Capillary permeability of 131I-albumin in skeletal muscle

Site-specific chemical modification of human serum albumin with polyethylene glycol prolongs half-life and improves intravascular retention in mice

Human serum albumin (HSA) is used as an important plasma volume expander in clinical practice. However, the infused HSA may extravasate into the interstitial space and induce peripheral edema in treating the critical illness related to marked increase in capillary permeability. Such poor intravascular retention also demands a frequent administration of HSA. We hypothesize that increasing the molecular weight of HSA by PEGylation may be a potential approach to decrease capillary permeability of HSA. In the present study, HSA was PEGylated in a site-specific manner and the PEGylated HSA carrying one chain of polyethylene glycol (PEG) (20 kDa) per HSA molecule was obtained. The purity, PEGylated site and secondary structure of the modified protein were characterized by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), thiol group blockage method and circular dichroism (CD) measurement, respectively. In addition, the pharmacokinetics in normal mice was investigated, vascular permeability of the PEGylated HSA was evaluated in lipopolysaccharide (LPS)-induced lung injury mouse model and the pharmacodynamics was investigated in LPS-induced sepsis model with systemic capillary leakage. The results showed that the biological half-life of the modified HSA was approximately 2.3 times of that of the native HSA, PEG-HSA had a lower vascular permeability and better recovery in blood pressure and haemodilution was observed in rats treated with PEG-HSA. From the results it can be inferred that the chemically well-defined and molecularly homogeneous PEGylated HSA is superior to HSA in treating capillary permeability increase related illness because of its longer biological half-life and lower vascular permeability.

Transient diffusion of albumin in aortic walls: effects of binding to medial elastin layers

The goal of this study was to measure diffusive transport of albumin through artery walls experimentally and to analyze the results theoretically, taking into account the binding of albumin to elastic lamellae. Segments of rabbit aorta were placed in solutions of fluorescently labeled albumin for periods of 30, 60, 90, and 120 min, and the distributions of fluorescence intensity through the arterial media were observed. On average, intensity increased almost linearly with time. Bands of high intensity were observed corresponding to elastin layers within the media. The temporal and spatial variations of intensity were compared with predictions of theoretical models, including effects of albumin binding and hindered diffusion resulting from the complex wall structure. Based on these analyses, it was concluded that the spatial distribution of free albumin within the media equilibrated relatively rapidly, and that the observed linear increase in intensity reflected gradual accumulation of albumin bound to medial elastin layers. The results imply that previous theoretical analyses, in which binding was neglected, substantially underestimated albumin diffusivity in the aortic wall. With respect to stent-associated delivery of inhibitors of vascular cell proliferation, the results suggest that albumin might serve as an “affinity vehicle” for drug delivery to the aorta, by attaching the drug to an abundant component of the artery wall.

Recombinant Human Serum Albumin Dimer has High Blood Circulation Activity and Low Vascular Permeability in Comparison with Native Human Serum Albumin

PURPOSE

Human serum albumin (HSA) is used clinically as an important plasma expander. Albumin infusion is not recommended for critically ill patients with hypovolemia, burns, or hypoalbuminemia because of the increased leakage of albumin into the extravascular spaces, thereby worsening edema. In the present study, we attempted to overcome this problem by producing a recombinant HSA (rHSA) dimer with decreased vascular permeability and an increased half-life.

METHODS

Two molecules of rHSA were genetically fused to produce a recombinant albumin dimer molecule. The pharmacokinetics and biodistribution of the recombinant proteins were evaluated in normal rats and carrageenin-induced paw edema mouse model.

RESULTS

The conformational properties of this rHSA dimer were similar to those for the native HSA (the HSA monomer), as evidenced by the Western blot and spectroscopic studies. The biological half-life and area under the plasma concentration-time curve of the rHSA dimer were approximately 1.5 times greater than those of the monomer. Dimerization has also caused a significant decrease in the total body clearance and distribution volume at the steady state of the native HSA. rHSA dimer accumulated to a lesser extent in the liver, skin, muscle, and fat, as compared with the native HSA. Up to 96 h, the vascular permeability of the rHSA dimer was less than that of the native HSA in paw edema mouse models. A prolonged plasma half-life of the rHSA dimer was also observed in the edema model rats.

CONCLUSIONS

rHSA dimer has a high retention rate in circulating blood and a lower vascular permeability than that of the native HSA.

On the active vascular absorption of plasma proteins from tissue: rethinking the role of the lymphatic system

According to Starling's hypothesis, the osmotic pressure of plasma proteins in the capillary is the principal force for fluid absorption. The leakage of plasma proteins from capillaries to tissue during 24 h accounts for the total amount of plasma proteins in the vascular system. The same amount must therefore be reabsorbed by the lymphatic system, which is considered to be the sole absorber of proteins from tissue. However, it is a well-established routine in all kinds of organ transplantation to not restore the lymphatic system of the transplant. Experience has shown that this reconstruction is unnecessary, which consequently implies that the lymphatics are not of crucial importance for the survival of the organ. Inevitably, we must therefore question the vital role that the lymphatic system has been attributed in maintaining homeostasis as the sole absorber of proteins. Instead, it is proposed that the major part of plasma proteins in tissue is actively absorbed by the capillaries.

Endothelial vesicles in the blood-brain barrier: are they related to permeability?

1. Macromolecules cross capillary walls via large vascular pores that are thought to be formed by plasmalemmal vesicles. Early hypotheses suggested that vesicles transferred plasma constituents across the endothelial wall either by a "shuttle" mechanism or by fusing to form transient patent channels for diffusion. Recent evidence shows that the transcytotic pathway involves both movement of vesicles within the cell and a series of fusions and fissions of the vesicular and cellular membranes. 2. The transfer of macromolecules across the capillary wall is highly specific and is mediated by receptors incorporated into specific membrane domains. Therefore, despite their morphological similarity, endothelial vesicles from heterogeneous populations in which the predominant receptor proteins incorporated in their membranes define the functions of individual vesicles. 3. Blood-brain barrier capillaries have very low permeabilities to most hydrophilic molecules. Their low permeability to macromolecules has been presumed to be due to an inhibition of the transcytotic mechanism, resulting in a low density of endothelial vesicles. 4. A comparison of vesicular densities and protein permeabilities in a number of vascular beds shows only a very weak correlation, therefore vesicle numbers alone cannot be used to predict permeability to macromolecules. 5. Blood-brain barrier capillaries are fully capable of transcytosing specific proteins, for example, insulin and transferrin, although the details are still somewhat controversial. 6. It has recently been shown that the albumin binding protein gp60 (also known as albondin), which facilitates the transcytosis of native albumin in other vascular beds, is virtually absent in brain capillaries. 7. It seems likely that the low blood-brain barrier permeability to macromolecules may be due to a low level of expression of specific receptors, rather than to an inhibition of the transcytosis mechanism.

Plasma clearance of polyfructosan and extracellular body fluid distribution in idiopathic dilated cardiomyopathy and after heart transplantation

The total extracellular fluid volume and distribution in plasma and interstitial spaces, and the microvascular permeability properties were studied in 16 nonedematous patients with congestive heart failure (CHF) due to idiopathic dilated cardiomyopathy and 17 such patients who underwent heart transplantation (HT) by analyzing the 3-hour plasma disappearance curve of polyfructosan. Eighteen healthy subjects served as controls. Polyfructosan (3.5 kD) is an extracellular marker and inulin analog transported almost solely by diffusion. The initial capillary membrane plasma clearance (i.e., the permeability-surface area product), the interstitial plasma clearance determined at 10 minutes (clearance[10), and the extracellular volume were determined from the polyfructosan curves. I-131-albumin was used as a plasma volume reference. Permeability-surface area product was elevated in both patient groups (6.6 +/- 1.9 ml/ kg/min in the CHF group and 6.7 +/- 2.0 ml/kg/min in the HT group vs 5.1 +/- 1.3 ml/kg/min in controls, p <0.01 for both), whereas clearance(10) was normalized in the HT group (4.5 +/- 0.9 ml/kg/min in the HT group, 4.4 +/- 0.7 ml/kg/min in controls vs 5.0 +/- 0.9 ml/kg/ min in the CHF group, p <0.1 and p <0.05, respectively). The normalization of interstitial plasma clearance of polyfructosan was associated with time since HT (r = 0.49, p <0.05). Plasma volumes were similar in all 3 groups (41 +/- 8 ml/kg in controls, 44 +/- 13 in the CHF group and 39 +/- 8 in the HT group). In contrast, total extracellular volume was elevated in both patients groups (177 +/- 27 ml/kg in the CHF group and 173 +/-27 in the HT group vs 152 +/- 12 in controls, p <0.01). The results strongly suggest a microvascular permeability defect in both patient groups that perhaps plays a role in the extravascular distribution of the excess extracellular fluid volume.

Microvascular hematocrit and permeability-surface area product in contracting canine skeletal muscle in situ

The dynamics of the microvasculature of the blood-perfused canine gastrocnemius-plantaris muscle in situ at rest and during contraction were determined using multiple-indicator dilution analysis. Permeability-surface area product (PS) was estimated using a bolus indicator dilution of 86Rb, with 125I-albumin serving as the reference tracer, while microvascular hematocrit (Hmv) was estimated using the relationship between plasma (125I-albumin) and erythrocyte (51Cr) tracer washout curves. The muscle was stimulated to contract, under self-perfusion, for 3-min periods with either isometric twitch (1.5, 3, or 5 Hz; 4 ms) or tetanic (20, 40, or 60 trains/min, 200 ms, 100 Hz) contractions, separated by 25 min of rest, randomized to prevent ordering effects. At all stimulation frequencies, Hmv increased significantly from rest value of 36.5 +/- 1.6% to 3 min of either isometric twitch or tetanic contractions. PS rose significantly from 0.08 +/- 0.002 ml/g min at rest to a maximum of 0. 40 +/- 0.01 ml/g min at 60 isometric tetanic contractions per minute and 0.38 +/- 0.01 at 5 Hz. Changes in PS appeared related to stimulation frequency in both twitch and tetanic contractions. The change in Hmv with muscle contraction appeared to depend on contraction frequency during twitch contractions only, but was independent of stimulus frequency during tetanic contractions.

Diffusional transport of the aminoterminal propeptide of type III procollagen in the interstitium of the globally ischaemic cat myocardium

Local repair after acute myocardial infarction appears to be reflected by levels in serum of the aminoterminal propeptide of type III procollagen (serum-PIIINP). Furthermore, serum-PIIINP has recently been reported to provide information on prognosis after acute myocardial infarction. However, no attention has yet been paid to the resistance to diffusion offered by the myocardial interstitium. We determined the diffusion coefficient of PIIINP in the interstitium of the globally ischaemic interstitium of the cat (D'37) by means of a "true transient diffusion' method, and compared with the free diffusion in water (D37). D'37 (in cm2 s-1.10(-5) was 0.0157 +/- 0.0005 (mean +/- SEM) (n = 13), and D37 was 0.0624 +/- 0.0024 (n = 12). The mean diffusive progression during 20 min of the concentration profile of [125I]PIIINP into the tissue was calculated to be 0.19 mm. The D'37 of albumin is practically identical to the D'37 of PIIINP, and the myocardium offers a similar resistance to diffusion of PIIINP and albumin, as expressed from the ratio D37/D'37 of approximately 4 for both molecules. PIIINP has a molecular weight of 42,000 Da, is rod shaped and has an overall negative charge. These characteristics explain the similarity in diffusion coefficients of PIIINP and albumin, which has a molecular weight of 69,000 Da. Albumin is known to pass the membrane of the continuous capillaries of the heart, making it very likely that direct exchange of PIIINP between interstitium and capillary plasma can also occur. During one hour of interstitial diffusion PIIINP will have traversed a distance calculated tp correspond to 15-20 capillaries. Therefore, the results support the concept of serum-PIIINP as a direct marker of events taking place locally in the myocardium following acute myocardial infarction.

The kinetics of continuously infused indocyanine green in the pig

Indocyanine green (ICG) is used in cardiology and hepatology for the estimation of cardiac output, liver function, and splanchnic blood flow. ICG is bound to plasma proteins and ultimately excreted by the liver. We studied the whole body kinetics of ICG during constant infusion in pigs weighing 30-40 kg. The conventional kinetic model (backflux model) assumes that deviations from one-compartmental linear kinetics is caused by backflux from a liver storage to plasma, and that no extravascular, extrahepatic distribution takes place. This model was tested against an alternative (redistribution) model postulating that temporary redistribution of ICG into an extrahepatic extravascular storage was responsible for the deviations while the hepatic uptake was a one-way first-order process. A mathematical analysis of the two models showed that they predicted different time courses of the hepatic extraction fraction of ICG. Thus, with blood sampling from both a peripheral artery and a hepatic vein, a discriminative model-testing experiment was possible. This test required a first-order steady-state hepatic removal of ICG which was confirmed in 7 experiments with infusion rates varied in a stepwise fashion (0.133 +/- 0.003, 0.269 +/- 0.010, 0.547 +/- 0.020 and 0.130 +/- 0.003 mumol.min-1). In the model-testing experiments (n = 10) ICG was infused at a constant rate of 0.135 +/- 0.07 mumol.min-1. The mean concentration in peripheral artery (microM) was well fitted by the biexponential function C(t) = 0.476.(1-0.632.e-0.216.1-0.368.e-0.0172.1). The time course of the observed hepatic extraction fraction was significantly different (p = 0.004) from that predicted from the backflux model but in agreement (p = 0.98) with the new model assuming hepatic removal to be a one-way process and implying temporary ICG redistribution into an extrahepatic, extravascular storage with an apparent volume of 0.144 +/- 0.023 L.Kg-1. Accordingly, extravascular ICG was demonstrated in a number of different tissues after 4-hr infusion (n = 3). If ICG is used to estimate hepatic blood flow according to Fick's principle, the use of a backflux model to correct for non-steady-state conditions will lead to an overestimation of hepatic blood flow of 28% after 25-min infusion, 16% after 50 min, and 6% after 100 min. The study indicated that distribution of ICG between plasma and tissues is not instantaneous, and that the time course of the redistribution itself significantly influences whole body kinetics. Comparison with a previously published study by Ott, Keiding, and Bass of ICG kinetics after bolus injection suggested that a two-compartment model was insufficient and that the kinetics for the exchange of ICG between plasma and the redistribution space may be nonlinear. The study demonstrates how blood sampling on both sides of the eliminating organ can expose the influence of redistribution. The discriminative model test for constant infusion experiments is novel and may be useful with other ligands.

Discrepancies in pharmacokinetic parameter estimation between bolus and infusion studies in the perfused rat hindlimb

Isolated, perfused rat hindlimb consists of skeletal muscle, skin, bone, and adipose. Hence, it is a heterogeneous preparation composed of slowly equilibrating tissues of different characteristics and fractional flow rates. This paper shows how caution should be exercised in interpreting the results following bolus administration and subsequent statistical moment analysis of intravascular markers (51Cr-erythrocytes and 125I-albumin) and lipophilic barbiturates. For the intravascular markers, the events in the hindlimb are overshadowed by events in the connecting tubing and cannulas, due to their comparable volumes. For the barbiturates, these estimates appear to apply to short-term effects as the volume estimates obtained following infusion to steady state are greater than after bolus administration. For the extravascular markers, 14C-sucrose, 14C-urea, and 3H-water, no such time dependency was shown. However, it is only from the outflow profiles following bolus administration that events in the tissue beds can be elucidated.

Microvascular function in the peripheral vascular bed during ischaemia and oxygen-free perfusion

OBJECTIVES

To determine the influence of acute ischaemia and absence of leukocytes on the microvascular function and capillary permeability in skeletal muscle.

DESIGN

Prospective, open study.

SETTING

University Department of Vascular Surgery and Institute of Medical Physiology.

MATERIALS AND METHODS

Ten isolated cat gastrocnemius muscles were perfused with oxygen-free Ringer-albumin solution through the femoral artery. At 5 microliters bolus with 14.8 MBq 51Cr-EDTA was injected through a side branch into the femoral artery, and the response function was detected over the muscle by a scintillation detector connected to a spectrometer and a computer. The perfusion coefficient was measured directly at the venous outlet. The response function was analysed in accordance with non-compartmental black box kinetic principles to give perfusion rate, capillary extraction fraction and capillary diffusional permeability-surface area product (PdS). In separate experiments the molecular size and the free diffusion coefficient of 51Cr-EDTA in water at 37 degrees C were determined by a modified true transient diffusion method.

MAIN RESULTS

During perfusion the PdS-product increased as a function of flow rate, f, in accordance with the linear regression line PdS = 1.78 + 0.15 f between 5 to 60 ml/100 g/min. This permeative conductance was identical to that found previously in a similar experimental set up with oxygenated whole blood perfusion. During oxygen free perfusion the perfusion rate was a linear function of arterial perfusion pressure, and autoregulation of blood flow did not occur in response to variations of arterial perfusion pressures. The free diffusion coefficient in water at 37 degrees C for 51Cr-EDTA was 7.4 x 10(-6) cm2/s (n = 36), which corresponds to a Stokes-Einstein molecular radius, rSE, of 0.439 nm.

CONCLUSIONS

In spite of complete anoxia and absence of normal microcirculatory flow regulating mechanisms there is no sign of changes in capillary diffusional permeability for smaller hydrophilic molecules and functional membrane damage is not elicited in the absence of oxygen under these conditions.

Capillary diffusion capacity for Cr-EDTA and cyanocobalamine in spontaneously beating rat hearts

In order to obtain a functional estimate of the diffusional capacity of the myocardial capillary bed, the permeability surface area product (PS) for Cr-EDTA (mol. wt = 341) and cyanocobalamine (vitamin B12, mol. wt = 135) was determined in spontaneously beating Langendorff-perfused rat hearts over a wide range of coronary flow rates (700-3000 ml min-1 100 g-1). PS was determined by a single injection, colorimetric indicator dilution technique, allowing multiple, rapid and accurate determinations to be made in the same heart. During maximal vasodilation with nitroprusside Na PS averaged 535 +/- 33 and 220 +/- 22 ml min-1 100 g-1 for Cr-EDTA and vitamin B12 respectively at the highest flow (2917 +/- 74 ml min-1 100 g-1). The vasculature of the heart was found to be highly heterogeneous, since PS increased with flow and there were marked variations of extraction over transit times. A functional estimate of 'equivalent pore radius' was obtained from the ratio PSCr-EDTA/PSB12, which was 2.61 +/- 0.15 demonstrating a marked restriction to diffusion corresponding to a pore radius of 51 (41-75) A. This value is similar to that from skeletal muscle determined by the same method while PS-values are 40-45 times higher in the heart (Haraldsson & Rippe 1986). Taken together with morphological estimations of capillary surface area and endothelial path depth, these data indicate a 3-fold increase in the density of pores available for diffusion in the myocardium, compared to skeletal muscle.

Initial plasma disappearance and tissue uptake of 131I-albumin in normal rabbits

The simultaneous plasma disappearance curves of 131I-albumin and 125I-fibrinogen were recorded in normal rabbits for 1 hr. Using fibrinogen as a plasma reference, the disappearance curves of albumin were shown to contain two separate phases of efflux: one fast from zero to 10 min. comprising 8% of the total tracer; and one slow appearing in the interval of 10 to 60 min. containing another 9% of the tracer. Total albumin escape was analyzed to yield an initial slope of 0.024 +/- 0.004 min-1, corresponding to a wholebody unidirectional albumin clearance (Cl(0)) of 0.090 +/- 0.009 ml(min*100 g)-1. The distribution of efflux was assessed by biopsy uptakes using the same tracers in spleen, kidney, heart, lung, liver, intestine, skin, muscle, and brain. The disappearance curve generally reflects a biphasic pattern of uptake in peripheral tissue, predominantly by muscle and lung. The rapid phase has contributions from the fast near equilibration of liver, and intestine and skin are significant codeterminants of the slow phase. Due to their low body masses highly perfused organs such as kidney, spleen, and heart have little influence on the plasma disappearance. In accordance, the Cl(0) determined for the wholebody was higher than initial clearances found in skin (0.053 ml(min*100 g)-1 and muscle (0.054 ml(min*100 g)-1), but much lower than those found in the highly perfused organs. The initial (unidirectional) rates of peripheral albumin transfer demonstrated, ranged from 10 to 30 times higher than estimates of lymphatic return, suggesting that transcapillary albumin exchange is mediated by high-rate bidirectional diffusion. The rapid decrease of net albumin exchange rates suggests a second, highly significant barrier located within the interstitial matrix, which restricts plasma escape and reduces plasma to lymph albumin transport.

Tissue to plasma capillary permeability of 131I-albumin in the perfused rabbit ear

The tissue to plasma transfer of 131I-albumin was recorded in perfused rabbit ears (n = 6) following equilibration for 24 hr. 125I-fibrinogen served as the plasma marker, and was introduced intravenously 15 min before clamping. The ears were rollerpump perfused with isotonic diluted plasma at a constant rate of (mean +/- SD) 5.1 +/- 1.5 ml (min.100 g)-1. The mean extravascular albumin distribution volume was 12.4 +/- 1.1 ml.100 g-1, and the fibrinogen volume (plasma volume in tissue) was 3.1 +/- 0.4 ml.100 g-1 as determined from biopsies of the contralateral ear. The initial transfer of albumin was marked, and occurred at rates corresponding to a unidirectional clearance (Cl(0)) of 0.068 +/- 0.012 ml (min.100 g)-1. However, with a reduction of mean interstitial albumin tracer content of no more than 4%, net transport decreased to reach slowly declining levels 5 to 10 times lower within 10 min of continued perfusion. The decrease was considered due to rapid exhaustion of a small interstitial pool of tracer immediately adjacent to the exchange vessel membrane, followed by an increasingly retarded outwash from more distant areas. The results suggest a bimodal structural resistance to albumin movement: a relatively low resistance in the capillary membrane, and a considerable restriction to albumin transport located within the interstitial space.

Mathematical modeling of mass transfer in microvascular wall and interstitial space

A one-dimensional, unsteady-state mathematical model was developed to describe the transfer of macromolecules across a microvascular wall and into the interstitial space. The proposed theoretical model accounts for both molecular diffusion and convective transfer through the microvascular wall as well as in the interstitial space. The resulting partial differential equations were simultaneously solved using the Laplace transform method. The inversion of the Laplace transformed equations was obtained by using contour integration in the complex region. The final solution is represented by two equations expressing the macromolecule concentration in the microvascular wall region and in the interstitial space, respectively, as functions of time, spatial coordinate, macromolecule concentration in the microvascular wall at the plasma-wall interface, wall thickness, wall-interstitial space equilibrium constant for the macromolecules, ratio of the cross-sectional area of the two regions, sieving coefficients, diffusivity coefficients, and average fluid velocity terms in the two regions. Plots of the macromolecule concentration in both regions as a function of time are presented and discussed for selected values of the parameters. An analytical expression for the total amount of mass which has accumulated in a portion of the interstitial space at any given time was also derived and used to determine the average fluid velocity term and the diffusivity coefficient for each of the two regions from published experimental data (A. Y. Bekker, A. B. Ritter, and W. N. Durán, 1989, Microvasc. Res. 34, 200-216). A numerical nonlinear regression method was used for this purpose. The values for the diffusivity coefficients found in this work for this particular data set compare favorably with the results previously obtained by other workers in similar systems. It is expected that our model will be used in the future to describe the dynamics of mass transfer across a microvascular wall and into the interstitial space, on the basis of the molecular diffusion and/or convective transport mechanisms, thus contributing to the solution of the controversy regarding the nature of the transfer mechanism controlling macromolecule transport in living systems.

Blood-nerve transfer of albumin and its implications for the endoneurial microenvironment

Blood-nerve transfer of plasma albumin was studied by measuring the permeability coefficient-surface area (PS) product of the blood-nerve barrier (BNB) to 125I-albumin in rat sciatic nerve using the i.v. bolus injection method. The calculated PS was 6.3 +/- 0.5 (S.E.M.) x 10(-7) ml.g-1.s-1. This value is smaller by more than an order of magnitude of that measured for sucrose and confirms the relative impermeance of the BNB to blood-borne solutes. From a review of the available evidence, it is concluded that normal blood-nerve exchange occurs predominantly across the endoneurial microvasculature, and the PS of the BNB reflects the permeability of capillaries to a greater extent than that of the perineurium. The only capillaries found to be less permeable than these are the cerebral capillaries. Proximo-distal differences (sciatic vs tibial) of the PS could not be detected. Blood-nerve albumin transfer was calculated at 1.2 mg.g-1.day-1, and the daily turnover of endoneurial albumin to be about 30%. It is postulated that small increases in PS of BNB to albumin lead to an elevation of endoneurial albumin concentration and, through the operation of Starling forces, subsequently produce endoneurial oedema. A major question posed by the results of this study is the identity of pathways for clearance of albumin and other macromolecules from the endoneurium.

Initial plasma disappearance and distribution volume of [131I]albumin and [125I]fibrinogen in man

The simultaneous plasma disappearance curves of albumin and fibrinogen were recorded in eight normal subjects from 10 to 60 min following intravenous injection. Additional samples were taken at 3, 4, 5, 6 and 7 min. The initial distribution volume (IDV) of albumin calculated by semilogarithmic extrapolation to zero time was 5.56% (range 3.73-8.53) larger than that of fibrinogen, denoting an initial high-rate function of albumin efflux extending from zero to about 10 min after tracer injection. The following slower phase of the albumin curve from 10 to 60 min was found to be similar to the so-called transcapillary escape rate (TER) of single-tracer experiments. By introducing the value Cp(0) (i.e. the estimated curve height at t = 0, from the injected amount of albumin tracer divided by the IDVf), the entire initial part of the albumin curves was analysed. From this analysis the mean value of 0.0135 +/- 0.0038 min-1 was determined for initial slope, corresponding to a whole-body unidirectional albumin efflux [j(0)] of 0.0572 +/- 0.0160 ml 100 g-1 min-1. The result is about 16 times higher than normal estimates of total lymphatic albumin return, indicating a huge backflux of interstitial albumin at the whole-body capillary level. Both phases of efflux seem to reflect uptake in a variety of peripheral tissues, and the hypothesis that the second phase (TER) expresses the initial slope of albumin escape into non-liver tissues is not substantiated. Based on the difference in IDV of the tracers demonstrated, the uncritical use of albumin as a plasma volume marker is not justified.

Validation of transport measurements in skeletal muscle with N-13 amino acids using a rabbit isolated hindlimb model

We are studying the transport of C-11 and N-13 labeled amino acids in tumor-bearing rabbits to determine the role of amino acid transport in the pathogenesis of muscle wasting in cancer. To validate a new, in vivo, method for measuring transport in skeletal muscle with these compounds, an isolated hindlimb model was developed in rabbits. The limb was perfused with a non-recirculating, normothermic, constant pressure system and a cell-free perfusate. Hemodynamic and metabolic parameters were measured during the first 75 min. of perfusion and found to remain normal and stable. Flow varied directly with perfusion pressure over the normal range of resting flows in the intact rabbit hindlimb. Time-activity curves (TAC's) were recorded from the medial thigh following bolus co-injection of L-[amide N-13] glutamine or N-13 L-glutamate with Tc-99m human serum albumin (HSA) into the femoral artery. Regional plasma flow was determined from the Tc-99m data. The N-13 TAC's consistently manifested a three-phased washout with half times of approximately 30 sec., 5 min. and 2 hr. Capillary and cellular transport parameters were computed from the N-13 data using a double barrier, single capillary model of capillary and cellular transport and assuming that the three washout components result, respectively, from tracer throughput, extraction into the interstitial space and extraction into the intracellular space. This interpretation was validated and the sensitivity of the technique to transport processes demonstrated by examining the effects on the N-13 TAC's and computed transport parameters of several factors known to influence cellular transport of amino acids, viz., the insulin concentration, amino acid concentration and pH of the perfusate. Time-activity curves and transport parameters for N-13 L-glutamine in the isolated limb were very similar to those observed in the intact rabbit hindlimb, suggesting that studies in the perfused model are indicative of amino acid transport in vivo. The methodology described here is especially well suited for studying the specific effects on transport of factors which influence amino acid metabolism in skeletal muscle (e.g., hormones and monokines).

Muscle capillary permeability for [14C]inulin and [51Cr]EDTA in human forearm

Capillary permeability of [14C]inulin and [51Cr]EDTA was examined in human forearm in five healthy, subjects by indicator diffusion technique. Injections of, initially [125I]albumin and [14C]inulin, and after 30 min resting, of [125I]albumin and [51Cr]EDTA, were given in a brachial artery. During light exercise of the forearm, blood was sampled in 2-s periods from a deep cubital vein primarily draining muscles. The plasma flow rate, calculated as the dose of [125I]albumin in the injectate divided by the area under the curve for the venous concentration of 125I, was, on average, 8.5 ml min-1 100 g-1 forearm. Assuming [125I]albumin is a partially permeable tracer, a correction for extraction of albumin was performed. This gave extraction fractions of 0.107 +/- 0.015 (mean +/- SEM) for [14C]inulin and 0.377 +/- 0.033 for [51Cr]EDTA, respectively. The capillary permeability surface area product per 100 g tissue (CDC) was for [14C]inulin 0.90 +/- 0.19, and for [51Cr]EDTA 3.31 +/- 0.38 ml min-1 100 g-1 forearm. The average of the ratios of the CDC values of [51Cr]EDTA to those of [14C]inulin, 4.0 +/- 0.5, is significantly higher than the corresponding ratio between the measured free diffusion coefficients in water at 37 degrees C, 3.07 +/- 0.002 (N = 36 and 17, respectively). This indicates that there is some degree of restriction for [14C]inulin (MW 5200) relative to [51Cr]EDTA (MW 340.2) and it points to an 'equivalent pore radius estimate' of about 160 A in human muscle capillaries.

Diffusional transport of albumin from interstitium to blood across small pores in the capillary walls of rat skeletal muscle

The transport of radiolabelled albumin from tissue to blood was measured with an external detection technique in isolated, maximally vasodilated rat skeletal muscles. Initially, rat hindlimbs were perfused with albumin-serum solutions containing [99mTc]albumin for at least 2 h, during which time the tracer accumulated interstitially. The accumulated tracer albumin was then washed out over a period of 1 h, using a tracer-free, otherwise identical, perfusate. The wash-out curve was multi-exponential and the last 30-min period was used to calculate the turnover rate constant (k), which was 7.5 x 10(-4) min-1, (+/- 0.7 x 10(-4), n = 5). Moreover, if albumin was assumed to be distributed homogeneously within the interstitium, with a distribution volume (Vi) of 10 ml 100 g-1, a tissue-to-blood clearance of albumin (ClT-B) of 0.0075 ml min-1 100 g-1 could be calculated. By this approach ClT-B is probably slightly overestimated, but is still only 30% of the clearance from blood to tissue (ClB-T), as determined in several previous studies under similar conditions. Thus, transcapillary passage of albumin is highly asymmetrical, being at least three times greater from blood to tissue than in the opposite direction. This is in agreement with the concept of the capillary walls being composed of two populations of functional pores, where macromolecules are transported from blood to tissue mainly by convection through large pores, even at low filtration rates.

Thrombin-induced alterations in endothelial permeability

Figure 15 summarizes the current understanding of mechanisms of endothelial permeability alterations induced with thrombin. If thrombin generation exceeds the antiprotease activity, thrombin results in clotting of fibrinogen and intravascular fibrin accumulation. Pulmonary neutrophil sequestration also occurs after fibrin deposition, and this is related to the degree and duration of fibrin sequestration. Neutrophil activation appears to be an essential requirement for the mediation of the pulmonary vascular injury. Thrombin-induced intravascular coagulation results in the generation of lipid mediators (LTB4 and HETEs), which may be involved in increasing endothelial permeability. The release of thrombin in higher concentrations during lysis of fibrin (sequence; see text) FIGURE 15. Hypothesis showing mechanisms of thrombin-induced increase in endothelial permeability to proteins. Thrombin may have direct effects on endothelial permeability, or thrombin induced fibrinogen clotting, activation of neutrophils, and the release of lipid metabolites that subsequently lead to an increase in endothelial permeability. clots may induce a direct formation of interendothelial "gaps." Therefore, the vascular injury induced by neutrophil activation and the formation of endothelial "gaps" induced directly by thrombin can both increase the endothelial permeability to proteins. Thrombin is an important mediator of increased endothelial permeability to macromolecules, and may participate in the inflammatory response. In this regard, thrombin may be similar to other mediators (such as histamine and serotonin) that have been previously documented to increase macromolecule transport across the endothelium. The implications of free thrombin in increasing endothelial permeability may be greater because thrombin not only has a direct effect on endothelial permeability, but also induces clotting of fibrinogen and the subsequent generation of mediators that activate neutrophils and that in turn can induce endothelial injury.