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Aim: Endothelial progenitor cell (EPC) proliferation may contribute to the maintenance of normal pregnancy (NOR) with angiogenic factors, which can be generated by nucleated red blood cells (NRBCs) from fetal blood. In this study, we investigated the effect of NRBCs on EPC proliferation in normal pregnancy and preeclampsia (PE). Methods: NRBCs were collected using a cell sorter with anti-CD71 antibody from umbilical venous blood. Following incubation with or without erythropoietin (EPO), vascular endothelial growth factor (VEGF) concentration in the supernatant was measured using an enzyme-linked immunosorbent assay kit. Mononucleated cells excluding NRBCs were cultured with or without NRBCs. On day 7, acLDLand lectin-positive cells were counted as EPCs using flow cytometry. Results: In PE, the number of NRBCs and the VEGF production was significantly increased (P < 0.05), while the number of EPCs decreased significantly (P < 0.05). NRBCs significantly decreased EPC proliferation in NOR (P < 0.05). EPO significantly increased VEGF production by NRBCs in NOR (P < 0.05). Low concentrations of EPO significantly increased EPC proliferation with NRBCs in PE. Conclusions: In PE, increased NRBCs in the fetal circulation may inhibit fetal EPC proliferation; however, EPO could have a favorable influence on placental vasculature through EPC proliferation. Hypertension Research In Pregnancy

Nucleated red blood cells are involved in endothelial progenitor cell proliferation in umbilical venous blood of preeclamptic patients