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A biophysical approach to capillary permeability.

In this preliminary report, the capillary leakage that occurs after scald injury is considered a biophysical phenomenon and is treated by sealing the "pores," or endothelial gaps, in the capillary membranes with biodegradable macromolecules of the appropriate size and shape. We have measured albumin leakage from standardized scald burns in the rat jejunum with and without variously sized fractions of intravenous macromolecules of hydroxyethyl starch (HES) used as a sealing agent. The observed reduction of albumin leakage from injured capillaries was attributed to the sealing effect. The fraction HES (Fm) with molecular weights of 100,000 to 300,000 daltons performed significantly better (p less than 0.05) as a sealing agent when compared with HES (F1) fraction molecular weights of 300,000 to 3.4 million daltons, HES (Fs) molecular weight less than 50,000 daltons, and two control groups receiving the intravenous Ringer's lactate solution or serum albumin 5%. This capillary sealing phenomenon was shown to be independent of colloid osmotic pressure effect. It is believed to be related to the size and the shape of the noncharged macromolecules.

Animals↗

[Ultrastructure of capillary permeability in human brain tumors. 2: Mechanisms of contrast enhancement in gliomas].

In order to elucidate the mechanism of contrast enhancement on computerized tomography (CT), the alteration of capillary permeability was studied in 3 cases of medulloblastoma, 2 cases of ependymoma, 5 cases of glioblastoma and 5 cases of astrocytoma. The surgical specimens were studied with conventional ultrathin section and freeze-fracture replica techniques. Contrast enhancement on CT scan defined in order of medulloblastoma, ependymoma, glioblastoma and astrocytoma. In the medulloblastomas and glioblastomas, the cell junctions of the capillaries were short, elongated, and, in fact open. Other capillary abnormalities included endothelial hyperplasia with extensive vesicular formation, surface infolding of endothelial cells, irregularity of the basal lamina, and a large extravascular space. Tight junctions were seen as one or twe strands. These tight junctions presented irregular lining of intramembranous particles. In the astrocytomas, the blood vessels appeared relatively normal, and the tight junction were seen as networks of seven strands. The particles lines were not disrupted. In the ependymomas, the tight junctions in one area were seen as a network of six strands, but in the other areas as three strands, and the fenestrae were observed in the replicas but not confirmed in the ultrathin sections. The conclusion drawn from this study is that osmotic opening of the tight junctions that have fewer strands play an important role in the marked contrast enhancement of the gliomas, in addition to transcellular transport of increased pinocytotic vesicles and fenestrations. The irregular basal lamina and large perivascular space also increase extravasation of contrast medium.

Adult↗

The evaluation of the effect of the venous tonic 263-E on capillary permeability in the rabbit after administration by intradermal and intravenous routes.

The effects of 2,5-dihydroxybenzene-1,4-disulphonic acid-bisdiethylamine salt (263-E) and trihydroxyethylrutoside (Vitamin P4) on capillary permeability have been compared in the rabbit. Both drugs were administered by intradermal and intravenous routes. Histamine and bradykinin were injected intradermally to increase permeability. 263-E was sown to be a potent inhibitor of permeability changes induced by histamine and bradykinin intravenous routes. Vitamin P4 maximally inhibited permeability at the lowest intravenous dose level but with increasing dose the inhibition became negligible. After intradernal administration, vitamin P4 did not inhibit permeability but potentiated the permeability response induced by histamine and bradykinin.

Animals↗

The failure of serum albumin to affect capillary permeability in the isolated rabbit heart.

The method of local tissue clearance was used to measure capillary permeability-surface area products (PS) for [3H]inulin and [14C]sucrose in the left ventricular wall of the isolated rabbit heart. As soon as a heart was excised, its coronary arteries were perfused with Ringer solution at 37 degrees for at least 30 min before clearance trials were begun. In paired trials, Ringer perfusion fluid containing 1% bovine serum albumin (Sigma) was compared with protein-free Ringer solution in terms of sucrose PS (PSs), inulin PS (PSi), and the PS ratio (Pi/Ps). With or without protein, the mean Pi/Ps was significantly less than the ratio of the free diffusion coefficients. With the untreated albumin, flow resistance rose markedly, and the PSs of both solutes fell but not Pi/Ps. To remove the unidentified vasoactive contaminant (which apparently resisted dialysis), the albumin was "defatted" by the procedure of R. F. Chen (1967, J. Biol. Chem. 242, 173-181). Defatted albumin (1% in the perfusion fluid) did not affect the volume of distribution (lambda) of sucrose or inulin in the myocardium, the heart rate, coronary flow, flow resistance, PSs, PSi, or Pi/Ps. Apparently bovine serum albumin does not influence capillary permeability in the rabbit heart. A protein effect on permeability, however, could have been missed if it has a long latent period (more than 15 min) or a long persistence (more than 30 min).

Animals↗

Pharmacokinetic analysis of immunotoxin uptake in solid tumors: role of plasma kinetics, capillary permeability, and binding.

The delivery of cell-specific protein toxins to the interstitium of solid tumors was examined in athymic mice bearing s.c. human rhabdomyosarcoma (TE671) tumors. The toxins are diphtheria toxin (DT), Mr = 60,000, and an immunotoxin, Mr = 210,000. The immunotoxin is a chemical conjugate of a mutant DT defective in binding and a monoclonal antibody specific for the human transferrin receptor. The plasma, tumor, and muscle concentrations of DT, immunotoxin, and closely related nonbinding controls were measured 2, 6, and 24 h after i.v. injection into tumor-bearing mice. Both DT and immunotoxin are specific for the human xenograft in the mouse because DT is very toxic to human cells but not to murine cells and immunotoxin is directed against a human cell receptor. A compartmental pharmacokinetic model was developed for the analysis of the in vivo data to provide plasma-to-tissue transport constants (capillary permeability-area products), binding parameters (products of the association constant and the initial binding site concentration), and the interstitial fluid flow rate. The model also provides a simple mathematical framework for understanding the effect of these variables on the localization of macromolecules in tumors. The plasma-to-tissue transport constant of immunotoxin in TE671 tumor was 0.13 microliters/min/g, compared to 0.29 microliters/min/g for DT. However, despite the lower capillary permeability of the larger molecular weight toxin, the cumulative tumor exposure to immunotoxin was 80% higher than that to DT after 24 h. A longer plasma half-life and higher apparent in vivo binding parameter of immunotoxin compared to DT contributed to the higher tumor exposure. Plasma-to-tissue transport constants for tumor were 60 to 100% higher than those for muscle. This finding is consistent with observations by others that tumor vasculature is more permeable than are normal muscle capillaries. Also, the interstitial fluid flow of the tumor, 0.80 microliters/min/g, was higher than that of muscle, 0.58 microliters/min/g. The product of the binding affinity and binding site concentration for immunotoxin in vivo was 530 times lower than that predicted based on in vitro measurements. Lower expression of antigen binding sites, inaccessibility of binding sites in vivo, and degradation of the toxin are several possible factors that may account for the in vitro-in vivo differences in binding. This study illustrates the interrelationship of plasma kinetics, capillary permeability, and binding and their effects on toxin concentrations that are achieved in the tissue interstitium.

Animals↗

Pulmonary epithelial cell injury and alveolar-capillary permeability in berylliosis.

Inhaled beryllium induces specific sensitization and nonspecific effects leading to chronic beryllium disease (CBD). It is not known whether beryllium induces epithelial cell injury and increases alveolar-capillary leak. We hypothesize that lung injury is an early event in this disease and that markers of lung injury reflect severity of CBD. We measured serum and bronchoalveolar lavage fluid (BALF) KL-6 level, a marker of epithelial cell injury, and BALF/serum albumin, a marker of alveolar-capillary permeability, in 26 patients with CBD, 15 beryllium-sensitized subjects without disease (BeS), and 32 control subjects (Ctrl). We examined the association of these markers, BAL cellularity, pulmonary function, gas exchange, serum angiotensin-converting enzyme, chest radiograph, the effects of glucocorticoid therapy, and clinical course. BALF/serum albumin and serum KL-6 increased in CBD and were discriminative markers for CBD. BALF KL-6 and BALF/serum albumin reflected mainly lung cellular and granulomatous inflammation. Serum KL-6, like and BALF KL-6, was associated with permeability change and reflected functional and radiologic abnormalities. Serum KL-6 detected early lung injury in BeS. Epithelial injury and permeability changes occur early in CBD, indicating disease severity. Monitoring of these events with serum KL-6 may be useful for management of CBD.

Adult↗

Increased capillary permeability in systemic rheumatoid vasculitis: detection by dynamic fluorescence nailfold videomicroscopy.

OBJECTIVE: Several histological studies suggest a vascular involvement in rheumatoid arthritis (RA). We evaluated morphological and functional changes of skin capillaries in patients with RA. METHODS: We studied capillary permeability by nailfold fluorescence videomicroscopy in patients with RA with and without systemic vasculitis to establish the sensitivity, specificity, and the prognostic value of the technique for the diagnosis of systemic rheumatoid vasculitis (SRV). Nine patients with SRV, 22 patients with active RA without signs of vasculitis, and 16 controls were evaluated. RESULTS: No difference in conventional capillaroscopy was observed when we compared patients with SRV and RA. Using fluorescence videomicroscopy after intravenous injection of fluorescein sodium, we observed an increase of transcapillary dye diffusion in 9/9 patients with SRV, in 13/22 patients with RA without vasculitis and in 4/16 control patients. Our results give a sensitivity of 100% in SRV, a specificity of 44%, a positive predictive value of 34% and a negative predictive value of 100%. CONCLUSION: Our present study points out the functional alteration of the capillary wall in patients with RA with or without vasculitis and suggests the usefulness of dynamic fluorescence nailfold capillaroscopy in patients with RA when systemic vasculitis is suspected, not as a diagnostic tool, but because of the high negative predictive value of the technique.

Aged↗

Pulmonary oxygen toxicity: demonstration of abnormal capillary permeability using contrast-enhanced MRI.

An animal model of oxygen-induced pulmonary injury was used to assess the potential of contrast-enhanced MRI to identify and quantify abnormal capillary permeability. Sprague-Dawley rats were exposed to 100% oxygen for 48 h (n = 5) or 60 h (n = 9). Axial spin-echo MR images were acquired in intubated, anesthetized rats with ECG-gating (TR 400; TE 6) immediately or 7 days after the cessation of oxygen exposure. Polylysine-Gd-DTPA, a macromolecular paramagnetic blood-pool marker, was then given intravenously and the lungs were serially imaged for 42 to 47 min to monitor changes in signal intensity. Pulmonary enhancement was stable in rats exposed to 48 h of oxygen, and in rats exposed to 60 h of oxygen and given 7 days to recover. However, animals exposed to 100% oxygen for 60 h without a period of recovery showed a progressive increase in lung signal intensity for 15 min after polylysine-Gd-DTPA. Pleural effusions also showed progressively increasing signal, reflecting a capillary endothelial leak. A two compartment model describing the kinetics of polylysine-Gd-DTPA in the plasma and interstitial water of the lung was consistent with the dynamic MRI data and allowed estimation of the fractional leak rate (0.235 min-1) of the contrast agent from plasma to interstitial water. Given the assumption of our kinetic model, MRI following intravenous administration of polylysine-Gd-DTPA can be used to quantitate changes in capillary integrity induced by hyperoxia, including acute capillary leakiness and return to normal endothelial integrity with recovery from hyperoxic injury.

Animals↗