The imbalance between circulating endothelial cells and progenitors in cardiovascular diseases: a mirror of disrupted endothelial integrity.

The disruption of endothelial integrity is at the crossroads of the initiation and progression of multiple cardiovascular diseases pathophysiology. During these last years, it has been evidenced that endothelium is a highly dynamic tissue in equilibrium with a circulating compartment composed of various sub-populations offering important opportunities for a non-invasive exploration. Among these, circulating endothelial cells (CEC) are mature cells detached from injured vessels. Rarely found in blood in the health, CEC number is raised in a wide variety of pathological conditions associated with profound vascular insult. An additional population are the endothelial progenitor cells derived from bone marrow and characterised by their ability to participate in endothelial repair. Reduced number and impaired function of EPC have been related to situations with increased cardiovascular risk or to clinical atherosclerotic diseases. This review will focus on present data concerning CEC and endothelial cells and progenitors (PEC) in the setting of cardiovascular diseases. Particular emphasis will be given on the clinical value of these endothelial biomarkers to monitor endothelial homeostasis depending on the balance between endothelial injury and repair.