Castejón O J
J Submicrosc Cytol. 1985 Jan;17(1):105-14.
Cortical biopsies of 12 patients with diagnosis of cerebral tumor or complicated brain trauma were studied with the electron microscope to analyse the alterations of endothelial junctions and their probable participation in the pathogenesis of human brain edema. Capillaries with increased vesicular and vacuolar transport from areas with moderate and severe edema were examined. Some endothelial tight junctions were structurally closed and intact while others showed openings and dehiscence of processes. Some accessory mechanisms of bypassing the endothelial junctions were found, such as: a) communicating micropinocytotic vesicles with the extracellular space at the basal segment of endothelial junction; b) chained micropinocytotic vesicles between endothelial luminal membrane and basal segment of endothelial junction and c) tubular structures connecting the extracellular pockets of endothelial junction with the basement membrane bifurcation. In severe brain edema a considerable enlargement of interjunctional pockets of extracellular space was seen, suggesting that in highly increased cerebrovascular permeability the endothelial junctions are partially opened and that an intercellular route through interendothelial clefts for transferring hematogenous edema fluid from blood to the capillary basement membrane is formed.
对12例诊断为脑肿瘤或复杂性脑外伤的患者进行了皮质活检，并用电子显微镜分析内皮连接的改变及其在人类脑水肿发病机制中的可能作用。对来自中度和重度水肿区域的、囊泡和液泡运输增加的毛细血管进行了检查。一些内皮紧密连接在结构上是封闭且完整的，而另一些则显示出连接结构的开口和裂开。发现了一些绕过内皮连接的辅助机制，例如：a）在内皮连接基底部，连通微胞饮小泡与细胞外空间；b）在内皮腔面膜和内皮连接基底部之间存在成链的微胞饮小泡；c）管状结构将内皮连接的细胞外腔隙与基底膜分支相连。在严重脑水肿中，可见细胞外间隙连接间腔隙显著扩大，这表明在脑血管通透性高度增加时，内皮连接部分开放，并且形成了一条通过内皮间裂隙的细胞间途径，用于将血源性水肿液从血液转移至毛细血管基底膜。
