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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pediatr. | doi: 10.3389/fped.2019.00490

Endothelial progenitor and mesenchymal stromal cells in newborns with congenital diaphragmatic hernia undergoing extracorporeal membrane oxygenation

 Neysan Rafat1,  Christian Patry2*,  Ursula Sabet2, Tim Viergutz1, Christel Weiss3,  Burkhard Tönshoff3, grietje beck4 and  Thomas Schaible1
  • 1University Medical Center Mannheim (UMM), Germany
  • 2Heidelberg University Hospital, Germany
  • 3Heidelberg University, Germany
  • 4Helios dr. Horst Schmidt Clinics Wiesbaden, Germany

Background: Endothelial progenitor (EPC) and mesenchymal stromal cells (MSC) can regenerate damaged endothelium and thereby improve pulmonary endothelial dysfunction. We do not know, how extracorporeal membrane oxygenation (ECMO) might affect EPC- and MSC-mediated regenerative pathways in patients with congenital diaphragmatic hernia (CDH). Therefore, we investigated, if ECMO support impacts EPC and MSC numbers in CDH patients.
Methods: Peripheral blood mononuclear cells from newborns with ECMO-dependent (n=18) and ECMO-independent CDH (n=12) and from healthy controls (n=12) were isolated. The number of EPC and MSC was identified by flowcytometry. Serum levels of vascular endothelial growth factor (VEGF) and angiopoietin (Ang)-2 were determined.
Results: EPC and MSC were elevated in newborns with CDH. ECMO-dependent infants had higher EPC subpopulation counts (2,1-7,6-fold) before treatment compared to ECMO-independent infants. In the disease course, EPC and MSC subpopulation counts in ECMO-dependent infants were lower than before ECMO initiation. During ECMO, VEGF serum levels were significantly reduced (by 90,5%) and Ang2 levels significantly increased (by 74,8%).
Conclusions: Our data suggest that ECMO might be associated with a rather impaired mobilization of EPC and MSC and with a depression of VEGF serum levels in newborns with CDH.

Keywords: progenitor cells, Stem Cells, ECMO, Congenital Diaphragmatic Hernia, neonates

Received: 04 Aug 2019; Accepted: 07 Nov 2019.

Copyright: © 2019 Rafat, Patry, Sabet, Viergutz, Weiss, Tönshoff, beck and Schaible. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Christian Patry, Heidelberg University Hospital, Heidelberg, Germany,