Androgens stimulate EPC-mediated neovascularization and are associated with increased coronary collateralization

Yuen Ting Lam, Chi-Jen Hsu, Philippa J. L. Simpson, Louise L. Dunn, Renee W. Chow, Kim H. Chan, Andy S. C. Yong, Young Yu, Daniel P. Sieveking, Laura Lecce, Jun Yuan, David S. Celermajer, Steven G. Wise, Martin K. C. Ng

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Endothelial progenitor cells (EPCs) play a key role in neovascularization and have been linked to improved cardiovascular outcomes. Although there is a well-established inverse relationship between androgen levels and cardiovascular mortality in men, the role of androgens in EPC function is not fully understood. In this study, we investigated the effects of androgens on 2 subpopulations of EPCs, early EPCs (EEPCs) and late outgrowth EPCs (OECs), and their relationships with coronary collateralization. Early EPCs and OECs were isolated from the peripheral blood of young healthy men and treated with dihydrotestosterone (DHT) with or without androgen receptor (AR) antagonist, hydroxyflutamide, in vitro. Dihydrotestosterone treatment enhanced AR-mediated proliferation, migration, and tubulogenesis of EEPCs and OECs in a dose-dependent manner. Furthermore, DHT augmented EPC sensitivity to extracellular stimulation by vascular endothelial growth factor (VEGF) via increased surface VEGF receptor expression and AKT activation. In vivo, xenotransplantation of DHT pretreated human EPCs augmented blood flow recovery and angiogenesis in BALB/c nude male mice, compared to mice receiving untreated EPCs, following hindlimb ischemia. In particular, DHT pretreated human OECs exhibited higher reparative potential than EEPCs in augmenting postischemic blood flow recovery in mice. Furthermore, whole blood was collected from the coronary sinus of men with single vessel coronary artery disease (CAD) who underwent elective percutaneous intervention (n = 23). Coronary collateralization was assessed using the collateral flow index. Serum testosterone and EPC levels were measured. In men with CAD, circulating testosterone was positively associated with the extent of coronary collateralization and the levels of OECs. In conclusion, androgens enhance EPC function and promote neovascularization after ischemia in mice and are associated with coronary collateralization in men.

Original languageEnglish
Article numberbqaa043
Pages (from-to)1-13
Number of pages13
Issue number5
Publication statusPublished - 1 May 2020
Externally publishedYes


  • androgens
  • collateral circulation
  • coronary artery disease
  • endothelial progenitor cells
  • ischemia


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