Evidence for the in vivo existence and mobilisation of myeloid angiogenic cells and pericyte‐like cells in wound patients after skin grafting

Myeloid angiogenic cells (MACs) and pericyte‐like cells, derived from peripheral blood mononuclear cells (MNCs) by in vitro culturing, are suggested as relevant cell types for angiogenesis and tissue repair. However, the in vivo existence and relevance of these cells has so far remained unknown. Our aim was thus to study, if MACs and pericyte‐like cells exist in circulation during the wound healing of skin graft patients, and to evaluate the cellular features of wound repair. MNCs were isolated from blood samples of healthy controls (n = 4) and patients with a traumatic full thickness skin defect (n = 4) before skin grafting and on postoperative days 1 and 6. The numbers of circulating CD14(+)CD45(+)CD31(+)CD34(−) MACs and CD14(+)CD45(+)NG2(+) pericyte‐like cells were assessed by flow cytometry, and gene expression of various pro‐angiogenic factors was analysed by qPCR. Wound bed biopsies were taken on postoperative days 6 and 14, and MAC (CD31, CD14 and CD45) and pericyte‐related markers (NG2 and PDGFRβ) were histologically studied. MACs and pericyte‐like cells were detected in both healthy controls and in patients. Before reconstruction, on average 18% of all circulating MNCs represented MACs and 2% pericyte‐like cells in wound patients. Number of MACs significantly increased 1.1−1.7‐fold in all patients 1 day after skin grafting (p < 0.01). In addition, histological analysis demonstrated effective vascularization of skin grafts, as well as presence of pericytes, and CD14 and CD45 expressing myeloid cells during wound healing. In conclusion, our data shows, for the first time, the presence and mobilisation of MACs and pericyte‐like cells in human circulation.