Effects of aging and comorbidities on endothelial progenitor cells

Endothelial Progenitor Cells (EPCs) are postulated to participate in the function of the vessel endothelium and are emerging as key cellular elements of vessel and tissue repair. These bone marrow-derived cells play a central role in maintaining blood vessel health and function under physiological conditions. Several investigations have identified these cells as mediators of repair; however, their number and function vary among subjects according to age, sex, and comorbid circumstances, which may negatively condition the characteristics and functions of EPCs. Lifestyle habits in developed countries increase the prevalence of comorbid conditions, including cardiovascular diseases and disorders in which the health of the vascular system is compromised. In this review, we describe how age, diabetes, hypertension, and obesity (significant comorbid conditions) may influence the opportunities for vascular remodeling by modifying the bio-distribution and functions of EPCs. We provide evidence for the need to improve cardiovascular protection beyond endothelial function and the vascular wall structure by preserving the endogenous mechanisms of vascular repair based on the actions of the endothelial progenitor pools.