Effect Of Rehabilitation On Circulating Endothelial Progenitor Cells In Patients With Acute Ischemic Stroke

Objective:To explore the effect and the possible mechanism of rehabilitation therapy on the mobilization of circulating endotheial progenitor cells in patients on examining the level of circulating endotheial progenitor cells, vascular endothelial cell growth factor, inflammatory and anti-inflammatory cytokines in blood serum.Methods:60patients with acute Ischemic Stroke were randomly divided into two groups: rehabilitation group(treated with rehabilitation,n=30),control group(not treated with rehabilitation,n=30).Flow cytometry(FCM) was used to examine the level of circulating endothelial progenitor cells in peripheral blood.Enzyme-linked immunoassay(ELISA) was used to examine the level of vascular endothelial cell growth factor(VEGF),tumor necrosis factor (TNF-α) and Interleukin-10(IL-10) in blood serum. National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA) and Modifed Barthel Index(MBI) was measured at admission and seven days after admission.Results:The level of circulating progenitor cells days after7days rehabilitation treatment in rehabilitation group are higher than control group(p<0.001). The level of VEGF and IL-10on the seventh day of rehabilitation group was obviously higher than control group(P<0.001).The level of TNF-a on the seventh day of rehabilitation group was obviously lower than control group(P<0.001).The NIHSS significantly decreased in the seventh day both in the two groups(P=0.003and <0.001).There was no difference in NIHSS between the two groups in the seventh day(P=0.523).There was no difference in FMA and MBI both in the two groups between the seventh day and the first day(P=0.057,0.133and0.159,0.071). There was no difference in FMA and MBI between the two groups in the seventh day(P=0.791and0.210).Conclusion:1. Rehabilitation therapy may increase the level of circulating progenitor cells,but no effect on improving the early neurological function after AIS.2. Rehabilitation therapy may increase the level of VEGF and IL-10and reduce the level of TNF-a after AIS.3.The higher level of VEGF and IL-10and the lower level of TNF-α may be concerned with the rehabilitation-induced mobilization of EPCs after AIS.