AUTHOR=Rafat Neysan , Patry Christian , Sabet Ursula , Viergutz Tim , Weiss Christel , Tönshoff Burkhard , Beck Grietje , Schaible Thomas 

TITLE=Endothelial Progenitor and Mesenchymal Stromal Cells in Newborns With Congenital Diaphragmatic Hernia Undergoing Extracorporeal Membrane Oxygenation

JOURNAL=Frontiers in Pediatrics

VOLUME=7

YEAR=2019

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2019.00490

DOI=10.3389/fped.2019.00490

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Methods:</bold> Peripheral blood mononuclear cells from newborns with ECMO-dependent (<italic>n</italic> = 18) and ECMO-independent CDH (<italic>n</italic> = 12) and from healthy controls (<italic>n</italic> = 12) were isolated. The numbers of EPC and MSC were identified by flowcytometry. Serum levels of vascular endothelial growth factor (VEGF) and angiopoietin (Ang)-2 were determined.</p><p><bold>Results:</bold> 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%).</p><p><bold>Conclusions:</bold> 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.</p>