Transplantation of Endothelial Progenitor Cells Improves Pulmonary Endothelial Function and Gas Exchange in Rabbits with Endotoxin-Induced Acute Lung Injury

BACKGROUND: Circulating endothelial progenitor cells (EPCs) have been therapeutically applied to aid vascular repair and myocardial regeneration. The number of circulating EPCs also provides invaluable outcome prediction for fatal diseases such as acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). However, evidence for the therapeutic potential of EPCs in subjects with ALI/ADRS is limited. METHODS: Circulating EPCs were obtained from rabbits using Ficoll centrifugation. One week after culturing EPCs in endothelial growth medium-2, ALI was induced in rabbits by intratracheal instillation of lipopolysaccharide (500 mu g/kg). Autologous EPCs or saline were administered IV after induction of ALI and animals were killed 2 days later. Pulmonary artery endothelial function and gas exchange were determined. Degrees of lung injury were assessed by alveolocapillary permeability, lung hemoglobin content, and myeloperoxidase activity. RESULTS: In comparison with controls, Po-2 in arterial blood was significantly elevated and pulmonary artery endothelium-dependent relaxation response was restored in rabbits receiving EPC transplantation. Lung water, Evan's blue, and bronchoalveolar lavage protein contents were significantly reduced in the EPC transplanted group, indicating a better preservation of the alveolocapillary membrane. Transplantation of EPCs decreased the lung hemoglobin level. Furthermore, expressions of CD11b and myeloperoxidase activity were also suppressed after administration of EPCs. CONCLUSIONS: Transplantation of EPCs restored pulmonary endothelial function, preserved integrity of the alveolocapillary barrier and suppressed the lung inflammatory response, thereby improving pulmonary gas exchange in rabbits with intratracheal lipopolysaccharide-induced ALI. Transplantation of EPCs can be a novel cell-based, endothelium-targeted therapeutic strategy for prevention and treatment of ALI/ARDS. (Anesth Analg 2011;112:620-7)