Ionic lanthanum passage across cerebral endothelium exposed to hyperosmotic arabinose

Hyperosmotic mannitol induces Src kinase-dependent phosphorylation of beta-catenin in cerebral endothelial cells

Mannitol, which is a cell-impermeable and nontoxic polyalcohol, has been shown to be a useful tool for reversible opening of the blood-brain barrier (BBB). Despite successful clinical trials, the molecular mechanism of the mannitol-induced changes in cerebral endothelial cells (CECs) are poorly understood. For our experiments, we used CECs in culture, which were treated with different, clinically relevant concentrations of mannitol. We found that mannitol induced a rapid, concentration-dependent, and reversible tyrosine phosphorylation of a broad range of proteins between 50 and 190 kDa. One of the targets of tyrosine phosphorylation turned out to be the adherens junction protein beta-catenin. Phosphorylation of beta-catenin on tyrosine residues caused its subcellular redistribution and its dissociation from cadherin and alpha-catenin as shown by coimmunoprecipitation studies. All these effects could be inhibited by the Src kinase inhibitor PP-1 but not by the Erk inhibitor U0126, the Rho kinase inhibitor Y27632, or the calcium channel blocker verapamil. Because beta-catenin is a key component of the junctional complex, its Src-mediated phpsphorylation may play an important role in the mannitol induced reversible opening of the BBB.

Cytokines, nitric oxide, and cGMP modulate the permeability of an in vitro model of the human blood-brain barrier

The endothelial cells (EC) of the microvasculature in the brain form the anatomical basis of the blood-brain barrier (BBB). In the present study, the effects of agents that modify the permeability of a well-established in vitro model of the human BBB were studied. The monolayers formed by confluent human brain microvessel endothelial cell (HBMEC) cultures are impermeable to the macromolecule tracer horseradish peroxidase (HRP) and have high electrical resistance. Exposure of HBMEC to various cytokines including TNF-alpha, IL-1beta, interferon gamma (IFN-gamma), or lipopolysaccharide (LPS) decreased transendothelial electrical resistance (TEER) mainly by increasing the permeability of the tight junctions. Primary cultures of HBMEC express endothelial nitric oxide synthase (eNOS) and produce low levels of NO. Treatment with the NO donors sodium nitroprusside (SNP) and DETA NONOate or the cGMP agonist 8-Br-cGMP significantly increased monolayer resistance. Conversely, inhibition of soluble guanylyl cyclase with ODQ rapidly decreased the resistance, and pretreatment of HBMEC with Rp-8-CPT-cGMPS, an inhibitor of cGMP-dependent protein kinase, partially prevented the 8-Br-cGMP-induced increase in resistance. Furthermore, NO donors and 8-Br-cGMP could also reverse the increased permeability of the monolayers induced by IL-1beta, IFN-gamma, and LPS. These results indicate that NO can decrease the permeability of the human BBB through a mechanism at least partly dependent on cGMP production and cGMP-dependent protein kinase activation.

Advances in osmotic opening of the blood-brain barrier to enhance CNS chemotherapy

The blood-brain barrier (BBB) to water-soluble drugs and macromolecules can be opened in vivo by infusing a hypertonic solution of arabinose or mannitol into the carotid artery for 30 sec. Opening involves widening of tight junctions between endothelial cells of the cerebrovasculature and is mediated by endothelial cell shrinkage, vascular dilatation associated with removal of water from brain, and modulation of the contractile state of the endothelial cytoskeleton and junctional proteins by increased intracellular calcium. A 10-fold increase in BBB permeability to intravascular substances, lasting about 10 min following osmotic exposure, reflects both increased diffusion and bulk fluid flow from blood into brain. Furthermore, recent evidence indicates that the duration of peak BBB opening can be extended beyond 30 min, by pre-treatment with a Na(+)/Ca(2+) channel blocker. In experimental animals, the osmotic method has been used to grant wide access to brain of water-soluble drugs, peptides, antibodies, boron compounds for neutron capture therapy, viral vectors for gene therapy and enzymes. Ongoing multi-centre clinical studies suggest that the method, when used with intra-arterially administered anticancer drugs, can prolong survival in patients with malignant brain tumours, with minimal morbidity. However, controlled clinical trials are critical to see if the osmotic procedure with intra-arterial drugs enhances survival in brain tumour patients compared with intra-arterial drug alone.

Osmotic opening of the blood-brain barrier: principles, mechanism, and therapeutic applications

1. Osmotic opening of the blood-brain barrier by intracarotid infusion of a hypertonic arabinose or mannitol solution is mediated by vasodilatation and shrinkage of cerebrovascular endothelial cells, with widening of the interendothelial tight junctions to an estimated radius of 200 A. The effect may be facilitated by calcium-mediated contraction of the endothelial cytoskeleton. 2. The marked increase in apparent blood-brain barrier permeability to intravascular substances (10-fold for small molecules) following the osmotic procedure is due to both increased diffusion and bulk fluid flow across the tight junctions. The permeability effect is largely reversed within 10 min. 3. In experimental animals, the osmotic method has been used to grant wide access to the brain of water-soluble drugs, peptides, antibodies, boron compounds for neutron capture therapy, and viral vectors for gene therapy. The method also has been used together with anticancer drugs to treat patients with metastatic or primary brain tumors, with some success and minimal morbidity.

Modulation of blood-brain barrier permeability

Genetic and other defects leading to brain changes in Down syndrome, Alzheimer disease, amyotrophic lateral sclerosis, Huntington disease, Gaucher disease, hypertension and other disorders are rapidly being identified. If brain access were possible, new candidates for gene replacement therapy, antisense oligonucleotides, immune proteins or growth factors might be used for treating these disease (Lowenstein et al., 1994; Wielbo et al., 1995). Further, a number of drugs, peptides, antibodies and biological response modifiers have proven valuable in inhibiting malignant, infectious and other pathological processes in vitro, but are unlikely to be employed clinically because of their limited access to brain.

Pathway across blood-brain barrier opened by the bradykinin agonist, RMP-7

The route taken by lanthanum (MW 139) across cerebral endothelium was delineated when the blood-brain barrier was opened by RMP-7, a novel bradykinin agonist. Balb C mice were infused through a jugular vein with LaCl3 with or without RMP-7 (5 micrograms/kg). Ten minutes later, the brains were fixed with aldehydes and processed for electron microscopy. The patency of the junctions between endothelial cells was estimated by counting the number of junctions penetrated by LaCl3. Tracer penetrated the junctions in about 25% of microvessels in vehicle infused, control mice and about 58% in the RMP-7 group, where more junctions per vessel were also penetrated. The LaCl3 then penetrated the basal lamina in about 20% of all microvessels in the RMP-7 group, versus 0.50% in the control group. From the basal lamina, the tracer entered perivascular spaces in about 13% of all microvessels in the RMP-7 group and about 0.07% in the controls. Very few endocytic pits or vesicles in the RMP-7 group were labeled, so LaCl3 did not cross endothelium by transcytosis. The increased number of tight junctions penetrated by tracer and its spread into periendothelial basal lamina and interstitial clefts indicated, therefore, a paracellular route of exudation in the RMP-7 treated animals.

A quantitative immunocytochemical study of the osmotic opening of the blood-brain barrier to endogenous albumin

The time sequence of the blood-brain barrier opening to endogenous albumin in rat brain after intracarotid infusion of hyperosmolar L(+)arabinose was studied using quantitative immunocytochemistry. Brain samples obtained 1, 5, and 30 min after insult were immersion-fixed in formaldehyde-glutaraldehyde mixture and embedded at low temperature in Lowicryl K4M. Untreated rats or rats exposed only to Ringer's solution were used as a control. Ultrathin sections were exposed to anti-rat albumin antiserum followed by protein A-gold. The density of immunosignals (gold particles per square micrometre) was recorded over four compartments: vascular lumen, endothelium, subendothelial (perivascular) space including basement membrane, and brain parenchyma (neuropil). The labelling density of the vessel lumen, containing blood plasma, was considered to represent 100% of the circulating albumin. Morphometric and statistical analysis indicated that in control animals only 0.4-0.6% of circulating albumin appears in the subendothelial space and in the basement membrane. As soon as one minute after L(+)arabinose infusion, this value increased to 3%, followed by a further increase to 25% and 56% after 5 and 30 min, respectively. A slow increase of the labelling density in the adjacent neuropil suggests that the basement membrane represents an obstacle for escaping albumin, which apparently sticks to or is trapped by this membrane. The results indicate that the applied procedure, although based on morphometric analysis of static electron micrographs can also be used for studying dynamic processes such as transvascular passage of albumin after disruption of the brain-blood barrier.

Effect of atrial natriuretic factor on permeability of the blood-cerebrospinal fluid barrier

The demonstration of 125I-labelled atrial natriuretic factor (ANF)-binding sites on choroid plexus suggests a physiological role of ANF on the blood-cerebrospinal fluid barrier. This ultrastructural study was undertaken to determine whether ANF (0.5 microgram) alters the permeability of rat blood-cerebrospinal fluid barrier under steady states. Horseradish peroxidase (HRP) was used as a marker of protein permeability and ionic lanthanum as a marker of ionic permeability. HRP was not observed in the walls of choroid plexus vessels of control rats at 3 or 6 min, while at 12 min HRP was present in vessel walls and occasionally in continuity in the adjacent intercellular space between choroidal epithelial cells. In ANF-treated rats, HRP was observed in vessel walls and in the intercellular space between the choroidal epithelial cells up to the apical tight junctions at 3 min, indicating an accelerated passage of tracer. Although HRP was never observed beyond the apical tight junctions in control or test animals, at 6 min test rats showed ionic lanthanum within these junctions in focal areas and in continuity in the adjacent ventricular cavity. These studies demonstrate that ANF causes accelerated passage of both HRP and ionic lanthanum from blood into choroid plexuses with passage of ionic lanthanum into the ventricular cavity through the apical tight junctions of choroidal epithelial cells. The latter is in keeping with the known function of ANF in regulating water and electrolyte fluxes.

Oleic acid reversibly opens the blood-brain barrier

This study examined the effect of intracarotid oleic acid infusion on blood-brain barrier permeability. Oleic acid was infused for 30 s at a rate of 6 ml/min into the right internal carotid artery at concentrations of 10(-6), 10(-5), 2 x 10(-5) and 5 10(-5) M. Extensive Evans blue-albumin extravasation was observed 15 min after the administration of 2 x 10(-5) M oleic acid. The permeability surface area product for alpha-aminoisobutyric acid (AIB), determined 1-11 min following the infusion of oleic acid was increased 10-fold following infusion of 10(-5) M oleic acid and 20-fold following the administration of 5 x 10(-5) M oleate. The blood-brain barrier opening to AIB proved to be reversible 80-90 min after the infusion of 2 x 10(-5) M oleic acid. The possible mechanisms of the oleic acid effect are discussed.

Structural and functional aspects of the interaction of inflammatory cells with the blood-brain barrier in experimental brain inflammation

Interaction between various subclasses of inflammatory cells (ICs) and endothelial cells (ECs) lining selective blood vessels of the mammalian blood-brain barrier (BBB) is an initial, important event during inflammatory conditions of the central nervous system (CNS). In this review, we will present a brief ultracytochemical and immunocytochemical assessment of our perspective on this intimate cellular interaction which has been described recently in conditions that involve immunological alterations of the BBB. We will discuss some morphological aspects of what is currently known about acute and chronic inflammatory BBB disorders that are involved in inflammatory processes. We will focus, in particular, on experimental allergic encephalomyelitis (EAE), an animal model for human multiple sclerosis (MS). Many of the past and more recent concepts found in the literature concerning IC attachment and diapedesis, as well as our own experimental efforts over more than two decades will be presented.

Transcytosis of macromolecules through the blood-brain barrier: a cell biological perspective and critical appraisal

A critical appraisal is presented of nearly two decades of research publications and review articles advocating the bidirectional transcytosis of fluid-phase molecules, most notably native horseradish peroxidase (HRP), through the normal and experimentally modified blood-brain barrier (BBB). Extracellular routes circumventing the BBB in normal and pathological states and artifact introduced in histological preparation of CNS tissue exposed to blood-borne peroxidase are emphasized. The potential for transcytosis of macromolecules entering the nonfenestrated cerebral endothelium by the processes of non-specific fluid phase endocytosis (e.g., HRP), adsorptive endocytosis (e.g., lectins) and receptor-mediated endocytosis (e.g., ligands) is analyzed in the context of the cellular secretory process and the complimentary events of endocytosis and exocytosis at the luminal and abluminal plasma membranes. Available data suggest that the cerebral endothelium is polarized with regard to endocytosis and the internalization of cell surface membrane; hence, the transcytosis of specific macromolecules through the BBB may be vectorial. If these data are correct, the blood-brain barrier is not absolute, whereas its counterpart, the brain-blood barrier, may be.

Polyamines and Ca2+ mediate hyperosmolal opening of the blood-brain barrier: in vitro studies in isolated rat cerebral capillaries

We recently presented evidence that the reversible opening of the blood-brain barrier (BBB) by the infusion of 1.6 M mannitol into the rat internal carotid artery is mediated by a rapid stimulation of ornithine decarboxylase (ODC) activity and putrescine synthesis in cerebral capillaries. We have now investigated this hypothesis further, using isolated rat cerebral capillaries as an in vitro model of the BBB. The ODC activity of cerebral capillary preparations was enriched up to 15-fold over that of the cerebral homogenate. Hyperosmolal mannitol in physiological buffer evoked a rapid (less than 15 s), concentration- and time-dependent increase in capillary ODC activity and an accumulation of putrescine and spermidine which was blocked by the specific ODC inhibitor, alpha-difluoromethylornithine (DFMO, 10 mM). Mannitol (1 M), as well as 2 M urea, evoked a two- to fivefold increase in the temperature-sensitive influx of 45Ca2+ and uptake of horseradish peroxidase (HRP) and 2-deoxy-D-[1-3H]glucose (DG), but not alpha-[1-14C]aminoisobutyrate, during a 2-min incubation. DFMO (10 mM) abolished 1 M mannitol-mediated stimulation of 45Ca2+ influx and uptake of HRP and DG, whereas 1 mM putrescine replenished capillary polyamines and reversed the DFMO effects. Mannitol (1 M)-induced stimulation of ODC activity and membrane transport processes was Ca2+-dependent and verapamil- and nisoldipine-sensitive. Phorbol myristate acetate (PMA, 10 nM), a protein kinase C activator, also evoked a two- to threefold stimulation of 45Ca2+ transport and HRP and DG uptake. This PMA effect was abolished by DFMO, suggesting involvement of rapid, ODC-controlled polyamine synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Polyamines mediate the reversible opening of the blood-brain barrier by the intracarotid infusion of hyperosmolal mannitol

The blood-brain barrier (BBB) can be opened transiently by infusing a hyperosmolal solution of a non-electrolyte into the internal carotid artery. We investigated the hypothesis that capillary polyamines and their rate-regulating synthetic enzyme, ornithine decarboxylase (ODC), may be involved in mediating BBB breakdown in this model, as they are in BBB breakdown by focal cold injury. The intracarotid infusion of 1.6 M mannitol induced a prompt (less than 2 min) increase in ODC activity and the levels of polyamines in the ipsilateral hemisphere. Isolated cerebral capillary preparations and neural elements showed similar increases in ODC activity. The rank order of increase at 2 min, ODC (170%) greater than putrescine (90%) greater than spermidine (15%) greater than spermine (7%), was consistent with an activation of the ODC-regulated pathway of polyamine synthesis. The specific ODC inhibitor alpha-difluoromethylornithine (DFMO) blocked the 1.6 M mannitol-induced increase in ODC activity and the accumulation of polyamines, and concurrently prevented BBB breakdown, monitored by transport of intravenously administered Evans blue and alpha-[3H]aminoisobutyrate into cerebral tissue. Exogenous putrescine, the product of ODC activity, replenished brain polyamines and negated DFMO protection allowing BBB breakdown by 1.6 M mannitol. These experiments support the hypothesis that BBB breakdown induced by the intracarotid infusion of hyperosmolal mannitol is mediated by rapid, ODC-regulated synthesis of microvascular polyamines. In addition, increases in ODC-controlled polyamine synthesis in nerve cells may play a significant role in the pathophysiology of the reversible neuronal dysfunction, e.g. diazepam-sensitive seizure-like activity, enhanced glucose utilization, evoked by the intracarotid infusion of hyperosmolal mannitol.

Effects of lanthanum in cellular systems. A review

Lanthanum belongs to the group of elements known as "lanthanons," which also includes cerium, europium, promethium, and thulium. It is the most electropositive element of the rare earth group, is uniformly trivalent, and is similar in its chemical properties to the alkaline earth elements. The effects of this element and its compounds on cellular systems are of considerable interest because of their increasing use in industry and as a substitute or antagonist for calcium in a variety of cellular reactions. Lanthanum is also being employed extensively in studying anatomical barriers, membrane structure, and subcellular transport systems, particularly the calcium pathway.

Kinetics and distribution volumes for tracers of different sizes in the brain plasma space

Regional brain and plasma concentrations were determined for a series of radiotracers that differ in molecular weight and size in pentobarbital-anesthetized rats at 1, 5 and 30 min after i.v. injection. The tracers, [3H]inulin (mol. wt. 5000 Da, radius 1.5 nm), 5 [3H]dextrans (10,000-200,000 Da, 2.3-9.5 nm) and [51Cr]transferrin (79,000 Da, 3.8 nm), are not taken up into erythrocytes and do not measurably cross the blood-brain barrier in 30 min. Results were expressed as a brain distribution volume, defined as (dpm/g brain)/(dpm/ml plasma). Within 1 min after injection, all tracers attained an initial distribution volume which varied regionally from 0.4 to 1.6 X 10(-2) ml/g. The volumes remained constant between 1 and 30 min for tracers with radii greater than or equal to 3.8 nm, whereas the volumes increased up to 90% for tracers with radii less than or equal to 3.1 nm. Rates of equilibration for tracers with radii less than or equal to 3.1 nm were size dependent with smaller tracers equilibrating before larger tracers. These results indicate that the brain distribution volume for plasma tracers consists of two compartments: one which is quickly filled (less than or equal to 1 min) by all tracers and comprises approximately 60% of the total volume, and one which allows only tracers with radii less than or equal to 3.1 nm and comprises 40% of the total volume. The inverse relation between the rate of equilibration in the second compartment and molecular size may indicate a diffusion limitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Sequelae of the osmotic blood-brain barrier opening in rats

Histopathological sequelae of the osmotic blood-brain barrier opening were studied in 69 adult Wistar rats sacrificed between 2 minutes and 6 days after infusion of 1.6 M mannitol into the unilateral internal carotid artery. The results were correlated with immunohistochemical localization of autologous albumin in the brain parenchyma on paraffin sections. Extravasation of serum albumin was evident in all rats, and the albumin immunoreactivity, commonly localized to the territories of the ipsilateral anterior, middle, and posterior cerebral arteries and contralateral anterior cerebral artery, showed maximum intensity in the rats sacrificed 30 minutes after infusion. The albumin immunoreactivity remained macroscopically visible in the brain parenchyma for 24 to 48 hours, and then gradually faded out. Serum extravasation was accompanied by widening of the perivascular space and focal edema, which largely subsided within 48 hours as the albumin immunoreactivity of the tissue diminished. Although no overt neurological sequelae were seen in the present experiment, minute but definite foci of infarction with focal accumulation of albumin were found in 23 (38%) of 61 rats surviving more than 30 minutes. In addition, ischemic neuronal death of delayed onset was encountered among neurons in the CA-1 region of the hippocampus, in the cerebellum, and in the thalamus in five (25%) of 20 rats sacrificed between Days 4 and 6. Thus, care should be exercised in the practice of this procedure.

Facilitation of drug entry into brain by osmotic opening of the blood-brain barrier

1. After osmotic opening, the blood-brain barrier (BBB) has been shown to reclose more rapidly to large than to small neutral, water-soluble molecules. Quantitative analysis of these data supports the creation of interendothelial pores with radii of about 200 A through which such molecules pass by both restricted diffusion and bulk flow (with solute drag) from blood to brain. 2. The major reduction in BBB permeability from 6 to 35 min following osmotic opening seems to be due to a reduction in bulk flow by a factor of about 10, rather than marked decreases in pore densities or effective pore size. On this basis, quantitative predictions of brain uptake of neutral, water soluble substances are made for various times after osmotic opening of the BBB, as a function of molecular size. 3. Implications of these results are discussed for enhancement of uptake of drugs, including enzymes and certain anti-cancer agents, by the brain. 4. The idea of a 'therapeutic window' as the period of time, following reversible osmotic opening, during which the permeability of the BBB is enhanced significantly for a particular compound, is introduced. Since the BBB is normally highly impermeable to plasma proteins, the effect of BBB opening on the uptake of highly protein-bound drugs is discussed briefly. 5. The effect of molecular charge on the passage of molecules through interendothelial pores into the brain is also discussed.

Quantitative study of microvessel ultrastructure in human peritumoral brain tissue. Evidence for a blood-brain barrier defect

The form and function of blood vessels are determined by the cells that constitute their microenvironment. Brain tissue around tumors contains varying numbers of tumor cells that could influence local capillaries to lose their blood-brain barrier (BBB), as they do in the tumor itself. Microvascular permeability cannot be measured directly in humans but can be inferred from a knowledge of vessel ultrastructure. The authors have examined the vascular ultrastructure associated with the BBB in human peritumoral brain tissue for evidence of BBB compromise and to correlate BBB features with the cellular components of the vessel microenvironment. Light microscopic examination of brain tissue samples in patients with primary brain tumors showed that the tissue lying beyond the visible edge of the tumor ranged from essentially normal to grossly infiltrated with tumor cells. Although some of the vessels were structurally normal, the microvessels as a group had elongated junctional clefts (unfused regions) and an increase in the density of endothelial vesicles. Furthermore, the cleft index (the percentage of the junctional profile that is unfused) varied directly with the local cell density. A subpopulation of vessels enveloped by a layer of tumor cells was grossly abnormal. However, vessels that were not immediately invested by tumor cells also showed some abnormalities. It is concluded that tumor cells infiltrating peritumoral brain tissue cause blood vessels to take on some of the structural characteristics of leaky vessels. Since direct contact is not required, and since the degree of abnormality correlates with the number of tumor cells in the environment, the authors suggest that this inductive influence is exerted over a distance and is dependent on the concentration of the inducing factors.

Intracarotid infusions of protamine sulfate disrupt the blood-brain barrier of rabbits

This study examined the effect of intracarotid infusions of protamine sulfate on the blood-brain barrier of the rabbit. Evans blue, which binds tightly to serum albumin, served as the marker for blood-brain barrier disruption. Brains from 12 of 14 rabbits receiving 30-50 mg of protamine sulfate in an intracarotid infusion over 3 min demonstrated intense Evans blue-albumin staining in the distribution of the infused internal carotid artery. In contrast, brains from 5 animals receiving 0.9% saline and from 5 animals receiving 50 mg of protamine sulfate by the intravenous route showed no evidence of blood-brain barrier disruption. Premixing protamine sulfate with heparin prior to intracarotid administration greatly reduced or abolished Evans blue staining of the brain as did delayed administration of the marker dye. Thus, the interaction of the positively charged protamine molecule with the vascular endothelium of cerebral capillaries transiently alters the permeability of the blood-brain barrier in the rabbit.

Interendothelial junctional changes underlie the developmental 'tightening' of the blood-brain barrier

The structural basis for the decline in non-specific permeability (tightening) of the blood-brain barrier (bbb) during development was investigated in fetal, newborn and weanling mice cerebral hemispheres. Permeability was assessed by measuring the peroxidase activity in the brain 4 h after i.p. injection of horseradish peroxidase--a commonly used vascular tracer that does not cross the intact bbb. Peroxidase activity in brain declined by about two-thirds between birth and weaning, despite increases in both circulating levels and vessel density. Morphometric analysis of the cerebral vessels showed that vesicular density was low (less than 4/micron 2 cytoplasm) at all ages examined , and therefore, is unlikely to be related to permeability changes. Interendothelial junctions changed in that the proportion of the junction composed of zonulae occludens increased, while junctional clefts decreased, and expanded junctional clefts virtually disappeared. We conclude, therefore, that junctional changes underlie the developmental tightening of the bbb. The observation that junctional changes also showed a strong inverse correlation with vessel density suggests that junctional leakiness, and therefore high non-specific permeability, may be a consequence of vessel proliferation in the developing brain.

A quantitative analysis of blood-brain barrier ultrastructure in the aging human

The unique ultrastructure of brain endothelial cells restricts nonspecific leakage of blood-borne molecules across the blood-brain barrier (bbb). Human barrier ultrastructure has not been studied extensively because of the rapid ultrastructural degeneration that takes place after death. We have obtained living, structurally normal neocortex and underlying white matter at biopsy from patients of various ages, and have quantitated ultrastructural features that are associated with the bbb so that we could characterize human barrier ultrastructure and determine whether it changes with age. We found that gray matter capillaries have thinner walls than white matter capillaries, and that during aging white matter capillary walls became thinner until they approached the dimensions of those in gray matter. Thinning is due to loss of pericytes and thinning of the endothelial cytoplasm. The mitochondrial density was found to be higher in gray matter than in white matter, but this is a consequence of there being a smaller cytoplasmic volume and not more (or larger) mitochondria. The mitochondrial population did not change with age. Presumptive nonspecific permeability routes (endothelial vesicles, junctional gaps) did not change with age; therefore we found no morphological substrate for increased nonspecific bbb permeability in the aging human. The loss of pericytes, however, suggests that the bbb in the elderly may be less able to compensate for transient leaks.

Calcium influxes into brain and cerebrospinal fluid are linearly related to plasma ionized calcium concentration

Unidirectional Ca influxes into brain and cerebrospinal fluid (CSF) were measured at different plasma concentrations of ionized Ca ([Ca]i) in pentobarbital-anesthetized rats. Plasma [Ca]i was varied acutely from 0.6 to 3.0 mumol/ml by intravenous infusion of EGTA, NaCl or CaCl2 or by thyroparathyroidectomy. Ca influx was determined from the 15-min uptake of 45Ca after intravenous injection. There were significant regional differences in 45Ca uptake into the CNS, with a approximately 20-fold greater rate into ventricular CSF than into frontal cortex. Autoradiographs of 45Ca uptake demonstrated that uptake into frontal cortex reflects primarily transport across the cerebral capillaries, whereas uptake into ventricular CSF reflects transport across the choroid plexuses. At both sites, Ca influx was a linear function of plasma [Ca]i and extrapolated to zero at [Ca]i = 0. Infusion of EGTA or CaCl2 did not alter the integrity of the blood-brain barrier, as determined by the permeability to [14C]sucrose. These results indicate that Ca influx into the CNS is not regulated by a saturable mechanism that is sensitive to acute changes in plasma [Ca]i. The proportionality between influx and concentration is suggestive of passive diffusional transport. The brain is protected from acute changes in plasma [Ca]i by the low cerebrovascular permeability to Ca, approximately 5 X 10(-8) cm/s.

Morphometric analysis of CNS microvascular endothelium

The ultrastructural features that are critical to the efficient functioning of the blood-brain barrier (b-bb) were quantified in typical barrier vessels, i.e., cerebral gray and white matter capillaries, and compared with the same parameters in cerebral nonbarrier capillaries (area postrema), and in somatic capillaries, (muscle) of the mouse. The image analysis was done with the help of a simple, rapid system that required only a digitized bit pad and a microcomputer. We found that: (1) The number of pinocytotic vesicles that are thought to be associated with vascular permeability was three times higher in area postrema vessels and nearly seven times higher in muscle vessels than in barrier vessels. (2) A percentage of interendothelial junctions in nonbarrier capillaries displayed areas of separation that may represent interendothelial channels coursing from the luminal to the abluminal surface between areas of tight junctional complexes. Such areas were not observed in barrier capillaries under the normal conditions studied here, but have been seen by others under conditions in which the barrier has been breached. (3) A 39% decrease in wall thickness in barrier capillaries. (4) No differences in mitochondrial density or in area of associated pericytes among capillaries from any region. Therefore we have questioned both the universality of the apparently increased metabolic work capacity of barrier capillaries, and whether pericytes play any role in the barrier under normal conditions.

A quantitative study of blood-brain barrier permeability ultrastructure in a new rat glioma model

Cerebral edema, a major complication of tumors in the brain, is the result of an alteration in the blood-brain barrier (B-BB). The vascular ultrastructural changes that underlie edema formation have been described in a variety of tumors. Interendothelial junction abnormalities, fenestrations, and large numbers of tubulo-vesicular profiles in the tumor vascular endothelium have been presumed to represent permeability routes that permit the escape of serum constituents into the tumor, from where they flow into the surrounding brain. Descriptive studies do not provide information on the relative frequency of these presumptive permeability routes. In the study reported here we have quantified ultrastructural features associated with the B-BB in the vessels of an experimental glioma in rat. We found that approximately 60% of the tumor vessel profiles have junctional abnormalities and 30% have one or more fenestrations. The density of tubulo-vesicular profiles, however, was not increased. In addition, tumor vessel walls were thicker than normal vessels of the same caliber and the mitochondrial density was in the range of that for non-barrier vessels. Vessels in peritumoral regions were not altered in any of the parameters measured.

Tracer study on a paracellular route in experimental hydrocephalus

Considering the possibility of a paracellular pathway for edema resolution, we studied the intracerebral movement of proteins and ionic lanthanum in rats with experimental hydrocephalus. Hydrocephalus was induced by injection of kaolin suspension into the cisterna magna. After induction of hydrocephalus, horseradish peroxidase (HRP), microperoxidase (MP), or lanthanum chloride (LaCl3) were perfused into the ventricle system. HRP and MP were localized mainly in the intercellular spaces between ependymal cells, glial cells, and in perivascular spaces and were restricted by endothelial tight junctions. Ionic lanthanum (La3+), however, penetrated these tight junctions and moved between the blood and CSF cavities by paracellular pathways. These findings indicate that in obstructive hydrocephalus, the tight junctions may constitute part of a paracellular pathway for the transendothelial movement of small solutes, although they prevent the movement of larger molecules.

Measurement of blood-brain barrier permeability with positron emission tomography and [68Ga]EDTA

Positron emission tomography (PET) was employed to examine time-dependent changes in blood-brain barrier (BBB) permeability to [68Ga]ethylenediaminetetraacetate (EDTA) in the rhesus monkey, following reversible barrier opening by intracarotid infusion of a hypertonic mannitol solution. The PET technique, when combined with measurements of plasma radioactivity, provided a quantitative measure of the cerebrovascular permeability-area product (PA) at different times following mannitol infusion. Hypertonic mannitol treatment reversibly increased PA to [68Ga]EDTA more than 10-fold; much of the barrier effect was over by 10 min after mannitol treatment. The results show that PET can be used to measure transient changes in BBB integrity in specific brain regions, under in vivo, noninvasive conditions.

Hyperosmotic arabinose solutions open the tight junctions between brain capillary endothelial cells in tissue culture

Tight junctions between bovine brain capillary endothelial cells in primary cell culture are impermeable to horseradish peroxidase (HRP) after 5 min of incubation. However, following 1-5 min of exposure to 1.6 M arabinose, HRP penetrates the extracellular space between successive tight junctions. Endothelial cells in control cultures contain a small number of cytoplasmic pits and vesicles containing HRP which do not increase in number after hyperosmotic treatment.

A possible paracellular route for the resolution of hydrocephalic edema

Considering the possibility of a paracellular route for edema resolution we studied the microvasculature of the subependymal and subcortical white matter in hydrocephalic rats. Normal adult rats were used as controls. After injection of kaolin suspension into the cisterna magna, the animals were killed at intervals of 1, 2, 4, and 8 weeks. In hydrocephalic rats at 1 week after kaolin injection, widening of the interendothelical cleft between the tight junction (dehiscence) was seen in 27 of 76 (35%) vessels. At 2 weeks after kaolin injection, the number of the dehiscences had increased (39/7:56%) and some were enlarged, forming interendothelial blisters. At 4 weeks in hydrocephalic rats, both dehiscences and blisters were still prominent (45/73:63%) and at 8 weeks the dehiscences were still prominent, but the number of the blisters had decreased (25/81:31%). The blisters and dehiscences were most pronounced in the corpus callosum and occipital regions. Following i.v. injection of horseradish peroxidase, the interendothelial dehiscences and blisters were completely devoid of the marker substance. These findings indicate that in obstructive hydrocephalus the tight junctions may constitute part of a paracellular pathway for the resorption of interstitial edema fluid.