Capillary rarefaction in the forearm skin in essential hypertension

Prasad, Arvind; Dunnill, Giles; Mortimer, Peter; MacGregor, Graham A.

doi:10.1097/00004872-199502000-00015

Cited by 85 publications

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“…Blood capillary rarefaction (31)(32)(33)(34) or reduced eNOS expression (35)(36)(37)(38)(39)(40)(41)(42)(43) as well as lymphatic capillary rarefaction may lead to arterial hypertension in patients treated with angiogenesis inhibitors. In contrast to selective VEGFR2 blockade (44), however, the hypertension induced by VEGFR3 blockade in our mice was strictly salt sensitive.…”

Section: Figurementioning

confidence: 99%

Immune cells control skin lymphatic electrolyte homeostasis and blood pressure

et al. 2013

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The skin interstitium sequesters excess Na + and Cl -in salt-sensitive hypertension. Mononuclear phagocyte system (MPS) cells are recruited to the skin, sense the hypertonic electrolyte accumulation in skin, and activate the tonicity-responsive enhancer-binding protein (TONEBP, also known as NFAT5) to initiate expression and secretion of VEGFC, which enhances electrolyte clearance via cutaneous lymph vessels and increases eNOS expression in blood vessels. It is unclear whether this local MPS response to osmotic stress is important to systemic blood pressure control. Herein, we show that deletion of TonEBP in mouse MPS cells prevents the VEGFC response to a high-salt diet (HSD) and increases blood pressure. Additionally, an antibody that blocks the lymph-endothelial VEGFC receptor, VEGFR3, selectively inhibited MPS-driven increases in cutaneous lymphatic capillary density, led to skin Cl -accumulation, and induced salt-sensitive hypertension. Mice overexpressing soluble VEGFR3 in epidermal keratinocytes exhibited hypoplastic cutaneous lymph capillaries and increased Na + , Cl -, and water retention in skin and salt-sensitive hypertension. Further, we found that HSD elevated skin osmolality above plasma levels. These results suggest that the skin contains a hypertonic interstitial fluid compartment in which MPS cells exert homeostatic and blood pressure-regulatory control by local organization of interstitial electrolyte clearance via TONEBP and VEGFC/VEGFR3-mediated modification of cutaneous lymphatic capillary function.

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Section: Figurementioning

confidence: 99%

Immune cells control skin lymphatic electrolyte homeostasis and blood pressure

et al. 2013

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“…The characteristic increase in peripheral vascular resistance in essential hypertension is, therefore, likely to reflect structural or functional changes in these microvessels (4). Structural abnormalities in vessels of hypertensive patients include decreased luminal diameter, predominantly in larger arterioles (5,6), but also in capillaries (7,8), and a reduction in the density of vessels per volume of tissue (known as rarefaction), which occurs predominantly in the smallest vessels (2,(7)(8)(9)(10)(11)(12)(13). Functional abnormalities of microvessels in established essential hypertension include reduced capillary blood flow in the basal state (14) and reduced vasodilatation induced by heating (15).…”

Section: Introductionmentioning

confidence: 99%

Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure.

Noon¹,

Walker²,

Webb³

et al. 1997

J. Clin. Invest.

299

186

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“…[1][2][3][4][5] We recently showed that the rarefaction of capillaries in the skin of the dorsum of the fingers in patients with essential hypertension is due to the structural (anatomic) absence of capillaries rather than nonperfusion or functional rarefaction. 1 It is not yet known whether this rarefaction is primary (ie, antedates the onset of hypertension) or secondary (ie, occurring as a consequence of prolonged elevation of blood pressure).…”

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confidence: 99%

Rarefaction of Skin Capillaries in Borderline Essential Hypertension Suggests an Early Structural Abnormality

et al. 1999

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Abstract-We recently showed that rarefaction of skin capillaries in the dorsum of the fingers of patients with essential hypertension is due to the structural (anatomic) absence of capillaries rather than functional nonperfusion. It is not known whether this rarefaction is primary (ie, antedates the onset of hypertension) or secondary (ie, as a consequence of sustained and prolonged elevation of blood pressure [BP]). The aim of the present investigation was to study skin capillary density in a group of patients with mild borderline hypertension to assess whether rarefaction antedates the onset of sustained elevation of BP. The study group included 18 patients with mild borderline hypertension (mean supine BP, 136/83 mm Hg), 32 normotensive controls (mean BP, 126/77 mm Hg), and 45 patients with established essential hypertension (mean BP, 156/98 mm Hg). The skin of the dorsum of the fingers was examined by intravital capillary videomicroscopy before and after venous congestion at 60 mm Hg for 2 minutes. Patients with borderline essential hypertension had the lowest resting capillary density when compared with normotensive controls and patients with established hypertension. Maximal capillary density with venous congestion in the borderline group remained the lowest. The study confirmed that patients with borderline essential hypertension have skin capillary densities that are equally low as or even lower than patients with established hypertension. Both groups had significantly lower capillary densities than normal controls. One explanation for the results is that capillary rarefaction may be due to an early structural abnormality in essential hypertension. (Hypertension. 1999;34:655-658.)

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Capillary rarefaction in the forearm skin in essential hypertension

Cited by 85 publications

References 0 publications

Immune cells control skin lymphatic electrolyte homeostasis and blood pressure

Immune cells control skin lymphatic electrolyte homeostasis and blood pressure

Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure.

Rarefaction of Skin Capillaries in Borderline Essential Hypertension Suggests an Early Structural Abnormality

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