Inhibition of tumor growth, angiogenesis, and microcirculation by the novel Flk-1 inhibitor SU5416 as assessed by intravital multi-fluorescence videomicroscopy

Vascular endothelial growth factor (VEGF) plays a fundamental role in mediating tumor angiogenesis and tumor growth. Here we investigate the direct effect of a novel small molecule inhibitor of the Flk-1-mediated signal transduction pathway of VEGF, SU5416, on tumor angiogenesis and microhemodynamics of an experimental glioblastoma by using intravital multifluorescence videomicroscopy. SU5416 treatment significantly suppressed tumor growth. In parallel, SU5416 demonstrated a potent antiangiogenic activity, resulting in a significant reduction of both the total and functional vascular density of the tumor microvasculature, which indicates an impaired vascularization as well as significant perfusion failure in treated tumors. This malperfusion was not compensated for by changes in vessel diameter or recruitment of nonperfused vessels. Analyses of the tumor microcirculation revealed significant microhemodynamic changes after angiogenesis blockage such as a higher red blood cell velocity and blood flow in remnant tumor vessels when compared with controls. Our results demonstrate that the novel antiangiogenic concept of targeting the tyrosine kinase of Flk-1/KDR by means of a small molecule inhibitor represents an efficient strategy to control growth and progression of angiogenesis-dependent tumors. This study provides insight into microvascular consequences of Flk-1/KDR targeting in vivo and may have important implications for the future treatment of angiogenesis-dependent neoplasms.

Exocrine, but not endocrine, tissue is susceptible to microvascular ischemia/reperfusion injury following pancreas transplantation in the rat

While post-transplant pancreatitis is still a frequently occurring complication of whole pancreas transplantation, dysfunction of the endocrine tissue is rarely observed. Given that microcirculatory disorders play a major role in the pathogenesis of pancreatitis, we hypothesized a dissociation of endocrine and exocrine microvascular control in pancreas transplantation (cold ischemia-reperfusion) and studied this dissociation quantitatively, analyzing the pancreatic microcirculation after heterotopic isogeneic pancreaticoduodenal transplantation in rats by means of fluorescence microscopy. Functional capillary density (FCD) of both exocrine and endocrine tissue of pancreatic grafts after 1 h of cold storage in HTK solution did not differ when compared to sham-operated, time-matched controls. Intermittent capillary perfusion, which is absent under sham control conditions and which is proposed to be operative as a compensatory mechanism to counteract malperfusion, was observed in 52% of the exocrine, but in only 8% of the endocrine, tissue studied (p < 0.05). In contrast, cold storage of pancreatic grafts for 6 h in HTK resulted in a complete loss of intermittent capillary perfusion in exocrine tissue and, consequently, marked exocrine perfusion failure (decrease in FCD), while FCD of pancreatic endocrine tissue was preserved without any significant change in the incidence of intermittent capillary perfusion. Thus, our results indicate a higher susceptibility of the exocrine pancreas to cold ischemia/reperfusion events that is associated with significant alterations in nutritive perfusion and, thus, with limitations of the oxygen supply to the tissue. This may lead to inflammatory tissue reactions in the clinical setting of pancreas transplantation.

Epi-illumination fluorescent light microscopy for the in vivo study of rat hepatic microvascular response to cryothermia

To elucidate the hepatic microvascular response to cryothermia, we studied the liver microcirculation of Sprague-Dawley rats after one and two 4-minute freeze-thaw cycles using intravital fluorescence microscopy. Irrespective of the number of freeze-thaw cycles applied, the nature of hepatic microvascular injury was characterized by complete stasis of sinusoidal blood flow within the central part of the cryolesions and heterogeneous sinusoidal perfusion in a critically perfused border zone located at the periphery of the lesions. Analysis over time (2 hours) revealed a successive shutdown of sinusoidal perfusion within this critically perfused border zone, which was caused by intravascularly lodging cell aggregates, blocking the lumen of individual sinusoids. The aggregates consisted of parenchymal cells and cell fragments, but did not include leukocytes or platelets. Strikingly, microvascular perfusion failure was associated with Ito cell disintegration and marked dilation of sinusoids (15.6 +/- 0.8 microm vs. 8.8 +/- 0.8 microm; P <.05). This excludes sinusoidal constriction as the cause of nutritive perfusion failure, and may indicate dysfunction of Ito cell-regulated vasomotor control by cryothermia. However, because circulating cell aggregates were frequently observed plugging individual microvessels, dilation of sinusoids may just be the result of passive distension caused by outflow blockade. Analysis of hepatic tissue at 8 weeks after cryothermia did not reveal regeneration and microvascular remodeling, but loss of hepatic tissue, which corresponded well with the tissue area presenting with sinusoidal perfusion failure during the initial observation period after cryothermia. The fact that there was no recovery of sinusoidal perfusion over the initial 2-hour observation period, but loss of tissue after 8 weeks, supports the view that cryothermia induces injury not only by direct low-temperature-mediated action, but also through ischemia caused by irreversible deterioration of the microcirculation.

Effectiveness of a hands-on training course for laparoscopic spine surgery in a porcine model

BACKGROUND

Although it is widely proposed that surgeons, before introducing a novel laparoscopic technique in man, should practice in an appropriate animal model for acquisition of the necessary technical skills, the effectiveness of those hands-on training courses are rarely documented.

METHODS

In 1995 we have organized eight hands-on training courses for laparoscopic anterior interbody spine fusion in an in vivo porcine model. A total of 72 colleagues from 50 different centers of 12 countries participated, including orthopedic, trauma, visceral, neuro-, and vascular surgeons. Quality and effectiveness of the course were evaluated by a questionnaire after a 1.5- to 2.5-year period.

RESULTS

During this time, 42.2% of the participating centers had applied the new technique successfully in man. Centers which participated in the course with a team that included a skilled laparoscopic surgeon and an orthopedic or trauma surgeon introduced the technique more frequently to clinical practice (57.9%) than those represented by only one participant (30. 8%). Moreover, there was a tendency toward a more frequent introduction of the technique to clinical practice in centers associated with university hospitals (57.1% vs. 29.2%), indicating the requirement of a particular infrastructure for this complex interdisciplinary procedure. Almost all participants (98.3%) agreed that for novel surgical techniques requiring advanced technical skills, there should first be training in a large animal model before the technique is applied in man.

CONCLUSIONS

Complex laparoscopic procedures (i.e., laparoscopic spine surgery) can be successfully learned by in vivo hands-on training courses. We propose that for refinements and modifications of the technique (e.g. , the lumboscopic approach), there should also first be training in a large animal model before these are applied in man.

In vivo analysis of hepatic NADH fluorescence. Methodological approach to exclude Ito-cell vitamin A-derived autofluorescence

Assessment of hepatic surface NADH fluorescence is complicated by questions concerning the relative contribution of Ito cell-associated vitamin A autofluorescence, which cannot be distinguished from each other using ultraviolet epi-illuminated microfluorographs. However, as presented herein, vitamin A autofluorescence can easily be eliminated due to its rapid photobleaching property. In line with in vitro studies on liver perfusion reported by Suematsu and coworkers (1993b), we assessed NADH fluorescence in liver surface regions, which were epi-illuminated for elimination of vitamin A autofluorescence and were allowed to recover for 20 min prior to onset of the experiment. To assess whether this procedure is stringent for accurate estimation of NADH fluorescence, we studied NADH fluorescence in non prebleached surface regions after a 30 sec and 60 sec epi-illumination period. Epi-illumination of these hepatic surface regions for more than 20 sec guaranteed also complete elimination of vitamin A autofluorescence (Vollmar et al., 1996) and further allowed to calculate the subsequent loss of NADH fluorescence due to a potential photobleaching effect after 30 sec and 60 sec of continuous light exposure. Corresponding data of the present study reveal a constant loss of NADH fluorescence of approximately 20% due to its photobleaching property over the time period from 20-60 sec of epi-illumination. Linear regression analysis of the kinetics of NADH fluorescence upon continuous light exposure allowed the calculation of the initial NADH fluorescence, excluding the interference with the Ito cell vitamin A-derived autofluorescence. The concurrency of this mathematically assessed value for the initial (non-bleached) NADH fluorescence within normal hepatic livers with the recovered value of NADH fluorescence allows the conclusion that the procedure for elimination of vitamin A autofluorescence, including ultraviolet epi-illumination with a subsequent NADH recovery period of at least 20 min, is not a prerequisite for the reliable assessment of intraindividual changes of hepatic NADH fluorescence in vivo. Thus, valid assessment of hepatic NADH fluorescence in vivo can be performed by analyzing initial NADH fluorescence bleaching kinetics, and does not necessarily require the 20 min recovery period after bleaching of the Ito cell vitamin A-derived autofluorescence.

Microvascular response to compartment syndrome-like external pressure elevation: an in vivo fluorescence microscopic study in the hamster striated muscle

OBJECTIVE

To quantitatively assess the nature and the magnitude of the microvascular response of striated muscle tissue upon elevation of external pressure, as in compartment syndrome.

METHODS

Using the skinfold chamber model in Syrian golden hamsters and intravital fluorescence microscopy, we studied the individual response of the different segments of the microcirculation, i.e., the arterioles, capillaries, and postcapillary venules, in terms of vasomotor control (change of vessel diameter) and cessation of blood flow upon defined changes in external tissue pressure.

RESULTS

The unique findings of our study are that (1) arteriolar flow ceased at mean external pressures of 25.6+/-2.4, 28.3+/-2.8, 34.5+/-4.6, and 44.4+/-6.8 mm Hg in vessels with diameters of less than 20, 20 to 40, 40 to 60, and greater than 60 microm, respectively, without signs of spasm or collapse even at a pressure maximum of 70 mm Hg, whereas (2) in venules the increase of external pressure was associated with a diameter reduction ranging from 5 to 25% with cessation of blood flow at mean external pressures between 27 and 33 mm Hg. Blood flow ceased in 50% of the muscle capillaries already at an external pressure of 12 mm Hg. Thus, at distinct external pressure levels venous and capillary blood flow ceased, but arterioles were still capable of carrying flow, which was directed along arteriolo-arteriolar "thoroughfare" channels. To restart blood flow, external pressure had to be decreased by 9, 11, 15, and 17 mm Hg in arterioles with diameters of less than 20, 20 to 40, 40 to 60, and greater than 60 microm, and by approximately 9 mm Hg in venules regardless of vessel diameter. Capillary blood flow was found to be restored at a mean reduction of external tissue pressure of approximately 4 mm Hg.

CONCLUSION

Our study disproves the critical closing theory but complies-in particular because of the supposed constriction-induced increase of venular resistance-with the hypothesis of reduced arteriovenous pressure gradients as the cause of flow cessation in compartment syndrome. The necessity of a substantially increased perfusion pressure gradient to restart blood flow in arterioles, capillaries, and venules confirms the existence of yield stress in these microvessels. The high susceptibility of capillaries to elevated external pressure indicates the necessity of early fasciotomy to restore impaired nutritive circulation in cases of compartment syndrome.

Effects of cyclosporine A on the process of vascularization of freely transplanted islets of Langerhans

We studied in vivo the effect of cyclosporine A (CsA) on both pancreatic islet vascularization and microvascular perfusion using intravital fluorescence microscopy and the dorsal skinfold chamber model in Syrian golden hamsters. Syngeneic transplantation was performed in order to exclude allograft- or xenograft-induced microvascular alterations. To study the effect of CsA on islet angiogenesis and vascularization, animals received 20 mg/kg CsA daily from day 0 until day 14 after transplantation (group A). To study toxic effects of CsA on islet microcirculation, the grafts were allowed to vascularize without immunosuppression, and 20 mg/kg CsA was given daily from day 10 until day 20 after transplantation (group B). Quantitative analysis of the process of islet vascularization in group A revealed a functional capillary density (FCD) of 515.6+/-72.7 cm(-1) at day 6 after transplantation without further increase until day 14 (504.3+/-16.7 cm(-1)). Islet transplants which were not treated with CsA during the process of angiogenesis/vascularization (group B) demonstrated a slightly but significantly (P<0.05) higher FCD (604.7+/-42.5 cm(-1)) at day 14 after transplantation, indicating slightly improved vascularization when compared to transplants of group A. Additional CsA treatment of these islet grafts until day 20 did not induce derangements of microvascular perfusion (601.2+/-67.0 cm(-1)), indicating that the immunosuppressive, drug has no toxic/detrimental effects on the transplants nutritional blood supply. We conclude that CsA only slightly alters the process of final vascularization of freely transplanted islets, and does not deteriorate nutritive perfusion of completely vascularized grafts.

Effects of local cooling on microvascular hemodynamics and leukocyte adhesion in the striated muscle of hamsters

OBJECTIVES

Cellular metabolism is dependent on the local temperature in tissues. Induced hypothermia has been shown to be protective in a number of conditions, especially traumatic, ischemic, burn, and neurological injury. However, the protective mechanisms of cold therapy remain controversial and the hemodynamic changes in the microcirculation of striated muscles in response to hypothermia have not been studied in detail previously.

METHODS

In this study, we investigated the microvascular response of local cooling and rewarming in the striated muscle of hamsters by use of the dorsal skinfold preparation and in vivo fluorescence microscopy.

RESULTS

We found that reduction of the surface temperature to 8 degrees C for 30 minutes caused arteriolar vasoconstriction with a decrease in diameters by 43+/-7% while the venular and capillary diameters remained unchanged. The cooling procedure also markedly reduced the functional capillary density and the blood flow velocity and diameters in all vessel types, i.e., arterioles, venules, and capillaries. Moreover, the percentage of capillaries with no flow increased from 0.4+/-0.5% to 44+/-14% after 10 minutes of cold therapy. However, these hemodynamic changes induced by local hypothermia were completely reversed to the precooling values after termination of cooling and 30 min of rewarming. Strikingly, we found no increase in the number of adherent leukocytes and vascular permeability after the cooling and rewarming period, while, in contrast, additional experiments with warm ischemia (30 minutes) and reperfusion (30 minutes), i.e., reduced microvascular perfusion and reperfusion at normothermia, caused a sustained decrease in local perfusion and a nine-fold increase in venular leukocyte adhesion.

CONCLUSIONS

Taken together, our functional data demonstrate that hypothermia markedly reduces microvascular perfusion, which is completely restored upon rewarming. The reduced microvascular perfusion during hypothermia did not provoke an inflammatory response, whereas leukocyte recruitment was prominent after reduced perfusion at normothermia, indicating that transient hypothermia has no adverse effects on microvascular parameters in the striated muscle in vivo.

In vivo analysis of microvascular injury after myocardial cryothermia

We studied microvascular injury after myocardial cryothermia in rats using intravital fluorescence microscopic techniques. Cryolesions were induced to the right ventricle by freezing with -160 degrees C (probe diameter: 5 mm) for a total of 5 min. Fluorescence microscopy was performed at 15, 30, 60, 90, and 120 min as well as at 3 and 7 days after cryothermia. Analysis of the epicardial microvasculature 15 min after cryothermia revealed an area of 24.6 +/- 3.8 mm2 of nonperfused tissue, which was reduced to 5.3 +/- 1.5 mm2 (P < 0.05) after the initial 2-h observation period. Vital microscopic images of reperfused tissue characteristically demonstrated extravasation of the macromolecular fluorescent tracer FITC-dextran (21.7 +/- 3.4 mm2), suggesting substantial loss of endothelial integrity. In vivo propidium iodide staining confirmed membrane damage of microvascular endothelial cells. Three days after cryoinjury the area of nonperfused tissue was reduced further to 1.1 +/- 0.4 mm2 in the center of the lesion, while the area of perfused tissue with disruption of endothelial integrity was found significantly increased to 47.4 +/- 5.9 mm2 (P < 0.05) toward the periphery. Analysis at 7 days revealed endothelial repair at the periphery of the cryolesion, but now a central necrotic area was found demarcated (nonperfused), presenting with a size (26.0 +/- 3.5 mm2) similar to that shown during the very early (15 min) reperfusion period. Our study demonstrates recovery of microvascular perfusion during the first hours and days after myocardial cryothermia. This is, however, associated with endothelial injury, i.e., damage of plasma membrane and loss of barrier function. Infarction with capillary perfusion failure is evident at 7 days with a size which strikingly corresponds to the sizeof nonperfused tissue observed immediately after cryointervention.

In vivo analysis of antithrombotic effectiveness of recombinant hirudin on microvascular thrombus formation and recanalization

PURPOSE

This study was undertaken to evaluate in vivo the effect of recombinant hirudin (r-hirudin [HBW 023]), a potent thrombin inhibitor, on the process of microvascular thrombus formation and recanalization.

METHODS

Thrombosis was induced photochemically in distinct arterioles (n = 25) and venules (n = 30) of the ear of 16 hairless hr/hr mice (8 to 10 weeks old, 25 to 30 g of body weight). r-Hirudin (1 mg/kg of body weight) was administered intravenously directly before thrombus induction; saline-treated animals served as controls. Thrombus formation (i.e., first platelet deposition at the endothelial lining [FPD]; inner luminal diameter reduction to 50% [D/2]; complete vessel occlusion [CVO]), vessel recanalization, microcirculatory parameters, and leukocyte-endothelial cell interaction were analyzed by means of intravital fluorescence microscopy.

RESULTS

Hirudin significantly delayed the process of thrombus formation compared with saline-treated controls in both arterioles (FPD: 381 +/- 80 vs 137 +/- 25 seconds, P < 0.05; D/2: 627 +/- 49 vs 501 +/- 71 seconds; CVO: 925 +/- 78 vs 854 +/- 60 seconds) and venules (FPD: 173 +/- 11 vs 59 +/- 4 seconds; D/2: 342 +/- 54 vs 228 +/- 27 seconds; CVO: 541 +/- 85 vs 344 +/- 43 seconds; P < 0.05). In addition, r-hirudin-treated animals showed an increased rate of vessel recanalization at 24 hours after thrombus induction (arterioles: 54% [7 of 13] vs 0% [0 of 12], P < 0.05; venules: 77% [10 of 13] vs 53% [9 of 17]), whereas microcirculatory parameters and leukocyte-endothelial cell interaction were not affected.

CONCLUSION

Our data indicate that r-hirudin not only counteracts the process of thrombus formation but also promotes vessel recanalization, thus supporting its use in clinical microvascular surgery.

Striated muscle microvascular response to zymosan-induced generalized inflammation in awake hamsters

The effect of zymosan-induced generalized inflammation on the microcirculation of distant striated skin muscle was studied for a 12 day period in awake Syrian golden hamsters (n = 18) using the dorsal skinfold chamber model and intravital fluorescence microscopy. Intraperitoneal zymosan exposure (125 mg/100 g body weight) induced significant nutritive perfusion failure in the distant striated muscle tissue at Day 1 without complete recovery over the 12 day observation period, as indicated by the marked reduction of functional capillary density when compared with both baseline values and values of sham-treated control animals. Moreover, intraperitoneal zymosan exposure induced endothelial disintegration, as demonstrated by the continuous increase of macromolecular leakage throughout the 12 days of observation. Strikingly, zymosan did not induce significant leukocyte adherence to the endothelial lining of postcapillary and collecting venules of the striated muscle tissue. Thus, we conclude that in this model of generalized inflammation nutritive perfusion failure and loss of endothelial integrity in distant striated muscle is not mediated by activated leukocytes, but must rather be attributed to direct toxic effects of mediators, elicited by the local (intraperitoneal) zymosan challenge and systemically released.

The use of intravital microscopy in surgical research. 26-years of experience analyzed by studies presented at the Surgical Forum of the Annual Congress of the German Society of Surgery

Recent developments in intravital microscopy make this technique an attractive approach to studying microvascular, cellular, and molecular mechanisms of distinct surgical diseases. We investigated the value of this technique in surgical research laboratories by analyzing the studies presented during the past 26 years (1972-1997) at the Surgical Forum of the Annual Congress of the German Society of Surgery. From a total of 2279 papers 188 contributions (8.3%) presented data which derived from the analysis of the microcirculation using techniques, such as H2 and 133Xe clearance, autoradiography, thermodiffusion, laser Doppler fluxmetry, laser speckle, radioactive and fluorescent microspheres, polarographic oximetry, and intravital microscopy. There were 72 presentations (3.2% of all contributions) reporting the use of intravital microscopy, thus reflecting 38.3% of all microcirculatory analyses. Although these numbers may be considered quite small, analysis over time revealed a significant (P<0.05) increase in the number of microcirculatory studies (11.4%) and in particular of those using intravital microscopy (6.3%) in the 1990s when compared to the 1970s (5.3%; 0.1%) and 80th (7.1 %; 1.3%). In 1997, 27 of 165 contributions (16.4%) included microcirculatory analyses, and 18 of the 165 contributions (10.9%) reported results analyzed by intravital microscopy. Thus our analysis reflects an increasing interest of surgical researchers to study in vivo the microcirculation, and by doing so to use intravital microscopy for the elucidation of mechanisms of surgical disease.

Cell surface and nuclear changes during TNF-alpha-induced apoptosis in WEHI 164 murine fibrosarcoma cells. A correlative light, scanning, and transmission electron microscopical study

Tumour necrosis factor (TNF)-alpha-induced apoptosis is associated with several nuclear and cell surface alterations, in particular with the condensation of chromatin and the fragmentation of the cell nucleus, formation of blebs on the cell surface and breakdown of the plasma membrane. However, there is little information about the relationship between the cell surface alterations and the nuclear changes during apoptosis. To study this, cultured WEHI cells were exposed to TNF-alpha over different time periods. The cytological changes were studied using a correlative approach, which allowed observation of the same cell consecutively under light, scanning and transmission electron microscopy. The earliest sign of cell alteration was a reduction of the number of microvilli after 15 min of TNF-alpha exposure. This reaction was reversible (reappearance of microvilli) and took place during the first hour, in which neither nuclear alterations nor plasma membrane breakdown were observed. The changes in the nucleus began with condensation of chromatin after approximately 1 h of TNF-alpha-exposure. After 4-5 h the microvilli disappeared again, particularly in areas where the formation of blebs (blebbing) was observed. Strikingly, cell surface alterations (bleb formation) were detected only in those cells that presented with condensed chromatin, and not in cells with a normal chromatin pattern, proving at least a close correlation between nuclear and cell surface changes during the process of apoptosis.

A novel approach for comparative study of periosteum, muscle, subcutis, and skin microcirculation by intravital fluorescence microscopy

Herein, we report a new model, which allows comparative study of the microcirculation of different peripheral tissues, i.e., periosteum, skeletal muscle, subcutis, and skin. Using dextran-insensitive Wistar rats gracilis and semitendinosus muscles of the left hindlimb were prepared in association with their appertaining tibial fragments, subcutis, and skin. Blood supply was guaranteed by the femoral artery via the saphenous vessels. High-resolution intravital epi-illumination microscopy of the two muscles displayed the typical microvascular architecture with the capillaries running in parallel to each other (capillary density (CD) 128.4 +/- 4.5 cm-1). In subcutis and skin, capillaries were found arranged as interconnecting mesh-like networks with a density, which was significantly higher (P < 0.05) in subcutis (191.0 +/- 5.5 cm-1) compared with skin (108.9 +/- 3.3 cm-1). Analysis of periosteal tissue revealed two distinct types of arrangements of microvascular architecture. Adjacent to the major feeding and draining vessels of the periosteum, capillaries were organized in densely meshed shunt-like networks, revealing the highest capillary density (242.7 +/- 13.2 cm-1; P < 0.05) of all tissues studied. Periosteal capillaries distant from the major feeding and draining vessels were arranged in parallel to the longitudinal axis of the tibial bone and presented with a density similar to that of the skeletal muscle (128. 6 +/- 9.4 cm-1). Topical application of acetylcholine for analysis of physiological reactivity of the microvasculature showed dose-dependent arteriolar dilation. Moreover, a 3-min upstream femoral artery occlusion demonstrated an appropriate hyperemic response in all tissues studied, indicating intact myogenic control. A prolonged period of ischemia (120 min) followed by reperfusion (60 min) caused massive (P < 0.05) leukocyte-endothelial cell interaction in postcapillary venules, similarly as reported in other microvascular tissue preparations. We propose that the model presented provides a good approach to all peripheral tissues for both the analysis of the physiology of tissue-confined microvascular control and the development of novel therapeutic strategies to counteract manifestation of nutritional dysfunction and inflammatory response in disease.

An intravital fluorescence microscopic study of hepatic microvascular and cellular derangements in developing cirrhosis in rats

Quantitative data defining the relationship between the hepatic microcirculation and the development of liver pathological changes could provide a basis for a better understanding of fibrogenic processes, such as cirrhosis. Therefore, we established the technique of intravital fluorescence microscopy and computer-assisted microcirculation analysis systems in developing cirrhosis in rats with the aim of quantitatively assessing the association of hepatic microvascular morphology with its disordered acinar architecture, and nonparenchymal cell transformation with collagen deposition, parenchymal cell loss, and liver dysfunction. In animals chronically exposed to carbon tetrachloride (CCl4), the most significant microvascular changes progressively observed in vivo were the concomitant appearance of 1) sinusoid-free space around dilated postsinusoidal venules with 2) substituting occurrence of yellow-green autofluorescent collagen deposition, 3) reduction in sinusoidal density, but 4) increase of vascular lumen caused by the formation of shunting vessels bypassing the sinusoids. Present on-line analysis further indicated the local coincidence of changed spatial distribution of Ito cells (accumulation of vitamin A ultraviolet autofluorescence in zone 3) with fibrotic autofluorescent septa, causing significant collapse of parenchymal tissue (hepatocellular bis-benzamide fluorescence) and diminution of hepatocellular excretory function (bile flow). Regression analysis revealed strong correlations between loss of parenchymal tissue and both collagen deposition and sinusoidal rarefication, as well as between sinusoidal rarefication and collagen deposition. Thus, sequential in vivo analysis presented herein provides the new information on the concomitant onset of cellular, fibrotic, and microvascular changes in developing fibrosis/cirrhosis, excluding that distinct cellular or fibrotic alterations are a prerequisite for the manifestation of microcirculatory and vascular derangements or vice versa.

Experimental intracoronary stenting: comprehensive experience in a porcine model

Appropriate animal models for intracoronary stenting are most important for improving understanding of the pathophysiology of acute occlusion and long-term re-stenosis, which currently limits the safety and efficacy of percutaneous transluminal coronary angioplasty in humans. Since the anatomy and physiology of swine coronary arteries closely resemble those of humans, the procine model should be ideal for testing of stents. This is a comprehensive report on an experimental set-up in pigs, communicating in detail the necessary techniques as well as some modifications facilitating safe intracoronary stent placement and successful follow-up studies for weeks or months. Stent procedure is performed in mechanically ventilated and haemodynamically monitored animals under balanced anaesthesia. Intracoronary application of flow wires allows the assessment of local flow conditions, flow properties and coronary flow reserve. Real-time intravascular ultrasonography (IVUS) provides detailed information on coronary morphology and enables the appropriate sizing of the coronary lumen. From our own experience, we like to propose that the use of the porcine model has the potential to gain new insights into the pathophysiology of intracoronary stent placement-associated complications and allows for the study of modifications in techniques and materials, and the development of novel pharmacological therapeutic strategies.

Cold preservation of the small intestine with the new Celsior-solution. First experimental results

The aim of the present study was to evaluate the potential of Celsior, a recently developed cardioplegic and heart storage solution, to protect the small bowel during ischemic storage. Small bowel segments were isolated from rats, flushed with either UW or Celsior solution, and cold-stored for 18 h at 4 degrees C in the respective solution. After ischemic storage, some preparations were freeze-clamped for analysis of tissue metabolites while other preparations were tested for structural and functional integrity by isolated perfusion in vitro using a previously validated model. After 18 h of ischemic storage no significant differences were seen between Celsior and UW with regard to the development of edema, energy charge, or creatine phosphate, but lactate accumulation was significantly reduced in the Celsior group, although glucose catabolism was not inhibited. Histological evaluation of the cold-stored organs showed no differences with regard to structural integrity between the two groups. Total vascular resistance upon reperfusion was significantly lower in the Celsior group (666 +/- 126 vs 827 +/- 88 MPa s m-3*), as was the intestinal release of LDH (9.7 +/- 4.4 vs 18.2 +/- 4.6 U/l*). Carbohydrate absorption from the intestinal lumen amounted to venous effluent concentrations of 0.58 +/- 0.24 vs 0.18 +/- 0.15 mg% * of galactose in the Celsior and UW groups, respectively. Within the limits of this in vitro pilot study, Celsior provided better postischemic recovery of the small bowel than UW in terms of vascular perfusion characteristics, enzyme release, and carbohydrate absorption and may, thus, be considered a suitable alternative for intestinal organ preservation.

Failure of Kupffer cell blockade to prevent disseminated intravascular coagulation in endotoxemic rats despite improved survival

OBJECTIVE

Studies were conducted to evaluate the impact of gadolinium chloride (GdCl3), an agent which blocks the phagocytosis of liver macrophages (Kupffer cells, KC), on the coagulation system and on mortality in a model of rats subjected to a lethal dose of Escherichia coli lipopolysaccharide (LPS) (10 mg/kg body weight, intravenously).

METHODS

Rats were either pretreated with GdCl3 (10 mg/kg, i.v., 48 h and 24 h prior to LPS exposure) or saline vehicle. A variety of coagulation parameters such as activated partial prothrombin time (aPTT), fibrinogen, systemic platelet count, antithrombin III (AT III), and activities of factors V, VII, and XII were monitored in the early (1 h) and late time course (16 h) following administration of E.coli LPS.

RESULTS

The administration of LPS resulted in the development of disseminated intravascular coagulation (DIC) and was associated with a mortality rate of 47% within 16 h. Blockade of KC by GdCl3 completely abolished LPS-related mortality (0%). However, despite improved survival, GdCl3 failed to prevent laboratory and clinical signs of DIC. GdCl3 per se even contributed to coagulatory and fibrinolytic disorders.

CONCLUSION

These results confirm reports on the protective potential of GdCl3 pretreatment in experimental endotoxemia. However, the present study does not support the concept of DIC as a strong prognostic criterion for the outcome of sepsis and septic shock. Furthermore, the results presented suggest a minor role for KC in LPS-mediated activation of coagulation and indicate an involvement of KC in LPS-associated lethality independent of the coagulation system.

Microscopic analysis of NADH fluorescence during aerobic and anaerobic liver preservation conditions: A noninvasive technique for assessment of hepatic metabolism

Gaseous insufflation of oxygen via the venous vascular system is thought to be an useful tool for preventing anoxic tissue injury during extended time periods of ischemic preservation and for allowing for an improved recovery of organ function after transplantation. The present study aimed at the application of a noninvasive technique for monitoring effectiveness and homogeneity of gaseous areation by using an epiillumination microscopic technique for assessment of tissue nicotinamide adenine dinucleotide (NADH) fluorescence. Rat livers were flushed with and stored in University of Wisconsin solution at 4 degrees C for 48 h (n = 20). In half of the experiments (n = 10) gaseous oxygen was applied subsequent to organ harvest. Using ultraviolet-excitation high-resolution microscopy and computer-assisted image analysis liver surfaces were scanned for NADH intensity and spatial heterogeneity at 1, 24, and 48 h preservation time. Livers simply stored without aeration served as controls (n = 10). NADH intensity data were compared with corresponding data of tissue adenosine triphosphate (ATP) concentrations determined enzymatically. NADH fluorescence already differed at 1 h preservation between the two groups with significantly lower values in the aerobically stored livers. NADH fluorescence further decreased between 1 and 24 h preservation and remained low until 48 h, whereas in the anaerobically stored livers NADH fluorescence was found to be constantly high over the entire observation period. Aerobic storage resulted in rather homogeneous tissue oxygenation with an intrahepatic variation of NADH fluorescence <20%. In parallel, oxygen persufflation appropriately restored tissue ATP content within 1 to 24 h of preservation, while the simply stored livers exhibited pronounced depletion of ATP. We demonstrate for the first time that by means of retrograde gaseous oxygenation, ischemic livers can be readily and effectively oxygenated. Our study further indicates that the noninvasive microscopic analysis of tissue NADH fluorescence may be an useful tool for estimating efficiency of strategies in organ preservation.

[Antithrombotic and thrombolytic effectiveness of rhirudin in mcrovessels]

Using the thrombosis model of the hairless mouse ear, we demonstrate that intravenous application of hirudin significantly delays thrombus formation and increases the rate of vessel recanalization, thus, supporting its use in clinical microvascular surgery.

[Differential effect of preservative solutions (UW vs HTK) on mitochondrial redux status and energy metabolism during liver ischemia with oxygen persufflation]

Venous-systemic oxygen persufflation (VSOP) was performed in rat livers stored at 4 degrees C in either UW or HTK preservation solution. Since tissue anoxia is associated with a transformation of cellular NAD+ to NADH and the latter fluoresces upon UV-epiillumination, homogeneity and intensity of liver oxygenation could be analysed by intravital microscopic detection of NADH fluorescence. VSOP resulted in a significant decrease of the NADH signal, documenting effective tissue oxygenation in both UW and HTK. This effect was quite homogeneous (spatial variance < 15%). After 48 h of cold storage tissue levels of ATP (mumol/g dry weight) were increased upon VSOP in UW to 17.3 +/- 4.8 but only to 2.9 +/- 0.6 in HTK, while ATP amounted to less than 0.4 without VSOP in either of the groups. It is concluded that VSOP is an appropriate tool to prevent alterations of the hepatic redox status during ischemic preservation in UW and HTK. Metabolic preservation of energy-rich adenine nucleotides seems to be largely improved in combination with UW compared with HTK.

[Differential modulation of CINC, NOSII and ICAM- gene expression in parenchyma and non-parenchyma cells of the liver by G-CSF--possible protective mechanisms of endotoxin-associated hepatotoxicity]

In endotoxin-exposed rat livers, G-CSF caused a reduction of CINC gene transcripts in the nonparenchymal cell fraction, which might be the mechanism for attenuation of microvascular leukocyte adherence and leukocyte-dependent tissue injury, as observed upon G-CSF application in a model of endotoxin-induced hepatotoxicity.

[Extent of bacterial contamination is a derminant fur microvascular damage in soft tissue infection]

With the use of intravital microscopy, we demonstrate that the extent of bacterial contamination is a determinant for the microvascular response and consecutively the microvascular injury. The model of bacterial soft tissue infection used, ideally allows to study the influence of foreign materials on microvascular immune response.

[Significance of the size of islands of Langerhans for successful vascularization after free transplantation]

With the use of intravital microscopy and computer-assisted image analysis systems the quantitative analysis of angiogenesis of freely transplanted islets of Langerhans shows that large islets compared with small islets become significantly better vascularized.

[Significance of blood flow for vascular pedicled multi-tissue flaps in critical perfusion conditions]

In pedicled composite flaps critical perfusion-induced capillary flowmotion, which develops only in muscle, is calcium mediated and maintains adequate nutritive perfusion not only in muscle but also in skin and periost probably by blood flow redistribution.

Immunomodulatory action of G-CSF in a rat model of endotoxin-induced liver injury: an intravital microscopic analysis of Kupffer cell and leukocyte response

In contrast to the anticipation that in sepsis granulocyte colony-stimulating factor (G-CSF) would overactivate the nonspecific immune system by recruiting and priming leukocytes with consequent aggravation of inflammatory tissue lesions, recombinant (r) G-CSF pretreatment was protective in various experimental non-neutropenic models of inflammation. The mechanisms of protection, however, are not fully understood. Using intravital fluorescence microscopy, we show that rG-CSF enhances leukocyte endothelial cell interaction within the microvasculature of normal rat livers, whereas rG-CSF pretreatment of animals exposed to lipopolysaccharide (LPS) attenuates the LPS-induced leukocytic response, including stasis in sinusoids as well as rolling and adherence in postsinusoidal venules with subsequent tissue infiltration. Moreover, rG-CSF, which did not affect Kupffer cell activity in normal rat livers, reduced the immediate activation of Kupffer cells on LPS exposure, as indicated in vivo by the delayed adherence/phagocytosis of intra-arterially administered latex particles associated with attenuation of proinflammatory cytokine release (tumor necrosis factor alpha and interleukin-6). Finally, rG-CSF reduced LPS-induced nutritive perfusion failure and hepatocellular excretory dysfunction. This study provides evidence for a distinct, possibly tumor necrosis factor alpha-dependent modulation of LPS-induced cellular response within the liver by rG-CSF, thereby achieving protection against microcirculatory perfusion failure and hepatic dysfunction.

A new model for quantitative in vivo microscopic analysis of thrombus formation and vascular recanalisation: the ear of the hairless (hr/hr) mouse

The alteration of rheological blood properties as well as deterioration of vascular perfusion conditions and cell-cell interactions are major determinants of thrombus formation. Herein, we present an experimental model which allows for quantitative in vivo microscopic analysis of these determinants during both thrombus formation and vascular recanalisation. The model does not require surgical preparation procedures, and enables for repeated analysis of identical microvessels over time periods of days or months, respectively. After i.v. administration of FITC-dextran thrombus formation was induced photochemically by light exposure to individual arterioles and venules of the ear of ten anaesthetised hairless mice. In venules, epi-illumination induced rapid thrombus formation with first platelet deposition after 0.59 +/- 0.04 min and complete vessel occlusion within 7.48 +/- 1.31 min. After a 24-h time period, 75% of the thrombosed venules were found recanalised. Marked leukocyte-endothelial cell interaction in those venules indicated persistent endothelial cell activation and/or injury, even after an observation period of 7 days. In arterioles, epi-illumination provoked vasomotion, while thrombus formation was significantly (p <0.05) delayed with first platelet deposition after 2.32 +/- 0.22 min and complete vessel occlusion within 20.07 +/- 3.84 min. Strikingly, only one of the investigated arterioles was found recanalised after 24 h, which, however, did not show leukocyte-endothelial cell interaction. Heparin (300 U/kg, i.v.) effectively counteracted the process of thrombus formation in this model, including both first platelet deposition and vessel occlusion. We conclude that the model of the ear of the hairless mouse allows for distinct in vivo analysis of arteriolar and venular thrombus formation/recanalisation, and, thus, represents an interesting tool for the study of novel antithrombotic and thrombolytic strategies, respectively.

High-resolution microscopic determination of hepatic NADH fluorescence for in vivo monitoring of tissue oxygenation during hemorrhagic shock and resuscitation

Impaired microvascular oxygen supply reduces oxidative phosphorylation and causes an increase in cellular NADH, which was monitored densitometrically in vivo by high-resolution fluorescence microscopy (330-390/ > 430 nm excitation/emission wavelengths) in rat livers (n = 8) subjected to hemorrhagic shock and resuscitation. At each time point, NADH fluorescence was recorded from 10 different observation fields of the left liver lobe. Withdrawal of a total of 4.5 ml arterial blood for induction of volume-controlled hemorrhagic shock resulted in an increase in NADH fluorescence by approximately 31% from 45.1 +/- 3.9 to 59.2 +/- 4.2 aU, which was associated with a fall of arterial blood pressure from 110 +/- 3 to 51 +/- 8 mmHg, a decrease in hepatic tissue oxygenation (flexible polarographic surface electrode) from 18 +/- 2 to 2 +/- 1 mmHg, and a restriction of hepatic bile flow from 1.7 +/- 0.1 to 0.5 +/- 0.2 microliter/min x g. Normovolemic resuscitation with 10% hydroxyethylstarch failed to completely restore the metabolic state of liver tissue (NADH fluorescence 49.9 +/- 3.1 aU), arterial blood pressure (83 +/- 8 mmHg), hepatic tissue oxygenation (7.4 +/- 1.5 mmHg), and hepatocellular excretory function (1.3 +/- 0.1 microliters/min x g). During both shock and resuscitation, the ratio between pericentral and periportal NADH fluorescence intensities slightly increased, but calculation of coefficients of variance of interlobular NADH fluorescence did not reveal an increase in heterogeneity of tissue metabolic state. Significant correlations were found between NADH fluorescence and both hepatic tissue oxygenation (r2 = 0.78, P < 0.01) and hepatic bile flow (r2 = 0.85, P < 0.01), indicating that high-resolution intravital microscopic assessment of NADH fluorescence reflects appropriately the relation between local oxygen supply and demand in hepatic tissue in vivo.

Pentoxifylline reduces venular leukocyte adherence ("reflow paradox") but not microvascular "no reflow" in hepatic ischemia/reperfusion

Postischemic reperfusion injury is caused by microcirculatory disturbances, including both nutritive perfusion failure (no reflow) and leukocyte activation (reflow paradox). Recent studies brought evidence that pentoxifylline (PTX) reduces tissue injury, decreases enzyme release, and improves survival after normothermic liver ischemia/reperfusion. The mechanisms of action, however, by which PTX protects postischemic tissue from injury have not been elucidated yet. With the use of fluorescence microscopy in a rat hepatic ischemia/reperfusion model, we studied in vivo the action of PTX on the manifestation of postischemic sinusoidal perfusion failure and microvascular leukocyte adherence. Microvascular reperfusion after 20 min portal triad cross-clamping was characterized by the cessation of blood flow within individual sinusoids (no reflow) and accumulation of leukocytes within the hepatic microvasculature, with stasis in sinusoids and rolling and firm adherence in postsinusoidal venules. PTX (20 mg/kg x hr i.v.) significantly (P < 0.05) attenuated microvascular leukocyte accumulation (44,600 +/- 1833 mm(-3) vs 67,684 +/- 2620 mm(-3) in saline-treated controls) and firm adherence of leukocytes in postsinusoidal venules (316.9 +/- 40.9 mm(-2) vs 522.9 +/- 95.0 mm(-2)); however, PTX did not influence manifestation of individual sinusoidal perfusion failure. Since reperfusion-induced parenchymal cell damage was found reduced in treated animals, we conclude that PTX attenuates postischemic injury in rat liver by reduction of leukocytic/inflammatory response but not by prevention of nutritive perfusion failure.

Lymph vessel expansion and function in the development of hepatic fibrosis and cirrhosis

The process of lymph vessel expansion and function in the development of CCl4-induced hepatic fibrosis and cirrhosis was studied using intravital fluorescence microscopy of the rat liver. The unique aspect of our approach was the use of high molecular fluorescein-isothiocyanate-labeled dextran (MW, 150,000) as fluorescent marker, which allowed for simultaneous assessment of both 1) the macromolecular blood hepatocytic exchange from the sinusoidal microvasculature (extra-/intrasinusoidal gray level intensity at 1, 3, 5, and 10 minutes after intravenous injection) and 2) the hepatic lymph system. In animals exposed with CCl4 up to 4 weeks, macromolecular trans-sinusoidal exchange was found progressively delayed. This was strongly associated with lymph vessel expansion and function, as indicated by a continuous increase of lymph vessel density and area. Delay of macromolecular exchange and lymph vessel expansion was found not further enhanced at fibrotic and cirrhotic stages of 8- and 12-week CCl4-exposed livers. Linear regression analysis revealed a strong negative correlation between lymphatic network density development and macromolecular trans-sinusoidal exchange (r2 = 0.99; P < 0.01). Thus, our study provides for the first time direct evidence for the pivotal role of lymphatic function for macromolecular transport in case of deteriorated sinusoidal hepatocellular exchange capacity.

Capillary dysfunction in striated muscle ischemia/reperfusion: on the mechanisms of capillary "no-reflow"

The major dysfunction of capillaries after prolonged periods of ischemia is the lack of re-establishment of nutritive blood flow upon onset of reperfusion, i.e., capillary no-reflow. Several mechanisms have been proposed to cause capillary no-reflow, including intravascular hemoconcentration and thrombosis, leukocyte plugging, endothelial cell swelling, vasomotor dysfunction, and interstitial edema formation. Electron microscopic studies suggest that thrombus formation and intravascular clotting are not significant mechanisms. Moreover, intravital microscopic studies have demonstrated that plugging of capillaries by leukocytes is not a primary cause for the manifestation of no-reflow in postischemic striated muscle. In contrast, both in vivo studies and histological examinations support the concept that ischemia/reperfusion induces the disruption of the endothelial integrity with loss of fluid to endothelial cells and the interstitial space. As a consequence, these pathological sequelae are associated with intravascular hemoconcentration, endothelial cell swelling and interstitial edema formation, which contribute to capillary lumenal narrowing, increase of hydraulic resistance, and, thus, impairment of perfusion. Whether the postischemic diameter response with dilation of reperfused capillaries and lumenal narrowing of no-reflow capillaries involves endothelin/nitric oxide-triggered capillary pericyte function remains to be determined.

Biophysical aspects of liver aeration by vascular persufflation with gaseous oxygen

BACKGROUND

Venous systemic oxygen persufflation of the liver (i.e., gaseous insufflation of oxygen via the venous vascular system) has proven to be an effective tool for preventing anoxic tissue injury during extended time periods of ischemic preservation. It also allows for an improved recovery of the persufflated organ after orthotopic transplantation.

METHODS

Biophysical aspects of the persufflation technique with regard to persufflation pressure (9 mmHg versus 18 mmHg) and oxygen concentration (pure oxygen versus air) in the persufflation gas were investigated in rat livers, using epi-illumination microscopic detection of autofluorescence of NADH, which accumulates in anoxic tissue.

RESULTS

We demonstrated that a low-pressure persufflation (9 mmHg) is as sufficient as a higher pressure persufflation (18 mmHg) in oxygenating the ischemic organ. Moreover, oxygenation of the liver was found to be complete and rather homogeneous upon the pure oxygen persufflation, irrespective of the insufflation pressure used. In contrast, insufflation of air instead of pure oxygen resulted in insufficient aeration of the liver, even at the higher persufflation pressure of 18 mmHg.

CONCLUSIONS

Our results indicate that the oxygen concentration of the persufflation gas rather than the persufflation pressure is a determinant of successful tissue oxygenation during cold storage.

Liver ischemia/reperfusion induces an increase of microvascular leukocyte flux, but not heterogeneity of leukocyte trafficking

Leukocytic response plays a major role in the manifestation of hepatic ischemia/reperfusion (I/R) injury. To clarify whether post-ischemic hepatic leukocyte accumulation is based on increased leukocyte flux to the hepatic tissue due to systemic inflammation or chemoattractant activities or whether it represents solely a local tissue response without changing overall leukocyte flux and trafficking characteristics through the microvasculature, we studied acinar and sinusoidal leukocyte flux and distribution in rat livers in vivo both under normal (sham, n = 8) and post-ischemic (60' ischemia/75' reperfusion) conditions (I/R, n = 8), using fluorescence epi-illumination microscopy (rhodamine-6G). Hepatic ischemia/reperfusion significantly (p < 0.05) increased acinar leukocyte flux (58.4 +/- 20.9 cells/min vs 36.4 +/- 12.8 cells/min in sham controls); however, it did not exhibit increased heterogeneity of acinar leukocyte distribution, as indicated by the unchanged coefficient of variance (CV) of 0.36 +/- 0.16 (sham controls: 0.31 +/- 0.14). In parallel, analysis of individual sinusoidal leukocyte flux demonstrated significantly (p < 0.05) higher values (8.9 +/- 3.7 cells/min) after ischemia/reperfusion when compared with sham controls (5.7 +/- 1.9 cells/min), which, however, was not associated with increased heterogeneity of sinusoidal leukocyte trafficking (CV: 0.85 +/- 0.15 vs 0.85 +/- 0.16 in sham controls) and manifestation of preferential pathways. Analysis of blood cell count did not demonstrate an overall increase of total blood leukocyte count; however, an increased (p < 0.01) fraction of polymorphonuclear leukocytes (65.2 +/- 11.2%) and stab cells (9.5 +/- 7.9%) during post-ischemic reperfusion when compared with sham controls (8.8 +/- 3.5% and 0.2 +/- 0.4%) was demonstrated. Thus, the increase of hepatic leukocyte flux after ischemia/reperfusion may be the result of both the manifestation of a systemic inflammatory response and the increase of local chemoattractant activities, such as the production and release of the cytokine-induced neutrophil chemoattractant of the IL-8 family.

Enhancement of the leukocyte-endothelial cell interaction in collecting venules of skeletal muscle by protamine

OBJECTIVE

A transient but severe systemic leukopenia regularly occurs after the antagonization of heparin by protamine in patients and in animals. The aim of the present study was to investigate the site and mechanisms of white blood cell retention during this transient leukopenia by studying the leukocyte-endothelial cell interaction in skeletal muscle venules.

METHODS

Syrian golden hamsters were equipped with a dorsal skinfold chamber for intravital fluorescence microscopy and arterial and venous catheters for drug infusion, blood pressure measurement, and blood sampling. Microhemodynamic parameters and leukocyte-endothelial cell interactions were observed in one single collecting venule per animal after intravenous infusion of saline solution (control, n = 10), of protamine (n = 9), and after infusion of heparin followed by either intravenous protamine (n = 9) or intraarterial protamine (n = 9).

RESULTS

All parameters remained unchanged in the control group. Whereas venular diameters remained unchanged, protamine transiently increased arterial blood pressure and venular erythrocyte velocity in all groups. Systemic leukocyte counts and the venular leukocyte discharge concentration decreased concurrently after protamine administration by about 60% to 70% at 2 minutes while the fraction of rolling leukocytes and the number of adherent leukocytes remained unchanged. Two and one-half minutes later, systemic leukocyte counts and venular discharge concentrations normalized while the fraction of leukocytes rolling slowly along or adhering firmly to the venular endothelial wall increased considerably and similarly in all groups receiving protamine. Myeloperoxidase (an indicator of polymorphonuclear leukocytes) determination in 20 separate hamsters 2 minutes after protamine infusion revealed increased myeloperoxidase activity exclusively in the lungs.

CONCLUSION

The response of leukocytes to protamine infusion with or without prior heparinization is biphasic: initial retention of leukocytes in the lungs is followed by enhanced leukocyte-endothelial cell interaction in the systemic circulation.

Dietary vitamin E does not protect from endotoxin-induced hepatic microvascular dysfunction

Starting from the concept that lipopolysaccharide (LPS)-associated hepatotoxicity involves the action of reactive oxygen species, the present study was conducted to test whether vitamin E, a lipophilic antioxidant, prevents LPS-induced hepatic microvascular dysfunction and liver injury. Fifty-two rats were divided into three groups and fed diets containing 0 (n = 16), 75 (n = 18) or 8000 mg (n = 18) alpha-tocopherol acetate/kg food for four weeks. At 1 h and 6 h after intravenous LPS-exposure (10 mg/kg E. coli LPS) hepatic microvascular response and liver injury were assessed by the analysis of Kupffer cell phagocytic activity, leukocyte-endothelial cell interaction and nutritive sinusoidal perfusion (intravital fluorescence epi- illumination technique) as well as bile flow, serum liver enzyme activities and tissue histomorphology. In animals fed with 75 mg vitamin E/kg (standard diet), LPS caused hepatic Kupffer cell activation (increased phagocytic activity) and hepatic microvascular leukocyte activation, with stasis in sinusoids and adherence in postsinusoidal venules (1 h) followed by leukocytic infiltration into tissue (6 h) and progredient sinusoidal perfusion failure (6 h). Hepatic microvascular injury was accompanied by reduced bile flow and enhanced liver enzyme release. Vitamin E-enriched diet (8000 mg/kg) and even vitamin E-deficient diet did not significantly affect LPS-induced hepatic microvascular cell activation and perfusion failure. Thus, we conclude, that vitamin E is not effective to protect from endotoxin-induced hepatic microvascular dysfunction.