Hematopoietic and Nonhematopoietic Differentially Regulates Stem Cell Traffic and Vascular Response to Ischemia in Diabetes.

Peripheral artery disease (PAD) is a severe complication of diabetes, characterized by defective traffic of hematopoietic stem/progenitor cells (HSPCs). We examined the hematopoietic nonhematopoietic role of p66Shc in regulating HSPC traffic and blood flow recovery after ischemia in diabetic mice. Using streptozotocin-induced diabetes, chimeric mice with green fluorescent protein (GFP) bone marrow (BM), and the hind limb ischemia model, we found that the physiologic mobilization and homing of HSPCs were abolished by diabetes, along with impaired vascular recovery. Hematopoietic deletion of , obtained by transplanting BM cells into wild-type (Wt) recipients, but not nonhematopoietic deletion, constrained hyperglycemia-induced myelopoiesis, rescued postischemic HSPC mobilization, and improved blood flow recovery in diabetic mice. In Wt diabetic mice transplanted with BM cells from mice, the amount of HSPCs homed to ischemic muscles was greater than in mice transplanted with cells, with recruited cells displaying higher expression of adhesion molecules and . In 40 patients with diabetes, gene expression in mononuclear cells was correlated with myelopoiesis and elevated in the presence of PAD. In 13 patients with diabetes and PAD, expression in HSPC-mobilized peripheral blood cells was inversely correlated with expression. For the first time, we dissect the role of hematopoietic nonhematopoietic p66Shc in regulating HSPC traffic and ischemic responses. Hematopoietic deletion of was sufficient to rescue HSPC mobilization and homing in diabetes after ischemia and improved blood flow recovery. Inhibiting p66Shc in blood cells may be a novel strategy to counter PAD in diabetes. . 36, 593-607. Clinical Trial No.: NCT02790957.