Recovery of multipotent progenitors from the peripheral blood of patients requiring extracorporeal membrane oxygenation support.

Authors:	Kim Chi T Bui, Dinithi Senadheera, Xingchao Wang, Benjamin Hendrickson, Philippe Friedlich, Carolyn Lutzko
Language:	Eng.
Date:	2010-01-22
Journal:	American journal of respiratory and critical care medicine (1535-4970)
Release:	Am J Respir Crit Care Med. 2010 Feb;181(3):226-37
Abstract:	RATIONALE: Studies have demonstrated that bone marrow-derived cells can be recruited to injured lungs through an unknown mechanism. We hypothesize that marrow progenitors are mobilized into the circulation of patients with cardiac and/or respiratory failure, and may then traffic to and incorporate into the sites of tissue injury. OBJECTIVES: To determine whether progenitor populations are increased in the blood of patients with severe acute cardiorespiratory failure placed on extracorporeal membrane oxygenation (ECMO). METHODS: Mononuclear cells from ECMO, umbilical cord, and control blood samples were evaluated in colony-forming assays for hematopoietic, mesenchymal, and epithelial cells. Progenitors were identified by proliferative and differentiative capacities, and confirmed by the expression of lineage-specific markers. MEASUREMENTS AND MAIN RESULTS: Significantly higher levels of hematopoietic progenitors were observed in ECMO (n = 41) samples than neonatal intensive care unit (n = 16) or pediatric intensive care unit controls (n = 14). Hematopoietic progenitor mobilization increased with time on ECMO support. Mesenchymal progenitors (MSC) were recovered from 18/58 ECMO samples with rapid sample processing (< 4 h) critical to their recovery. MSC were not recovered from normal controls. ECMO-derived MSC had osteogenic, chondrogenic, and adipogenic differentiation potential. The recovery of MSC did not influence survival outcome (61%). Epithelial progenitors were observed in eight ECMO samples but not in control samples. Their presence was associated with a lower survival trend (38%). CONCLUSIONS: Hematopoietic, mesenchymal, and epithelial progenitors were mobilized into the circulation of patients on ECMO. This may reflect a response to severe cardiopulmonary injury, blood-foreign surface interactions with the ECMO circuit, and/or hemodilution.
Copyright:	American journal of respiratory and critical care medicine Mattel Children's Hospital at UCLA Medical Center, David Geffen School of Medicine, Los Angeles, CA, USA.
Full text:	DOI - American journal of respiratory and critical care medicine (DOI) HighWire Press - HTML (needs subscription) ProQuest Information and Learning - HTML (needs subscription)
Terms:	Adolescent, Adult, Aged, Blood Cell Count, Cell Differentiation, Cells, Cultured, Child, Child, Preschool, Extracorporeal Membrane Oxygenation, Female, Flow Cytometry, Humans, Infant, Infant, Newborn, Male, Middle Aged, Multipotent Stem Cells, Recovery of Function, Respiratory Insufficiency, Retrospective Studies, Young Adult