O treinamento físico aeróbio (TF) tem sido utilizado como um importante tratamento não farmacológico da hipertensão arterial (HA), uma vez que ele corrige a rarefação microvascular e reduz a pressão arterial; entretanto, os mecanismos envolvidos são pouco conhecidos. Investigamos se o número e a capacidade funcional das células progenitoras endoteliais (CPE) derivadas da medula óssea, sabidamente diminuídas na HA, melhoram pós TF, potencialmente contribuindo para a neovascularização e regressão da doença. O efeito do TF sobre a pressão arterial, freqüência cardíaca, tolerância ao esforço, consumo de oxigênio (VO2), morfologia e bioquímica da musculatura esquelética foram estudados em ratos espontaneamente hipertensos (SHR, n=28) e Wistar Kyoto (WKY, n=28) com 12 semanas de vida e divididos em 4 grupos: SHR, SHR treinado (SHR-T), WKY e WKY Treinado (WKY-T). O TF promoveu redução da pressão arterial em SHR e bradicardia de repouso acompanhado por um aumento da atividade da citrato sintase muscular, tolerância ao esforço e VO2 nos grupos de animais treinados. Concomitantemente, o TF corrigiu a alteração na distribuição dos tipos de fibra muscular e a rarefação capilar em SHR, mediado em grande parte por um aumento nos níveis protéicos periféricos de VEGF, VEGFR2, eNOS e a desativação das vias de apoptose. O número de CPE (CD34+/Flk1+) no sangue periférico (SP) analisadas por FACS foram aumentadas 115% no grupo WKY-T em comparação ao grupo controle. Em contraste, o grupo SHR reduziu 39% o número de CPE, entretanto o TF normalizou os níveis no grupo SHR-T. Resultado similar foi encontrado na quantificação das CPE na medula óssea (MO) avaliadas por células duplamente positivas para Di-acLDL e Lectina-FITC. A senescência das CPE na MO foi aumentada 126% no grupo SHR vs. WKY, e o TF foi eficiente em reduzir 72% este processo no grupo SHR-T. Além disso, os ensaios funcionais avaliados pelo número de unidades formadoras de colônia mostraram um aumento de 40% na MO e 70% no SP de WKY-T vs. WKY. Em contraste, a HA reduziu 35% na MO e 45% no SP este número de colônias vs. WKY, porém o TF corrigiu esta disfunção das CPE na HA. De fato, o TF recuperou a falha na formação de tubos como capilares sobre matrigel na HA. Os resultados demonstram que o remodelamento vascular acompanhado pela redução da pressão arterial induzido pelo TF na HA ocorreram em sinergia com a recuperação do número e das propriedades funcionais das CPE da MO e SP, bem como de seus fatores mobilizadores e angiogênicos. Estes resultados sugerem que o TF pode participar do reparo vascular por meio da ação das CPE, promovendo a revascularização periférica. Assim, há perspectiva do potencial terapêutico das CPE no tratamento da HA pós TF. / Aerobic exercise training (ET) has been established as an important non-pharmacological treatment for hypertension, since it counteracts microvascular rarefaction and decreased blood pressure; however, underlying mechanisms remain to be further determined. We investigated for the first time if the endothelial progenitor cells (EPC) number and the functional capacity, impaired in hypertension; are improved after ET potentially contributing to neovascularization and disease regression. The effect of ET on blood pressure, heart rate, exercise tolerance, peak VO2 and skeletal muscle morphology and biochemistry was studied in twelve-week old male Spontaneously Hypertensive Rats (SHR, n=28) and Wistar Kyoto (WKY, n=28) assigned into 4 groups: SHR, trained SHR (SHR-T), WKY and trained WKY (WKY-T). The ET promoted a decrease in blood pressure in SHR and resting bradycardia, an increase in exercise tolerance, peak VO2 and citrate synthase activity in trained groups. In parallel, the ET repaired the skeletal muscle fiber type shift and capillary rarefaction in SHR, at least partly, by enhancing protein levels of VEGF, VEGFR-2, eNOS and deactivated apoptosis pathway. Numbers of EPC (CD34+/Flk1+) in the peripheral blood (PB) quantified by FACS analysis were enhanced 115% in WKY-T of control levels. In contrast, the SHR group decreased 39%, but ET normalized in the SHR-T. Similar results were found in the EPC quantification of the bone marrow (BM) by double positive cells to Di-acLDL and Lectin-FITC. BM-EPC senescence was increased 126% in SHR and this process was reduced 72% by ET. Moreover, EPC functional assay by colony-forming units showed an increase of 40% to BM and 70% to PB in WKY-T of control levels. In contrast, the SHR group reduced 35% to BM and 45% to PB; however the ET repaired EPC dysfunction in hypertension. In fact, the ET corrected failure in the capillary-like tube formation on matrigel. The present findings reveal that the vascular remodeling accompanied by reduction of blood pressure induced by ET occurs in synergy with the restoration of the BM and PB- EPC number and functional properties, as well as of their mobilizing and angiogenic factors. These results suggest that the ET can participate in the vascular repair by means of the EPC, promoting the peripheral revascularization in hypertension. In this way, there is perspective of therapeutic potential of the EPC in treatment of hypertension after ET.

The influence of immunosuppressive drugs on neural stem/progenitor cell fate in vitro.

Malgré l’efficacité thérapeutique avérée des agents anti-angiogéniques et des agents anti-vasculaires (VDA), le mécanisme d’action précis des stratégies ciblant les vaisseaux sanguins tumoraux, les raisons de leur efficacité ainsi que les mécanismes de résistance à ces drogues sont encore mal compris. Il est rapidement apparu essentiel d’identifier des biomarqueurs capables de refléter l’angiogénèse tumorale ou les effets sur la vascularisation tumorale de ces traitements. Compte tenu de leur importance dans des pathologies vasculaires, les cellules endothéliales matures circulantes (CEC) et les progéniteurs endothéliaux circulants (CEP) ont d’emblée été pressenties comme des candidats intéressants pour être des biomarqueurs de réponse aux stratégies ciblant la vascularisation tumorale. Nous avons exploré l’intérêt de ces cellules en tant que biomarqueurs de l’angiogénèse dans des tumeurs pédiatriques, et leur rôle en tant que biomarqueurs de traitement par des agents anti-angiogéniques chez des sujets adultes atteints de cancer. Ces travaux ont mis en lumière l’intérêt des CEP et ont été à la source d’un travail plus « mécanistique » où nous avons étudié dans différents modèles murins le rôle des CEC et CEP dans le mécanisme d’action des agents anti-vasculaires et plus particulièrement le rôle fonctionnel des CEP dans la résistance à ces molécules. Par des stratégies d’association d’agents anti-angiogéniques aux VDA destinées à inhiber les CEP, nous montrons l’augmentation de l’activité anti-tumorale des VDA et offrons un rationnel mécanistique pour optimiser les schémas thérapeutiques actuels des traitements anti-vasculaires. Nos données apportent des arguments en faveur du rôle potentiel de ces cellules en tant que biomarqueurs de l’angiogénèse, des traitements anti-angiogéniques et de la résistance aux traitements anti-vasculaires. / Despite their therapeutic impact and clinical benefit, the mecanisms of action of anti-angiogenic agents and vascular disrupting agents (VDA), the reasons for their efficacy as well as the mechanisms underlying resistance to these drugs are not fully understood. Thus, identifying surrogate biomarkers of tumor angiogenesis and of the effects of these new therapeutic agents targeting tumor blood vessels has become a crucial objective. Because of their importance in vascular diseases, mature circulating endothelial cells (CEC) and circulating endothelial progenitor cells (CEP) were suggested to be potential candidate biomarkers of disease response and relapse to vascular targeting strategies. We investigated the role of these cells as biomarkers of tumor angiogenesis in pediatric solid tumors, as well as biomarkers of response to anti-angiogenic therapies in adult cancer patients. By revealing the particularly important role of CEP, these initial studies led to a more “mechanistic” study in which the cellular and molecular effects of a VDA were evaluated with regard to CEC and CEP in different mouse models; in particular, the “catalytic” role of CEP was explored as a mechanism of resistance to VDA. By combining anti-angiogenic agents aimed to inhibit CEP mobilized by the VDA, we demonstrate an increase in the anti-tumor activity of the VDA and offer a mechanistic rational to optimize VDA-based therapeutic strategies. Our data support the role of CEC and CEP as biomarkers of angiogenesis, of anti-angiogenic strategies and of resistance to vascular-disrupting therapies.

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Umbilical cord blood (UCB) is used as a source of haematopoietic stem cells (HSCs) for transplantation but shows defective homing to the bone marrow niche and delayed haematological reconstitution. Following transplantation, HSCs will home to the bone marrow in response to the CXCL12 chemokine, adhere to the bone marrow sinusoidal endothelial cells and then migrate into and lodge in bone marrow niches. In addition to CXCR4, a variety of molecules have been described as being important in these processes. In this laboratory, junctional adhesion molecule-A (JAM-A) was shown to be expressed on human UCB CD133⁺/CD34⁺ cells and regulated by hypoxia. In this thesis, further phenotypic studies show that this molecule is most highly expressed on human CD41a⁺ megakaryocytes and CD14⁺ monocytes/macrophages in UCB. JAM-A was also found to be expressed on all human UCB CD133⁺ cells, which have been shown by others to encompass the HSCs and early myeloid-lymphoid precursors and on the majority of CD34⁺ haematopoietic progenitor cells (HPCs). While it is also present on bone marrow sinusoidal endothelium (BMEC), JAM-A is not detected on cultured bone marrow mesenchymal stromal cells (MSCs). JAM-A blockade, silencing and overexpression experiments showed that JAM-A contributes to, but is not solely responsible for, the adhesion of CD34⁺ haematopoietic progenitor cells to IL-1β activated BMEC-60 cells and fibronectin. Lack of significance in cell migration suggested that JAM-A is more likely to act as an adhesion molecule or a regulator of adhesion rather than as a migratory molecule in such cells. Further functional studies using the proximity ligation assay highlight a potential association of JAM-A with CXCR4 and the adhesion molecules, tetraspanin CD82 and integrin β1. Mechanistic studies were commenced to establish if JAMA could modulate CXCR4 signalling following CXCL12 stimulation, but time constraints prevented these from being completed. These preliminary experiments which were carried out first in the Jurkat cell line lacking JAM-A or transduced to express JAM-A, however, suggest that JAM-A may modulate CXCL12-induced Rap1 phosphorylation and ERK1/2 phosphorylation. The former pathway is important for integrin function and the latter pathway is important in cell adhesion. The results described here, although requiring finalisation, support the hypothesis that JAM-A acts as an adhesion molecule and also may fine tune CXCR4 and integrin mediated functions on human CD34⁺ cells, thereby potentially regulating engraftment of these cells to the bone marrow niche.

Thesis (PhD (Physiology (Human and animal))-- University of Stellenbosch, 2007. / Definition: Stem cells are unspecialised cells with the capacity for long-term self-renewal and the ability to differentiate into multiple cell-lineages. The potential for the application of stem cells in clinical settings has had a profound effect on the future of regenerative medicine. However, to be of greater therapeutic use, selection of the most appropriate cell type, as well as optimisation of stem cell incorporation into the damaged tissue is required. In adult skeletal muscle, satellite cells are the primary stem cell population which mediate postnatal muscle growth. Following injury or in diseased conditions, these cells are activated and recruited for new muscle formation. In contrast, the potential of resident adult stem cell incorporation into the myocardium has been challenged and the response of cardiac tissue, especially to ischaemic injury, is scar formation. Following muscle damage, various growth factors and cytokines are released in the afflicted area which influences the recruitment and incorporation of stem cells into the injured tissue. Transforming Growth Factor-β (TGF-β) is a member of the TGF-β-superfamily of cytokines and has at least three isoforms, TGF-β1, -β2, and -β3, which play essential roles in the regulation of cell growth and regeneration following activation and stimulation of receptor-signalling pathways. By improving the understanding of how TGF-β affects these processes, it is possible to gain insight into how the intercellular environment can be manipulated to improve stem cell-mediated repair following muscle injury. Therefore, the main aims of this thesis were to determine the effect of the three TGF-β isoforms on proliferation, differentiation, migration and fusion of muscle progenitor cells (skeletal and cardiac) and relate this to possible improved mechanisms for muscle repair. The effect of short- and long-term treatment with all three TGF-β isoforms were investigated on muscle progenitor cell proliferation and differentiation using the C2C12 skeletal muscle satellite and P19 multipotent embryonal carcinoma cell-lineages as in vitro model systems. Cells were treated with 5 ng/mℓ TGF-β isoforms unless where stated otherwise. In C2C12 cells, proliferating cell nuclear antigen (PCNA) expression and localisation were analysed, and together with total nuclear counts, used to assess the effect of TGF-β on myoblast proliferation (Chapter 5). The myogenic regulatory factors MyoD and myogenin, and structural protein myosin heavy chain (MHC) were used as protein markers to assess early and terminal differentiation, respectively. To establish possible mechanisms by which TGF-β isoforms regulate differentiation, further analysis included determination of MyoD localisation and the rate of MyoD degradation in C2C12 cells. To assess the effect of TGF-β isoforms on P19 cell differentiation, protein expression levels of connexin-43 and MHC were analysed, together with the determination of embryoid body numbers in differentiating P19 cells (Chapter 6). Furthermore, assays were developed to analyse the effect of TGF-β isoforms on both C2C12 and P19 cell migration (Chapter 7), as well as fusion of C2C12 cells (Chapter 8). Whereas all three isoforms of TGF-β significantly increased proliferation of C2C12 cells, differentiation results, however, indicated that especially following long-term incubation, TGF-β isoforms delayed both early and terminal differentiation of C2C12 cells into myotubes. Similarly, myocyte migration and fusion were also negatively regulated following TGF-β treatment. In the P19 cell-lineage, results demonstrated that isoform-specific treatment with TGF-β1 could potentially enhance differentiation. Further research is however required in this area, especially since migration was greatly reduced in these cells. Taken together, results demonstrated variable effects following TGF-β treatment depending on the cell type and the duration of TGF-β application. Circulating and/or treatment concentrations of this growth factor could therefore be manipulated depending on the area of injury to improve regenerative processes. Alternatively, when selecting appropriate stem or progenitor cells for therapeutic application, the effect of the immediate environment and subsequent interaction between the two should be taken into consideration for optimal beneficial results.

L’athérosclérose est la principale cause d’infarctus du myocarde, de mort subite d’origine cardiaque, d’accidents vasculaires cérébraux et d’ischémie des membres inférieurs. Celle-ci cause près de la moitié des décès dans les pays industrialisés. Lorsque les obstructions artérielles athérosclérotiques sont tellement importantes que les techniques de revascularisation directe ne peuvent être effectuées avec succès, la sévérité de l’ischémie tissulaire résiduelle dépendra de l’habilité de l’organisme à développer spontanément de nouveaux vaisseaux sanguins (néovascularisation). La néovascularisation postnatale est le résultat de deux phénomènes : la formation de nouveaux vaisseaux à partir de la vasculature existante (angiogenèse) et la formation de vaisseaux à partir de cellules souches progénitrices (vasculogenèse). Notre laboratoire a démontré que plusieurs facteurs de risque associés aux maladies cardiovasculaires (tabagisme, vieillissement, hypercholestérolémie) diminuaient également la réponse angiogénique suite à une ischémie. Cependant, les mécanismes précis impliqués dans cette physiopathologie sont encore inconnus. Un point commun à tous ces facteurs de risque cardiovasculaire est l’augmentation du stress oxydant. Ainsi, le présent ouvrage visait à élucider l’influence de différents facteurs de risque cardiovasculaire et du stress oxydant sur la néovascularisation. Nos résultats démontrent que l’exposition à la fumée de cigarette et le vieillissement sont associés à une diminution de la néovascularisation en réponse à l’ischémie, et que ceci est au moins en partie causé par une augmentation du stress oxydant. De plus, nous démontrons que les acides gras dérivés de la diète peuvent affecter la réponse à l’ischémie tissulaire. La première étude du projet de recherche visait à évaluer l’impact de l’exposition à la fumée de cigarette sur la néovascularisation post-ischémique, et l’effet d’une thérapie antioxydante. L’exposition à la fumée de cigarette a été associée à une réduction significative de la récupération du flot sanguin et de la densité des vaisseaux dans les muscles ischémiques. Cependant, une récupération complète de la néovascularisation a été démontrée chez les souris exposées à la fumée de cigarette et traitées au probucol ou aux vitamines antioxydantes. Nous avons démontré qu’une thérapie antioxydante administrée aux souris exposées à la fumée de cigarette était associée à une réduction significative des niveaux de stress oxydant dans le plasma et dans les muscles ischémiques. De plus, les cellules endothéliales progénitrices (EPCs) exposées à de l’extrait de fumée de cigarette in vitro présentent une diminution significative de leur activité angiogénique (migration, adhésion et incorporation dans les tissus ischémiques) qui a été complètement récupérée par le probucol et les vitamines antioxydantes. La deuxième étude avait pour but d’investiguer le rôle potentiel de la NADPH oxydase (Nox2) pour la modulation de la néovascularisation post-ischémique dans le contexte du vieillissement. Nous avons trouvé que l’expression de la Nox2 est augmentée par le vieillissement dans les muscles ischémiques des souris contrôles. Ceci est associé à une réduction significative de la récupération du flot sanguin après l’ischémie chez les vieilles souris contrôles comparées aux jeunes. Nous avons aussi démontré que la densité des capillaires et des artérioles est significativement réduite dans les muscles ischémiques des animaux vieillissants alors que les niveaux de stress oxydant sont augmentés. La déficience en Nox2 réduit les niveaux de stress oxydant dans les tissus ischémiques et améliore la récupération du flot sanguin et la densité vasculaire chez les animaux vieillissants. Nous avons aussi démontré que l’activité fonctionnelle des EPCs (migration et adhésion à des cellules endothéliales matures) est significativement diminuée chez les souris vieillissantes comparée aux jeunes. Cependant, la déficience en Nox2 est associée à une récupération de l’activité fonctionnelle des EPCs chez les animaux vieillissants. Nous avons également démontré une augmentation pathologique du stress oxydant dans les EPCs isolées d’animaux vieillissants. Cette augmentation de stress oxydant dans les EPCs n’est pas présente chez les animaux déficients en Nox2. La troisième étude du projet de recherche a investigué l’effet des acides gras dérivés de la diète sur la néovascularisation postnatale. Pour ce faire, les souris ont reçu une diète comprenant 20% d’huile de maïs (riche en oméga-6) ou 20% d’huile de poisson (riche en oméga-3). Nos résultats démontrent qu’une diète riche en oméga-3 améliore la néovascularisation post-ischémique au niveau macro-vasculaire, micro-vasculaire et clinique comparée à une diète riche en oméga-6. Cette augmentation de la néovascularisation postnatale est associée à une réduction du ratio cholestérol total/cholestérol HDL dans le sérum et à une amélioration de la voie VEGF/NO dans les tissus ischémiques. De plus, une diète riche en acides gras oméga-3 est associée à une augmentation du nombre d’EPCs au niveau central (moelle osseuse) et périphérique (rate). Nous démontrons aussi que l’activité fonctionnelle des EPCs (migration et incorporation dans des tubules de cellules endothéliales matures) est améliorée et que le niveau de stress oxydant dans les EPCs est réduit par la diète riche en oméga-3. En conclusion, nos études ont permis de déterminer l’impact de différents facteurs de risque cardiovasculaire (tabagisme et vieillissement) et des acides gras dérivés de la diète (oméga-3) sur la néovascularisation post-ischémique. Nous avons aussi identifié plusieurs mécanismes qui sont impliqués dans cette physiopathologie. Globalement, nos études devraient contribuer à mieux comprendre l’effet du tabagisme, du vieillissement, des oméga-3, et du stress oxydant sur l’évolution des maladies vasculaires ischémiques. / Atherosclerosis is the main cause of myocardial infarction, sudden cardiac death, stroke and lower limb ischemia. It is responsible for nearly half of all deaths in industrialized countries. When atherosclerotic arterial obstructions are so important that direct revascularization techniques cannot be successfully performed, the severity of residual tissue ischemia depends on the ability of the organism to spontaneously develop new blood vessels (neovascularization). Postnatal neovascularization is the result of two phenomena: the formation of new bloods vessels from the existing vasculature (angiogenesis) and vessel formation from progenitor cells (vasculogenesis). Our laboratory has demonstrated that several cardiovascular risk factors (smoking, aging, and hypercholesterolemia) also impair the angiogenic response after ischemia. However, the precise mechanisms involved in that pathophysiology are still unknown. A common feature of all the cardiovascular risk factors is increased oxidative stress. Therefore, the purpose of the present work was to elucidate the influence of cardiovascular risk factors and oxidative stress on neovascularization. Our results demonstrate that exposure to cigarette smoke and aging are associated with impaired neovascularization in response to ischemia, and that this is at least in part due to increased oxidative stress. In addition, we demonstrate that fatty acids derived from the diet can modulate the response to tissue ischemia. The first study of the research project evaluated the effect of cigarette smoke exposure on neovascularization in response to ischemia, and the effect of an antioxidant therapy. Exposure to cigarette smoke was associated with a significant reduction in the recovery of blood flow perfusion and vessel density in ischemic muscles. However, a complete recovery of neovascularization was demonstrated in mice exposed to cigarette smoke that were treated with probucol or antioxidant vitamins. We found that antioxidant therapy in mice exposed to cigarette smoke was associated with a significant reduction of oxidative stress levels in the plasma and in ischemic muscles. In addition, endothelial progenitor cells (EPCs) exposed to cigarette smoke extracts in vitro showed a significant decrease in their angiogenic activities (migration, adhesion and homing into ischemic tissues) that was completely rescued by probucol and antioxidants vitamins. The goal of the second study was to investigate the potential role of NADPH oxidase (Nox2) in the modulation of ischemia-induced neovascularization in the context of aging. We found that the expression of Nox2 is increased by aging in ischemic muscles of control mice. This is associated with a significant reduction of blood flow recovery after ischemia in older compared to young control mice. We also demonstrated that the density of capillaries and arterioles is significantly reduced in ischemic muscles of older animals, whereas oxidative stress levels are increased. Nox-2 deficiency reduces oxidative stress levels in ischemic tissues and improves blood flow recovery and vascular densities in older animals. We also demonstrated that the functional activities of EPCs (migration and adhesion to mature endothelial cells) were significantly reduced in older compared to young mice. However, Nox2 deficiency is associated with preserved EPCs functional activities in older animals. We also demonstrated an age-dependent pathological increase of oxidative stress in EPCs that is not found in Nox2-deficient animals. The third study of the research project investigated the effect of fatty acids derived from the diet on postnatal neovascularization. To this end, mice received a diet containing either 20% corn oil (rich in omega-6) or 20% fish oil (rich in omega-3). Our results demonstrate that an omega-3 rich diet increases neovascularization in response to ischemia at the macrovascular, microvascular and clinical level compared to an omega-6 rich diet. This increased postnatal neovascularization is associated with decreased total cholesterol/HDL cholesterol ratio in the serum and improved VEGF/NO pathway in ischemic tissues. In addition, the omega-3 rich diet is associated with a significant increase of central (bone marrow) and peripheral (spleen) EPCs. We also show that the functional activities of EPCs (migration and incorporation into tubules) are improved and oxidative stress level in EPCs is reduced by the omega-3 rich diet. In conclusion, our studies have clarified the impact of cardiovascular risk factors (smoking and aging) and fatty acids derived from the diet (omega-3) on ischemia-induced neovascularization. We have also identified several mechanisms involved in that physiopathology. Globally, our studies should contribute to a better understanding of the effects of cigarette smoking, aging and omega-3 on the evolution of ischemic vascular diseases.

Le faible poids de naissance (FPN) est un facteur de risque indépendant reconnu de maladies cardiovasculaires et d'hypertension à l'âge adulte, mais les mécanismes physiopathologiques sous-tendant cette programmation précoce ne sont que partiellement connus. Chez l'adulte, la dysfonction endothéliale et l'altération tant quantitative que qualitative de la cellule progénitrice endothéliale (PEC) sont un marqueur précoce et sensible de risque cardiovasculaire. Des altérations vasculaires (raréfaction microvasculaire, anomalies de la structure vasculaire) et une dysfonction endothéliale (altération de la vasodilatation endothélium-dépendante) sont retrouvées chez le nouveau-né de FPN. Cependant, l'hypothèse d'une altération de la cellule progénitrice endothéliale chez le nouveau-né de FPN reste à être démontrée. Au cours de notre travail, nous avons montré une altération des capacités clonogéniques et angiogéniques des PECs des nouveau-nés de FPN, tant in vitro qu'in vivo. Cette dysfonction pourrait être liée à un déséquilibre antiangiogénique d'origine environnementale conduisant à un profil antiangiogénique d'expression génique de la PEC. Ainsi, nous avons pu montrer qu'une surexpression du gène de la thrombospondine-1 pouvait en partie expliquer la réduction du potentiel angiogénique des PECs du nouveau-né de FPN via une inhibition de la transduction du signal de la voie Akt/PI3K. D'autre part, une diminution des concentrations circulantes de VEGF, dont le rôle critique dans la néovascularisation est bien connu, peut-être liée à une augmentation de son inhibiteur circulant, sFlt1 (récepteur soluble au VEGF), a été retrouvée chez le nouveau-né de FPN. / Low birth weight (LBW) is a risk factor for cardiovascular disease in adulthood. However, the mechanisms explaining cardiovascular programming are incompletely understood. In adults, a reduced level of circulating endothelial progenitor cells (EPCs) is correlated with cardiovascular disease and independently predicts atherosclerosis disease progression. Recent studies demonstrated an impairment of vascular structure (microvascular rarefaction) and function (impaired vasodilation) in LBW neonates. Thus, we hypothesized that LBW infants display an EPCs impairment.We demonstrated an alteration of clonogenic and angiogenic capacities of EPCs fropm LBW infants, both in vitro and in vivo. This could be due to a fetal antiangiogenic imbalance and a subsequent antiangiogenic gene expression profile in EPCs of LBW infants. Through an inhibition of Akt/PI3K signaling, an upregulation of thrombospondin-1 expression could partially explain such observations. Moreover, VEGF pathway, the main angiogenesis regulator, could be involved as we found reduced circulating levels of VEGF, probably due to an increase of its main inhibitor, sFlt1 (soluble receptor of VEGF 1) in LBW infants. The addition of VEGF reversed the in vitro negative effect of LBW infants' sera on EPCs angiogenic function.This investigation opens the way for more studies of EPCs function in LBW subjects. Indeed, many questions emerged about the impact of such dysfunction on the future health of LBW infants.