Microvascular fluid exchange and the revised Starling principle
Identifieur interne : 005B14 ( Main/Exploration ); précédent : 005B13; suivant : 005B15Microvascular fluid exchange and the revised Starling principle
Auteurs : J. Rodney Levick [Royaume-Uni] ; C. Charles Michel [Royaume-Uni]Source :
- Cardiovascular Research [ 0008-6363 ] ; 2010-07-15.
Abstract
Microvascular fluid exchange (flow Jv) underlies plasma/interstitial fluid (ISF) balance and oedematous swelling. The traditional form of Starling's principle has to be modified in light of insights into the role of ISF pressures and the recognition of the glycocalyx as the semipermeable layer of endothelium. Sum-of-forces evidence and direct observations show that microvascular absorption is transient in most tissues; slight filtration prevails in the steady state, even in venules. This is due in part to the inverse relation between filtration rate and ISF plasma protein concentration; ISF colloid osmotic pressure (COP) rises as Jv falls. In some specialized regions (e.g. kidney, intestinal mucosa), fluid absorption is sustained by local epithelial secretions, which flush interstitial plasma proteins into the lymphatic system. The low rate of filtration and lymph formation in most tissues can be explained by standing plasma protein gradients within the intercellular cleft of continuous capillaries (glycocalyx model) and around fenestrations. Narrow breaks in the junctional strands of the cleft create high local outward fluid velocities, which cause a disequilibrium between the subglycocalyx space COP and ISF COP. Recent experiments confirm that the effect of ISF COP on Jv is much less than predicted by the conventional Starling principle, in agreement with modern models. Using a two-pore system model, we also explore how relatively small increases in large pore numbers dramatically increase Jv during acute inflammation.
Url:
DOI: 10.1093/cvr/cvq062
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: 004C26
- to stream Istex, to step Curation: 004C26
- to stream Istex, to step Checkpoint: 000858
- to stream Main, to step Merge: 005B69
- to stream Main, to step Curation: 005B14
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Microvascular fluid exchange and the revised Starling principle</title><author><name sortKey="Levick, J Rodney" sort="Levick, J Rodney" uniqKey="Levick J" first="J. Rodney" last="Levick">J. Rodney Levick</name></author><author><name sortKey="Michel, C Charles" sort="Michel, C Charles" uniqKey="Michel C" first="C. Charles" last="Michel">C. Charles Michel</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A2290D63624B146C12FB82C756FE627821931F5C</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1093/cvr/cvq062</idno><idno type="url">https://api.istex.fr/document/A2290D63624B146C12FB82C756FE627821931F5C/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">004C26</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">004C26</idno><idno type="wicri:Area/Istex/Curation">004C26</idno><idno type="wicri:Area/Istex/Checkpoint">000858</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">000858</idno><idno type="wicri:doubleKey">0008-6363:2010:Levick J:microvascular:fluid:exchange</idno><idno type="wicri:Area/Main/Merge">005B69</idno><idno type="wicri:Area/Main/Curation">005B14</idno><idno type="wicri:Area/Main/Exploration">005B14</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Microvascular fluid exchange and the revised Starling principle</title><author><name sortKey="Levick, J Rodney" sort="Levick, J Rodney" uniqKey="Levick J" first="J. Rodney" last="Levick">J. Rodney Levick</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Physiology, Basic Medical Sciences, St George's Hospital Medical School, London SW17 0RE</wicri:regionArea><wicri:noRegion>London SW17 0RE</wicri:noRegion></affiliation></author><author><name sortKey="Michel, C Charles" sort="Michel, C Charles" uniqKey="Michel C" first="C. Charles" last="Michel">C. Charles Michel</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Bioengineering, Imperial College, Exhibition Road, London SW7 2AZ</wicri:regionArea><wicri:noRegion>London SW7 2AZ</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Royaume-Uni</country></affiliation></author></analytic><monogr></monogr><series><title level="j">Cardiovascular Research</title><idno type="ISSN">0008-6363</idno><idno type="eISSN">1755-3245</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2010-07-15">2010-07-15</date><biblScope unit="volume">87</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="198">198</biblScope><biblScope unit="page" to="210">210</biblScope></imprint><idno type="ISSN">0008-6363</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0008-6363</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Microvascular fluid exchange (flow Jv) underlies plasma/interstitial fluid (ISF) balance and oedematous swelling. The traditional form of Starling's principle has to be modified in light of insights into the role of ISF pressures and the recognition of the glycocalyx as the semipermeable layer of endothelium. Sum-of-forces evidence and direct observations show that microvascular absorption is transient in most tissues; slight filtration prevails in the steady state, even in venules. This is due in part to the inverse relation between filtration rate and ISF plasma protein concentration; ISF colloid osmotic pressure (COP) rises as Jv falls. In some specialized regions (e.g. kidney, intestinal mucosa), fluid absorption is sustained by local epithelial secretions, which flush interstitial plasma proteins into the lymphatic system. The low rate of filtration and lymph formation in most tissues can be explained by standing plasma protein gradients within the intercellular cleft of continuous capillaries (glycocalyx model) and around fenestrations. Narrow breaks in the junctional strands of the cleft create high local outward fluid velocities, which cause a disequilibrium between the subglycocalyx space COP and ISF COP. Recent experiments confirm that the effect of ISF COP on Jv is much less than predicted by the conventional Starling principle, in agreement with modern models. Using a two-pore system model, we also explore how relatively small increases in large pore numbers dramatically increase Jv during acute inflammation.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Levick, J Rodney" sort="Levick, J Rodney" uniqKey="Levick J" first="J. Rodney" last="Levick">J. Rodney Levick</name></noRegion><name sortKey="Michel, C Charles" sort="Michel, C Charles" uniqKey="Michel C" first="C. Charles" last="Michel">C. Charles Michel</name><name sortKey="Michel, C Charles" sort="Michel, C Charles" uniqKey="Michel C" first="C. Charles" last="Michel">C. Charles Michel</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 005B14 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 005B14 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= LymphedemaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:A2290D63624B146C12FB82C756FE627821931F5C
|texte= Microvascular fluid exchange and the revised Starling principle
}}
| This area was generated with Dilib version V0.6.31. |  |