Vitality of endothelial colony-forming cells correlates with cardiovascular risk and arterial stiffness – A study with cell donors at a German blood bank

Since cardiovascular diseases are the leading cause of death worldwide, autologous endothelial colony-forming cells (ECFCs) are often considered for tissue engineering applications and expanded in vitro , e.g., to seed vascular scaffolds as a vascular substitute or within EC regenerative cell therapies. Despite the simple isolation procedure, success rates vary markedly between individuals. The primary goal of this study was to define pre-collection parameters in participant blood donors that reveal the potential of generating high-quality ECFCs for vascular regeneration therapy. ECFCs were isolated from peripheral blood mononuclear cells from 43 healthy blood donors (23 females, 20 males) and characterized regarding their expandability for therapeutic applications. In addition to data on blood pressure, heart rate, and vascular function – using pulse-wave velocity (PWV) and flow-mediated dilation (FMD) examinations –, questionnaires regarding physical activity, family history, lifestyle factors, and medication were collected. A key finding is the association between the number of giant cells in ECFC cultures and arterial stiffness in blood donors, as reflected by PWV > 8.5 m/s and an FMD < 5%, as well as the absence or at least a significantly reduced proliferative capacity of ECFCs in vitro . It was also found that donors with a higher number of cardiovascular risk factors – such as higher age or body mass index, lack of exercise, and high blood pressure – not only exhibited increased vascular stiffness, but also ECFC isolates that showed reduced ex vivo expandability. Future studies must investigate whether lifestyle changes could also have a positive effect on vascular quality or ECFC quality.