Microvascular Rheology and Hemodynamics

On the near-wall accumulation of injectable particles in the microcirculation: smaller is not better

Although most nanofabrication techniques can control nano/micro particle (NMP) size over a wide range, the majority of NMPs for biomedical applications exhibits a diameter of ~100 nm. Here, the vascular distribution of spherical particles, from 10 to 1,000 nm in diameter, is studied using intravital microscopy and computational modeling. Small NMPs (≤100 nm) are observed to move with Red Blood Cells (RBCs), presenting an uniform radial distribution and limited near-wall accumulation. Larger NMPs tend to preferentially accumulate next to the vessel walls, in a size-dependent manner (~70% for 1,000 nm NMPs). RBC-NMP geometrical interference only is responsible for this behavior. In a capillary flow, the effective radial dispersion coefficient of 1,000 nm particles is ~3-fold larger than Brownian diffusion. This suggests that sub-micron particles could deposit within diseased vascular districts more efficiently than conventional nanoparticles.

Low-cost microcontroller platform for studying lymphatic biomechanics in vitro

The pumping innate to collecting lymphatic vessels routinely exposes the endothelium to oscillatory wall shear stress and other dynamic forces. However, studying the mechanical sensitivity of the lymphatic endothelium remains a difficult task due to limitations of commercial or custom systems to apply a variety of time-varying stresses in vitro. Current biomechanical in vitro testing devices are very expensive, limited in capability, or highly complex; rendering them largely inaccessible to the endothelial cell biology community. To address these shortcomings, the authors propose a reliable, low-cost platform for augmenting the capabilities of commercially available pumps to produce a wide variety of flow rate waveforms. In particular, the Arduino Uno, a microcontroller development board, is used to provide open-loop control of a digital peristaltic pump using precisely timed serial commands. In addition, the flexibility of this platform is further demonstrated through its support of a custom-built cell-straining device capable of producing oscillatory strains with varying amplitudes and frequencies. Hence, this microcontroller development board is shown to be an inexpensive, precise, and easy-to-use tool for supplementing in vitro assays to quantify the effects of biomechanical forces on lymphatic endothelial cells.

Role of red blood cell elastic properties in capillary occlusions

The shape transformations of red blood cells stuck in capillary narrowings with radii close to the critical radius where the maximum deformations occur are analyzed. The membrane skeleton deformations are studied within the effective network model and the continuum elastic model, whereas the area-difference elasticity model is applied to describe the phospholipid bilayer. A minimization of the total free energy is performed to determine the cell shapes in a stopped flow, which are calculated by a triangulated representation of the membrane surface. The shapes are asymmetric, characterized by a single invagination, which decreases with decreasing radii of the narrowing and vanishes at its critical radius. The largest stretching deformations of the skeleton are at the ends of the elongated shape, and remarkable shear deformations appear around the invagination. The membrane's mechanical energy increases with the decreasing radius of the narrowing, predominantly due to the deformation of membrane skeleton. The increase in the shear energy is significantly larger than any other energy contribution within both models. The pressure differences needed for the penetration into the narrowing are strongly coupled with the membrane's mechanical energy. Their values were found to be of the order of 10 Pa. Both models correspond well.

Flow and anastomosis in vascular networks

We analyze the effect that the geometrical place of anastomosis in the circulatory tree has on blood flow. We introduce an idealized model that consists of a symmetric network for the arterial and venous vascular trees. We consider that the network contains a viscoelastic fluid with the rheological characteristics of blood, and analyze the network hydrodynamic response to a time-dependent periodic pressure gradient. This response is a measurement of the resistance to flow: the larger the response, the smaller the resistance to flow. We find that for networks whose vessels have the same radius and length, the outer the level of the branching tree in which anastomosis occurs, the larger the network response. Moreover, when anastomosis is incorporated in the form of bypasses that bridge vessels at different bifurcation levels, the further apart are the levels bridged by the bypass, the larger the response is. Furthermore, we apply the model to the available information for the dog circulatory system and find that the effect that anastomosis causes at different bifurcation levels is strongly determined by the structure of the underlying network without anastomosis. We rationalize our results by introducing two idealized models and approximated analytical expressions that allow us to argue that, to a large extent, the response of the network with anastomosis is determined locally. We have also considered the influence of the myogenic effect. This one has a large quantitative impact on the network response. However, the qualitative behavior of the network response with anastomosis is the same with or without consideration of the myogenic effect. That is, it depends on the structure that the underlying vessel network has in a small neighborhood around the place where anastomosis occurs. This implies that whenever there is an underlying tree-like network in an in vivo vasculature, our model is able to interpret the anastomotic effect.

Distinct sites within the vascular cell adhesion molecule-1 (VCAM-1) cytoplasmic domain regulate VCAM-1 activation of calcium fluxes versus Rac1 during leukocyte transendothelial migration

Vascular adhesion molecules regulate the migration of leukocytes from the blood into tissue during inflammation. Binding of leukocytes to vascular cell adhesion molecule-1 (VCAM-1) activates signals in endothelial cells, including Rac1 and calcium fluxes. These VCAM-1 signals are required for leukocyte transendothelial migration on VCAM-1. However, it has not been reported whether the cytoplasmic domain of VCAM-1 is necessary for these signals. Interestingly, the 19-amino acid sequence of the VCAM-1 cytoplasmic domain is 100% conserved among many mammalian species, suggesting an important functional role for the domain. To examine the function of the VCAM-1 cytoplasmic domain, we deleted the VCAM-1 cytoplasmic domain or mutated the cytoplasmic domain at amino acid N724, S728, Y729, S730, or S737. The cytoplasmic domain and S728, Y729, S730, or S737 were necessary for leukocyte transendothelial migration. S728 and Y729, but not S730 or S737, were necessary for VCAM-1 activation of calcium fluxes. In contrast, S730 and S737, but not S728 or Y729, were necessary for VCAM-1 activation of Rac1. These functional data are consistent with our computational model of the structure of the VCAM-1 cytoplasmic domain as an α-helix with S728 and Y729, and S730 and S737, on opposite sides of the α-helix. Together, these data indicate that S728 and Y729, and S730 and S737, are distinct functional sites that coordinate VCAM-1 activation of calcium fluxes and Rac1 during leukocyte transendothelial migration.

Feasibility of conjunctival hemodynamic measurements in rabbits: reproducibility, validity, and response to acute hypotension

OBJECTIVE

To evaluate the feasibility of conjunctival hemodynamic measurements based on assessment of reproducibility, validity, and response to acute hypotension.

METHODS

Image sequences of the conjunctival microvasculature of rabbits were captured using a slit lamp biomicroscope under a steady-state condition, after topical administration of phenylephrine, and after intravenous administration of esmolol. Venous hemodynamic parameters (diameter, blood velocity, blood flow, and wall shear stress) were derived.

RESULTS

Conjunctival venous diameters ranged from 9 to 34 μm and blood velocities ranged from 0.08 to 0.95 mm/s. Coefficients of variation of venous diameter and blood velocity measurements were, on average, 6% and 14%, respectively. Automated and manual measurements of venous diameter and velocity were highly correlated (R = 0.97; p < 0.001; n = 16). With phenylephrine administration, diameter and velocity were reduced by 21% and 69%, respectively. Following esmolol administration, blood pressure was reduced with a concomitant decrease in velocity, followed by recovery to baseline. Venous blood velocity, flow, and WSS were correlated with blood pressure (R ≥ 0.52; p ≤ 0.01).

CONCLUSIONS

The feasibility of quantifying alterations in microvascular hemodynamics in the bulbar conjunctiva was established. The method is of potential value in evaluating microcirculatory hemodynamics related to cardiovascular function.

Use of inotropes and vasopressor agents in critically ill patients

Inotropes and vasopressors are biologically and clinically important compounds that originate from different pharmacological groups and act at some of the most fundamental receptor and signal transduction systems in the body. More than 20 such agents are in common clinical use, yet few reviews of their pharmacology exist outside of physiology and pharmacology textbooks. Despite widespread use in critically ill patients, understanding of the clinical effects of these drugs in pathological states is poor. The purpose of this article is to describe the pharmacology and clinical applications of inotropic and vasopressor agents in critically ill patients.

A biophysical indicator of vaso-occlusive risk in sickle cell disease

The search for predictive indicators of disease has largely focused on molecular markers. However, biophysical markers, which can integrate multiple pathways, may provide a more global picture of pathophysiology. Sickle cell disease affects millions of people worldwide and has been studied intensely at the molecular, cellular, tissue, and organismal level for a century, but there are still few, if any, markers quantifying the severity of this disease. Because the complications of sickle cell disease are largely due to vaso-occlusive events, we hypothesized that a physical metric characterizing the vaso-occlusive process could serve as an indicator of disease severity. Here, we use a microfluidic device to characterize the dynamics of "jamming," or vaso-occlusion, in physiologically relevant conditions, by measuring a biophysical parameter that quantifies the rate of change of the resistance to flow after a sudden deoxygenation event. Our studies show that this single biophysical parameter could be used to distinguish patients with poor outcomes from those with good outcomes, unlike existing laboratory tests. This biophysical indicator could therefore be used to guide the timing of clinical interventions, to monitor the progression of the disease, and to measure the efficacy of drugs, transfusion, and novel small molecules in an ex vivo setting.

Arteries dominate volume changes during brief functional hyperemia: evidence from mathematical modelling

Variations in local neural activity are accompanied by rapid, focal changes in cerebral blood flow and volume. While a range of observations have shown that dilation occurs in cerebral arteries, there is conflicting evidence about the significance of volume changes in post-arteriole vessels. Here, we reconcile the competing observations using a new mathematical model of the hemodynamic response. First, we followed a 'top down' approach, without constraining the model, but using experimental observations at progressively more detailed scales to ensure physiological behaviour. Then, we blocked dilation of post-arteriole vessels, and predicted observations at progressively more aggregated scales (a 'bottom up' approach). Predictions of blood flow, volume, velocity, and vessel diameter changes were consistent with experimental observations. Interestingly, the model predicted small, slow increases in capillary and venous diameter in agreement with recent in vivo data. Blocking dilation in these vessels led to erroneous volume predictions. The results are further evidence that arteries make up the majority of blood volume increases during brief functional activation. However, dilation of capillaries and veins appears to be increasingly significant during extended stimulation. These are important considerations when interpreting results from different neurovascular imaging modalities.

Spatio-temporal development of the endothelial glycocalyx layer and its mechanical property in vitro

The endothelial glycocalyx is a thin layer of polysaccharide matrix on the luminal surface of endothelial cells (ECs), which contains sulphated proteoglycans and glycoproteins. It is a mechanotransducer and functions as an amplifier of the shear stress on ECs. It controls the vessel permeability and mediates the blood-endothelium interaction. This study investigates the spatial distribution and temporal development of the glycocalyx on cultured ECs, and evaluates mechanical properties of the glycocalyx using atomic force microscopy (AFM) nano-indentation. The glycocalyx on human umbilical vein endothelial cells (HUVECs) is observed under a confocal microscope. Manipulation of the glycocalyx is achieved using heparanase or neuraminidase. The Young's modulus of the cell membrane is calculated from the force-distance curve during AFM indentation. Results show that the glycocalyx appears predominantly on the edge of cells in the early days in culture, e.g. up to day 5 after seeding. On day 7, the glycocalyx is also seen in the apical area of the cell membrane. The thickness of the glycocalyx is approximately 300 nm-1 μm. AFM indentation reveals the Young's modulus of the cell membrane decreases from day 3 (2.93 ± 1.16 kPa) to day 14 (0.35 ± 0.15 kPa) and remains unchanged to day 21 (0.33 ± 0.19 kPa). Significant difference in the Young's modulus is also seen between the apical (1.54 ± 0.58 kPa) and the edge (0.69 ± 0.55 kPa) of cells at day 7. By contrast, neuraminidase-treated cells (i.e. without the glycocalyx) have similar values between day 3 (3.18 ± 0.88 kPa), day 14 (2.12 ± 0.78 kPa) and day 21 (2.15 ± 0.48 kPa). The endothelial glycocalyx in vitro shows temporal development in the early days in culture. It covers predominantly the edge of cells initially and appears on the apical membrane of cells as time progresses. The Young's modulus of the glycocalyx is deduced from Young's moduli of cell membranes with and without the glycocalyx layer. Our results show the glycocalyx on cultured HUVECs has a Young's modulus of approximately 0.39 kPa.

OCT methods for capillary velocimetry

TO DATE, TWO MAIN CATEGORIES OF OCT TECHNIQUES HAVE BEEN DESCRIBED FOR IMAGING HEMODYNAMICS: Doppler OCT and OCT angiography. Doppler OCT can measure axial velocity profiles and flow in arteries and veins, while OCT angiography can determine vascular morphology, tone, and presence or absence of red blood cell (RBC) perfusion. However, neither method can quantify RBC velocity in capillaries, where RBC flow is typically transverse to the probe beam and single-file. Here, we describe new methods that potentially address these limitations. Firstly, we describe a complex-valued OCT signal in terms of a static scattering component, dynamic scattering component, and noise. Secondly, we propose that the time scale of random fluctuations in the dynamic scattering component are related to red blood cell velocity. Analysis was performed along the slow axis of repeated B-scans to parallelize measurements. We correlate our purported velocity measurements against two-photon microscopy measurements of RBC velocity, and investigate changes during hypercapnia. Finally, we image the ischemic stroke penumbra during distal middle cerebral artery occlusion (dMCAO), where OCT velocimetry methods provide additional insight that is not afforded by either Doppler OCT or OCT angiography.

In vitro modeling of the microvascular occlusion and thrombosis that occur in hematologic diseases using microfluidic technology

In hematologic diseases, such as sickle cell disease (SCD) and hemolytic uremic syndrome (HUS), pathological biophysical interactions among blood cells, endothelial cells, and soluble factors lead to microvascular occlusion and thrombosis. Here, we report an in vitro "endothelialized" microfluidic microvasculature model that recapitulates and integrates this ensemble of pathophysiological processes. Under controlled flow conditions, the model enabled quantitative investigation of how biophysical alterations in hematologic disease collectively lead to microvascular occlusion and thrombosis. Using blood samples from patients with SCD, we investigated how the drug hydroxyurea quantitatively affects microvascular obstruction in SCD, an unresolved issue pivotal to understanding its clinical efficacy in such patients. In addition, we demonstrated that our microsystem can function as an in vitro model of HUS and showed that shear stress influences microvascular thrombosis/obstruction and the efficacy of the drug eptifibatide, which decreases platelet aggregation, in the context of HUS. These experiments establish the versatility and clinical relevance of our microvasculature-on-a-chip model as a biophysical assay of hematologic pathophysiology as well as a drug discovery platform.

Occlusion of cortical ascending venules causes blood flow decreases, reversals in flow direction, and vessel dilation in upstream capillaries

The accumulation of small strokes has been linked to cognitive dysfunction. Although most animal models have focused on the impact of arteriole occlusions, clinical evidence indicates that venule occlusions may also be important. We used two-photon excited fluorescence microscopy to quantify changes in blood flow and vessel diameter in capillaries after occlusion of single ascending or surface cortical venules as a function of the connectivity between the measured capillary and the occluded venule. Clotting was induced by injuring the target vessel wall with femtosecond laser pulses. After an ascending venule (AV) occlusion, upstream capillaries showed decreases in blood flow speed, high rates of reversal in flow direction, and increases in vessel diameter. Surface venule occlusions produced similar effects, unless a collateral venule provided a new drain. Finally, we showed that AVs and penetrating arterioles have different nearest-neighbor spacing but capillaries branching from them have similar topology, which together predicted the severity and spatial extent of blood flow reduction after occlusion of either one. These results provide detailed insights into the widespread hemodynamic changes produced by cortical venule occlusions and may help elucidate the role of venule occlusions in the development of cognitive disorders and other brain diseases.

Rapid tumoritropic accumulation of systemically injected plateloid particles and their biodistribution

Nanoparticles for cancer therapy and imaging are designed to accumulate in the diseased tissue by exploiting the Enhanced Permeability and Retention (EPR) effect. This limits their size to about 100nm. Here, using intravital microscopy and elemental analysis, we compare the in vivo localization of particles with different geometries and demonstrate that plateloid particles preferentially accumulate within the tumor vasculature at unprecedented levels, independent of the EPR effect. In melanoma-bearing mice, 1000×400nm plateloid particles adhered to the tumor vasculature at about 5% and 10% of the injected dose per gram organ (ID/g) for untargeted and RGD-targeted particles respectively, and exhibited the highest tumor-to-liver accumulation ratios (0.22 and 0.35). Smaller and larger plateloid particles, as well as cylindroid particles, were more extensively sequestered by the liver, spleen, and lungs. Plateloid particles appeared well-suited for taking advantage of hydrodynamic forces and interfacial interactions required for efficient tumoritropic accumulation, even without using specific targeting ligands.

Mechanisms for vascular cell adhesion molecule-1 activation of ERK1/2 during leukocyte transendothelial migration

BACKGROUND

During inflammation, adhesion molecules regulate recruitment of leukocytes to inflamed tissues. It is reported that vascular cell adhesion molecule-1 (VCAM-1) activates extracellular regulated kinases 1 and 2 (ERK1/2), but the mechanism for this activation is not known. Pharmacological inhibitors of ERK1/2 partially inhibit leukocyte transendothelial migration in a multi-receptor system but it is not known whether VCAM-1 activation of ERK1/2 is required for leukocyte transendothelial migration (TEM) on VCAM-1.

METHODOLOGY/PRINCIPAL FINDINGS

In this study, we identified a mechanism for VCAM-1 activation of ERK1/2 in human and mouse endothelial cells. VCAM-1 signaling, which occurs through endothelial cell NADPH oxidase, protein kinase Cα (PKCα), and protein tyrosine phosphatase 1B (PTP1B), activates endothelial cell ERK1/2. Inhibition of these signals blocked VCAM-1 activation of ERK1/2, indicating that ERK1/2 is activated downstream of PTP1B during VCAM-1 signaling. Furthermore, VCAM-1-specific leukocyte migration under physiological laminar flow of 2 dynes/cm(2) was blocked by pretreatment of endothelial cells with dominant-negative ERK2 K52R or the MEK/ERK inhibitors, PD98059 and U0126, indicating for the first time that ERK regulates VCAM-1-dependent leukocyte transendothelial migration.

CONCLUSIONS/SIGNIFICANCE

VCAM-1 activation of endothelial cell NADPH oxidase/PKCα/PTP1B induces transient ERK1/2 activation that is necessary for VCAM-1-dependent leukocyte TEM.

Cortical microhemorrhages cause local inflammation but do not trigger widespread dendrite degeneration

Microhemorrhages are common in the aging brain, and their incidence is correlated with increased risk of neurodegenerative disease. Past work has shown that occlusion of individual cortical microvessels as well as large-scale hemorrhages can lead to degeneration of neurons and increased inflammation. Using two-photon excited fluorescence microscopy in anesthetized mice, we characterized the acute and chronic dynamics of vessel bleeding, tissue compression, blood flow change, neural degeneration, and inflammation following a microhemorrhage caused by rupturing a single penetrating arteriole with tightly-focused femtosecond laser pulses. We quantified the extravasation of red blood cells (RBCs) and blood plasma into the brain and determined that the bleeding was limited by clotting. The vascular bleeding formed a RBC-filled core that compressed the surrounding parenchymal tissue, but this compression was not sufficient to crush nearby brain capillaries, although blood flow speeds in these vessels was reduced by 20%. Imaging of cortical dendrites revealed no degeneration of the large-scale structure of the dendritic arbor up to 14 days after the microhemorrhage. Dendrites close to the RBC core were displaced by extravasating RBCs but began to relax back one day after the lesion. Finally, we observed a rapid inflammatory response characterized by morphology changes in microglia/macrophages up to 200 µm from the microhemorrhage as well as extension of cellular processes into the RBC core. This inflammation persisted over seven days. Taken together, our data suggest that a cortical microhemorrhage does not directly cause significant neural pathology but does trigger a sustained, local inflammatory response.

Two-photon microscopy of cortical NADH fluorescence intensity changes: correcting contamination from the hemodynamic response

Quantification of nicotinamide adenine dinucleotide (NADH) changes during functional brain activation and pathological conditions provides critical insight into brain metabolism. Of the different imaging modalities, two-photon laser scanning microscopy (TPLSM) is becoming an important tool for cellular-resolution measurements of NADH changes associated with cellular metabolic changes. However, NADH fluorescence emission is strongly absorbed by hemoglobin. As a result, in vivo measurements are significantly affected by the hemodynamics associated with physiological and pathophysiological manipulations. We model NADH fluorescence excitation and emission in TPLSM imaging based on precise maps of cerebral microvasculature. The effects of hemoglobin optical absorption and optical scattering from red blood cells, changes in blood volume and hemoglobin oxygen saturation, vessel size, and location with respect to imaging location are explored. A simple technique for correcting the measured NADH fluorescence intensity changes is provided, with the utilization of a parallel measurement of a physiologically inert fluorophore. The model is applied to TPLSM measurements of NADH fluorescence intensity changes in rat somatosensory cortex during mild hypoxia and hyperoxia. The general approach of the correction algorithm can be extended to other TPLSM measurements, where changes in the optical properties of the tissue confound physiological measurements, such as the detection of calcium dynamics.

In vivo photoacoustic and photothermal cytometry for monitoring multiple blood rheology parameters

Alterations of blood rheology (hemorheology) are important for the early diagnosis, prognosis, and prevention of many diseases, including myocardial infarction, stroke, sickle cell anemia, thromboembolism, trauma, inflammation, and malignancy. However, real-time in vivo assessment of multiple hemorheological parameters over long periods of time has not been reported. Here, we review the capabilities of label-free photoacoustic (PA) and photothermal (PT) flow cytometry for dynamic monitoring of hemorhelogical parameters in vivo which we refer to as photoacoustic and photothermal blood rheology. Using phenomenological models, we analyze correlations between both PT and PA signal characteristics in the dynamic modes and following determinants of blood rheology: red blood cell (RBC) aggregation, deformability, shape (e.g., as in sickle cells), intracellular hemoglobin distribution, individual cell velocity, hematocrit, and likely shear rate. We present ex vivo and in vivo experimental verifications involving high-speed PT imaging of RBCs, identification of sickle cells in a mouse model of human sickle cell disease and in vivo monitoring of complex hemorheological changes (e.g., RBC deformability, hematocrit and RBC aggregation). The multi-parameter platform that integrates PT, PA, and conventional optical techniques has potential for translation to clinical applications using safe, portable, laser-based medical devices for point-of-care screening of disease progression and therapy efficiency.

Error in noninvasive spectrophotometric measurement of blood hemoglobin concentration under conditions of blood loss

This paper discusses a current misinterpretation between different parameters of hemoglobin concentration measurement and its amplification under conditions of blood loss. The paper details the distinction between microcirculatory hematocrit and the hematocrit of the macrocirculation to analyze clinical use of real-time patient hemoglobin concentration measurement by noninvasive point-of-care devices such as the Rainbow Pulse CO-Oximetry™ (Masimo Corp., Irvine, CA). The hemoglobin concentration or hematocrit values have clinical significance such as for diagnosing anemia or as indicators to when a blood transfusion is needed. The device infers hemoglobin concentration from spectrophotometry of the fingertip and therefore the measured absorption is due to hemoglobin present in capillaries as well as in larger vessels, and the device accordingly reports the hemoglobin concentration as 'total hemoglobin' in a proprietary SpHb parameter. SpHb and macro hemoglobin concentration are different parameters. However, the numerical resemblance of SpHb values to values of macro hemoglobin concentrations, combined with the widely used unspecified term "Hb" in the medical setting, suggests that SpHb values are often interpreted by the clinician as macro hematocrit values. The claim of this paper is that under conditions of blood loss the portion of the SpHb total hemoglobin measure that is contributed from microcirculation increases, due to the decrease of macro hematocrit while microcirculatory hematocrit remains constant when above a critical value. The device is calibrated from phlembotomy drawn blood (from a vein in the arm), which is the gold standard in blood collection, and hence this changing contribution of microcirculatory hemoglobin to the SpHb value would distort the gap between macro hemoglobin and total hemoglobin, SpHb. The hypothesis is that if clinicians indeed interpret the SpHb values as macro hemoglobin values then there is an unreported discrepancy between SpHb to macro hemoglobin concentrations during blood loss due to the increasing effect of microcirculatory hemoglobin measurement on the mixed parameter, SpHb.

Ultrahigh sensitive optical microangiography reveals depth-resolved microcirculation and its longitudinal response to prolonged ischemic event within skeletal muscles in mice

The primary pathophysiology of peripheral arterial disease is associated with impaired perfusion to the muscle tissue in the lower extremities. The lack of effective pharmacologic treatments that stimulate vessel collateralization emphasizes the need for an imaging method that can be used to dynamically visualize depth-resolved microcirculation within muscle tissues. Optical microangiography (OMAG) is a recently developed label-free imaging method capable of producing three-dimensional images of dynamic blood perfusion within microcirculatory tissue beds at an imaging depth of up to ∼2 mm, with an unprecedented imaging sensitivity of blood flow at ∼4 μm∕s. In this paper, we demonstrate the utility of OMAG in imaging the detailed blood flow distributions, at a capillary-level resolution, within skeletal muscles of mice. By use of the mouse model of hind-limb ischemia, we show that OMAG can assess the time-dependent changes in muscle perfusion and perfusion restoration along tissue depth. These findings indicate that OMAG can represent a sensitive, consistent technique to effectively study pharmacologic therapies aimed at promoting the growth and development of collateral vessels.

Engineering the Lymphatic System

The recent advances in our understanding of lymphatic physiology and the role of the lymphatics in actively regulating fluid balance, lipid transport, and immune cell trafficking has been furthered in part through innovations in imaging, tissue engineering, quantitative biology, biomechanics, and computational modeling. Interdisciplinary and bioengineering approaches will continue to be crucial to the progression of the field, given that lymphatic biology and function are intimately woven with the local microenvironment and mechanical loads experienced by the vessel. This is particularly the case in lymphatic diseases such as lymphedema where the microenvironment can be drastically altered by tissue fibrosis and adipocyte accumulation. In this review we will highlight contributions engineering and mechanics have made to lymphatic physiology and will discuss areas that will be important for future research.

Hemorheology and microvascular disorders

The present review presents basic concepts of blood rheology related to vascular diseases. Blood flow in large arteries is dominated by inertial forces exhibited at high flow velocities, while viscous forces (i.e., blood rheology) play an almost negligible role. When high flow velocity is compromised by sudden deceleration as at a bifurcation, endothelial cell dysfunction can occur along the outer wall of the bifurcation, initiating inflammatory gene expression and, through mechanotransduction, the cascade of events associated with atherosclerosis. In sharp contrast, the flow of blood in microvessels is dominated by viscous shear forces since the inertial forces are negligible due to low flow velocities. Shear stress is a critical parameter in microvascular flow, and a force-balance approach is proposed for determining microvascular shear stress, accounting for the low Reynolds numbers and the dominance of viscous forces over inertial forces. Accordingly, when the attractive forces between erythrocytes (represented by the yield stress of blood) are greater than the shear force produced by microvascular flow, tissue perfusion itself cannot be sustained, leading to capillary loss. The yield stress parameter is presented as a diagnostic candidate for future clinical research, specifically, as a fluid dynamic biomarker for microvascular disorders. The relation between the yield stress and diastolic blood viscosity (DBV) is described using the Casson model for viscosity, from which one may be able determine thresholds of DBV where the risk of microvascular disorders is high.

Stiffness and heterogeneity of the pulmonary endothelial glycocalyx measured by atomic force microscopy

The mechanical properties of endothelial glycocalyx were studied using atomic force microscopy with a silica bead (diameter ∼18 μm) serving as an indenter. Even at indentations of several hundred nanometers, the bead exerted very low compressive pressures on the bovine lung microvascular endothelial cell (BLMVEC) glycocalyx and allowed for an averaging of stiffness in the bead-cell contact area. The elastic modulus of BLMVEC glycocalyx was determined as a pointwise function of the indentation depth before and after enzymatic degradation of specific glycocalyx components. The modulus-indentation depth profiles showed the cells becoming progressively stiffer with increased indentation. Three different enzymes were used: heparinases III and I and hyaluronidase. The main effects of heparinase III and hyaluronidase enzymes were that the elastic modulus in the cell junction regions increased more rapidly with the indentation than in BLMVEC controls, and that the effective thickness of glycocalyx was reduced. Cytochalasin D abolished the modulus increase with the indentation. The confocal profiling of heparan sulfate and hyaluronan with atomic force microscopy indentation data demonstrated marked heterogeneity of the glycocalyx composition between cell junctions and nuclear regions.

Optical coherence tomography for the quantitative study of cerebrovascular physiology

Doppler optical coherence tomography (DOCT) and OCT angiography are novel methods to investigate cerebrovascular physiology. In the rodent cortex, DOCT flow displays features characteristic of cerebral blood flow, including conservation along nonbranching vascular segments and at branch points. Moreover, DOCT flow values correlate with hydrogen clearance flow values when both are measured simultaneously. These data validate DOCT as a noninvasive quantitative method to measure tissue perfusion over a physiologic range.

Characterization of single-file flow through human retinal parafoveal capillaries using an adaptive optics scanning laser ophthalmoscope

Adaptive Optics Scanning Laser Ophthalmoscopy was used to noninvasively acquire videos of single-file flow through live human retinal parafoveal capillaries. Videos were analyzed offline to investigate capillary flow dynamics. Certain capillaries accounted for a clear majority of leukocyte traffic (Leukocyte-Preferred-Paths, LPPs), while other capillaries primarily featured plasma gap flow (Plasma-Gap-Capillaries, PGCs). LPPs may serve as a protective mechanism to prevent inactivated leukocytes from entering exchange capillaries, and PGCs may serve as relief valves to minimize flow disruption due to the presence of a leukocyte in a neighboring LPP.

Migration and fractionation of deformable particles in microchannel

The complexity of the coupling between soft particle deformation and fluid perturbation has limited studies of soft particle hydrodynamics to dilute suspensions. A hybrid Brownian dynamics-lattice Boltzmann method is presented that models nondilute soft spherical deformable particle (DP) suspensions in flow. Dependences on particle size and density are investigated for suspensions with over 100 DP. Multi-DP interactions lead to complex dependence of particle distributions on concentration and flow rate. Flow-induced DP migration toward channel center for DP in narrow channels is found. In wide channels, off-center peaks in the center of mass distribution for DP are found. The migration of DP leads to faster average speed of DP than the flow, which can be exploited for fractionating DPs of different sizes.

In vivo optical imaging of revascularization after brain trauma in mice

Revascularization following brain trauma is crucial to the repair process. We used optical micro-angiography (OMAG) to study endogenous revascularization in living mice following brain injury. OMAG is a volumetric optical imaging method capable of in vivo mapping of localized blood perfusion within the scanned tissue beds down to capillary level imaging resolution. We demonstrated that OMAG can differentiate revascularization progression between traumatized mice with and without soluble epoxide hydrolase (sEH) gene deletion. The time course of revascularization was determined from serial imaging of the traumatic region in the same mice over a one-month period of rehabilitation. Restoration of blood volume at the lesion site was more pronounced in sEH knockout mice than in wild-type mice as determined by OMAG. These OMAG measurements were confirmed by histology and showed that the sEH knockout effect may be involved in enhancing revascularization. The correlation of OMAG with histology also suggests that OMAG is a useful imaging tool for real-time in vivo monitoring of post-traumatic revascularization and for evaluating agents that inhibit or promote endogenous revascularization during the recovery process in small rodents.

Cerebral blood flow modeling in primate cortex

We report new results on blood flow modeling over large volumes of cortical gray matter of primate brain. We propose a network method for computing the blood flow, which handles realistic boundary conditions, complex vessel shapes, and complex nonlinear blood rheology. From a detailed comparison of the available models for the blood flow rheology and the phase separation effect, we are able to derive important new results on the impact of network structure on blood pressure, hematocrit, and flow distributions. Our findings show that the network geometry (vessel shapes and diameters), the boundary conditions associated with the arterial inputs and venous outputs, and the effective viscosity of the blood are essential components in the flow distribution. In contrast, we show that the phase separation effect has a minor function in the global microvascular hemodynamic behavior. The behavior of the pressure, hematocrit, and blood flow distributions within the network are described through the depth of the primate cerebral cortex and are discussed.

Simulation study of brain blood flow regulation by intra-cortical arterioles in an anatomically accurate large human vascular network: Part I: methodology and baseline flow

Hemodynamically based functional neuroimaging techniques, such as BOLD fMRI and PET, provide indirect measures of neuronal activity. The quantitative relationship between neuronal activity and the measured signals is not yet precisely known, with uncertainties remaining about the relative contribution by their metabolic and hemodynamic components. Empirical observations have demonstrated the importance of the latter component and suggested that micro-vascular anatomy has a potential influence. The recent development of a 3D computer-assisted method for micro-vascular cerebral network analysis has produced a large quantitative library on the microcirculation of the human cerebral cortex (Cassot et al., 2006), which can be used to investigate the hemodynamic component of brain activation through fluid dynamic modeling. For this purpose, we perform the first simulations of blood flow in an anatomically accurate large human intra-cortical vascular network (~10000 segments), using a 1D non-linear model taking account of the complex rheological properties of blood flow in microcirculation. This model predicts blood pressure, blood flow and hematocrit distributions, as well as volumes of functional vascular territories, and regional flow at voxel and network scales. First, the influence of the prescribed boundary conditions (BCs) on the baseline flow structure is investigated, highlighting relevant lower- and upper-bound BCs. Independent of these BCs, large heterogeneities of baseline flow from vessel to vessel and from voxel to voxel, are demonstrated. These heterogeneities are controlled by the architecture of the intra-cortical vascular network. In particular, a correlation between the blood flow and the proportion of vascular volume occupied by arterioles or venules, at voxel scale, is highlighted. Then, the extent of venous contamination downstream to the sites of neuronal activation is investigated, demonstrating a linear relationship between the catchment surface of the activated area and the diameter of the intra-cortical draining vein.

Label-free in vivo optical imaging of functional microcirculations within meninges and cortex in mice

Abnormal microcirculation within meninges is common in many neurological diseases. There is a need for an imaging method that is capable of monitoring dynamic meningeal microcirculations, preferably decoupled from cortical blood flow. Optical microangiography (OMAG) is a recently developed label-free imaging method capable of producing 3D images of dynamic blood perfusion within micro-circulatory tissue beds at an imaging depth up to ∼2 mm, with an unprecedented imaging sensitivity to blood flow at ∼4 μm/s. In this paper, we demonstrate the utility of OMAG in imaging the detailed blood flow distributions, at a capillary level resolution, within the meninges and cortex in mice with the cranium left intact. Using a thrombotic mouse model, we show that the OMAG can yield longitudinal measurements of meningeal vascular responses to the insult and can decouple these responses from those in the cortex, giving valuable information regarding the localized hemodynamics along with the dynamic formation of thrombotic event. The results indicate that OMAG can be a useful tool to study therapeutic strategies in preclinical animal models in order to mitigate various pathologies that are mainly related to the meningeal circulations.

Imaging retinal blood flow with laser speckle flowmetry

Laser speckle flowmetry (LSF) was initially developed to measure blood flow in the retina. More recently, its primary application has been to image baseline blood flow and activity-dependent changes in blood flow in the brain. We now describe experiments in the rat retina in which LSF was used in conjunction with confocal microscopy to monitor light-evoked changes in blood flow in retinal vessels. This dual imaging technique permitted us to stimulate retinal photoreceptors and measure vessel diameter with confocal microscopy while simultaneously monitoring blood flow with LSF. We found that a flickering light dilated retinal arterioles and evoked increases in retinal blood velocity with similar time courses. In addition, focal light stimulation evoked local increases in blood velocity. The spatial distribution of these increases depended on the location of the stimulus relative to retinal arterioles and venules. The results suggest that capillaries are largely unresponsive to local neuronal activity and that hemodynamic responses are mediated primarily by arterioles. The use of LSF to image retinal blood flow holds promise in elucidating the mechanisms mediating functional hyperemia in the retina and in characterizing changes in blood flow that occur during retinal pathology.

Mechanobiology and the microcirculation: cellular, nuclear and fluid mechanics

Endothelial cells are stimulated by shear stress throughout the vasculature and respond with changes in gene expression and by morphological reorganization. Mechanical sensors of the cell are varied and include cell surface sensors that activate intracellular chemical signaling pathways. Here, possible mechanical sensors of the cell including reorganization of the cytoskeleton and the nucleus are discussed in relation to shear flow. A mutation in the nuclear structural protein lamin A, related to Hutchinson-Gilford progeria syndrome, is reviewed specifically as the mutation results in altered nuclear structure and stiffer nuclei; animal models also suggest significantly altered vascular structure. Nuclear and cellular deformation of endothelial cells in response to shear stress provides partial understanding of possible mechanical regulation in the microcirculation. Increasing sophistication of fluid flow simulations inside the vessel is also an emerging area relevant to the microcirculation as visualization in situ is difficult. This integrated approach to study--including medicine, molecular and cell biology, biophysics and engineering--provides a unique understanding of multi-scale interactions in the microcirculation.

Label-free and highly sensitive optical imaging of detailed microcirculation within meninges and cortex in mice with the cranium left intact

We demonstrate for the first time that the detailed blood flow distribution within intracranial dura mater and cortex can be visualized by an ultrahigh sensitive optical microangiography (UHS-OMAG). The study uses an UHS-OMAG system operating at 1310 nm with an imaging speed at 150 frames per second that requires approximately 10 s to complete one 3-D scan of approximately 2.5 x 2.5 mm(2). The system is sensitive to blood flow with a velocity ranging from approximately 4 microms to approximately 23 mms. We show superior performance of UHS-OMAG in providing functional images of capillary level microcirculation within meninges in mice with the cranium left intact, the results of which correlate well with the standard dural histopathology.

[Microcirculatory alterations in critically ill patients: pathophysiology, monitoring and treatments]

Microcirculation represents a complex system devoted to provide optimal tissue substrates and oxygen. Therefore, pathophysiological and technological knowledge developments tailored for capillary circulation analysis should generate major advances for critically ill patients' management. In the future, microcirculatory monitoring in several critical care situations will allow recognition of macro-microcirculatory decoupling, and, hopefully, it will promote the use of treatments aimed at preserving tissue oxygenation and substrate delivery.

Special Edition of Microcirculation Commemorating the 50th Anniversary of the Microcirculatory Society, Inc

This special edition of Microcirculation brings together the proceedings from the Symposium held in the spring of 2004 in the Natcher Auditorium on the campus of the National Institutes of Health to commemorate the 50th Anniversary of the Microcirculatory Society, Inc. Twelve brief reviews are introduced with the goals being to present a collective sense of the history of research in microcirculation, provide insight into where established topics of inquiry stand today, and to define emerging topics of investigation for future research efforts.

Neuroimaging in assessment of risk of stroke in children with sickle cell disease

PURPOSE

Stroke and subclinical "silent infarcts" are major causes of morbidity in children with Sickle Cell Disease (SCD). Ischemic strokes are more common in younger children while hemorrhagic strokes are more frequent in adults. The goal of neuroimaging in acute stroke is to document whether the stroke is ischemic or hemorrhagic, to assess the extent of parenchymal abnormalities and to determine the presence of other cerebrovascular lesions. Computed Tomography (CT) is the primary modality for the assessment of acute stroke patients because of its 24/7 availability and ability to exclude hemorrhagic causes. Magnetic resonance imaging (MRI) and MR angiography (MRA) are recommended to determine precisely extent of infarction and detect cerebrovascular abnormalities. The goal of neuroimaging in patients with hemorrhagic stroke is to identify an arteriovenous malformation or aneurysm(s) amenable to surgery or catheter intervention.The risk of first stroke is very high in asymptomatic children with intracranial arterial mean velocities over 200 cm/s on transcranial Doppler (TCD) examination. The risk can be substantially reduced if chronic blood transfusions are timely implemented. Large cerebral vessel disease detected by TCD can be confirmed or excluded by MRI/MRA. Those with evidence of parenchymal and/or cerebrovascular lesions should be followed by preventive therapy. In patients with neurologic symptoms and negative MRI/MRA findings Positron Emission Tomography or single photon emission CT is recommended. There are no specific neuroimaging findings that suggest that blood transfusions can be safely halted in children with SCD.

Differential effect of high dietary fat intakes on haemorheological parameters in rats

High dietary intake of fats has been thought to be one of the major risk factors for the development of CVD. Less is known about the possible influence of fats from various sources on haemorheological abnormalities, which are considered an important factor in the pathogenesis of these diseases. The goal of the present study was to investigate effects of high-fat diets enriched in unsaturated fatty acids (USFA), SFA or trans-fatty acids (TFA), respectively, on haemorheological parameters in rats. Wistar female rats were divided into four groups and fed diets based on the AIN-93M formulation containing approximately 10 % energy from soyabean oil (control group) or 40 % energy from soyabean oil (USFA), palm oil (SFA) and vegetable shortening (TFA) for 8 weeks. The results showed that rats fed high-fat diets exhibited significant increases in serum TAG levels (P < 0.01), plasma viscosity (P < 0.01), whole blood viscosity (P < 0.01) and internal viscosity (P < 0.01) compared to the controls. The TFA group showed a significant decrease in erythrocyte deformability (P < 0.01) and increase in internal viscosity (P < 0.01) compared with the other groups. In addition, a significant increase in blood levels of free radicals (P < 0.01) was found in the TFA group, suggesting that the attack of oxygen-free radicals could be responsible for the impaired erythrocyte deformability. These impairments could be partly responsible for the development of various circulatory disorders. The present haemorheological study provides additional insights into the potential adverse effects of trans-fat and high-fat diets on haemorheological parameters.

Micro-PTV measurement of the fluid shear stress acting on adherent leukocytes in vivo

Leukocyte adhesion is determined by the balance between molecular adhesive forces and convective dispersive forces. A key parameter influencing leukocyte adhesion is the shear stress acting on the leukocyte. This measure is indispensable for determining the molecular bond forces and estimating cell deformation. To experimentally determine this shear stress, we used microparticle tracking velocimetry analyzing more than 24,000 images of 0.5 microm fluorescent microbeads flowing within mildly inflamed postcapillary venules of the cremaster muscle in vivo. Green fluorescent protein, expressed under the lysozyme-M promoter, made leukocytes visible. After applying stringent quality criteria, 3 of 69 recordings were fully analyzed. We show that endothelial cells, but not leukocytes, are covered by a significant surface layer. The wall shear rate is nearly zero near the adherent arc of each leukocyte and reaches a maximum at the apex. This peak shear rate is 2-6-fold higher than the wall shear rate in the absence of a leukocyte. Microbead trajectories show a systematic deviation toward and away from the microvessel axis upstream and downstream from the leukocyte, respectively. The flow field around adherent leukocytes in vivo allows more accurate estimates of bond forces in rolling and adherent leukocytes and improved modeling studies.

Blood vessel remodeling in pig ovarian follicles during the periovulatory period: an immunohistochemistry and SEM-corrosion casting study

BACKGROUND

The present research aims to describe the process of vascular readjustment occurring in pig ovary during the periovulatory phase (from LH surge to ovulation) that drives the transformation of the follicle, a limited blood supplied structure, into the corpus luteum, a highly vascularised endocrine gland required to maintain high levels of progesterone in pregnancy. The swine model was chosen because it is characterized by a long periovulatory window (about 40-44 hrs-similar to human) that permits to recover follicles at a precise endocrinological timing.

METHODS

By validated hormonal protocol (eCG+hCG), able to mimic the physiologic gonadotropin stimulation, preovulatory follicles (PreOFs, 60 h-eCG), follicles in the middle (early periovulatory follicles, EPerOFs, 18 h-hCG) or late (LPerOFs, 36 h-hCG) periovulatory phase were isolated from prepubertal gilts. To understand the angiogenic process, morphological/morphometrical analyses were performed by combining immunohistochemistry (IHC) and SEM of vascular corrosion casts (VCC) techniques.

RESULTS

PreOFs showed a vascular plexus with proliferating endothelial cells (EPI). This plexus was characterized by a dense inner capillary network, with angiogenic figures, connected to the outer network by anastomotic vessels (arterioles and venules of the middle network). EPerOFs decreased their EPI, blood vessel extension in the outer network, and evidenced a reduced compactness of blood vessels. In LPerOFs, a rapid neovascularization was associated to an intensive tissue remodeling: the follicle acquired an undulated aspect presenting arterioles/venules near the basal membrane, increased vascular extension by EPI, sprouting and non-sprouting angiogenesis.The analysis of vascular geometric relations and branching angles evidenced similar values at all stages.

CONCLUSION

These data allow us to hypothesize that EPerOFs are in a quiescent status. LPerOFs represent the "metamorphic" follicles that rapidly turn-on angiogenesis to sustain a successful corpus luteum formation. Particularly, it is interesting to underlie that the non-sprouting angiogenesis, typical of structures in rapid neovascularization, occurred only in the LPerOFs. Moreover, vascular geometric relations showed as blood vessel remodeling occurs with the "maximum output and the minimum energetic expense".This knowledge will allow to better understand the mechanisms regulating the reproductive success and to clarify the complex physiological angiogenic process in adult tissues.

Microcirculatory parameters after isotonic and hypertonic colloidal fluid resuscitation in acute hemorrhagic shock

BACKGROUND

Volume resuscitation is one of the primary therapeutic goals in hemorrhagic shock, but data on microcirculatory effects of different colloidal fluid resuscitation regimen are sparse. We investigated sublingual mucosal microcirculatory parameters during hemorrhage and after fluid resuscitation with gelatin, hydroxyethyl starch, or hypertonic saline and hydroxyethyl starch in pigs.

METHODS

To induce hemorrhagic shock, 60% of calculated blood volume was withdrawn. Microvascular blood flow was assessed by laser Doppler velocimetry. Microcirculatory hemoglobin oxygen saturation was measured with a tissue reflectance spectrophotometry, and side darkfield imaging was used to visualize the microcirculation and to quantify the flow quality. Systemic hemodynamic variables, systemic acid base and blood gas variables, and lactate measurements were recorded. Measurements were performed at baseline, after hemorrhage, and after fluid resuscitation with a fixed volume regimen.

RESULTS

Systemic hemodynamic parameters returned or even exceeded to baseline values in all three groups after fluid resuscitation, but showed significantly higher filling pressures and cardiac output values in animals treated with isotonic colloids. Microcirculatory parameters determined in gelatin and hydroxyethyl starch resuscitated animals, and almost all parameters except microvascular hemoglobin oxygen saturation in animals treated with hypertonic saline and hydroxyethyl starch, were restored after treatment.

DISCUSSION

Hemorrhaged pigs can be hemodynamically stabilized with either isotonic or hypertonic colloidal fluids. The main finding is an adequate restoration of sublingual microcirculatory blood flow and flow quality in all three study groups, but only gelatin and hydroxyethyl starch improved microvascular hemoglobin oxygen saturation, indicating some inadequate oxygen supply/demand ratio maybe due to a better restoration of systemic hemodynamics in isotonic colloidal resuscitated animals.

The endothelial glycocalyx mediates shear-induced changes in hydraulic conductivity

Recent in vitro and in vivo studies have reported fluid shear stress-induced increases in endothelial layer hydraulic conductivity (L(p)) that are mediated by an increased production of nitric oxide (NO). Other recent studies have shown that NO induction by shear stress is mediated by the glycocalyx that decorates the surface of endothelial cells. Here we find that a selective depletion of the major components of the glycocalyx with enzymes can block the shear stress-induced response of L(p). Heparinase and hyaluronidase block shear-induced increases in L(p), which is consistent with their effects on NO production. But chondroitinase, which does not suppress shear-induced NO production, also inhibits shear-induced L(p). A further surprise is that treatment with the general proteolytic enzyme pronase does not suppress the shear L(p) response. We also find that heparinase does not alter baseline L(p) significantly, whereas chondroitinase, hyaluronidase, and pronase increase it significantly.

Oxygen advection and diffusion in a three- dimensional vascular anatomical network

There is an increasing need for quantitative and computationally affordable models for analyzing tissue metabolism and hemodynamics in microvascular networks. In this work, we develop a hybrid model to solve for the time-varying oxygen advection-diffusion equation in the vessels and tissue. To obtain a three-dimensional temporal evolution of tissue oxygen concentration for realistic complex vessel networks, we used a graph-based advection model combined with a finite-element based diffusion model and an implicit time-advancing scheme. We validated this algorithm for both static and dynamic conditions. We also applied it to a complex vascular network obtained from a rodent somatosensory cortex. Qualitative agreement was found with in-vivo experiments.