Diabetes mellitus compromised the stroke-provoked recruitment of pericyte progenitor cells in peripheral blood
Yi-Te Huang, MD 1 , Yuan-Ting Sun, PhD 1 ,
1 Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Yi-Te Huang , MD
Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Type 2 Diabetes mellitus (T2DM) is one of the most important public health problems worldwide, and has been recognized as a risk factor for ischemic stroke. Although there have been improvements in long-term outcomes of DM-related large vascular complications, the managements for small vessel complications in brain such as small vascular infarcts, cerebral small vessel disease and cognitive impairment were still an unmet need. The repair and regeneration of brain after a vascular insult rely on the restore of neurovascular units, which comprised of capillary (including endothelical cells and pericyts) neuron and glia (mainly astrocytes). Growing evidence shows an emerging role of pericyte in the regeneration process. In an ischemic event, cerebral pericytes came from local migrations or recruitments of pericyte progenitor cells (PPC) in circulation. To address whether DM patients have a compromised post-stroke repair, we determined the recruitment of PPC in stroke patient with or without DM.
MATERIAL and METHOD:
From 2019/02 to 2020/03, AIS patients in NCKUH whose TOAST calssificaion were lacunar stroke and health controls were enrolled. Those with malignancy, large territory stroke, cardiac embolism, trauma, chronic kidney disease (CKD stage V) were excluded. Peripheral blood mononuclear cells (PBMC) were obtained within 5 days after the onset of stroke. The count of PPC was defined as double positivity of platelet-derived growth factor receptor-beta (PDGFR-β) and neuron-glial 2 (NG2) determnined by flow cytometry. Demographic data and brain image features were recorded and analyzed.
PBMC from 33 AIS patients and 10 health control were analyzed. Patients with AIS had significantly higher PPC counts compared with non-stroke controls. Among patients with AIS, patients with DM showed smaller stroke-provoked increments of PPC compared with non-DM patients.
Stroke-provoked recruitment of circulating PPC was attenuated in DM pateints. This support the relatively poor long term post-stroke outcome and the risk of developing vascular dementia in DM patients.