The partition of fluid between the vascular and interstitial compartments is regulated by forces (hydrostatic and oncotic) operating across the microvascular walls and the surface areas of permeable structures comprising the endothelial barrier to fluid and solute exchange, as well as within the extracellular matrix and lymphatics. In addition to its role in the regulation of vascular volume, transcapillary fluid filtration also allows for continuous turnover of water bathing tissue cells, providing the medium for diffusional flux of oxygen and nutrients required for cellular metabolism and removal of metabolic byproducts. Transendothelial volume flow has also been shown to influence vascular smooth muscle tone in arterioles, hydraulic conductivity in capillaries, and neutrophil transmigration across postcapillary venules, while the flow of this filtrate through the interstitial spaces functions to modify the activities of parenchymal, resident tissue, and metastasizing tumor cells. Likewise, the flow of lymph, which is driven by capillary filtration, is important for the transport of immune and tumor cells, antigen delivery to lymph nodes, and for return of filtered fluid and extravasated proteins to the blood. Given this background, the aims of this treatise are to summarize our current understanding of the factors involved in the regulation of transcapillary fluid movement, how fluid movements across the endothelial barrier and through the interstitium and lymphatic vessels influence cell function and behavior, and the pathophysiology of edema formation.
Table of Contents
Fluid Movement Across the Endothelial Barrier
The Interstitium
The Lymphatic Vasculature
Pathophysiology of Edema Formation
About the Author(s)
Joshua Scallan, University of Missouri-Columbia
Virginia Huxley, University of Missouri-Columbia
Ronald Korthuis, University of Missouri-Columbia
Ronald J. Korthuis, PhD, is the George L. and Melna A. Bolm Distinguished Professor in Cardiovascular Health and the Head of the Department of Medical Pharmacology and Physiology in the College of Medicine at the University of Missouri. After receipt of his PhD degree in Cardiovascular Physiology from Michigan State University in 1983, Dr. Korthuis joined the laboratories of Drs. Aubrey E. Taylor and D. Neil Granger as a Parker B. Francis Fellow. After this postdoctoral training, he joined the faculty at the University of Missouri in 1985, where he was supported by an NIH New Investigator Research Award. In 1987, Dr. Korthuis moved to the Louisiana State University Health Sciences Center-Shreveport, where he served as the Vice Chair of the Department of Molecular and Cellular Physiology and as the Assistant Dean for the School of Graduate Studies. At LSUHSC, Dr. Korthuis was awarded an Established Investigatorship from the American Heart Association and received the Dr. Allen A. Copping Award for Excellence in Teaching. Since returning to the University of Missouri, he received the Gold Chalk Award for Dedication and Service to the Advancement of Graduate Student Education and was elected to the Order of Socrates for Excellence in Medical Education and to the Alpha Omega Alpha National Medical Honor Society. Dr. Korthuis has served as a regular member on three grant peer review committees for the NIH, is appointed to several Editorial boards for scientific journals, and is very active in programmatic activities for the American Physiological Society. His major research interests relate to understanding the cellular and molecular mechanisms of ischemia/reperfusion-induced injury in the microcirculation and how postischemic microvascular dysfunction can be reduced by preconditioning with pharmacologic agents. Dr. Korthuis has published nearly 175 papers, book chapters, and review articles.
