The Potential Efficacy of Endothelial Progenitor Cells With and Without Nitric Oxide Inducer as Cell Therapy for Right Ventricular Impairments Caused by Pulmonary Hypertension in Rats

Background: A number of studies now suggest that endothelial progenitor cells (EPCs) may induce neovascularisation and could be a promising approach for cell based therapy for pulmonary artery hypertension (PAH). Purpose: We investigated whether or not intravenous injection of bone marrow-derived endothelial progenitor cells (EPCs), alone or combined with NO inducer restore pulmonary hemodynamics and increase microvascular perfusion in the rat monocrotaline (MCT) model of pulmonary artery hypertension so improve right ventricle performance. Material and Methods: Rats were divided into control, rats with PAH, PAH rats receiving EPCs, PAH rats receiving NO inducer (L-Arginine) and PAH rats receiving EPCs plus NO inducer, after 1 month, serum creatine phosphokinase enzyme, VEGF level in heart and lung were assessed. Histopathological analysis of both heart and lung tissues was performed. Results: The level of VEGF was increased in all treated groups. Immunohistochemical staining showed perivascular, intravascular and peribronchial CD34 positive cell aggregates in the groups received EPCs whether alone or combined with NO inducer. Conclusion: The present study proved that, administration of BM-EPCs alone, NO alone or EPCs plus NO, produce therapeutic effect in restoring pulmonary hemodynamics and so improving right ventricle performance in PAH. This effect may be through angiogenic action of EPCs and NO.