The Human Microcirculation Regulation of Flow and Beyond Circ Res
Date
01/08/2016Abstract
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
David D. Gutterman, Dawid S. Chabowski, Andrew O. Kadlec, Matthew J. Durand, Julie K. Freed, Karima Ait-Aissa, Andreas M. BeyerAuthor
Matt Durand PhD Associate Professor in the Physical Medicine and Rehabilitation department at Medical College of WisconsinView Online