Abstract
Introduction: There are no treatments directly targeting the pulmonary vasculature in chronic obstructive pulmonary disease (COPD), and further characterization of the underlying endothelial cell (EC) abnormalities could be helpful in drug development. Methods: We investigated the influence of exercise and the prostacyclin analog iloprost on extracellular vesicles derived from ECs (eEVs) in 15 moderate-severe COPD patients who were enrolled in a randomized, placebo-controlled crossover trial of iloprost. Results: Active smokers had a profile consistent with inflammatory-derived EVs, while exacerbation-prone COPD subjects had a profile consistent with apoptosis-derived eEVs. There were no significant effects of iloprost on eEV levels. However, there was a significant increase in CD144+ and CD31+/CD144+ EVs 1 h after exercise. Conclusions: Endothelial-derived EV profiles differed based on smoking and exacerbation history. Iloprost did not affect eEV levels, although maximal exercise induced a delayed increase in a subset of eEVs, possibly through shear stress.