Stem cell niches as clinical targets: the future of anti-ischemic therapy?

This article provides context for the research presented by Napoli et al., reported in this journal. Treatment strategies that target stem cell niches are promising avenues for stimulating inducible angiogenesis in many vascular diseases, such as diabetes mellitus and atherosclerosis. Here we discuss the study carried out by Napoli and colleagues--an analysis of the effects of parathyroid hormone on the vascular stem cell niche in peripheral ischemia. Napoli et al. demonstrate that parathyroid hormone administered in combination with granulocyte colony-stimulating factor induces angiogenesis in a hindlimb ischemia mouse model. This treatment seems to mobilize and localize endothelial cell progenitors specifically to ischemic vascular cell beds. We explore the mechanisms through which the multiple cells within the vascular niche respond to ischemia. The interaction between parathyroid hormone and granulocyte colony-stimulating factor in humans is also discussed. Further assessment is needed to elucidate the factors involved in migration and differentiation of endothelial cell progenitors in ischemia-damaged tissues.