Articles |
From the School of Animal and Microbial Sciences, University of Reading, Reading, UK.
Correspondence to Dr P.D. Weinberg, School of Animal and Microbial Sciences, University of Reading, Whiteknights PO Box 228, Reading RG6 6AJ, UK. E-mail p.d.weinberg@reading.ac.uk.
| Abstract |
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Key Words: arterial wall transport age arterial branches arterial permeability atherogenesis
| Introduction |
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Early studies investigated this hypothesis by examining the uptake of intravital dyes, but such methods may be unreliable.9 10 More recent studies have employed a range of novel techniques to quantify short-term and quasisteady state patterns of macromolecule uptake, mainly in the rabbit aorta. Almost all have shown that uptake is enhanced in areas downstream of branch ostia.11 12 13 14 15 These sites are prone to diet-induced lipid accumulation in rabbits16 but are particularly resistant to disease in adult human arteries. Consequently, the results could be construed as evidence for or against the possibility that elevated uptake leads to the development of human lesions. Furthermore, an apparently contradictory trend has been identified in a study of the rabbit aorta by Berceli et al;17 elevated uptake was seen in the outer walls of the bifurcation, a site that is susceptible to atherosclerosis in human vessels.18
In an attempt to clarify these issues, we investigated the influence of age on transport. The potential importance of age was inferred from the observation by Sinzinger et al19 that the distribution of lipid deposition in immature human aortas is the opposite of the adult pattern. Sudanophilia occurs most frequently downstream of branch ostia in these arteries. We found that although quasisteady state uptake of albumin is higher downstream than upstream of branches in immature rabbits, this difference decreases and then reverses with age.20 Thus, when age is taken into consideration, the pattern of transport in rabbit aortas does parallel the distribution of human lesions and is consistent with uptake being important in atherogenesis. The findings may also explain the apparently anomalous result of Berceli et al17 since this study, alone of those cited above, used mature rabbits.
The normal adult pattern of transport does not correlate well with the distribution of lesions in hyperlipidemic rabbits. Disease in this model seems to occur downstream of branches irrespective of age. However, we have subsequently shown that albumin transport reverts to its juvenile pattern, at least transiently, in older rabbits fed a cholesterol-enhanced diet.21
In the present study, mechanisms underlying the effects of age on quasisteady state transport were investigated. Albumin was labeled with a fluorescent dye and introduced into the circulation of normal, conscious rabbits. After 10 minutes, animals were administered an overdose of anesthetic, and their aortas were fixed in situ. Tracer uptake was subsequently assessed by applying digital imaging fluorescence microscopy to sections through branches. Such short-term transport predominantly reflects rates of influx into the wall. Variations were found that appear to account for the patterns of uptake described above and also for a decrease seen in the mean uptake shortly after weaning.20 Profiles of tracer concentration across the wall and the patterns seen in animals in which fixation was delayed give some indications about the mechanisms involved. Part of this work is described in a preliminary report.22
| Methods |
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Preparation of Tracer
Sulforhodamine B (Lissamine rhodamine,
CI 45100, Sigma) was
purified by extraction in 75% vol/vol ethanol and converted to its
sulfonyl chloride by grinding with PCl5. The sulfonyl
chloride was extracted in acetone and added to 20 times its own weight
of bovine serum albumin (fraction V, Sigma) at 2% wt/vol in
0.33 mol/L carbonate buffer, pH 9, at 4°C.25 The
resulting conjugate was purified of free dye and buffer salts by gel
filtration (Sephadex G-25, Pharmacia), frozen dropwise in liquid
nitrogen, freeze-dried, and stored at -20°C.
Just prior to use, the conjugate was reconstituted and then repurified of free dye by stirring with neutralized, activated charcoal (0.35 g/g protein) for 1 hour.25 Charcoal was removed by centrifugation (twice at 1000g for 30 minutes) and filtration (0.2-µm Minisart-plus, Sartorius). More than 99.8% of the dye, as assessed by absorbance at 575 nm, could be precipitated by trichloroacetic acid after this purification. The tracer is stable in vitro and in vivo and has similar physical, chemical, and biological properties to the unlabeled protein.11 26 27 28 29 Free dye does not bind to plasma proteins or tissue components.26
Animal Experiments
All animal procedures complied with Home
Office and local
regulations. Nineteen male New Zealand White rabbits aged 38 to 1463
days were used to assess tracer uptake or autofluorescence.
All animals had been weaned and were maintained on a standard lab diet
(200 g/d, Special Diet Services) with tap water ad libitum.
Tracer (700 mg/kg in 20 mL saline) was administered via the marginal ear vein to conscious, unrestrained animals over a period of approximately 1 minute. Unlabeled bovine serum albumin was used in control experiments. The vein was flushed with a small volume of saline before and after the introduction of tracer or albumin. Eight minutes after the end of this procedure, heparin (1000 IU, Sigma) was introduced in the same way. Two minutes later, the animals were killed with an overdose of pentobarbital (300 mg IV, Sagatal, Rhone Merieux). In rapid succession, the abdomen was opened along the midline, the viscera were deflected, and the diaphragm was partially removed. A blood sample was taken by cardiac puncture, and a retrograde cannula was tied into the aorta at the level of the diaphragm. The thoracic aorta was flushed for approximately 30 seconds with 50 mL isotonic saline at a pressure of 120 cm water. It was then fixed at the same pressure with formal sublimate (6% wt/vol HgCl2 plus 1% wt/vol formalin in water). This fixative rapidly immobilizes proteins but does not cause substantial tissue autofluorescence.30 The period from anesthesia until fixation averaged 3.6 minutes (SD=0.94, n=13) for the animals administered tracer. These figures exclude two animals for which the period was inadvertently extended to more than double the mean value. The latter experiments gave anomalous results and are discussed separately.
The proximal descending aorta was clamped after 2 minutes to reduce the volume of fixative required. After 20 minutes of fixation, the descending thoracic aorta was excised, and regions of the wall containing intercostal ostia were dehydrated in ascending concentrations of ethanol, transferred to propylene oxide, and embedded in epoxy resin31 (Polarbed 812, Fisons).
Plasma prepared from the terminal blood sample was diluted 1:100 with 12.5% wt/vol gelatin (type B, Sigma) in phosphate-buffered saline (0.15 mol/L, pH 7.4). Gels were set at 4°C, fixed with formal sublimate, and processed in the same way as arterial tissue.
Tracer Detection and Image Processing
Blocks of embedded
tissue were trimmed under a dissecting
microscope so that 2-µm-thick longitudinal sections could be cut
through the center of intercostal ostia. Sections were cut by using an
ultramicrotome and glass knives, and were mounted on coverslips. For
every animal, three to eight branches were examined; seven or more
sections were cut from each branch. Fluorescence from sections
was stimulated and examined by using an epifluorescence
microscope (Zeiss Axioplan) with oil immersion lenses, custom filters
(577±7-nm excitation filter, 590-nm dichroic mirror, and
610±10-nm
barrier filter; Omega Optical), reducing transfer optics (Microcam),
and an intensified CCD camera (Darkstar, Photonic Science).
Output from the camera was digitized by using a Hawk V12 digitizer (Wild Vision) in an Archimedes 540 microcomputer (Acorn). The circuitry of the digitizer was modified to improve the accuracy of black-level clamping.24 Custom software was written for image acquisition, processing, and analysis in ARM assembler.
One image was obtained for the aortic wall upstream of the ostial lip and one for the equivalent downstream region in each section. The maximum length of each aortic segment was 370 µm. Eight frames were grabbed and averaged for each image to improve signal-to-noise ratios. Images were processed to ensure a uniform, linear, and constant relationship between tracer concentration and gray level. Offsets were subtracted from all frames and a flat-field correction was used to remove the effects of spatial biases in the system. A correction factor was calculated to allow for changes in the exciting illumination, intensifier voltage, video amplifier gain, and extent of photobleaching. By using these techniques, spatial biases in the corrected image are <5%, and measured intensity is proportional to tracer concentration over at least a thousandfold range.24
Image Analysis
The upstream or downstream image was displayed
on a monitor, and
a line was drawn along the outer surface of the aortic
endothelium by using a tracker ball. This line was
smoothed by replacing the x and y coordinates of
each pixel with the mean coordinates of itself and the six nearest
neighbor pixels along the line. A series of lines parallel to this
endothelial boundary was then generated through the
intima and media. The spacing between lines was equivalent to 2.88 µm
before magnification, and the number of lines was near to the maximum
that could be fitted without impinging on the adventitia at any point.
The edges of the grid were defined by lines perpendicular to each end
of the endothelial boundary. An example of such a grid,
superimposed on an image, is shown in Fig 1a
.
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Corrected gray values of all the pixels within each depthwise slice of the intima and media were summed, and the pixels were counted. A mean concentration and a mean quantity of tracer for each slice were derived from these parameters. Concentrations were expressed as a percentage of the terminal plasma concentration of tracer as assessed by analysis of the images from calibration gels. Quantities of tracer were summed over various depths as described below. They were expressed as a normalized mass transfer coefficient32 that was defined as
![]() | (1) |
where Qw is the quantity of tracer in the wall, Cp is the tracer concentration in plasma, Ae is the area of endothelium, and t is the duration of exposure to the tracer. The term "permeability" has been avoided since it is variously used in connection with diffusion, convection, or both phenomena. The expression reduced to
![]() | (2) |
where
CGLw is the sum of corrected gray levels in
the wall, Ap is the area of the section imaged by a single
pixel,
g is the mean corrected gray level
for gel, and L is the length of the endothelium.
Sections from control animals were analyzed to determine autofluorescence intensities. These values were subtracted from all experimental data prior to averaging or calculating ratios between regions.
Statistical methods were obtained from Armitage and Berry.33
| Results |
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The wall had an irregular shape in upstream and downstream regions, making it difficult to define a representative intimal-medial thickness. However, an accurate indication of the fractional changes in thickness that occur with location and age can be obtained from the depth of the image-analysis grid, since the number of grid lines was adjusted for each branch to include most of the intima-media without impinging on the adventitia at any point. Grids penetrated to at least 90% of the minimum thickness of the intima-media in each region, and this proportion would not have varied systematically with location or age.
The grid depths (Table
1
) were on average 25% greater
downstream than upstream. They increased by <50% between weaning and
maturity; most of the change occurred before the age of 3 months.
Systemic blood pressure in rabbits shows a similar pattern, increasing
linearly from birth until 2.5 to 3 months and then remaining constant
for several years.35
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Autofluorescence
Naturally occurring autofluorescence from
tissue
components imposes a limit on the minimum concentration of tracer that
can be reliably detected. Fig 1b
shows a corrected image of
autofluorescence from the region and age with the highest
emission. The intensity is clearly negligible compared with
fluorescence from the experimental sections shown in the same
figure. Quantitative comparison of all control sections with
corresponding experimental data showed this to be true for most
locations and ages. The exceptions occurred in the mid media of animals
older than 1 year, in which tracer concentrations sometimes fell
substantially below 0.05% of the concentration in plasma. This
resulted in autofluorescence and tracer
fluorescence having intensities of comparable magnitude.
The variability of autofluorescence, as well as its mean intensity, determines the sensitivity of the technique. If autofluorescence were constant, it could be accurately subtracted from tracer fluorescence irrespective of their relative intensities. In the present study, variations in autofluorescence were found to be small. At each age and for each region of the wall, the SE of autofluorescence intensity never exceeded 7% of the mean value and was never equivalent to more than 0.0022% of the mean concentration of tracer in plasma. Consequently, the use of an autofluorescence subtraction technique was considered a reliable method for determining whether tracer was present across the entire wall of the artery and for measuring differences in tracer influx between upstream and downstream regions. However, as discussed below, the small fractional differences detected between mid medial areas of older rabbits were similar in size to variations in autofluorescence and cannot be regarded as reliable.
There was a significant increase in mean autofluorescence
with age (ANOVA applied to regression yielded F=102.8,
P<.005, n=59), and small, nonsignificant differences were
also detected between upstream and downstream regions (for all ages:
t>-1.90, P>.07, n=24) (Fig
3
). Hence, when subtracting
autofluorescence, a mean value from the equivalent region
of the control animal closest in age was used.
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Differences Between Upstream and Downstream Regions
Fig
1c
through 1f shows corrected images of the
fluorescence from upstream and downstream regions of an
immature rabbit and a mature rabbit administered tracer. Uptake is
visibly greater downstream of the branch than upstream in the young
rabbit, but the opposite pattern is apparent in the older animal.
For quantitative comparisons, differences in uptake between regions were scaled by the mean of both regions so that changes in the pattern of transport and changes in overall transport could be distinguished. The difference was calculated as
![]() | (3) |
where U and D are the normalized mass transfer coefficients for the upstream and downstream regions, respectively. Differences were calculated for every section and were averaged to obtain a representative value for each branch. The mean and SEM of the branch averages were then calculated for each age group.
A
problem in interpreting mass transfer coefficients is determining
which parts of the intima-media receive tracer from the luminal
surface and which from the adventitia. In the present study,
differences between regions were calculated after integrating tracer
quantities over a range of distances from the
endothelium to allow this question to be addressed. Fig 4a
through 4c shows the effect of age on the difference
for depths of 10, 20, and 30 grid lines, corresponding to 29, 58, and
86 µm, respectively.
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An alternative to examining the same depth for
both regions and all
ages is to scale the depth according to the thickness of the
intima-media. This procedure has been used in several studies of
nonbranch regions of wall.32 36 37 In the
present
study, in which thickness varied systematically with age and location,
the procedure might have introduced biases by enhancing the relative
uptake in downstream regions and in older animals. However, the method
was used so that comparison could be made with previous studies; tracer
quantities were integrated over approximately the full
intimal-medial thickness of each region (Fig 4d
).
Considering first the depth of 29 µm (Fig 4a
), the
normalized
difference between mass transfer coefficients was significantly greater
than zero in immature animals (groups 1 and 2: t=10.9,
P<.001, n=34) but less than zero in mature animals (groups
3 through 5: t=-3.3, P<.005, n=43).
There
was a significant fall in the difference between groups 1 and 2
(t=-3.92, P<.001, n=34). There was no
simple trend with age and no significant deviation from linearity
between the mature groups (ANOVA applied to regression yielded F=0.19,
P>.05, and F=0.80, P>.05, n=43). A large
variation between branches was observed, particularly in the older
animals. This variation was not found in a previous study of
quasisteady state transport.20
As the depth of the grid was increased from 10 to 30 lines, small changes occurred in the differences between regions but the main trends were not altered. The same general patterns were also apparent in the data for the full intimal-medial depth. Uptake in the downstream region was accentuated for groups 2 through 5, reflecting the greater depth and hence greater quantity of tracer that was sampled in this region. However, the difference between regions in mature animals still averaged -15% and remained significantly less than zero (t=-2.75, P<.005, n=43).
It is
not clear whether the same distance from ostia should have been
examined in all rabbits or whether this distance should have been
scaled according to the length of the animal. To determine whether the
latter procedure would have affected the trends described in Fig
4
, 10
branches from two animals in group 1 were reanalyzed over
approximately half the distance employed in the main study. This
scaling factor reflects the ratio of minimum and maximum animal
lengths, estimated as the cube root of weight. For the full
intimal-medial depth, this procedure altered the difference between
regions from 119.8±10.43% to 125.5±10.25%
(t=-0.038, P>.7, n=20). A similar
lack of
effect was found in the earlier study of quasisteady state
transport.20
Transmural Concentration Profiles
Profiles of tracer
concentration across the intima-media are
shown for upstream and downstream regions of the different age groups
in Fig 5a
through 5e. The profiles summarize data from a
subset of specimens comprising three branches per animal and at least
three sections from each branch. For the downstream regions of groups 1
and 2, the profiles show a nearly smooth decrease in concentration from
the luminal surface to the outer media. For all other profiles the
concentration decreased initially but then remained essentially
constant throughout the central region of the wall. The discontinuities
shown in the deepest layers of the wall are artifactual, reflecting
changes in sample size; for the greatest distances into the media, data
could be obtained from only a small number of sections. A slight rise
toward the adventitial border was seen in a few profiles.
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In groups 1 and 2, the maximum concentration and the depth required for the decline from this level to the minimum value were both substantially greater downstream of the branch. Comparable trends in the opposite direction were not readily discernible for groups 3 through 5, reflecting the smaller differences between regions in mature animals. Differences between regions were apparent at depths where the profiles had reached nearly steady levels but in some cases tracer concentrations were so low that these differences approached the limit of detection. Although they seem to be consistent, a small error in the assessment of autofluorescence intensities would have lead to a significant and systematic bias. Consequently, they must be interpreted with caution.
To ensure that such biases could
not have introduced a significant
error into the age-related patterns shown in Fig 4
, mean
differences between regions in mature animals were reexamined over the
first five grid lines (14 µm), since tracer concentrations are high
enough for the reliable detection of small differences up to this
depth. No evidence for the presence of biases was obtained. The mean
difference of -22% was identical to the value for 10 lines and
significantly below zero (t=3.26, P<.005,
n=43).
The variability remained high and therefore cannot be attributed to the
difficulty of measuring low levels of tracer.
The distribution of tracer in the innermost layers of the wall sometimes showed unexpected patterns. In several regions, the concentration in the first slice was lower than would be predicted by extrapolation of the profile and in some cases was lower in absolute terms than the concentration in the next layer. This was particularly apparent in the downstream regions of younger animals and the upstream regions of older animals, where uptake was relatively high.
High-Resolution Profiles Across the Inner Wall
To obtain
further information about the differences between
regions in mature rabbits and the unexpected patterns seen in the
innermost layers of the wall, the same images were
reanalyzed by using a finer grid, in which lines were
separated by 0.72 rather than 2.88 µm. This analysis was
applied to the first 10 µm (14 lines) of the wall. The grid was
superimposed over only a short segment of aorta in an attempt to reduce
the blurring of profiles that results from averaging long regions of
the wall. Data are shown in Fig 6a
through 6e. Because
only a short length of aorta was reanalyzed, there are
minor discrepancies in the heights, but not the overall pattern, of the
corresponding high- and low-resolution profiles.
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Differences between upstream and downstream regions in mature animals were more clearly visible in the high- than the low-resolution profiles. Peak heights were greater and concentrations declined more slowly with depth in the upstream profiles. In addition, all the high-resolution profiles revealed an apparent rise in tracer concentration that occurred over at least the initial 1.7 µm of the wall. The rise is likely to be partly artifactual, reflecting the response of the measuring system to a sharp edge; the theoretical resolution of the system under the conditions used in the present study is approximately 1.5 µm. However, this limit is unlikely to account for the differences seen between profiles.
In groups 1 and 2, apparent maximum concentrations occurred deeper in the wall downstream than upstream of branches. This pattern was not seen in mature rabbits. In groups 3 and 5, the peaks occurred at the same depth in upstream and downstream regions, while in group 4 the peak was deeper in the upstream region. The depths at which the maxima occurred were not a simple correlate of the absolute fluorescence intensities, which would have suggested a measurement artifact. The trends were consistent with the patterns seen in the low-resolution profiles. In the downstream region of immature animals, and occasionally in the upstream region of older animals, the highest concentrations appeared not to occur in the innermost layer of the wall. Further investigations employing higher magnifications, higher-resolution equipment, and thinner sections are required to clarify which anatomic structures are involved and to allow comparison with previous studies that have examined tracer concentrations between the endothelium and internal elastic lamina.38
Comparison With Transmural Profiles at Quasi Steady
State
A sample of images obtained in a previous study of
quasisteady state transport was reanalyzed by using
the grid technique so that the transmural profiles could be compared
with those for short-term uptake. The methods used to obtain the
images have been reported in detail.20 They were similar
to the methods described above except that the tracer was allowed to
circulate for 3 hours instead of 10 minutes; cannulation was performed
under anesthesia rather than immediately after death; and,
because reducing optics were not used, regions up to only 270 µm (not
370 µm) from the ostia were examined and the outermost layers of the
media could not always be included.
Only single animals were examined at each age in the previous study,20 and no animal was as old as those in group 5. Quasisteady state profiles were therefore derived for the four animals closest in age to the mean ages of groups 1 through 4. Animals were included only if terminal plasma concentrations had been obtained. At least three sections from each of four branches per rabbit were analyzed.
For the majority of regions and ages, peak tracer concentrations detected in the inner wall after 10 minutes approached or even exceeded those seen after 3 hours. This was invariably the case in mature age groups. The difference in the protocols used just prior to cannulation may have influenced this result but is unlikely to be the sole factor. A lower-resolution study of albumin transport in which all animals were cannulated rapidly after death also found that uptake in the first layer of the wall reached quasisteady state levels within 10 minutes.32
The fall in tracer concentration from the inner to the outer wall was much greater at 10 minutes than 3 hours. The ratio of minimum and maximum concentrations, averaged across regions and ages, was 10% at 10 minutes but 35% at 3 hours. Although maximum tracer concentrations were comparable at the two times, the minima, expressed as a fraction of terminal plasma concentrations, were on average 3.4-fold lower at 10 minutes.
The quasisteady state profiles for several ages showed
a
pronounced rise toward the medial-adventitial boundary that was
absent or greatly attenuated at 10 minutes. A rise with increasing
depth was also apparent for the innermost layers in several of the
3-hour profiles. Fig 7a
through 7d shows, as an example
of these trends, the low- and high-resolution profiles for group 1
compared with equivalent quasisteady state data from an animal
aged 37 days.
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Mean Mass Transfer Rates Near Branches
The mean of the mass
transfer coefficients for upstream and
downstream regions also changed but at an earlier age than the reversal
in the difference between regions. Averages were again calculated for
10, 20, and 30 grid lines into the wall and for approximately the full
intimal-medial thickness. Values were obtained for every section
and averaged to give a representative coefficient for
each branch. The mean and SEM of the branch averages for each age group
are shown in Fig 8a
through 8d. The trends were very
similar for all depth criteria. Taking 10 lines (Fig 8a
) as an
example,
mass transfer rates were significantly higher in group 1 than group 2
(t=-4.81, P<.001, n=34). Between
groups 2
through 5 there was no simple trend with age (ANOVA applied to
regression yielded F=1.33, P>.05, n=62), although
there was
a significant deviation from linearity (F=3.60, P<.05) as
group 4 had a lower value than the other three groups. The value for
group 1 was 2.5x10-8 cm/s, and
equivalent values for groups 2 through 5 averaged
0.91x10-8 cm/s. As depth was increased
to 20 lines, 30 lines, or the full intimal-medial thickness, these
values increased by 31%, 56%, and 69% for group 1 and 40%, 77%,
and 117% for groups 2 through 5.
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To determine whether the increase in animal size affected the measurement of changes in the mean coefficient, 10 branches from two animals in group 1 were again reexamined over approximately half the distance along the endothelium that had been employed for mature animals. As with the difference between regions, this scaling procedure did not significantly alter the data. For the full intimal-medial thickness, the coefficient changed from 3.22±0.32 to 3.34±0.32x10-8 cm/s (t=0.28, P>.7, n=20).
Effects of Delayed Cannulation
Two animals were excluded from
the analyses described
above because, following the normal 10-minute exposure to tracer in the
conscious state, there were inadvertent delays between
administration of the overdose of anesthetic and fixation. These delays
caused interesting deviations from expected values. In one animal from
group 3, fixation commenced 9 minutes after anesthesia. The
difference between regions was 61% and the mean mass transfer
coefficient was 4.0x10-8 cm/s, both
calculated for the full intimal-medial thickness. The second
animal, from group 4, had a delay of 7.5 minutes and gave corresponding
values of 20.5% and 1.7x10-8 cm/s.
Thus, in both these mature animals the juvenile pattern of transport
was seen, and overall uptake was approximately double the mean value
for the age group.
These results make it plausible that relative levels of tracer in the downstream region and the mean value of the mass transfer coefficients might both be overestimated for the other rabbits used in this study, since fixation commenced at least 2 and occasionally 5 minutes after anesthesia. However, further analysis showed no correlation between the length of the delay and either the difference between regions or the mean coefficient (data not shown). It appears that significant effects occur only if the period between anesthesia and cannulation is prolonged beyond 5 minutes.
| Discussion |
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The observation that mass transfer coefficients are greater downstream than upstream of branches in immature animals is consistent with reports that foci of high macromolecule uptake are more prevalent downstream than upstream of branches in young rabbits,14 15 although this pattern is not seen in rats.41 The same properties may also underlie an earlier finding that the influx of LDL is greater downstream of large aortic branches than in nonbranch regions.13 No comparable elevation was seen downstream of intercostal branches, but the technique employed may have had insufficient spatial resolution to detect variations around such small ostia. The present finding that the difference between regions decreases and then reverses with age and the measurement of transmural profiles around branches appear to be novel.
There is good agreement between those investigations in which animals of the same species and developmental stage have been studied, despite the diversity of techniques and tracers employed. This is evidence not only for the reliability of the methods used but also for the view that uptake near branches varies in a similar way for macromolecules that have a range of sizes and markedly different interactions with cells and extracellular matrix components. The phenomena observed for albumin may therefore have relevance to the transport of other molecules, including the much larger and more metabolically active lipoproteins that have been implicated in atherogenesis.
The main aim of this study was to investigate whether differences in the rate at which macromolecules enter the arterial wall can account for the age-related variations seen in quasisteady state albumin transport near branches. Quantities of tracer in the wall may depend not only on rates of influx but also efflux, metabolism, and the space available for the tracer within tissue. The relative importance of these additional factors increases with the duration of exposure to tracer. Transport over a 10-minute period was assessed in the present study. This is the shortest duration for which uptake in the conscious state substantially outweighs that occurring between anesthesia and fixation.
Only an insignificant proportion of the albumin entering the wall during a 10-minute period will be metabolized.42 Efflux from the intima-media is also likely to be negligible. After 10 minutes, tracer concentrations in the mid media were much lower than those in the inner wall. Because this fall was several times sharper than at quasisteady state, when influx and efflux are approximately equal, only a small proportion of tracer entering via the luminal surface could have been lost through the adventitia. If efflux was negligible, almost all the tracer that entered the intima-media will have remained there and will have been included in the measurements, irrespective of how its distribution was affected by variations in the available space. Furthermore, since tracer concentrations within the wall after 10 minutes are much lower than those seen at equilibrium,36 they can have little influence on the rate of influx itself. On balance, therefore, it appears reasonable to assume that the trends seen in 10-minute uptake predominantly reflect changes in the resistance of the wall to tracer influx.
Differences between upstream and downstream regions were compared for
the 10-minute and 3-hour experiments as a function of age (see Table
2
). Each group of animals from the present study was
matched with the animal closest in age from the study of
quasisteady state transport.20 There was an
excellent quantitative agreement between the two sets of data.
Furthermore, tracer concentrations in the wall fell 2.8-fold between
the ages of 38 and 56 days in the quasisteady state experiments,
while mass transfer coefficients fell 2.8-fold between 45 and 75 days
in the present study. Again, the agreement is excellent. The
transport gradients present in short-term experiments are not
the same as those occurring at quasisteady state or for native
macromolecules in vivo, since tracer concentrations are relatively low
in the media. Consequently, transport processes could also differ. The
good agreement seen between 10-minute and 3-hour patterns is
consistent with the same processes being critical in both cases
and with the quasisteady state phenomena being determined by
changes in the resistance to macromolecule influx.
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The rate of entry of macromolecules into the wall is often assumed to depend primarily on endothelial permeability. However, the possible role of convection and the resistances of other barriers to transport also need to be considered. Some indications of the transport processes taking place may be derived from transmural concentration profiles, although no definite conclusions can be drawn since profiles reflect the space that is available to tracer across the wall as well as the concentration of tracer within that space. The wide variety of reported profiles may reflect the range of vessels and techniques that has been employed.32 36 43 Age and location may also be important determinants. In the present study, profiles showed a nearly continuous decrease in concentration from the inner wall to the outer media when areas downstream of branches in young animals were examined but were flat over large parts of the wall upstream of branches and in older animals. The space available for tracer would have to be highly nonuniform for the latter type of profile to be compatible with a predominantly diffusive transport. The increases in concentration occasionally seen in the first few layers of the wall are consistent with the occurrence of concentration polarization.
Entry of tracer from the adventitia is possible in theory, and some evidence exists for the importance of this route.32 43 The present results, however, make it unlikely that adventitial influx is significant near intercostal branches. No substantial rises in tracer concentration were observed in the outer media. Although the geometry of the image-analysis grid excludes some parts of the outer media, rises were observed when using the same technique to study tissue exposed to tracer for 3 hours. Furthermore, only small changes were seen in the difference between regions as increasing depths of wall were examined, an unlikely occurrence if significant entry had occurred through both boundaries.
Some further inferences concerning the factors that determine macromolecule influx can be drawn from the patterns of transport obtained in this study. First, differences in uptake between upstream and downstream regions were more variable after 10 minutes than after 3 hours, the coefficient of variance being particularly high in older animals. This indicates that the rate of influx varies over short distances or fluctuates rapidly, since the quasisteady state uptake at any point reflects entry through channels distributed over a wider area and integrated over a longer period. Second, the observation of a juvenile distribution of tracer in those mature arteries fixed more than 5 minutes after death is consistent with blood pressure, flow, or some other systemic property being required to maintain the normal adult pattern and, again, with the existence of mechanisms capable of rapid change. A causal link between variations in hemodynamic shear stress and variations in endothelial transport properties near branches has been postulated in several theories of atherogenesis but not conclusively established. The effects of delayed cannulation are compatible with such an interaction being a characteristic of mature vessels and with the immature pattern of transport being independent of flow or related only to its long-term influence on more stable properties of the wall. If it is additionally correct to assume that the highest stresses occur downstream of branches,1 shear would appear to be reducing the uptake of macromolecules in mature vessels. The mechanisms involved may be inhibited by hyperlipidemia, since short-term administration of a cholesterol-enhanced diet can also induce the juvenile pattern in older animals.21
To investigate the role of hemodynamic stresses in more detail, an attempt was made to map the boundaries between endothelial cells near branches. Despite the use of standard silver-staining techniques, boundaries could not be visualized in areas upstream of ostia in young rabbits. Similar difficulties in observing cell boundaries near branches have been reported.44 45 It is possible that the low albumin influx and the poor staining in upstream regions of immature vessels are both related to unusual properties of the intercellular junctions.
The physiological and pathological significance of the variations in transport is uncertain. A previous suggestion11 that the elevated transport observed downstream of branches in young animals might serve a physiological role by helping to maintain the thicker wall of this region is contradicted by the present finding that transport variations reverse with age while the pattern of wall thickness does not. A direct connection with pathological processes in rabbits is also unlikely. Normocholesterolemic rabbits rarely develop spontaneous sudanophilia,16 whereas hyperlipidemic animals show different transport properties.21 However, the spatial correlation with the location of human lesions makes it plausible that similar transport variations occur in human arteries and influence the development of disease.
| Acknowledgments |
|---|
Received June 14, 1995; accepted September 29, 1995.
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