Influence of venous pressure on plasma-lymph transport in the dog's paw: Convective and dissipative mechanisms

Renkin, Eugene M.; Joyner, William L.; Sloop, C.H.; Watson, P. D.

doi:10.1016/0026-2862(77)90018-8

Cited by 96 publications

(42 citation statements)

References 24 publications

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“…Since interstitial protein concentration is inversely related to capillary filtration rate (e.g. Renkin, Joyner, Sloop & Watson, 1977;Taylor & Granger, 1984) the protein concentration is expected to rise after lymphatic damage (e.g. Casley-Smith & Gaffney, 1981;Browse & Stewart, 1985 (Noddeland, Omvick, Lund-Johansen, Ofstad & Aukland, 1984;Fauchald, 1985) which is close to arm oedema 7Fi here.…”

Section: Reduced It1 In Pmo: Volume Considerationsmentioning

confidence: 98%

Starling pressures in the human arm and their alteration in postmastectomy oedema.

Bates

Levick

Mortimer

1994

The Journal of Physiology

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SW17 ORE 1. Surgery and radiotherapy to axillary lymph nodes during breast cancer treatment is often followed, commonly years later, by chronic postmastectomy oedema (PMO). PMO is considered a 'high protein' oedema due to reduced axillary lymph drainage. Since oedema formation also depends on fluid input (capillary filtration), we studied the Starling pressures in the affected and contralateral arm. Colloid osmotic pressure was measured in patient serum (7rp) and interstitial fluid (i1). Subcutis fluid was collected from PMO arms by both wick and aspiration methods, and from the control arm by the wick method only. Interstitial hydraulic pressure (Pi) was measured by the wick-in-needle method. 2. Oedema iT was 19-2 + 4-1 cmH20 (n = 13, wick) to 16-3 + 4.4 cmH20 (n = 41, aspirate;difference not significant; means + S.D. throughout). This was significantly lower than rit in the control arm (21-4 + 3-8 cmH2O, n = 14, P < 0.01, analysis of variance). Also, there was a negative correlation between oedema 7Ti and the percentage increase in arm volume(correlation coefficient r = -0 35, P < 0'05) in contrast to conventional expectation.3. Oedema Pi (1P9 + 2-0 cmH20, n = 28) exceeded the subatmospheric control Pi (-2-8 + 3 0 cmH20; P < 0-01). Venous and arterial pressures were normal but 7rp was subnormal (31-1 + 2-7 cmH20, n= 47).4. Net pressure opposing capillary blood pressure, P., was calculated as Pi + ao (7rp -7it) for a reflection coefficient, C., of 0 90-0 99. P0 in the control arm, 6-2-8-5 cmH2O, was less than antecubital venous pressure, 10-5 cmH20. This provides no support for the traditional view that venous capillaries in the arm are in a state of continuous fluid reabsorption.5. In the PMO arm, PO was raised to 15-0 + 4-6 cmH2O (n = 28, P < 0.01, ANOVA) and correlated positively with increase in arm volume (r = 0-41, P < 0 05). A rise in P0 will reduce filtration rate if capillary pressure is unaltered, which should raise interstitial protein concentration and 7Ti -whereas 7iT actually decreased. Possible explanations include a rise in capillary pressure. The pathophysiology of postmastectomy oedema evidently involves additional mechanisms besides lymphatic damage.Chronic oedema of the arm is a common and distressing late complication of successful treatment of breast cancer. Its origin seems, on the face of it, obvious, namely that axillary lymph node extirpation and/or axillary radiotherapy impairs lymph drainage from the arm. Since interstitial protein drainage is also thought to be reduced, the oedema is classified as a 'high protein lymphoedema'. Lymphangiography reveals dilated lymphatic vessels in the arm and a collateral lymphatic system around obstructions (Clodius, 1977;McIvor & O'Connell, 1978). Lymphangiographic medium moves along the lymphatic vessels at reduced velocity, but flow (velocity x cross-sectional area) has never been measured. It is not known why the chronic postmastectomy oedema (PMO) often arises years after the initial nodal trauma.Lymphatic drainage is clearly abnormal in PMO, b...

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Section: Reduced It1 In Pmo: Volume Considerationsmentioning

confidence: 98%

Starling pressures in the human arm and their alteration in postmastectomy oedema.

Bates

Levick

Mortimer

1994

The Journal of Physiology

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“…For instance, if hydrostatic pressure is the major force, intraluminal pressure THE JOURNAL OF CELL BIOLOGY -VOLUME 98 FEBRUARY 1984 629-640 0 The Rockefeller University Press -0021-9525/84/02/0629/12 $1 .00 must be greater than atmospheric attimes, thus causing lymph to flow downstream, and less than atmospheric at other times, permitting fluid entry from the tissue spaces to the lumen. Comparable fluctuating differences in protein concentration, between capillary lymph and tissue fluid, have been proposed to satisfy the oncotic pressure theory (11,12).A second theory holds that cytoplasmic vesicles provide the major route for protein to traverse the endothelium (1,15,18,29,30). The oncotic gradient created by this protein transport is held responsible for further fluid flow between adjacent cells or through transendothelial channels.…”

mentioning

confidence: 99%

“…A second theory holds that cytoplasmic vesicles provide the major route for protein to traverse the endothelium (1,15,18,29,30). The oncotic gradient created by this protein transport is held responsible for further fluid flow between adjacent cells or through transendothelial channels.…”

mentioning

confidence: 99%

Temperature dependence of protein transport across lymphatic endothelium in vitro.

O’Morchoe¹,

Jones²,

Jarosz³

et al. 1984

The Journal of Cell Biology

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The purpose of the work was to develop an in vitro model for the study of lymphatic endothelium and to determine, using this model, whether or not a cytoplasmic process may be involved in transendothelial transport . Segments of canine renal hilar lymphatics were dissected clean, cannulated at both ends, and transferred to a perfusion chamber for measurement of transendothelial protein transport and for ultrastructural tracer studies . The segments were subsequently processed for light and electron microscopy. By both structural and functional criteria the lymphatics were judged to have retained their integrity. At 37°C, 36 lymphatics showed a mean rate of protein transport of 3 .51 ± 0 .45 (SEM) ug/min per cm' of lymphatic endothelium . The rate was influenced by the temperature of the system, being significantly reduced by 49% ± 4.8, 31% ± 5.3, and 29% ± 3 .9 when the temperature was lowered to 4°, 24°, and 30°C, respectively . When the temperature was raised to 40°C, the rate was significantly increased by 48% ± 12.2. The vesicular system and the intercellular regions in vessels with increased or reduced rates of transport were analyzed quantitatively to ascertain whether the rate changes could be correlated with ultrastructurally demonstrable changes in either of these postulated pathways . No significant changes in junctional or vesicular parameters were found between the control lymphatics and those perfused at 24°, 30°, and 40°C . At 4°C, the temperature at which the rate of protein transport was maximally reduced, vesicular size decreased, and the number of free cytoplasmic vesicles increased, whereas the number associated with the abluminal and luminal surfaces decreased . We concluded that isolated perfused lymphatic segments transport protein at a relatively constant rate under control conditions, and that this transendothelial transport comprises both temperaturedependent and temperature-independent mechanisms . The findings were considered in terms of the different theories of lymph formation and were interpreted as providing support for the vesicular theory .Lymph, by definition, is formed from that component of the interstitial fluid that moves across the endothelium of lymphatic vessels. However, the pathways taken and the forces that control this fluid movement are poorly understood and therefore have become the subjects of considerable controversy. According to one theory the major pathway lies between adjacent endothelial cells (11,20,21), and hydrostatic (16) or osmotic pressure (11, 12) provides the necessary force for fluid transport. Integral to this theory are the cyclic changes that occur because lymphatic vessels are alternately compressed and then relaxed within the tissues. For instance, if hydrostatic pressure is the major force, intraluminal pressure THE JOURNAL OF CELL BIOLOGY -VOLUME 98 FEBRUARY 1984 629-640 0 The Rockefeller University Press -0021-9525/84/02/0629/12 $1 .00 must be greater than atmospheric attimes, thus causing lymph to flow downstream, and less than atmo...

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“…An increase in venous pressure could cause a physical distortion of the subcutaneous capillaries and disturbed the integrity of the filtration barrier or forceful opening of ordinarily closed "large pores" in the microvascular membrane (34). This possibility is supported by earlier observations of increased plasma protein permeability at increased venous pressures (31).…”

Section: Discussionmentioning

confidence: 78%

“…Previous attempts to measure changes in capillary permeability in subcutaneous microcirculation have mostly been performed by either measuring lymph-to-plasma ratio of plasma proteins after increased venous pressure (11,12,31,39) or measuring tissue accumulation of tracer macromolecules (29,30). Compared with studies of lymph flow and lymph protein concentration for determination of capillary permeability, the microdialysis method has the advantage that the sampling site is much closer to the capillary wall.…”

mentioning

confidence: 99%

Changes in plasma protein extravasation in rat skin during inflammatory challenges evaluated by microdialysis

Borge

Iversen²,

Reed³

2006

American Journal of Physiology-Heart and Circulatory Physiology

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Borge, B. Å ., V. V. Iversen, and R. K. Reed. Changes in plasma protein extravasation in rat skin during inflammatory challenges evaluated by microdialysis. Am J Physiol Heart Circ Physiol 290: H2108-H2115, 2006. First published December 22, 2005 doi:10.1152/ajpheart.00395.2005.-Docetaxel and prostaglandin E 1 (PGE1) increase transcapillary albumin extravasation and reduce interstitial fluid pressure in the skin. In this study the microdialysate concentration (Cm) of 125 I-labeled human serum albumin ( 125 I-HSA) and different-sized endogenous plasma proteins (EPP) was compared to evaluate changes in transcapillary extravasation of plasma proteins.125 I-HSA was also used to estimate changes in the specific activity of albumin. Extravasation of 125 I-HSA and EPP from plasma to interstitium in the rat skin was compared during continuous administration of docetaxel and PGE 1 by using microdialysis in anesthetized rats. Also, 20 ml of Ringer solution (RS) were injected intravenously during 10 min in a separate group. Two hollow plasmapheresis fibers (3 cm, cut off 3,000 kDa), one acting as control, were placed subcutaneously on the back skin and perfused with RS (5 l/min, 140 min, collected every 10 min). The size of the different EPP was estimated to be 73, 65, 56, 47, and 39 Å , separated by a size-exclusion high-performance liquid chromatography column and quantified by UV detection (280 nm). Docetaxel (0.5 mg/ml, n ϭ 5) increased Cm of 125 I-HSA and EPP of sizes 73, 65, 56, and 39 Å significantly (P Ͻ 0.05) compared with control. PGE 1 (20 g/ml, n ϭ 6) increased Cm of 125 I-HSA significantly (P Ͻ 0.05) but none of the different-sized EPP was increased compared with control. Intravenous RS (20 ml, n ϭ 6) increased C m of 125 I-HSA and increased all the different-sized EPP significantly (P Ͻ 0.05) compared with control. Although the microdialysis method is able to monitor qualitative changes in capillary permeability, a quantitative determination of the capillary reflection coefficient or permeabilitysurface area product was not possible, because steady state between plasma and dialysate was not achieved during the measurement period. The different pattern of extravasation of EPP and 125 I-HSA after docetaxel, PGE 1, and RS indicates increased interstitial transport rate and/or increased capillary permeability after docetaxel and RS, whereas PGE 1 seems to increase transcapillary fluid flux without altering the permeability.high-performance liquid chromatography; prostaglandin E 1; docetaxel; transcapillary transport QUANTIFICATION of macromolecular passage from plasma to interstitial fluid may give important information of the integrity of the capillary barrier. Many pharmacological agents and pathological conditions have been shown to alter the permeability and/or protein flux across the capillaries in subcutaneous tissue (39) Docetaxel is a microtubule fixating agent and has previously been demonstrated to lower interstitial fluid pressure (P if ) and increase the extravasation of 125

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Influence of venous pressure on plasma-lymph transport in the dog's paw: Convective and dissipative mechanisms

Cited by 96 publications

References 24 publications

Starling pressures in the human arm and their alteration in postmastectomy oedema.

Starling pressures in the human arm and their alteration in postmastectomy oedema.

Temperature dependence of protein transport across lymphatic endothelium in vitro.

Changes in plasma protein extravasation in rat skin during inflammatory challenges evaluated by microdialysis

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