Title:Modeling Loss of Microvascular Wall Homeostasis during Glycocalyx Deterioration and Hypertension that Impacts Plasma Filtration and Solute Exchange
Volume: 13
Issue: 2
Author(s): Laura Facchini, Alberto Bellin and Eleuterio Francisco Toro
Affiliation:
Keywords:
Filtration, Solute transport, Time-dependent, One-dimensional, Multi-layer, Hemorrhage.
Abstract: The fiber matrix of the surface glycocalyx layer internally coating the endothelial cells and plugging the intercellular
clefts is crucial for microvascular wall homeostasis. Disruption of the glycocalyx is found in clinical conditions
characterized by microvascular and endothelial dysfunction such as atherosclerosis, diabetes mellitus, chronic renal failure
and cerebrovascular disease. Shedding of its components may also occur during oxidative stress and systemic inflammatory
states including septis. In this work, we investigate the effects of glycocalyx degradation, either due to enzymatic digestion
or to agonist recruitment, on plasma filtration and solute extravasation. We also take into account the possibility of
a physiological or pathological increase in blood pressure, as in hypertensive zones such as pre- and post-stenotic blood
vessels. Our mathematical model shows that a seriously damaged glycocalyx produces an augmentation of flux of both
solvent and solute, thus losing its role of transport barrier and macro-molecular sieve, in agreement with experimental
evidence. Similarly, hypertension causes an increase in both volume and solute fluxes, also according to physiological
findings. The combination of glycocalyx deterioration and hypertension further raises plasma and solute fluxes, potentially
leading in most severe cases to edema and hemorrhage, as in the case of diabetes.
