The Human Microcirculation: Regulation of Flow and Beyond. Circ Res 2016 Jan 08;118(1):157-72
Date
02/04/2016Pubmed ID
26837746Pubmed Central ID
PMC4742348DOI
10.1161/CIRCRESAHA.115.305364Scopus ID
2-s2.0-84954534623 (requires institutional sign-in at Scopus site) 255 CitationsAbstract
The microcirculation is responsible for orchestrating adjustments in vascular tone to match local tissue perfusion with oxygen demand. Beyond this metabolic dilation, the microvasculature plays a critical role in modulating vascular tone by endothelial release of an unusually diverse family of compounds including nitric oxide, other reactive oxygen species, and arachidonic acid metabolites. Animal models have provided excellent insight into mechanisms of vasoregulation in health and disease. However, there are unique aspects of the human microcirculation that serve as the focus of this review. The concept is put forth that vasculoparenchymal communication is multimodal, with vascular release of nitric oxide eliciting dilation and preserving normal parenchymal function by inhibiting inflammation and proliferation. Likewise, in disease or stress, endothelial release of reactive oxygen species mediates both dilation and parenchymal inflammation leading to cellular dysfunction, thrombosis, and fibrosis. Some pathways responsible for this stress-induced shift in mediator of vasodilation are proposed. This paradigm may help explain why microvascular dysfunction is such a powerful predictor of cardiovascular events and help identify new approaches to treatment and prevention.
Author List
Gutterman DD, Chabowski DS, Kadlec AO, Durand MJ, Freed JK, Ait-Aissa K, Beyer AMAuthors
Andreas M. Beyer PhD Professor in the Medicine department at Medical College of WisconsinMatt Durand PhD Vice Chair, Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Julie K. Freed MD, PhD Interim Sr Associate Dean, Associate Professor in the Anesthesiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AnimalsBlood Circulation
Cardiovascular Diseases
Endothelium, Vascular
Humans
Microcirculation
Vasodilation
