Genetic lineage tracing analysis of c-kit+ stem/progenitor cells revealed a contribution to vascular injury-induced neointimal lesions

Aims: Accumulating evidence indicates the presence of vascular stem/progenitor cells that may play a role in endothelial repair and lesion formation in the injured artery, in which c-kit(+) stem/progenitor cells have been reported to differentiate into endothelial and smooth muscle cells in vitro and in ischemic tissue. In this study, we investigated whether and how endogenous c-kit(+) stem/progenitor cells contribute to vascular injury and neointima formation in vivo. Methods and results: We created Kit-CreERxRosa26-RFP mice and performed genetic lineage tracing analysis of c-kit(+) stem/progenitor cells in injury-induced neointima formation in vivo. We provide direct evidence that endogenous c-kit(+) stem/progenitor cells minimally differentiate into endothelial or smooth muscle cells facilitating vascular repair, but predominantly generate monocytes/macrophages and granulocytes contributing to vascular immuno-inflammatory response to endothelial injury. Although c-kit(+) cells reside in both bone marrow and vessel wall, bone marrow transplantation data indicate that bone marrow-derived c-kit(+) cells are the main source for enhancing neointima formation. Furthermore, treatment of ACK2, a c-kit receptor antagonizer, attenuates neointimal hyperplasia after injury at least in part by depleting c-kit(+) cells and their generated progeny. Conclusions: c-kit(+) stem/progenitor cells are not a main source for endothelial regeneration and smooth muscle accumulation of the large artery injury, but a plausible interventional approach to reduce vascular immuno-inflammatory response and subsequently to ameliorate vascular lesions.