Plenary speakers in the spotlight: Majesky and Landmesser

Professor Ulf Landmesser

ENDOTHELIAL FUNCTION AND DYSFUNCTION: THE KEYS TO CORONARY AND PERIPHERAL CIRCULATION

Ulf Landmesser is Professor of Cardiology, Head, Acute and Invasive Cardiology and Head of Cardiovascular Research at the Department of Cardiology of the University Hospital Zurich.

A key focus of his research is progenitor cell-mediated repair capacity in cardiovascular disease.
Prof Landmesser is Deputy Editor, European Heart Journal, and a member of the ESC Congress Program Committee (2010-2012), the Science and Guidelines committee, EACPR and the Nucleus Exercise, Basic and Translational Science, EACPR.

Endothelial dysfunction underlies the development and progression of atherosclerosis and its clinical complications. In particular reduced endothelial availability of nitric oxide (NO), in part due to increased vascular oxidant stress, promotes a pro-inflammatory and prothrombotic phenotype of the endothelium. Clinical studies have shown close association between the degree of endothelial dysfunction and risk of future cardiovascular events. The development of novel methods for evaluating endothelial function offers the possibility for detecting endothelial dysfunction before overt coronary and peripheral vascular disease.

Cardiovascular risk factors reduce the number and impair the function of circulating endothelial progenitor cells, thereby impairing their repair capacity. Understanding these mechanisms may offer a potential therapeutic strategy in ischaemic heart disease. Approaches have been aimed at maintaining stem cell niche function and targeting mobilization/recruitment of specific stem/progenitor cell populations to preserve vascular and cardiac function. Although small studies suggest that cell-based therapy may improve cardiac function on top of standard therapy, there remain limitations and uncertainties.

Ultimately such approaches, combining emerging tools such as cell priming, bionanotechnology and tissue engineering, may offer the opportunity for a combined biological approach to ischaemic tissue repair.

Key references

Landmesser U, Hornig B, Drexler H. Endothelial function: a critical determinant in atherosclerosis ? Circulation 2004; 109(Suppl 1): II27-II33

Lekakis J, Abraham P, Balbarini A, Blann A, Boulanger CM, Cockcroft J, Cosentino F, Deanfield J, Gallino A, Ikonomidis I, Kremastinos D, Landmesser U, Protogerou A, Stefanadis C, Tousoulis D, Vassalli G, Vink H, Werner N, Wilkinson I, Vlachopoulos C. Methods for evaluating endothelial function: a position statement from the European Society of Cardiology Working Group on Peripheral Circulation. Eur J Cardiovasc Prev Rehabil 2011;18:775-89.

Besler C, Heinrich K, Rohrer L, Doerries C, Riwanto M, Shih DM, Chroni A, Yonekawa K, Stein S, Schaefer N, Mueller M, Akhmedov A, Daniil G, Manes C, Templin C, Wyss C, Maier W, Tanner FC, Matter CM, Corti R, Furlong C, Lusis AJ, von Eckardstein A, Fogelman AM, Lüscher TF, Landmesser U. Mechanisms underlying adverse effects of HDL on eNOS-activating pathways in patients with coronary artery disease. J Clin Invest 2011;121:2693-708.

Tongers J, Losordo DW, Landmesser U. Stem and progenitor cell-based therapy in ischaemic heart disease: promise, uncertainties, and challenges. Eur Heart J 2011;32:1197-206.

Forrás: The European Atherosclerosis Society website