Three patterns of distribution characterize the organization of endothelial microfilaments at aortic flow dividers

Remodeling of the Microvasculature: May the Blood Flow Be With You

The vasculature ensures optimal delivery of nutrients and oxygen throughout the body, and to achieve this function it must continually adapt to varying tissue demands. Newly formed vascular plexuses during development are immature and require dynamic remodeling to generate well-patterned functional networks. This is achieved by remodeling of the capillaries preserving those which are functional and eliminating other ones. A balanced and dynamically regulated capillary remodeling will therefore ensure optimal distribution of blood and nutrients to the tissues. This is particularly important in pathological contexts in which deficient or excessive vascular remodeling may worsen tissue perfusion and hamper tissue repair. Blood flow is a major determinant of microvascular reshaping since capillaries are pruned when relatively less perfused and they split when exposed to high flow in order to shape the microvascular network for optimal tissue perfusion and oxygenation. The molecular machinery underlying blood flow sensing by endothelial cells is being deciphered, but much less is known about how this translates into endothelial cell responses as alignment, polarization and directed migration to drive capillary remodeling, particularly in vivo. Part of this knowledge is theoretical from computational models since blood flow hemodynamics are not easily recapitulated by in vitro or ex vivo approaches. Moreover, these events are difficult to visualize in vivo due to their infrequency and briefness. Studies had been limited to postnatal mouse retina and vascular beds in zebrafish but new tools as advanced microscopy and image analysis are strengthening our understanding of capillary remodeling. In this review we introduce the concept of remodeling of the microvasculature and its relevance in physiology and pathology. We summarize the current knowledge on the mechanisms contributing to capillary regression and to capillary splitting highlighting the key role of blood flow to orchestrate these processes. Finally, we comment the potential and possibilities that microfluidics offers to this field. Since capillary remodeling mechanisms are often reactivated in prevalent pathologies as cancer and cardiovascular disease, all this knowledge could be eventually used to improve the functionality of capillary networks in diseased tissues and promote their repair.

The Optimality Principle Decreases Hemodynamic Stresses for Aneurysm Initiation at Anterior Cerebral Artery Bifurcations

OBJECTIVE

To investigate hemodynamic stresses on anterior cerebral artery bifurcation apex and possible mechanism of the optimality principle in protecting bifurcation wall from supercharged hemodynamic stresses.

METHODS

Three-dimensional angiographic datasets of 122 patients with anterior communicating artery (Acom) aneurysms, 21 patients with non-Acom aneurysms, and 220 control subjects with no aneurysms were used. Radii of parent (r0) and daughter branches (r1 and r2) were measured, and bifurcations obeying the optimality principle required optimal caliber control of r0n = r1n + r2n, with the junction exponent n approximating 3. Radius ratio = r03/(r13 + r23) and n were compared between aneurysmal and control bifurcations. Blood flow was simulated for analysis of hemodynamic stresses.

RESULTS

Acom bifurcations in subjects without Acom aneurysms displayed optimal caliber radius, with mean radius ratio of 0.99 and n of 3.25, whereas Acom aneurysmal bifurcations had significantly lower radius ratio, 0.62 (P < 0.05), but higher n, 4.23 (P < 0.05). Peak wall shear stress and corresponding total pressure were significantly smaller for bifurcations obeying than disobeying the optimality principle (P < 0.001 and P < 0.05, respectively). Total pressures in the direct impinging center, peak wall shear stress distance, and anterior cerebral artery bifurcation angle all were significantly smaller for bifurcations obeying than disobeying the optimality principle (P < 0.05 and P < 0.001, respectively).

CONCLUSIONS

Normal anterior cerebral artery bifurcations obey the optimality principle whereas bifurcations with Acom aneurysms do not. Disobeying the optimality principle presents significantly enhanced hemodynamic stresses to possibly damage the bifurcation wall for aneurysm initiation.

Computational flow dynamics in a geometric model of intussusceptive angiogenesis

Intussusceptive angiogenesis is a process that forms new blood vessels by the intraluminal division of a single blood vessel into two lumens. Referred to as nonsprouting or intussusceptive angiogenesis, this angiogenic process has been described in morphogenesis and chronic inflammation. Mechanical forces are relevant to the structural changes associated with intussusceptive angiogenesis because of the growing evidence that physiologic forces influence gene transcription. To provide a detailed analysis of the spatial distribution of physiologic shear stresses, we developed a 3D finite element model of the intraluminal intussusceptive pillar. Based on geometries observed in adult intussusceptive angiogenesis, physiologic shear stress distribution was studied at pillar sizes ranging from 1 to 10 microm. The wall shear stress calculations demonstrated a marked spatial dependence with discrete regions of high shear stress on the intraluminal pillar and lateral vessel wall. Furthermore, the intussusceptive pillar created a "dead zone" of low wall shear stress between the pillar and vessel bifurcation apex. We conclude that the intraluminal flow fields demonstrate sufficient spatial resolution and dynamic range to participate in the regulation of intussusceptive angiogenesis.

Effects of disturbed flow on endothelial cells

Vascular endothelial cells (ECs) play significant roles in regulating circulatory functions. The shear stress resulting from blood flow modulates EC functions by activating mechano-sensors, signaling pathways, and gene and protein expressions. Shear stress with a clear direction resulting form pulsatile or steady flow causes only transient activation of pro-inflammatory and proliferative pathways, which become down-regulated when such directed shearing is sustained. In contrast, shear flow without a definitive direction (e.g., disturbed flow in regions of complex geometry) causes sustained molecular signaling of pro-inflammatory and proliferative pathways. The EC responses to shear flows with a clear direction involve the remodeling of EC structure to maintain vascular homeostasis and are athero-protective. Such regulatory mechanism does not operate effectively when the flow pattern is disturbed. Therefore, the branch points and other regions of the arterial tree with a complex geometry are prone to atherogenesis, whereas the straight part of the arterial tree is generally spared. Understanding of the EC responses to different flow patters helps to elucidate the mechanism of the region-specific localization of atherosclerosis in the arterial system.

Mechanotransduction and endothelial cell homeostasis: the wisdom of the cell

Vascular endothelial cells (ECs) play significant roles in regulating circulatory functions. Mechanical stimuli, including the stretch and shear stress resulting from circulatory pressure and flow, modulate EC functions by activating mechanosensors, signaling pathways, and gene and protein expressions. Mechanical forces with a clear direction (e.g., the pulsatile shear stress and the uniaxial circumferential stretch existing in the straight part of the arterial tree) cause only transient molecular signaling of pro-inflammatory and proliferative pathways, which become downregulated when such directed mechanical forces are sustained. In contrast, mechanical forces without a definitive direction (e.g., disturbed flow and relatively undirected stretch seen at branch points and other regions of complex geometry) cause sustained molecular signaling of pro-inflammatory and proliferative pathways. The EC responses to directed mechanical stimuli involve the remodeling of EC structure to minimize alterations in intracellular stress/strain and elicit adaptive changes in EC signaling in the face of sustained stimuli; these cellular events constitute a feedback control mechanism to maintain vascular homeostasis and are atheroprotective. Such a feedback mechanism does not operate effectively in regions of complex geometry, where the mechanical stimuli do not have clear directions, thus placing these areas at risk for atherogenesis. The mechanotransduction-induced EC adaptive processes in the straight part of the aorta represent a case of the “Wisdom of the Cell,” as a part of the more general concept of the “Wisdom of the Body” promulgated by Cannon, to maintain cellular homeostasis in the face of external perturbations.

The role of shear stress in the pathogenesis of atherosclerosis

Although the pathobiology of atherosclerosis is a complex multifactorial process, blood flow-induced shear stress has emerged as an essential feature of atherogenesis. This fluid drag force acting on the vessel wall is mechanotransduced into a biochemical signal that results in changes in vascular behavior. Maintenance of a physiologic, laminar shear stress is known to be crucial for normal vascular functioning, which includes the regulation of vascular caliber as well as inhibition of proliferation, thrombosis and inflammation of the vessel wall. Thus, shear stress is atheroprotective. It is also recognized that disturbed or oscillatory flows near arterial bifurcations, branch ostia and curvatures are associated with atheroma formation. Additionally, vascular endothelium has been shown to have different behavioral responses to altered flow patterns both at the molecular and cellular levels and these reactions are proposed to promote atherosclerosis in synergy with other well-defined systemic risk factors. Nonlaminar flow promotes changes to endothelial gene expression, cytoskeletal arrangement, wound repair, leukocyte adhesion as well as to the vasoreactive, oxidative and inflammatory states of the artery wall. Disturbed shear stress also influences the site selectivity of atherosclerotic plaque formation as well as its associated vessel wall remodeling, which can affect plaque vulnerability, stent restenosis and smooth muscle cell intimal hyperplasia in venous bypass grafts. Thus, shear stress is critically important in regulating the atheroprotective, normal physiology as well as the pathobiology and dysfunction of the vessel wall through complex molecular mechanisms that promote atherogenesis.

Relationship between the distribution of stress fibers and centrosomes in endothelial cells of the rat aorta

Locomoting cells exhibit a polarity whereby certain organelles, like the centrosome, and cytoskeletal structures, like stress fibers, are preferentially oriented in the direction of migration. To determine if this was also true in endothelial cells (ECs) of the rat aorta that are migrating toward the heart, whole mounts of abdominal and thoracic aorta were double stained with rhodamine phalloidin to label stress fibers and sera that labels centrosomes. Our results show that in 66% of the ECs of the abdominal aorta where stress fibers were present, 47% had stress fibers on the heart side of the nucleus, 21% had stress fibers on the side of the nucleus away from the heart, and 32% had stress across the cell. Similarly, in 50% of the ECs of the thoracic aorta where stress fibers were present, these values were 56, 19, and 25%, respectively. The results also showed that the centrosome was preferentially located toward the heart in the majority (61%) of the ECs with stress fibers as well as in ECs without stress fibers. Since in both, the same percentage of ECs had centrosome preferentially oriented toward the heart, these results imply that while the centrosome may determine the position of the stress fibers, the stress fibers do not appear to determine the position of the centrosome. Nevertheless, both centrosomes and stress fibers in aortic ECs are preferentially oriented in the direction of migration, where they may be involved in defining the direction and providing the force of locomotion, respectively.

Hemodynamics of endovascular prostheses

A surgical study (Bergeron et al., 1991, International Angiology 10(3), 182-186) picked out that re-endothelialization of implanted expandable stents, frequently used to reduce the recurrent stenosis rate after balloon angioplasty, was correct and more rapid in femoro-popliteal arteries (quasi-straight vessels) than in iliac arteries (bifurcated vessels). Since it is now well known that local hemodynamics are considered to be an important atherogenic factor, we decided to compare and optimize the shape of the existing equipment, in order to further give some informations to surgeons about the optimal stenting at the site of bifurcation. Therefore, we studied in vitro (1) the influence of the protruding part of a stent on the flow patterns in the branches of an aorto-iliac bifurcation model, and (2) the possibility of reducing or preventing this impact. Qualitative information was obtained from visualizations in the horizontal median plane of the bifurcation model, while Doppler ultrasonic velocimetry provided quantitative data, at different points of the cardiac cycle. Results showed that a standard stent implanted in a daughter branch of the bifurcation may have a considerable influence on flow behaviour when it is sticking out of the daughter branch. A new design of stent, with a bevelled shape, showed a significant reduction of flow disturbance.

Alterations in endothelial F-actin microfilaments in rabbit aorta in hypercholesterolemia

The current study tests whether hypercholesterolemia influences the distribution of endothelial cell microfilaments during the initiation and growth of fatty streak-type lesions. We classified the lesions occurring over a 20-week period into four types based on the location and extent of macrophage infiltration observed microscopically. The earliest lesion was characterized by leukocytes adherent to the endothelial surface. Minimal lesions were characterized by a few cells in the subendothelium. Intermediate lesions consisted of numerous subendothelial leukocytes in a minimally raised lesion. Advanced fatty streak lesions were elevated, with several layers of leukocytes. The organization of peripheral junctional actin (the dense peripheral band) and of central endothelial cell actin microfilament bundles was studied in each of these lesions by using fluorescent microscopy. We found that in the aorta away from branch sites and in areas away from lesions, the central microfilament distribution was unaffected by hypercholesterolemia. The macrophages entered the wall without any identifiable reorganization in the microfilaments. During the accumulation of subendothelial macrophages in minimal and intermediate lesions, stress fibers were initially increased in comparison to lesion-free areas. In raised advanced lesions, the central microfilaments became thinner and disappeared. However, at flow dividers, where central stress fibers are normally prominent, endothelial cells on the surface of intermediate lesions showed a reduction in central fibers, and peripheral bands became prominent. This finding was associated with changes in cell shape from elongated to cobblestone type. Thus, actin microfilament bundles in endothelial cells underwent substantial changes in distribution during the accumulation of subendothelial macrophages, forming hypercholesterolemia-induced fatty streak-type lesions. These changes may influence endothelial substrate adhesion, permeability, or repair after injury.

Evidence for the migration of rat aortic endothelial cells toward the heart

Most vascular endothelial cells at the edge of experimentally induced wounds have their centrosomes oriented toward the wound in the direction of cell migration. The finding that the centrosomes in endothelial cells of non-wounded aorta and vena cava are also oriented toward the heart suggested the hypothesis that endothelial cells are normally migrating in this direction. To test this hypothesis, endothelial cells in a segment of the rat abdominal aorta were labeled with a relatively nontoxic dye, 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI), and the position of the labeled cells was determined 3 and 6 weeks later. The results obtained showed that in 6 of the 9 rat aortas examined at 3 weeks and 15 of the 20 rat aortas examined at 6 weeks, DiI-labeled endothelial cells had migrated various distances up to 5000 microns toward the heart. In contrast, no migration of endothelial cells was detected at the opposite end of the labeled segment, in the direction away from the heart. These results demonstrate that vascular endothelial cells in the abdominal aorta of the rat are not stationary but are migrating toward the heart. The significance of the migration of endothelial cells toward the heart is presently unknown; however, it would be interesting to explore whether or not the impairment of this migration may contribute to disease processes in which the ability to maintain an intact and normally functioning endothelial cell lining is compromised as in atherosclerosis.

A mechanism for heterogeneous endothelial responses to flow in vivo and in vitro

Exposure of endothelium to a nominally uniform flow field in vivo and in vitro frequently results in a heterogeneous distribution of individual cell responses. Extremes in response levels are often noted in neighboring cells. Such variations are important for the spatial interpretation of vascular responses to flow and for an understanding of mechanotransduction mechanisms at the level of single cells. We propose that variations of local forces defined by the cell surface geometry contribute to these differences. Atomic force microscopy measurements of cell surface topography in living endothelium both in vitro and in situ combined with computational fluid dynamics demonstrated large cell-to-cell variations in the distribution of flow-generated shear stresses at the endothelial luminal surface. The distribution of forces throughout the surface of individual cells of the monolayer was also found to vary considerably and to be defined by the surface geometry. We conclude that the endothelial three-dimensional surface geometry defines the detailed distribution of shear stresses and gradients at the single cell level, and that there are large variations in force magnitude and distribution between neighboring cells. The measurements support a topographic basis for differential endothelial responses to flow observed in vivo and in vitro. Included in these studies are the first preliminary measurements of the living endothelial cell surface in an intact artery.