The use of Endothelial Progenitor Cells (EPCs) in therapy is nowadays considered a feasible option to enhance neo-vascularization in the ischemic heart and lower limbs. Although autologous EPC sources such as the bone marrow (BM) and the peripheral blood (PB) have been already validated for their use to promote angiogenesis, heterologous sources such as the cord blood (CB) have not been yet approved for use in patients, due to risk for immune response induction. Studies in animal models of peripheral ischemia have shown, however, that protocols to pharmacologically suppress immune response allow a potentially successful use of cord-blood-derived CD34+ cells.
Since patients suffering cardiovascular diseases have a well-documented reduction of EPCs number and biological functions, the use of highly clonogenic EPCs, such as those obtained from the cord blood, may have an important therapeutic implication as an alternative option to promote angiogenesis in patients having a poor stem cell pool.
The present contribution will provide the EPC current definition(s), will discuss the fundamental biology of cord-blood-derived EPCs as potential “magic bullets” to combat consequences of ischemia and will report about potential risks and benefits arising from translation of cord-blood-derived EPCs into clinical practice.