Interdepartmental Center of Research on Hemorheology, Microcirculation, Oxygen Transport and Non Invasive Optical Technologies, Università degli studi di Bari Aldo Moro, Policlinico, Piazza G. Cesare, 11 70124, Bari, Italy.
Adv Exp Med Biol. 2010;662:33-9. doi: 10.1007/978-1-4419-1241-1_4.
The microcirculation is an important system, containing resistance arterioles, capillaries and venules, whose main function is to transport oxygen and nutrients to the tissues. Endothelial cells are the main cell types of the microcirculation; their homeostasis is modulated by constant shear stress. Altered hemorheology induces a change in the production of vasodilator and vasoconstrictor agents. The most important pattern inducing endothelium dysfunction is an increase in oxidative stress, which decreases the amount of nitric oxide and favors microvascular phlogosis. In this review we will consider the main scientific reports about the cardiovascular risk factors such as smoking, hypercholesterolemia, hyperviscosity, hypertension, diabetes, stress and increased homocysteine levels, all having as common etiopathogenetic factor alterations in microcirculation and in tissue oxygenation. We also focus on their influence on endothelial cells, inducing endothelial changes and dysfunction related to altered oxygen supply and linked to increased oxidative stress. Also important are endothelial stem cells, that are able to repair vascular endothelial damage, especially in cardiovascular patients, with or without endothelial dysfunction. Under these circumstances the numbers of these stem cells are altered, which means there is a decrease in regeneration capability (post ischaemia modified albumin, etc.). This could be an important negative prognostic factor. Microcirculation and tissue oxygenation are very important factors strongly linked to hemorheology, especially in cardiovascular patients, and their alterations could cause impairment, or initiate cardiovascular pathologies.
微循环是一个重要的系统，包含阻力小动脉、毛细血管和小静脉，其主要功能是将氧气和营养物质输送到组织中。内皮细胞是微循环的主要细胞类型；它们的内稳态受到持续切应力的调节。血液流变学的改变会引起血管舒张和收缩剂的产生发生变化。诱导内皮功能障碍的最重要模式是氧化应激增加，这会减少一氧化氮的量并促进微血管炎症。在这篇综述中，我们将考虑有关心血管危险因素的主要科学报告，如吸烟、高胆固醇血症、高粘度、高血压、糖尿病、压力和同型半胱氨酸水平升高，所有这些都有共同的发病机制改变在微循环和组织氧合中。我们还关注它们对内皮细胞的影响，诱导与氧气供应改变相关的内皮变化和功能障碍，并与氧化应激增加有关。内皮干细胞也很重要，它们能够修复血管内皮损伤，尤其是在有或没有内皮功能障碍的心血管患者中。在这种情况下，这些干细胞的数量发生了改变，这意味着再生能力下降（缺血后修饰白蛋白等）。这可能是一个重要的预后不良因素。微循环和组织氧合是与血液流变学密切相关的非常重要的因素，尤其是在心血管患者中，它们的改变可能导致功能障碍或引发心血管病理。
