4.1 EPCs
Until now, the clinical application of EPCs in PAH has been rare (Table
3). The search results from clinicaltrials show that only China and
Canada have achieved EPC therapy trials using human patients. Of the 31
idiopathic PAH patients in the Chinese trial, 16 patients were randomly
selected to receive conventional therapy, and 15 patients were randomly
selected to receive EPC infusion plus conventional therapy. This trial
lasted for 12 weeks, and the frequency and degree of adverse events were
similar between the 2 groups (p >0.05)(X. X. Wang et
al., 2007). However, the cell infusion group exhibited a significant
improvement in mean distance walked in 6 minutes, mPAP, pulmonary
vascular resistance, and cardiac output. The Canadian trial was more
radical because they used gene-edited EPCs in patients who were
refractory to conventional therapy. They injected seven patients with
eNOS-EPCs, but the number of patients was far less than that in the
Chinese trial, and there were five female subjects but only two male
subjects. Similar to the Chinese trial, the infusion of EPCs was well
tolerated in the cell infusion group, and there was a significant
increase in the mean distance walked in 6 minutes over all 6 months.
However, it is worth noting that some improvements (such as
hemodynamics) disappeared after 3 months, which may be due to the short
duration of EPCs(Granton et al., 2015).