endothelial cells were identified as live nucleated cells that are CD34 positive, CD45 negative or dimly positive, CD133 negative and CD146 positive. Furthermore, endothelial progenitor cells were recognised as live nucleated cells, that are CD34 positive, CD45 dimly positive, CD133 and CD309 positive. We proved good repeatability of our method and good correlation with the standard technique for hematopoietic steam cells determination. Because of the poor stability of circulating endothelial and endothelial progenitor cells the analysis must be done as soon as possible after the venepuncture. Accuracy was proven with the analysis of blood samples from patients with type 1 diabetes. Wilcoxon test for paired samples showed, that the number of circulating endothelial cells decreased significantly in patients receiving semaglutide for 3 months. In addition, the number of endothelial progenitor cells increased significantly after 3 months therapy with semaglutide and empagliflozin. On the other hand, in the control group significant difference between the number of circulating endothelial and endothelial progenitor cells at both time points was not observed. Due to the rarity of endothelial progenitor cells in the peripheral blood, their immunophenotype should be reevaluated before implementation into clinical practice.
|