Circulating Endothelial Cells:
A Novel Biomarker for
Cardiovascular Diseases
Endothelial cells are the innermost layer of a vessel. Through the loss of cell adhesion or mechanical force, these cells are released into the bloodstream, giving rise to Circulating Endothelial Cells (CECs). The concentration of CECs in blood correlates with the severity of endothelial damage present in cardiovascular disease and can therefore serve as a prognostic or monitoring tool.
CECs are morphologically similar to mature endothelial cells¹, but change their morphological appearance depending on their functional state. For example, in subjects with ST-elevated acute myocardial infarction, cellular and nuclear size can differ significantly², as well as cell shape, which suggests that the morphology of CEC changes during acute vascular events.
These features make CECs the ideal target cell to enable a personalized patient treatment in cardiology.
1: Source: Blann AD, Pretorius A., “Circulating endothelial cells and endothelial progenitor cells: two sides of the same coin, or two different coins?,” Atherosclerosis., pp. 188(1):12-8, Sep 2006.
2: Source: Mutin M, Canavy I, Blann A et al., “Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells.,” Blood, pp. 93(9):2951-8, 1 May 1999.
Indications with Elevated CECs
The CEC count is elevated in patients with heart infarction, diabetes mellitus, heart failure and other endothelial damage related conditions. The small blood volume used by current alternative detection methods limits their specificity and sensitivity. Our approach screens more than 100 times more blood for a precise cell count and downstream analysis.
Image Source: Muse ED, Kramer ER, Wang H,Topol, EJ et al., „A Whole Blood Molecular Signature for Acute Myocardial Infarction,” Nature, pp. 1-9, 1 September 2017.
Downstream Molecular Analysis
In addition to cell imaging and counting, downstream molecular analysis can be deployed to increase diagnostic precision. The RNA cell content reflects the ongoing processes in the cells. These molecular processes vary in relation to the cause of CEC release. Molecular processes in heart infarction CECs differ from the ones in CECs released due to stroke or diabetes mellitus. Similarly, endothelial cells originating in various vascular sites have RNA signatures characteristic of their cell niche specific to the site of origin. Based on these variances we strive for sensitive and specific personalized diagnosis.
Application of the BMProbe
The cells isolated by the BMProbe can be used for a proteomic and transcriptomic analysis of the circulating endothelial cells. This will enable physicians to monitor the status of the vascular system and assist in deciding the drug therapy.