Clinical Hemorheology and Microcirculation - Volume 45, issue 2-4
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Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research.
The endeavour of the Editors-in-Chief and publishers of
Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of
Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process.
Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.
The following professionals and institutions will benefit most from subscribing to
Clinical Hemorheology and Microcirculation: medical practitioners in all fields including hematology, cardiology, geriatrics, angiology, surgery, obstetrics and gynecology, ophthalmology, otology, and neurology. Pharmacologists, clinical laboratories, blood transfusion centres, manufacturing firms producing diagnostic instruments, and the pharmaceutical industry will also benefit.
Important new topics will increasingly claim more pages of
Clinical Hemorheology and Microcirculation: the role of hemorheological and microcirculatory disturbances for epidemiology and prognosis, in particular regarding cardiovascular disorders, as well as its significance in the field of geriatrics. Authors and readers are invited to contact the editors for specific information or to make suggestions.
Abstract: The flow properties of blood and its components vary widely throughout the animal kingdom. Even if nucleated avian and reptile red blood cells (RBC) are excluded from the analysis, RBC exhibit different rheological behavior among mammalian species. Both RBC aggregation and cellular deformability have been reported to vary among species, including placental mammals, marsupials, terrestrial and aquatic mammals. Although the relationships between blood flow behavior and species-specific characteristics have not been systematically investigated, studies to date allow recognition of interesting patterns, especially for RBC properties. These properties do not correlate with simple cellular parameters (e.g. mean cell volume), but more…detailed analysis of RBC structure may reveal cellular aspects (e.g. surface charge density) that can be related to rheologic behavior. It has been postulated that the athletic capacity of mammalian species may predict the aggregation behavior of their RBC, but this hypothesis has not been supported by data from a wide range of athletic and sedentary species. Aquatic mammals also exhibit a very interesting diversity of hemorheological properties, which again are not yet easily related to specific circulatory adaptations. Data from current comparative studies suggest that a better understanding of the relations between specific hemorheological properties and specific hemodynamic adaptations in a variety of species should contribute to a better understanding of circulatory behavior; future studies are thus clearly indicated.
Abstract: The vascular endothelium plays a pivotal role in modulating endothelial homeostasis. A number of methods have been developed to assess the function of this important tissue in humans in vivo, in the hope that such data may contribute to the early diagnosis and risk stratification of patients at risk for, or with, cardiovascular disease. Despite these efforts, a number of issues, both practical and theoretical, arise from the attempt of quantifying the elusive “endothelial function”, and from the attempt of defining what is “endothelial dysfunction”. The present paper, based on a lecture held at the conference of the European Society…of Hemorheology and Microcirculation, will try to deal with these issues.
Abstract: The degradation behavior and the effect on angiogenesis of multiblock copolymers based on poly(p-dioxanone)- and poly(ε-caprolactone)-segments (PDC) were studied in vivo. PDC is a multifunctional biomaterial combining degradability and shape-memory capabilities. The “in vivo” degradation of PDC is characterized by a fragmentation occurring at the material tissue interface. This observation is consistent with the enzyme supported degradation behaviour, which was determined “in vitro”. PDC revealed to induce the formation of blood micro-vessels nearby in the periimplantary tissues. Both might explain the good PDC integration into tissues in terms of a strong connection between the implant and the periimplantary tissue. Micro…blood-vessels might be involved in the clearance of the small particles, which appear in the periimplantary tissue when PDC degrades.
Abstract: Isoforms of the enzyme lactate dehydrogenase (LDH) were found in almost all cells of the organism and an elevated activity of LDH in the circulation is thought to be a clear indicator of elevated cell destruction coinciding with an increased release of components from the cellular cytoplasm, e.g. LDH. Here, we report on an in-vitro examination to test whether radiographic contrast media (RCM) could induce cell destruction followed by an increase in LDH release. The RCM were tested in non-flow cultures of human umbilical venous endothelial cells (HUVEC) of the fourth passage seeded on extracellular matrix and the results were…compared to those from control cultures not exposed to contrast media. The examination revealed that the addition of contrast media to the cell culture media supplemented with pooled human serum (HSP) as source of exogenous LDH was followed by a strong decrease in LDH activity both in the absence and presence of HUVEC. Within 1.5 min after the addition of contrast media to the culture medium supplemented with HSP (30% vol of the culture medium were replaced by either of two contrast media, Iodixanol or Iopromide) the LDH activity decreased about 80% compared to the initial values. In contrast, the LDH activity did not change in cell culture media not supplemented with RCM. The partial replacement of HSP supplemented cell culture medium by RCM will cause a dilution of cell culture medium constituents. The decrease of LDH activity, however, was much stronger than the decrease thought to be attributable to the effects of dilution of cell culture medium, so that the role of dilution seems to be a minor one in this case. It has to be assumed that the RCM could interact with the LDH available in the culture medium as well as with the substrates delivered with the measurement system for the assessment of LDH activity, so that both, the amount of LDH and the activities of enzymes involved might be influenced. In the presence of HUVEC a similar effect was observed. Here, a little less strong decrease of LDH activity occurred compared to the decrease in cell culture medium without HUVEC. This was unexpected because a considerable amount of HUVEC were detached after the addition of contrast media and many of these cells were damaged seriously so that a significant amount of endogenous LDH should have been released. These unexpected results make it necessary to re-evaluate those past time examinations focussed on cell damage/destruction in the presence of contrast media, where the measurement of LDH activity was used as indicator or cell vitality and where cell decease rates were correlated to questionable toxic influences. According to the results of the examination reported here it is difficult to uphold the interpretation of recently published findings that contrast media almost exclusively induce cellular apoptosis and not necrosis.
Abstract: The present article summarizes recent data presented at the Exercise and Hemorheology symposium during the 15th Conference of the European Society for Clinical Hemorheology and Microcirculation (June 28–July 1, Pontresina, Switzerland, 2009). The review starts with several unresolved paradoxes in exercise hemorheology. Then, we focus on the potential hemorheological and immunological mechanisms involved in the adverse events sometimes reported in exercising sickle cell trait carriers, and the role of habitual physical activity. In a fourth part, new results on the effects of acute hypoxia on blood rheology are presented. Finally, we will discuss recent experimental evidences on the role of…exercise on the regulation of nitric oxide synthesizing mechanisms in red blood cell.
Keywords: Exercise, red blood cell deformability, red blood cell NOS, sickle cell trait, hypoxia
Abstract: Elevated glucose concentration increases oxidation and Advanced Glycation End product (AGE) formation. The binding of circulatory AGEs or AGEs included in erythrocyte membrane to the receptor for AGEs (RAGE) generates in endothelial cells an oxidative stress and enhances the expression of inflammatory molecules. Engagement of RAGE by AGEs and subsequent signaling plays an important role in the development of diabetic complications. Soluble RAGE isoforms (sRAGE) neutralize the ligand-mediated damage by acting as a decoy. If the expression of RAGE is upregulated during the pathogenesis of inflammatory diseases, sRAGE mostly found decreased when complications ensue. By modulating RAGE isoform expression, it…could be possible to reduce the incidence of complications. This review focused on the capability of Angiotensin Receptor Blockers (ARBs), which are used to treat patients with hypertension and/or diabetes, to modulate RAGE isoform expression because some data reported the interference with RAGE downstream. In this regard, three ARBs – irbesartan, telmisartan, candesartan cilexetil – were tested and provided evidence for their ability to inhibit in human endothelial cells the expression of membrane-bound and soluble RAGE isoforms induced by the inflammatory factor Tumor Necrosis Factor-α (TNF-α), demonstrating the potential benefits of these molecules in RAGE-oriented therapies. Modulating RAGE isoforms expression by correcting endothelial dysfunction is achievable by drugs already used for hypertension or diabetes treatment such as ARBs.
Keywords: Receptor for advanced glycation end products (RAGE), soluble RAGE (sRAGE), oxidative stress, angiotensin receptor blocker (ARB)
Abstract: The evolution of rheological properties of erythrocytes and geometrical parameters of left ventricle during therapies aimed at reducing cardiovascular disease (CVD) risk has been investigated. The study group consisted of 29 individuals who were diagnosed with the presence of at least one CVD risk factor at the time of entry to the study. Appropriate therapies were applied and the patients were followed for two years. Two groups of patients could be distinguished. The first group consisted of 12 individuals who were rigorously applying the therapy and for whom blood pressure, total cholesterol, LDL and glucose returned to normal levels. The…second group included 17 patients for whom the above mentioned parameters remained pathological in spite of the applied therapy. In the first group, erythrocyte deformability as well as LVMI improved: deformability increased on average by 17% (p < 0.025), whereas LVMI decreased by 8% but not in a statistically significant manner (p < 0.27). In the second group, the results indicate worsening of both hemorheological properties and left ventricular geometry: RBC deformability became lower by 15% (p < 0.00001) and LVMI increased by 18% although this change was not statistically significant (p < 0.19). The results indicate that blood rheology improves when the CVD risk is reduced by administered therapy and worsens when the risk increases. Similar behavior shows LVMI. It is very likely that left ventricular geometry is influenced by blood rheology.
Keywords: Erythrocyte deformability, left ventricular geometry, CVD risk