The human lung is born with a fraction of the adult complement of alveoli. The postnatal stages of human lung development comprise an alveolar stage, a stage of microvascular maturation, and very likely a stage of late alveolarization. The characteristic structural features of the alveolar stage are well known; they are very alike in human and rat lungs. The bases for alveolar formation are represented by immature interairspace walls with two capillary layers with a central sheet of connective tissue. Interalveolar septa are formed by folding up of one of the two capillary layers. In the alveolar stage, alveolar formation occurs rapidly and is typically very conspicuous in both species; it has therefore been termed ‘bulk alveolarization’. During and after alveolarization the septa with double capillary networks are restructured to the mature form with a single network. This happens in the stage of microvascular maturation. After these steps the lung proceeds to a phase of growth during which capillary growth by intussusception plays an important role in supporting gas exchange. In view of reports that alveoli are added after the stage of microvascular maturation, the question arises whether the present concept of alveolar formation needs revision. On the basis of morphological and experimental findings we can state that mature lungs contain all the features needed for ‘late alveolarization’ by the classical septation process. Because of the high plasticity of the lung tissues, late alveolarization or some forms of compensatory alveolar formation may be considered for the human lung.

In order to investigate the postnatal growth of the gas exchange apparatus, the lungs of rats aged 1, 4, 7, 10, 13, and 21 days were fixed by intratracheal instillation of glutaraldehyde. The analysis and interpretation of the morphological changes observed by light and electron microscopy were based on the results of previous morphometric and autoradiographic studies performed on the same material.The newborn rat has no alveoli, but breathes with smooth walled air channels and saccules, which correspond to the prospective alveolar ducts and alveolar sacs, respectively. The bulk of alveoli are formed between days 4 and 13 by a rapid outgrowth of secondary septa from the primary septa present at birth. The arrangement of elastic fibers during this period suggests that these may play a role in septa1 outgrowth. Based on ultrastructural observations a model is described for the capillarisation of the secondary septa. Some evidence is given that alveoli may also be formed by outpouchings in the walls of terminal bronchioles.Primary and secondary septa have initially an immature appearance. They both show an apparently double capillary network, whereas the mature interalveolar septum is just wide enough to accommodate a single capillary. Possible mechanisms for this structural transformation which occurs within three weeks after birth are discussed.

The postnatal growth of the lung was quantitatively investigated in rats aged 1 , 4 , 7, 10, 13, 21,44 and 131 days by light and electron microscopic morphometry .Lung volume (V,) increased first directly with body weight (W). After day 10 V, followed the function WO.?O. Based on the quantitative findings the postnatal lung growth could be divided into three phases.

This review shall familiarize the reader with the various aspects of intussusceptive angiogenesis (IA). The basic event in IA is the formation of transvascular tissue pillars. Depending on location, timing, and frequency of pillar emergence, the IA process has different outcomes. In capillaries, a primary IA function is to expand the capillary bed in size and complexity (intussusceptive microvascular growth). It represents an alternative to capillary sprouting. Highly ordered pillar formation in a developing capillary network leads to the formation of vascular trees (intussusceptive arborization). In small arteries and veins, pillar formation at the vessels' branching angles leads either to remodeling of the branching geometry or even to vascular pruning (intussusceptive branching remodeling). It appears essential that future angiogenic research considers always both phenomena, sprouting and intussusception. Vascularization of tissues, organs, and tumors rely heavily on both mechanisms; neglecting one or the other would obscure our understanding of the angiogenesis process. Developmental Dynamics 231:474 -488, 2004.

Intussusception (growth within itself) is an alternative to the sprouting mode of angiogenesis. The protrusion of opposing microvascular walls into the capillary lumen creates a contact zone between endothelial cells. The endothelial bilayer is perforated, intercellular contacts are reorganized, and a transluminal pillar with an interstitial core is formed, which is soon invaded by myofibroblasts and pericytes leading to its rapid enlargement by the deposition of collagen fibrils. Intussusception has been implicated in three processes of vascular growth and remodeling. (1) Intussusceptive microvascular growth permits rapid expansion of the capillary plexus, furnishing a large endothelial surface for metabolic exchange. (2) Intussusceptive arborization causes changes in the size, position, and form of preferentially perfused capillary segments, creating a hierarchical tree. (3) Intussusceptive branching remodeling (IBR) leads to modification of the branching geometry of supplying vessels, optimizing pre- and postcapillary flow properties. IBR can also lead to the removal of branches by pruning in response to changes in metabolic needs. None of the three modes requires the immediate proliferation of endothelial cells but rather the rearrangement and plastic remodeling of existing ones. Intussusception appears to be triggered immediately after the formation of the primitive capillary plexus by vasculogenesis or sprouting. The advantage of this mechanism of growth over sprouting is that blood vessels are generated more rapidly in an energetically and metabolically more economic manner, as extensive cell proliferation, basement membrane degradation, and invasion of the surrounding tissue are not required; the capillaries thereby formed are less leaky. This process occurs without disrupting organ function. Improvements in our understanding of the process should enable the development of novel pro- and anti-angiogenic therapeutic treatments.