Increased levels of circulating SDF-1α and CD34+ CXCR4+ cells in patients with moyamoya disease

Background and Purpose: Recent studies reported that peripheral blood CD34(+) cells and endothelial progenitor cells contributed to angiogenesis in patients with moyamoya disease (MMD), and stromal cell-derived factor-1 alpha (SDF-1 alpha) modulated angiogenesis by interacting with corresponding CXCR4 receptors. We investigated in this study whether SDF-1 alpha/CXCR4 axis involved in neovascularization in patients with MMD. Methods: Eighteen patients with MMD and twelve healthy individuals were enrolled. Patients with MMD detected by cerebral angiography were retrieved from the Nanjing Stroke Registry Program. Peripheral whole blood cells were double stained with anti-CD34 and anti-CXCR4 (CD184). Numbers of CD34(+) CXCR4(+) cells were analyzed by flow cytometry. Plasma concentration of SDF-1a was determined by enzyme-linked immunosorbent assay. Results: In consecutive patients with MMD, the number of CD34(+) CXCR4(+) cells was greater than healthy individuals (54.1 +/- 28.6/mu l peripheral blood (PB) versus 24.6 +/- 25.6/mu l PB; P = 0.015). Plasma SDF-1 alpha level was significantly higher in patients with MMD compared with healthy controls (1676.76 +/- 198.65 pg/ml versus 1508.26 +/- 137.27 pg/ml; P = 0.016). No significant correlation between number of CD34(+) CXCR4(+) cells and plasma SDF-1 alpha level in the patients with MMD was observed (r = 0.185; P = 0.46). Conclusion: This study indicated that increased levels of circulating SDF-1 alpha and CD34(+) CXCR4(+) cells in patients with MMD, which may play an important role in the vasculogenesis in MMD.