capillary fluid exchange regulation functions and pathology pdf

Capillary fluid exchange regulation functions and pathology pdf

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Interstitium

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Influence of the Immune System on the Biological Dynamics of the Interstitial Fluid Pressure

Interstitium

The interstitium is a contiguous fluid-filled space existing between a structural barrier, such as a cell wall or the skin, and internal structures, such as organs , including muscles and the circulatory system. The non-fluid parts of the interstitium are predominantly collagen types I, III, and V, elastin , and glycosaminoglycans , such as hyaluronate and proteoglycans that are cross-linked to form a honeycomb -like reticulum. The interstitium in the submucosae of visceral organs, the dermis, superficial fascia and perivascular adventitia are fluid filled spaces supported by a collagen bundle lattice. The fluid spaces communicate with draining lymph nodes though they do not have lining cells or structures of lymphatic channels. The interstitial fluid is a reservoir and transportation system for nutrients and solutes distributing among organs, cells, and capillaries , for signaling molecules communicating between cells, and for antigens and cytokines participating in immune regulation. In people with lung diseases , heart disease, cancer , kidney disease, immune disorders , and periodontal disease , the interstitial fluid and lymph system are sites where disease mechanisms may arise or develop.

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Influence of the Immune System on the Biological Dynamics of the Interstitial Fluid Pressure

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The partition of fluid between the vascular and interstitial compartments is regulated by forces hydrostatic and oncotic operating across the microvascular walls and the surface areas of permeable structures comprising the endothelial barrier to fluid and solute exchange, as well as within the extracellular matrix and lymphatics. In addition to its role in the regulation of vascular volume, transcapillary fluid filtration also allows for continuous turnover of water bathing tissue cells, providing the medium for diffusional flux of oxygen and nutrients required for cellular metabolism and removal of metabolic byproducts. Transendothelial volume flow has also been shown to influence vascular smooth muscle tone in arterioles, hydraulic conductivity in capillaries, and neutrophil transmigration across postcapillary venules, while the flow of this filtrate through the interstitial spaces functions to modify the activities of parenchymal, resident tissue, and metastasizing tumor cells. Likewise, the flow of lymph, which is driven by capillary filtration, is important for the transport of immune and tumor cells, antigen delivery to lymph nodes, and for return of filtered fluid and extravasated proteins to the blood. Given this background, the aims of this treatise are to summarize our current understanding of the factors involved in the regulation of transcapillary fluid movement, how fluid movements across the endothelial barrier and through the interstitium and lymphatic vessels influence cell function and behavior, and the pathophysiology of edema formation.

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It is not often a textbook paradigm that has withstood time for years is put to the test. In , E.

Capillary Fluid Exchange: Regulation, Functions, and Pathology

The partition of fluid between the vascular and interstitial compartments is regulated by forces hydrostatic and oncotic operating across the microvascular walls and the surface areas of permeable structures comprising the endothelial barrier to fluid and solute exchange, as well as within the extracellular matrix and lymphatics. In addition to its role in the regulation of vascular volume, transcapillary fluid filtration also allows for continuous turnover of water bathing tissue cells, providing the medium for diffusional flux of oxygen and nutrients required for cellular metabolism and removal of metabolic byproducts. Transendothelial volume flow has also been shown to influence vascular smooth muscle tone in arterioles, hydraulic conductivity in capillaries, and neutrophil transmigration across postcapillary venules, while the flow of this filtrate through the interstitial spaces functions to modify the activities of parenchymal, resident tissue, and metastasizing tumor cells. Likewise, the flow of lymph, which is driven by capillary filtration, is important for the transport of immune and tumor cells, antigen delivery to lymph nodes, and for return of filtered fluid and extravasated proteins to the blood. Given this background, the aims of this treatise are to summarize our current understanding of the factors involved in the regulation of transcapillary fluid movement, how fluid movements across the endothelial barrier and through the interstitium and lymphatic vessels influence cell function and behavior, and the pathophysiology of edema formation.

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