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Am J Physiol Heart Circ Physiol 279: H2815-H2823, 2000;
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Vol. 279, Issue 6, H2815-H2823, December 2000

TNF-alpha increases entry of macromolecules into luminal endothelial cell glycocalyx

Charmaine B. S. Henry and Brian R. Duling

Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, Virginia 22906


    ABSTRACT
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

The endothelial luminal glycocalyx has been largely ignored as a target in vascular pathophysiology even though it occupies a key location. As a model of the inflammatory response, we tested the hypothesis that tumor necrosis factor-alpha (TNF-alpha ) can alter the properties of the endothelial apical glycocalyx. In the intact hamster cremaster microcirculation, fluorescein isothiocyanate (FITC)-labeled Dextrans 70, 580, and 2,000 kDa are excluded from a region extending from the endothelial surface almost 0.5 µm into the lumen. This exclusion zone defines the boundaries of the glycocalyx. Red blood cells (RBC) under normal flow conditions are excluded from a region extending even farther into the lumen. The cremaster microcirculation was pretreated with topical or intrascrotal applications of TNF-alpha . After infusion of FITC-dextran, FITC-albumin, or FITC-immunoglubulin G (IgG) via a femoral cannula, microvessels were observed with bright-field and fluorescence microscopy to obtain estimates of the anatomic diameters and the widths of fluorescent tracer columns and of the RBC columns (means ± SE). After 2 h of intrascrotal TNF-alpha exposure, there was a significant increase in access of FITC-Dextrans 70 and 580 to the space bounded by the apical glycocalyx in arterioles, capillaries, and venules, but no significant change in access of FITC-Dextran 2,000. The effects of TNF-alpha could be observed as early as 20 min after the onset of topical application. TNF-alpha treatment also significantly increased the penetration rate of FITC-Dextran 40, FITC-albumin, and FITC-IgG into the glycocalyx and caused a significant increase in the intraluminal volume occupied by flowing RBC. White blood cell adhesion increased during TNF-alpha application, and we used the selectin antagonist fucoidan to attenuate leukocyte adhesion during TNF-alpha stimulation. This did not inhibit the TNF-alpha -mediated increase in permeation of the glycocalyx. These results show that proinflammatory cytokines can cause disruption of the endothelial apical glycocalyx, leading to an increased macromolecular permeation in the absence of an increase in leukocyte recruitment.

inflammation; intravital microscopy; fluorescein isothiocyanate-dextrans; plasma proteins; leukocytes; tumor necrosis factor-alpha


    INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

THE VASCULAR INFLAMMATORY response in vivo is characterized by endothelial cell and leukocyte activation, leading to leukocyte adhesion and extravasation with accompanying tissue edema. There is much evidence in the literature implicating proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha ) as the initiating agents. The effects of TNF-alpha on vascular endothelium include a variety of events ranging from nuclear changes to cell surface modifications (24). There is emerging evidence of the importance of the endothelial cell glycocalyx in vascular function, and, given its key location at the interface between plasma and the endothelial interface, we thought it probably plays a significant role in inflammatory responses. Although the literature abounds with information on the recruitment and extravasation of leukocytes during inflammation, little is known about the response of the endothelial cell glycocalyx per se to proinflammatory cytokines.

The glycocalyx on the luminal surface has recently been shown to be as much as 0.5 µm thick (29). It excludes anionic macromolecules the size of 70-kDa dextran and larger, reduces the functional diameter of the vessel by excluding red blood cells, and can be removed by light-dye treatment (29) or made more permeable to macromolecules by enzyme treatment (8). Substantial evidence supports a role for the glycocalyx as a dynamic component of endothelial cell function. The distribution of endothelial surface glycoconjugates can change with altered states of permeability, i.e., after cold-lesion injury to the brain (31). Also, frog mesenteric capillaries become more permeable when their glycocalyx is enzymatically digested (1).

During inflammation, adhesion molecules on leukocytes must make contact with their ligands on the endothelium. Because these receptors are presumably buried within the glycocalyx, it would be functional if this thick surface layer were shed or modified during inflammation, thus enabling easy access of leukocytes or blood-borne macromolecules to the site of injury. The present study was undertaken to primarily examine the hypothesis that TNF-alpha can cause changes in the glycocalyx either dependent or independent of leukocyte adhesion. In this paper, we provide evidence that TNF-alpha treatment causes modifications of the endothelial luminal glycocalyx that result in increased solute permeation and an increase in the intraluminal volume occupied by red blood cells. These changes occurred while leukocyte adhesion was blocked by the selectin antagonist fucoidan.


    MATERIALS AND METHODS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

Animal preparation. All of the reagents were obtained from Sigma Chemical (St. Louis, MO). All of the procedures and the care of animals were in accordance with institutional guidelines.

Male Syrian golden hamsters weighing 110-160 were anesthetized with intraperitoneal sodium pentobarbital (70 mg/kg). The trachea was cannulated to ensure a patent airway, and the hamster spontaneously breathed room air. The left femoral vein was cannulated for fluid replacement and maintenance of anesthesia (0.5 ml/h) and for infusion of FITC-dextrans or other reagents. Throughout the surgical preparation and experimental protocol, esophageal temperature was maintained at 37oC. After we placed the hamster on a Plexiglas platter, the right cremaster muscle was prepared for visualization according to standard methodology (29). The tissue was continually superfused at 5 ml/min with a bicarbonate-buffered saline solution consisting of (in mM) 131.9 NaCl, 4.6 KCl, 2 CaCl2, 1.2 MgSO4, and 20 NaHCO3. Succinylcholine (10-5 M) was added to this solution to reduce spontaneous muscle contractions. The pH of the solution was maintained at 7.35-7.45 by bubbling with 5% CO2-95% N2, and the temperature was maintained at 34oC. After at least 30 min of stabilization, when arteriolar tone was evaluated, a bolus of 0.3 ml FITC-dextran (40, 70, 580, or 2,000 kDa; 20 mg/ml in saline), FITC-albumin, or FITC-IgG (20 mg/ml) was given via the femoral cannula.

Intravital microscopy. After FITC-dextran infusion, microvessels (capillaries, arterioles, and venules; 7-15 µm in diameter) were observed at ×55 with a Leitz water-immersion objective (numerical aperture = 0.84) on a Zeiss intravital microscope equipped with a SIT 66 MTI video camera. Transillumination light for bright-field measurements was obtained from a 150-W xenon lamp, and measurements were made as described previously (6). Light from a 75-W xenon lamp and epi-illuminator equipped with a 450- to 490-nm excitation filter, a dichroic beam splitter (FT 510), and a barrier filter (LP 520) was used for epi-illumination of the fluorescent tracer (29). Epi-illumination was controlled by a manual shutter and limited to <= 10 s per vessel to prevent light-dye injury to the endothelium (29). Transillumination was for 30 to 40 s. Images of vessels were displayed on a Dage MTI video monitor and recorded on S-VHS videotapes for subsequent image analysis.

Intrascrotal TNF-alpha treatment and infusion of macromolecules. To determine the effect of an inflammatory mediator on macromolecular penetration into the glycocalyx of skeletal muscle microvessels, recombinant murine TNF-alpha (0.5 µg in 0.3 ml of saline) was injected into the scrotal sac of 24 hamsters to induce a localized inflammatory response. After 2 h, the cremaster muscle was prepared for intravital microscopy. After stabilization, three hamsters each received a 0.3-ml bolus of either FITC-Dextran 40, 70, 580, or 2,000 or of the physiologically relevant plasma proteins, FITC-albumin, or FITC-goat-IgG via the femoral cannula. We used IgG (~150 kDa) to compare the effect of TNF-alpha on penetration rates of plasma proteins of different sizes because it is a major component of plasma and more than twice the molecular weight of albumin (~67 kDa). Six hamsters were pretreated with fucoidan before being injected with TNF-alpha ; three received FITC-albumin and three received FITC-IgG. Three of the control hamsters were injected with saline only before plasma protein infusion, and three of the control hamsters were pretreated with fucoidan in saline only (25 mg/kg iv) before plasma protein infusion. Images of vessels were recorded for analysis as described above.

Inhibition of leukocyte rolling and adhesion. Numerous studies have shown that adherent leukocytes can directly injure the endothelium (3, 15, 17, 19). However, it is not known if an inflammatory mediator will induce changes in the endothelial glycocalyx independent of disruption by bound leukocytes. Leukocyte rolling and adhesion were determined offline in postcapillary venules of four hamsters. Leukocytes that moved at a velocity less than that of the red blood cells were defined as rolling. Those that remained stationary for at least 30 s were considered to be adherent. Rolling leukocytes that passed a line perpendicular to the longitudinal axis of the vessel were monitored, and their velocities were calculated. Assuming cylindrical geometry of the venules, the number of adherent leukocytes was expressed per unit of inner surface area.

To determine the response of the endothelium to TNF-alpha in the absence of increased leukocyte adhesion, the selectin-binding carbohydrate fucoidan was used to block the initial capture and rolling of activated leukocytes. Three hamsters were pretreated with a 0.3-ml bolus of fucoidan (25 mg/kg iv in saline) before TNF-alpha intrascrotal injection. After 2 h, the cremaster was prepared for intravital microscopy, and the permeation of FITC-Dextran 70 and leukocyte adhesion and rolling velocity were studied as described above.

Topical application of TNF-alpha to the cremaster. To evaluate the time course of the onset of TNF-alpha -induced dextran penetration and leukocyte adhesion, topical applications of the cytokine were performed by micropipette in four hamsters. Three control cremasters were superfused with buffer only. For each cremaster, a microvascular unit consisting of a feed arteriole, capillaries, postcapillary venules, and a collecting venule was selected. Microvessel units were then subjected to TNF-alpha treatment for 2 h by topical micropipette application. At 10-min intervals, the vessels were viewed by trans- and epi-illumination, and images were recorded as described above.

Data and statistical analyses. Recorded video images of the microvessels were captured using Image-1 software (Universal Imaging) and a digital, time-base corrector. For determining tracer penetration into the glycocalyx of arterioles and venules, only vessels of <= 15 µm in diameter were used due to the difficulty in focusing on the dextran column boundary in larger vessels. For each vessel, the anatomic diameter, the width of the tracer column, and the red blood cell column were measured with the use of on-screen calipers that were calibrated with a vertical and horizontal image of a stage micrometer (Graticules, Kent, UK). Positioning of the calipers for anatomic measurements was done according to a previously validated method (6). With a comparison of in vivo and in vitro measurements, the accuracy in measuring the width of the fluorescent tracer column has been demonstrated (29). Briefly, the vessel midplane was brought into focus during transillumination, and the vessel was then viewed under epi-illumination. One of the calipers was positioned outside the dextran column with its luminal surface against the edge of the dextran column. The other caliper was positioned just inside the dextran column with its outer surface against the edge of the dextran column. Prior measurement established the accuracy of the endothelial boundary by comparing the bright-field diameter measurement to peaks of an intensity profile across a vessel labeled with a fluorescent membrane dye in the endothelium (29).

Measurements of the width of the fluorescent column were taken to represent the depth of penetration of the tracer into the apical glycocalyx at specific intervals after intravenous injection. Estimates of the width of the space occupied by the red blood cells and of the depth of penetration of tracer into the glycocalyx were calculated as one-half the difference between the bright-field vessel diameter measurement and the width of the red blood cell column or the tracer column. In vessels with rolling or adherent leukocytes, tracer, and red blood cell column widths were measured in a region of the vessel where leukocytes did not cause physical distortion of the glycocalyx. All data are expressed as means ± SE of number of vessels per experimental group. Group means were compared using paired t-tests, and differences were considered significant at P < 0.05.


    RESULTS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

Intrascrotal injection of TNF-alpha . For the purposes of this study, microvessels were categorized into capillaries (<7 µm diameter), small arterioles and postcapillary venules (7-10 µm diameter), and larger arterioles and postcapillary venules (10-15 µm diameter). In control hamsters, FITC-Dextran 70 had no access to a region extending ~0.4 µm from the endothelial cell membrane of small arterioles and venules (Fig. 1A). In larger arterioles and collecting venules, this region extended to ~0.5 µm. Restricted access of dextran to this space was stable over a period of >2 h. Treatment with TNF-alpha induced a significant increase in permeation of the glycocalyx of all vessels to FITC-Dextran 70. This increase in permeation of the glycocalyx was evident even when leukocyte adhesion was prevented by fucoidan. Immediately after infusion in the treated tissues, FITC-Dextran 70 filled all but 0.6 µm of the vessel lumen (Fig. 1B). Over the next 45 min, Dextran 70 penetrated the space adjacent to the endothelial cell with a half-time of 10 min and had reached the cell surface by 30 min.


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Fig. 1.   A: effect of 2-h exposure to 0.5 µg of tumor necrosis factor-alpha (TNF-alpha ) on the penetration of fluorescein isothiocyanate (FITC)-Dextran 70 into the apical glycocalyx of arterioles and postcapillary venules. Measurement is based on the difference between the endothelial cell membrane (bright-field microscopy) and the point of dextran penetration 15 min after dextran infusion (epifluorescence) (8, 29). Difference between open and light gray bars represents TNF-alpha -induced dextran penetration. Difference between open and dark gray bars represents TNF-alpha -induced dextran penetration in the presence of the selectin antagonist fucoidan. B: comparison of the penetration rate of FITC-Dextran 70 into the glycocalyx of cremaster microvessels of control hamsters and of hamsters exposed to 0.5 µg TNF-alpha for 2 h. *P < 0.05 compared with saline. All values are means ± SE.

In control hamsters, red blood cells had no access to a region averaging ~0.8 µm in arterioles and venules of different sizes (Fig. 2). After TNF-alpha treatment, the region from which red blood cells were excluded had decreased to ~0.6 µm from the endothelial surface in all vessels, indicating a significant increase in intraluminal volume available to the red blood cells. Only a few small petechiae were observed. Fucoidan treatment did not prevent the increase in intraluminal volume available to the red blood cells.


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Fig. 2.   Effect of 2-h exposure to 0.5 µg of TNF-alpha on the intravascular volume available to red blood cells (RBC) in arterioles and postcapillary venules. Difference between open and light gray bars represents TNF-alpha -induced increase in the intravascular volume available to RBC. Difference between open and dark gray bars represents the effect of TNF-alpha on the intravascular volume avalilable to RBC in the presence of the selectin antagonist fucoidan. *P < 0.05 compared with saline. All values are means ± SE.

In the capillaries of the control hamsters, FITC-Dextran 70 had no access to a region extending ~0.4 µm from the endothelial cell membrane, and red blood cells were excluded from a region extending 0.7 µm into the lumen (Fig. 3). After TNF-alpha treatment, there was a significant increase in permeation of the capillary glycocalyx to FITC-Dextran 70, and the region from which red blood cells were excluded had decreased to ~0.6 µm from the endothelial surface, indicating a significant increase in intraluminal volume available to the red blood cells.


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Fig. 3.   Effect of 2-h exposure to 0.5 µg of TNF-alpha on FITC-Dextran 70 (Dex 70) penetration into the capillary glycocalyx and on the capillary intravascular volume avalilable to RBC. Difference between open and gray bars represents TNF-alpha -induced dextran penetration and increase in the intravascular volume avalilable to RBC. *P < 0.05 compared with saline. All values are means ± SE.

The TNF-alpha -treated cremaster preparations were observed for an additional 2 h after infusion of dextran. However, an increase in background fluorescence occurred over time, which was attributed to extravasation of dextran molecules in the surrounding interstitium. This made detection of the dye front within the vessels extremely difficult. Thus a reversal of the glycocalyx changes induced by TNF-alpha could not be adequately determined using the current methodology.

Effect of TNF-alpha and fucoidan on leukocyte adhesion and rolling. In the controls, there were few adherent leukocytes in postcapillary venules and collecting venules (Fig. 4A). As expected, TNF-alpha treatment caused a significant increase in the number of adherent leukocytes. Leukocyte rolling velocity was significantly slower in TNF-alpha -treated hamsters (8.2 ± 1.1 µm/s) compared with control hamsters (28.6 ± 2.5 µm/s) and hamsters treated with both fucoidan and TNF-alpha (38.6 ± 2.3 µm/s) (Fig. 4B). The increase in leukocyte rolling velocity in the presence of fucoidan was significantly greater compared with saline treatment.


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Fig. 4.   A: leukocyte adhesion in postcapillary venules after pretreatment with the selectin antagonist fucoidan and 2 h of exposure to 0.5 µg of TNF-alpha . Difference between open and light gray bars represents TNF-alpha -induced adhesion. Difference between light and dark gray bars represents inhibition of TNF-alpha -induced adhesion by fucoidan. B: leukocyte rolling velocity in postcapillary venules. Difference between open and light gray bars represents a reduction in rolling velocity after TNF-alpha treatment. Difference between light and dark gray bars represents an increase in rolling velocity in the presence of the selectin antagonist fucoidan. *P < 0.05 compared with saline and fucoidan + TNF-alpha . #P < 0.05 compared with fucoidan + TNF-alpha . All values are means ± SE.

Leukocyte adhesion was also observed in larger venules and in arterioles >40 µm as well, but the depth of tracer penetration within vessels of this size could not be adequately determined. In some postcapillary venules, petechiae were also observed in close proximity to leukocyte aggregates on the endothelium. In hamsters that were pretreated with the carbohydrate fucoidan to block selectin-mediated leukocyte adhesion, there were significantly fewer leukocytes bound to the endothelium compared with hamsters treated with TNF-alpha alone. Importantly, fucoidan pretreatment did not prevent the TNF-alpha -mediated increase in FITC-Dextran 70 penetration into the glycocalyx (Fig. 1A, dark gray bars), although it prevented the increase in leukocyte adhesion (Fig. 4A).

Effect of TNF-alpha on penetration of albumin, IgG, and Dextrans 40, 580, and 2,000. TNF-alpha administration produced an increase in both the penetration rate and the cutoff size for exclusion of macromolecules. In control hamsters, FITC-albumin (~67 kDa) and FITC-IgG (~150 kDa) penetrated the apical glycocalyx of the venules with a half-time of 40 min (Fig. 5, A and B). After treatment with TNF-alpha , both albumin and IgG penetrated the apical glycocalyx with half-times of 15 min. The increase in permeation of both plasma proteins was significant as early as 5 min after infusion. Both macromolecules penetrated the full thickness of the glycocalyx within 25 min. A similar increase in penetration was also observed after TNF-alpha in the presence of the selectin antagonist fucoidan. Similar results were observed for the capillaries and arterioles. In the presence of fucoidan alone, there was no significant difference in penetration of the macromolecules compared with the controls.


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Fig. 5.   A: effect of 2-h exposure to 0.5 µg of TNF-alpha on the penetration rate of FITC-albumin into the glycocalyx of postcapillary venules. B: effect of 2-h exposure to 0.5 µg of TNF-alpha on the penetration rate of FITC-immunoglobulin G (IgG) into the glycocalyx of postcapillary venules. *P < 0.05 compared with TNF-alpha .

For comparison to FITC-Dextran 70, the effect of TNF-alpha on the permeation of the glycocalyx to two larger dextrans and one smaller dextran in the absence of leukocyte adhesion was also evaluated. In a previous study, we observed that FITC-Dextrans 580 and 2,000 did not penetrate the intact apical glycocalyx even after hyaluronidase treatment (8). On the other hand, Dextran 40 has been shown to penetrate the intact endothelial surface layer with a half-time of 40 min (30). In this study, however, after TNF-alpha treatment, the dextran molecules occupied an increased intraluminal volume immediately after infusion with the dye fronts located ~0.3 µm from the endothelial surface (Fig. 6). We also observed even faster penetration of FITC-Dextran 40 (half-time ~10 min). Given this rapid penetration of Dextran 40, dextrans smaller than 40 kDa were excluded from this study. The depth of penetration of FITC-Dextran 580 was significant as early as 5 min after infusion. By 15 min after infusion, FITC-Dextran 580 had penetrated the glycocalyx to within 0.1 µm of the endothelial membrane. On the other hand, TNF-alpha treatment did not induce significant penetration of FITC-Dextran 2,000. 


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Fig. 6.   Comparison of the penetration rates of different sizes of dextrans into the luminal glycocalyx of postcapillary venules after 2-h exposure to intrascrotal TNF-alpha .

Topical TNF-alpha treatment to a local area of cremaster. Topical microapplication of TNF-alpha to selected microvascular components caused a significant increase in penetration of FITC-Dextran 70 into the luminal glycocalyx of those vessels after 20 min of exposure compared with control hamsters (Fig. 7A). This showed that the effects we observed were local and not due to other secondary systemic effects of the TNF-alpha . After 40 min of TNF-alpha exposure, leukocyte adhesion to the endothelium had increased significantly compared with controls (Fig. 7B), and petechiae were observed at many sites of extravasated leukocytes. This was taken as evidence of direct injury to the endothelial layer by adherent leukocytes after TNF-alpha treatment.


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Fig. 7.   A: effect of topical application of TNF-alpha on penetration rate of FITC-Dextran 70 in the glycocalyx. B: effect of topical application of TNF-alpha on the number of adherent leukocytes in postcapillary venules. *P < 0.05 compared with TNF-alpha .


    DISCUSSION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES

For decades, it has been known that the interaction of leukocytes and endothelium during inflammation can damage the endothelium and alter its permeability properties. However, nothing was known of the effect of a proinflammatory cytokine on penetration of macromolecules into the endothelial glycocalyx per se. Activation by cytokines results in upregulation of adhesion molecules on leukocytes and on the luminal surface of the endothelium (14). Thus leukocyte recruitment to sites of inflammation is facilitated.

Adherent leukocytes can directly injure the endothelium by releasing free radicals, proteases, and cationic proteins (3, 15, 19). An increase in extravasation of plasma macromolecules such as albumin leads to water retention in the interstitium, producing the edema that is characteristic of an inflammatory response. Much of the damage is attributed to release of proteases and free radicals by adherent leukocytes as they migrate through the endothelial wall (3, 10, 22, 23). For example, neutrophil-derived elastase degrades matrix constituents such as fibronectin and can contribute significantly to the increased permeability of macromolecules (17).

Previous findings from our laboratory showed that luminally applied TNF-alpha can increase arteriolar permeability to fluorescein in vitro, suggesting an increased transport of small water-soluble reagents (15). TNF-alpha can also cause an increase in pulmonary vascular permeability independent of neutrophil adhesion (11). These findings imply that TNF-alpha can alter vascular transport mechanisms independent of leukocyte involvement. In this study, we have shown that TNF-alpha also alters the endothelial surface layer causing increased macromolecular penetration, and that leukocyte adhesion is not a requirement for this response.

We therefore propose three mechanisms by which TNF-alpha might affect the properties of the apical glycocalyx (Fig. 8). Increased macromolecular penetration of the glycocalyx might result from disruption by rolling or adherent leukocytes after TNF-alpha treatment. TNF-alpha might activate passing leukocytes to release free radicals and/or proteases that degrade components of the glycocalyx. TNF-alpha might also activate endothelial-derived free radicals or surface-bound proteases or phospholipases (2) that release syndecans or glypicans from the glycocalyx.


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Fig. 8.   Illustration showing 3 proposed mechanisms by which TNF-alpha might alter the endothelial luminal glycocalyx.

Once activated, leukocytes express selectins on the tips of their microvilli and are captured by their ligands on the endothelium (14). This initiates the slow rolling phase of adhesion and facilitates subsequent firm adhesion and extravasation by the integrins and Ig-type adhesion molecules. In our experiments, the increase in the capture and rolling of leukocytes was significantly reduced by fucoidan, yet we still observed an increased penetration of dextran and plasma proteins into the venular glycocalyx after TNF-alpha treatment. Furthermore, the capillaries and arterioles, which are not normal binding sites for leukocytes, also had disrupted glycocalyces after TNF-alpha treatment in the presence of fucoidan. Thus we have eliminated leukocyte adhesion as a necessary mechanism by which TNF-alpha increases penetration into the glycocalyx (Fig. 8).

A second possible explanation for the increased dextran and protein penetration and increase in intraluminal volume after exposure to TNF-alpha is that the localized pool of cytokine in the cremaster activates passing leukocytes that then release factors to disrupt the glycocalyx (Fig. 8). A third mechanism is that TNF-alpha directly stimulates the endothelium to either shed some constituents of the glycocalyx, release free radicals, or activate surface-bound proteases or phospholipases that degrade it (Fig. 8). Endothelial-derived metalloproteases are upregulated by TNF-alpha and have been implicated in changes in endothelial morphology (7, 21). Recent studies have shown changes in endothelial cAMP and protein kinase expression induced by TNF-alpha (12, 13), as well as changes in endothelial tight junctions, actin cytoskeletal changes, and increased permeability (32). In addition, endothelial cells internalize and degrade thrombomodulin (18) and shed plasminogen activator inhibitor-1 and tie receptor from their surfaces (26, 33). However, the degree to which these molecules might contribute to forming the glycocalyx is unknown. TNF-alpha treatment causes the endothelium to release superoxide (5). Thus it is reasonable to propose that TNF-alpha activation might also cause endothelial cell changes involving the glycocalyx.

To detect changes in the glycocalyx, our laboratory devised a sophisticated method of in vivo measurements of dextran penetration (6, 29). This required making sure that vessels were not underfocused or overfocused during transillumination or epi-illumination so that the boundary of the vessel (anatomic diameter) could be visualized as a thin black line. This works well for smaller vessels (up to ~15 µm), but, in larger vessels, edge detection becomes more dificult. For measuring the anatomic diameter of each vessel, precise placement of the calipers was achieved by positioning one caliper outside the thin black line, indicating the vessel wall with its luminal surface against the edge of the black line. The other caliper was positioned just inside the thin black line, indicating the vessel wall with its outer surface against the black line. Similarly, to measure the fluorescent tracer column, one caliper was positioned outside the tracer column with its luminal surface against the edge of the tracer column. The other caliper was positioned just inside the tracer column with its outer surface against the edge of the tracer column. By calculating the depth of tracer penetration as one-half of the difference between the bright-field anatomic diameter and the tracer column diameter, we obtain not the absolute value of tracer column dimensions but rather the difference in perceived boundaries of tracers within the vessel lumen. When measurements are made in this way, the results are consistent.

The release of endothelial superoxide on cytokine stimulation (5) is likely to contribute to degradation of constituents of the glycocalyx. Hyaluronan, a component of the glycocalyx, is particularly sensitive to superoxide cleavage, and depolymerization of hyaluronan has often been used as an assay for the presence of free radicals (4). A preliminary study in our laboratory showed that treatment with exogenous hyaluronan or free radical scavengers protected the endothelium from light-dye injury, suggesting involvement of free radicals in degradation of the hyaluronan content of the glycocalyx (C. Henry and B. Duling, unpublished results). Results from a follow-up study in our laboratory also suggest that free radicals and proteases are involved in degradation of the glycocalyx after TNF-alpha exposure without a concurrent increased leukocyte adhesion (9).

Here, we provide evidence that TNF-alpha significantly changes the penetration rate of the major plasma macromolecules albumin and IgG into the glycocalyx. In the intact glycocalyx, albumin (67 kDa) penetrates with a half-time of 40 min (30). We observed that in control hamsters, IgG, although more than twice the size of albumin, penetrates the glycocalyx at the same rate. Vink and Duling (30) observed identical penetration rates of two proteins of vastly different molecular weights and suggested that mechanisms other than simple diffusion are involved in protein penetration into the endothelial surface layer. After TNF-alpha treatment, the penetration of both albumin and IgG increases by the same rate, suggesting a specific interaction between proteins and the apical glycocalyx that is disrupted by inflammatory stimuli.

Although TNF-alpha treatment disrupts the barrier properties of the luminal glycocalyx and causes some degradation, it does not cause total removal of the matrix. The continued size dependence of dextran penetration for up to 3 h after TNF-alpha exposure is evidence of this. Although all dextrans used in this study were anionic, the observed penetration rates in control hamsters reflect variations in both size and charge. It is unlikely that osmotic effects could produce these differences in penetration rates because the final blood concentration of each dextran was small (<10-4 M). The FITC-dextran molecules we used are labeled with an efficiency of about 0.01 FITC-molecules/glucose (Sigma, personal communication). Thus the net charge would be proportional to the molecular weight. If the glycocalyx had been totally lost after TNF-alpha treatment, we would have expected to see no difference in penetration rate of the dextrans, and we should have detected a change in the exclusion zone between the red blood cells and the endothelial surface. Therefore, we conclude that certain constituents of the surface coat remained intact and that these are sufficient to restrict free movement of the dextrans.

Taken together, these findings support our earlier data on the heterogeneous composition of the glycocalyx (8). In that study, we showed that cleavage of cell surface hyaluronan by the enzyme hyaluronidase, resulted in increased penetration of FITC-Dextrans 70 and 145 without increasing the penetration of FITC-Dextrans 580 and 2,000 or the intravascular volume available for the red blood cells. Here, we now show that the TNF-alpha response also involves disruption of glycocalyx constituents resulting in increased penetration of FITC-Dextran 70 and plasma proteins. However, there are important differences. TNF-alpha treatment produced a significant increase in the intravascular volume available to red blood cells, as well as an increase in penetration of FITC-Dextran 580. Hyaluronidase treatment did not produce these effects. Thus the degradation induced by TNF-alpha appears to be more extensive than that produced by hyaluronidase.

Other inflammatory mediators and vasoactive molecules may have a similar effect on the glycocalyx. We observed increased penetration of FITC-Dextran 70 into the luminal glycocalyx of hamster cremaster microvessels after topical adenosine or histamine application (C. Henry and B. Duling, unpublished results). Histamine can also cause selectin-mediated leukocyte adhesion and leukocyte-independent extravasation of plasma macromolecules in rat mesenteric venules (28). We cannot ignore the possibility that other endogenous cytokines were induced by TNF-alpha in our experiments. For example, interferon-gamma has been shown to be upregulated by TNF-alpha and then to act synergistically with it in enhancing the inflammatory response (27). Endothelial activation by TNF-alpha can also upregulate the production of interleukin-1, another proinflammatory cytokine (20).

In conclusion, we have shown that TNF-alpha treatment significantly alters the permeation properties of the endothelial luminal glycocalyx independent of leukocyte adhesion. This supports the idea that the glycocalyx is a significant site of cytokine-mediated injury. Taken together with evidence in the literature, our findings lead us to further hypothesize that initial disruption of the matrix by proinflammatory cytokines may result in loss of anticoagulant surface molecules and predispose the endothelium to exposure to blood components. Coupled with leukocyte adhesion and extravasation, as well as disruption of intercellular junctions, these processes might lead to increased microvascular dysfunction.


    ACKNOWLEDGEMENTS

B. R. Duling was supported in part by National Institutes of Health Grant HL-12792, and C. B. S. Henry was supported by American Heart Association Fellowship 9920377U.


    FOOTNOTES

Address for reprint requests and other correspondence: B. R. Duling, Dept. of Molecular Physiology and Biological Physics, Univ. of Virginia, PO Box 800736, Charlottesville, VA 22908-0736 (E-mail: brd{at}virginia.edu).

The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 15 November 1999; accepted in final form 14 July 2000.


    REFERENCES
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
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Am J Physiol Heart Circ Physiol 279(6):H2815-H2823
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