Differences and similarities in albumin and red blood cell flows through cerebral microvessels

Improved measurement of drug exposure in the brain using drug-specific correction for residual blood

A major challenge associated with the determination of the unbound brain-to-plasma concentration ratio of a drug (K(p,uu,brain)), is the error associated with correction for the drug in various vascular spaces of the brain, i.e., in residual blood. The apparent brain vascular spaces of plasma water (V(water), 10.3 microL/g brain), plasma proteins (V(protein), 7.99 microL/g brain), and the volume of erythrocytes (V(er), 2.13 microL/g brain) were determined and incorporated into a novel, drug-specific correction model that took the drug-unbound fraction in the plasma (f(u,p)) into account. The correction model was successfully applied for the determination of K(p,uu,brain) for indomethacin, loperamide, and moxalactam, which had potential problems associated with correction. The influence on correction of the drug associated with erythrocytes was shown to be minimal. Therefore, it is proposed that correction for residual blood can be performed using an effective plasma space in the brain (V(eff)), which is calculated from the measured f(u,p) of the particular drug as well as from the estimates of V(water) and V(protein), which are provided in this study. Furthermore, the results highlight the value of determining K(p,uu,brain) with statistical precision to enable appropriate interpretation of brain exposure for drugs that appear to be restricted to the brain vascular spaces.

Functional brain mapping in freely moving rats during treadmill walking

A dilemma in functional neuroimaging is that immobilization of the subject, necessary to avoid movement artifact, extinguishes all but the simplest behaviors. Recently, we developed an implantable microbolus infusion pump (MIP) that allows bolus injection of radiotracers by remote activation in freely moving, nontethered animals. The MIP is examined as a tool for brain mapping in rats during a locomotor task. Cerebral blood flow-related tissue radioactivity (CBF-TR) was measured using [14C]-iodoantipyrine with an indicator-fractionation method, followed by autoradiography. Rats exposed to walking on a treadmill, compared to quiescent controls, showed increases in CBF-TR in motor circuits (primary motor cortex, dorsolateral striatum, ventrolateral thalamus, midline cerebellum, copula pyramis, paramedian lobule), in primary somatosensory cortex mapping the forelimbs, hindlimbs and trunk, as well as in secondary visual cortex. These results support the use of implantable pumps as adjunct tools for functional neuroimaging of behaviors that cannot be elicited in restrained or tethered animals.

The cerebral 'no-reflow' phenomenon after cardiac arrest in rats--influence of low-flow reperfusion

OBJECTIVE

Experimental data indicate that early microcirculatory reperfusion is disturbed after cardiac arrest. We investigated the influence of prolonged cardiac arrest and basic life support (BLS) procedures on the quality of cerebral microcirculatory reperfusion.

MATERIALS AND METHODS

In mechanically ventilated male Wistar rats anesthetized with N2O and halothane, cardiac arrest was induced by electrical fibrillation. Ten animals (group I) were subjected to 17 min of cardiac arrest (no-flow). Nine additional animals (group II) underwent only 12 min of cardiac arrest (no-flow), which was followed by a 5-min phase of BLS (i.e. mechanical ventilation and external cardiac compressions). In both groups, advanced resuscitation procedures including mechanical ventilation, external cardiac massage, 0.2 mg kg-1 epinephrine, 0.5 mmol kg-1 NaHCO3, and defibrillation were started 17 min after induction of cardiac arrest. The perfusion of the cerebral microcirculation was visualized by injection of 0.3 g kg-1 15% fluorescein isothiocyanate (FITC)-albumin 5 min after restoration of spontaneous circulation (ROSC), and the animals were decapitated 2 min later. The left hemispheres were fixed in 4% formalin, and coronal sections of 200 microns thickness at three different standard levels of the rat brain were investigated using fluorescence microscopy. Areas without capillary filling (cerebral 'no-reflow') were identified and calculated.

RESULTS

ROSC could be achieved in five of 10 animals (50%) of group I, and in six of nine animals (67%) of group II (P = n.s.). The severity of cerebral 'no-reflow' was higher in group II compared with group I (6.9 +/- 7.6 vs. 0.7 +/- 0.7% of total sectional areas; P < or = 0.05). Two sham-operated animals showed homogeneous reperfusion.

CONCLUSIONS

Wistar rats did not develop a marked cerebral 'no-reflow' phenomenon after circulatory arrest. A relevant degree of cerebral 'no-reflow' occurred, however, in animals subjected to a phase of BLS before circulatory stabilization. Therefore, low-flow states following prolonged cardiocirculatory arrest may aggravate early cerebral microcirculatory reperfusion disorders.

Erythrocytes and the transport of drugs and endogenous compounds

This review considers the significance and measurement of endogenous compounds and drugs on erythrocytes. Part I examines literature examples where a direct measurement of hydrocortisone, phenytoin and valproate was performed on unwashed red cells in vitro and in vivo, showing a consistent contribution of the erythrocyte fraction to the transport of these compounds. In vitro partition experiments using systems composed of plasma water, plasma proteins and erythrocytes are discussed. When spiked blood is diluted with blank autologous plasma water, erythrocytes always discharge the compound over-proportionally compared to plasma proteins. In vivo, during the distribution phase, the elimination half-life from the erythrocyte is the same as or shorter than that from plasma water, and substantial amounts of drug leaving the circulation originate from erythrocytes. In Part II, the transfer of compounds is considered and evidence for the facilitated exchange of red cell associated substances between the erythrocyte and capillary endothelium presented. Situations where a failure to analyse the erythrocyte compartment leads to the loss of vital information are identified. Part III explores methods for analysing erythrocyte associated substances, most commonly indirect calculation, or analysis of washed erythrocytes. A direct determination is rarely performed, but one such method, allowing concurrent plasma analysis, is discussed. An instrument collects a fixed and known quantity of a maximally compressed cell mass, without disturbing the equilibrium between cells and plasma. To isolate compounds associated with the mass of erythrocytes, the red cell sediment can often be extracted quantitatively into a blank protein solution.