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(Circulation Research. 2008;103:1200.)
© 2008 American Heart Association, Inc.

Editorials

Showing up Isn’t Enough for Vascularization

Persistence Is Essential

Mark A. Sussman

From the SDSU Heart Institute and Department of Biology, San Diego State University, Calif.

Correspondence to Mark A. Sussman, PhD, San Diego State University, SDSU Heart Institute, Department of Biology, NLS 426, 5500 Campanile Dr, San Diego, CA 92182. E-mail sussman@heart.sdsu.edu

See related article, pages 1327–1334

Key Words: angiogenesis • vascularization • hematopoetic • endothelial • progenitor • cell

An extract of the first 250 words of the full text is provided, because this article has no abstract.

When Woody Allen claims that "80% of success is showing up" he underestimates the importance of sticking around. Case in point: formation of functional vessels in the wake of an ischemic injury by adoptively transferred cells. Although paracrine factor release, survival signaling, cell–cell communication, and endogenous cell recruitment all undoubtedly contribute to the process, an elegant study by Ziebart et al¹ in this issue of Circulation Research demonstrates persistence of adoptively transferred cells is also a critical facet of successful revascularization.

Potent vascularization mediated by adoptively transferred endothelial progenitor cells (EPCs) has been widely documented and is now part of our collective regenerative therapy dogma.^2,3 The initial isolation of EPCs as CD34⁺ hematopoietic progenitors⁴ more than a decade ago prompted intense research throughout the world to delineate the mechanistic basis for vessel formation by these cells. Complexities abound in the process of EPC-mediated vasculogenesis involving a multistep process of recruitment, homing, attachment and migration, proliferation, plexus formation, and, eventually, vessel stabilization. Along the way to revascularization, bidirectional communication between circulating EPCs recruited to ischemic injury sites and cells residing in the compromised target tissue. The multifaceted nature of this process and the multiple players involved obscure the relative contributions of recruited EPCs versus resident tissue populations to establish mature vasculature. This is a pivotal issue for myocardial regenerative therapy, because the ultimate efficacy of rebuilding healthy and functional contractile tissue depends on establishment of an integrated and stable vascular network.

Incorporation of bone marrow–derived EPCs into neovascularization has been demonstrated . . . [Full Text of this Article]