Curry FitzRoy E, Michel C Charles
Department of Physiology and Membrane Biology and Biomedical Engineering, University of California, Davis, California, USA.
Department of Bioengineering, Imperial College London, London, UK.
Microcirculation. 2025 May;32(4):e70010. doi: 10.1111/micc.70010.
Eugene Renkin used simplified uniform models of microvascular exchange units to describe the fundamental functions of the microcirculation: a cylindrical pore to characterize the barriers to exchange of water and solutes; a uniformly perfused capillary to distinguish flow-limited exchange from diffusion-limited exchange; and a membrane with large and small pores to describe macromolecule exchange between blood and lymph. A key idea linking these concepts to microvascular dysfunction is that local blood flows, microvascular pressures, and the permeability of the vascular wall are not uniformly distributed within microvascular beds. Renkin's concept of microvascular clearance of small solute was extended to show how heterogeneity in blood transit times compromised exchange. It was also extended to evaluate the relative contribution of diffusion, convection, and vesicle exchange to microvascular exchange of macromolecules when there is heterogeneity in macromolecule permeability, measured by the presence of large pores. An extension of his analysis to smaller proteins (14-20 KDa) showed that convective transport may limit the diffusion of inflammatory peptides, therapeutic agents, and toxins from the tissue into circulating blood. We include recent examples of the growing understanding of microvascular dysfunction in chronic disease and approaches to modeling heterogeneity in normal and diseased states.
尤金·伦金使用简化的微血管交换单位统一模型来描述微循环的基本功能:用一个圆柱形孔来表征水和溶质交换的屏障;用一根均匀灌注的毛细血管来区分流量限制型交换和扩散限制型交换;用一个有大小孔的膜来描述血液和淋巴之间的大分子交换。将这些概念与微血管功能障碍联系起来的一个关键观点是,局部血流、微血管压力和血管壁通透性在微血管床内并非均匀分布。伦金关于小溶质微血管清除的概念得到了扩展,以表明血液通过时间的异质性如何损害交换。它还被扩展用于评估当存在由大孔的存在所衡量的大分子通透性异质性时,扩散、对流和囊泡交换对大分子微血管交换的相对贡献。他对较小蛋白质(14 - 20 kDa)的分析扩展表明,对流运输可能会限制炎症肽、治疗剂和毒素从组织扩散到循环血液中。我们纳入了近期对慢性疾病中微血管功能障碍不断加深的理解的例子,以及在正常和疾病状态下对异质性进行建模的方法。