Vascular Regenerative Cell Deficiencies in South Asian Adults

Aishwarya Krishnaraj, Ehab Bakbak, Hwee Teoh, Yi Pan, Irene N. Firoz, Arjun K. Pandey, Daniella C. Terenzi, Raj Verma, Basel Bari, Asaad I. Bakbak, Shakkeela Padanilathu Kunjummar, Bobby Yanagawa, Kim A. Connelly, C. David Mazer, Ori D. Rotstein, Adrian Quan, Deepak L. Bhatt, Darren K. McGuire, David A. Hess, Subodh Verma

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: South Asian individuals shoulder a disproportionate burden of cardiometabolic diseases. Objectives: The purpose of this study was to determine if vascular regenerative cell content varies significantly between South Asian and White European people. Methods: Between January 2022 and January 2023, 60 South Asian and 60 White European adults with either documented cardiovascular disease or established diabetes with ≥1 other cardiovascular risk factor were prospectively enrolled. Vascular regenerative cell content in venous blood was enumerated using a flow cytometry assay that is based on high aldehyde dehydrogenase (ALDHhi) activity and cell surface marker phenotyping. The primary outcome was the difference in frequency of circulating ALDHhi progenitor cells, monocytes, and granulocytes between the 2 groups. Results: Compared with White European participants, those of South Asian ethnicity were younger (69 ± 10 years vs 66 ± 9 years; P < 0.05), had lower weight (88 ± 19 kg vs 75 ± 13 kg; P < 0.001), and exhibited a greater prevalence of type 2 diabetes (62% vs 92%). South Asian individuals had markedly lower circulating frequencies of pro-angiogenic ALDHhiSSClowCD133+ progenitor cells (P < 0.001) and ALDHhiSSCmidCD14+CD163+ monocytes with vessel-reparative capacity (P < 0.001), as well as proportionally more ALDHhi progenitor cells with high reactive oxygen species content (P < 0.05). After correction for sex, age, body mass index, and glycated hemoglobin, South Asian ethnicity was independently associated with lower ALDHhiSSClowCD133+ cell count. Conclusions: South Asian people with cardiometabolic disease had less vascular regenerative and reparative cells suggesting compromised vessel repair capabilities that may contribute to the excess vascular risk in this population.

Original languageEnglish
Pages (from-to)755-769
Number of pages15
JournalJournal of the American College of Cardiology
Volume83
Issue number7
DOIs
StatePublished - 20 Feb 2024
Externally publishedYes

Keywords

  • cardiovascular disease
  • ethnicity
  • monocytes
  • progenitor cells
  • vascular repair

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