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International Journal of Vascular Medicine
Volume 2014, Article ID 589412, 7 pages
Clinical Study

Prognostic Significance of Circulating and Endothelial Progenitor Cell Markers in Type 2 Diabetic Foot

1Metabolism Disease and Clinical Nutrition Unit, Santa Maria di Ca’ Foncello Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
2Department of Pathology, Santa Maria di Ca’ Foncello Hospital, Treviso, Italy
3Hematology Unit, Santa Maria di Ca’ Foncello Hospital, Treviso, Italy
4Immunohematology and Transfusion Service, Santa Maria di Ca’ Foncello Hospital, Treviso, Italy

Received 22 June 2013; Accepted 10 November 2013; Published 3 February 2014

Academic Editor: Georgios Vourliotakis

Copyright © 2014 Maria Sambataro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. We studied circulating precursor cells (CPC) in type 2 diabetes mellitus (T2DM) with neuropathic foot lesions with or without critical limb ischemia and relationships between endothelial precursor cells (EPC) and peripheral neuropathy. Methods and Subjects. We measured peripheral blood CD34, CD133, and CD45 markers for CPC and KDR, CD31 markers for EPC by citofluorimetry and systemic neural nociceptor CGRP (calcitonin gene related protein) by ELISA in 8 healthy controls (C) and 62 T2DM patients: 14 with neuropathy (N), 20 with neuropathic foot lesions (N1), and 28 with neuroischemic recent revascularized (N2) foot lesions. Timing of lesions was: acute (until 6 weeks), healed, and not healed. Results. CD34+ and CD133+ were reduced in N, N1, and N2 versus C, and CD34+ were lower in N2 versus N1 ( ). In N2 CD34+KDR+ remain elevated in healed versus chronic lesions and, in N1 CD133+31+ were elevated in acute lesions. CGRP was reduced in N2 and N1 versus C ( versus C  pg/mL). CD34+KDR+ correlated in N2 with oximetry and negatively in N1 with CGRP. Conclusions. CD34+ CPC are reduced in diabetes with advanced complications and diabetic foot. CD34+KDR+ and CD31+133+ EPC differentiation could have a prognostic and therapeutic significance in the healing process of neuropathic and neuroischemic lesions.