| Objective: To investigate impacts of essential hypertensive (EH) condition and blood pressure control on number and functions (including apoptosis rate, proliferation and adhesion) of endothelial progenitor cells (CEPCs) which cultured in vitro; then to provide evidences for statins'clinic application in simple essential hypertensive patients by further studying statins'contributions on CEPCs'number, proliferation and adhesion in the patients.Methods: (1) 45 individuals, including 30 essential hypertensive patients (15 with uncontrolled blood pressure, 15 with controlled blood pressure) and 15 healthy individuals (as normal control group, matched with age and gender), were enrolled into the study. All the subjects shared normal range in body mass index (BMI), blood glucose and blood lipid. And no damage evidence could be found in their target organs. CEPCs were separated from five milliliters peripheral blood of the subjects and then cultivated in vitro. After seven days cultivation, CEPCs were identified by bi-dyeing fluorescent labeling with both 1,1-dioctadecy 1-3,3,3,3-tetramethylindo-carbocyanine perchlorate labeled acetylated Low Density Liporotein (DiI-acLDL) and Fluorescein isothiocyanate-Ulex europaeus agglutinin-1 (FITC-UEA-1); then counted under the laser confocal microscopy. CEPCs apoptosis rate were detected by terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL). Proliferation and adhesion function were determined by MTT and adhesive cells counting. (2) 102 simple controlled essential hypertensive patients were enrolled into the second part of the study. Every 6 of them were randomly distributed into routine antihypertensive drugs treatment group (antihypertensive drugs group), antihypertensive drugs combined with pravastatin treatment group ( pravastatin group ) or antihypertensive drugs combined with Xue zhi kang capsules treatment group ( XZK group ). An eight-week drugs intervention trial was undertaken. Changes of pre-post-intervention and differences among each group in CEPCs'number, proliferation and adhesion were observed.Results: (1) Compared with normal control group, apoptosis cells in uncontrolled essential hypertension group increased significantly (16.81±2.00 vs. 6.03±0.92, P<0.01). And CEPCs'number decreased significantly (65.1±14.19 vs. 130.8±13.61, P<0.01). Proliferation and adhesion of the cells were weakened remarkably (0.291±0.019 vs. 0.400±0.021, P<0.01; 21.9±7.78 vs. 33.5±7.74, P<0.01). Though survival, number and proliferation of CEPCs in controlled essential hypertension group were significantly higher than that in uncontrolled essential hypertension group, yet not comparable to that in normal control group (11.24±1.93 vs. 16.81±2.00, P<0.01; 91.0±12.11 vs. 65.1±14.19, P<0.01; 0.359±0.012 vs. 0.291±0.019, P<0.01). (2) 88 enrolled subjects, which including 29 in antihypertensive drugs group, 29 in pravastatin group and 30 in XZK group completed the follow-up study. After eight weeks of statin associated intervention, CEPCs'number increased significantly(88.0±6.32 vs. 116.6±5.70 vs. 114.4±6.55, P<0.01); proliferation and adhesion were improved(0.333±0.021 vs. 0.406±0.016 vs. 0.415±0.018, P<0.01; 23.3±3.19 vs. 33.6±4.26 vs. 34.3±3.77, P<0.01). No significant difference could be found between pravastatin group and XZK group.Conclusions: (1) CEPCs damage caused by essential hypertension might be not conducive to recovery of blood vessel endothelium. (2) Blood pressure control increase CEPCs number and improve CEPCs functions of essential hypertensive patients, suggesting that reducing blood pressure of essential hypertensive patients within permitted range could protect the target organs and promote their recovery. (3) Associated statin with regular antihypertensive drugs, number and function of CEPCs could be further improved, which benefits essential hypertensive patients additionally.
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