Endothelial progenitor cell-seeded grafts: Rash and riskyLes greffes endothéliales de cellules souches : Téméraires et risquées

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The patency of prosthetic vascular grafts is impaired by intimal hyperplasia (IH) near the anastomotic regions. The absence of a functional endothelial monolayer on the prosthetic grafts is an important stimulus for IH. To improve the outcome of synthetic vascular bypass surgery, cell seeding is a promising concept that has been extensively investigated and is still evolving. In the present paper, the concept of prosthetic graft cell seeding is discussed, with emphasis on its newest era: seeding with endothelial progenitor cells. Although experimental studies on prosthetic graft seeding using endothelial progenitor cells have shown excellent results on graft endothelialization, none of these studies reported favourable effects on the more clinically relevant end points such as IH or graft patency.

La perméabilité des greffes vasculaires prosthétiques est perturbée par l’hyperplasie intimale (HI) près des zones anastomosées. L’absence de monocouche endothéliale fonctionnelle sur les greffes prosthétiques est un important stimulus d’HI. Pour améliorer l’issue des pontages vasculaires synthétiques, l’implantation de cellules est un concept prometteur qui a fait l’objet de recherches poussées et qui est toujours en évolution. Dans le présent article, le concept d’implantation de greffes de cellules prosthétiques est abordé, surtout axé sur son domaine le plus novateur : l’implantation de cellules souches endothéliales. Bien que les études expérimentales sur l’implantation de cellules prosthétiques au moyen de cellules souches endothéliales aient obtenu d’excellents résultats sur l’endothélialisation des greffes, aucune n’a d’effets favorables sur les éléments décisifs plus pertinents d’un point de vue clinique, comme l’HI et la perméabilité.

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