Precapillary sphincter | |
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Anatomical terminology |
A precapillary sphincter is a band of contractile mural cells either classified as smooth muscle or pericytes that adjusts blood flow into capillaries. They were originally described in the mesenteric microcirculation, and were thought to only reside there. [1] [2] At the point where each of the capillaries originates from an arteriole, contractile mural cells encircle the capillary. This is called the precapillary sphincter. The precapillary sphincter has now also been found in the brain, where it regulates blood flow to the capillary bed. [3] The sphincter can open and close the entrance to the capillary, by which contraction causes blood flow in a capillary to change as vasomotion occurs. [4] [ unreliable source? ] In some tissues, the entire capillary bed may be bypassed by blood flow through arteriovenous anastomoses or through preferential flow through metarterioles. [2] If the sphincter is damaged or cannot contract, blood can flow into the capillary bed at high pressures. When capillary pressures are high (as per gravity, etc.), fluid passes out of the capillaries into the interstitial space, and edema or fluid swelling is the result.[ citation needed ]
Precapillary sphincters and metarterioles were discovered in the mesenteric circulation in the 1950s. Medical and physiological textbooks, such as Guyton , Boron and Fulton, etc. were quick to claim the existence of said sphincters and metarterioles all over the body, despite lack of evidence. [2] At least since 1976 there has been considerable debate about the existence of precapillary sphincters and metarterioles. [5] In 2020, precapillary sphincters were identified as a mechanism for controlling cerebral blood flow. [6]
Veins are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins.
A capillary is a small blood vessel, from 5 to 10 micrometres in diameter, and is part of the microcirculation system. Capillaries are microvessels and the smallest blood vessels in the body. They are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the site of the exchange of many substances from the surrounding interstitial fluid, and they convey blood from the smallest branches of the arteries (arterioles) to those of the veins (venules). Other substances which cross capillaries include water, oxygen, carbon dioxide, urea, glucose, uric acid, lactic acid and creatinine. Lymph capillaries connect with larger lymph vessels to drain lymphatic fluid collected in microcirculation.
The renin-angiotensin system (RAS), or renin-angiotensin-aldosterone system (RAAS), is a hormone system that regulates blood pressure, fluid, and electrolyte balance, and systemic vascular resistance.
The microcirculation is the circulation of the blood in the smallest blood vessels, the microvessels of the microvasculature present within organ tissues. The microvessels include terminal arterioles, metarterioles, capillaries, and venules. Arterioles carry oxygenated blood to the capillaries, and blood flows out of the capillaries through venules into veins.
Vasodilation, also known as vasorelaxation, is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. Blood vessel walls are composed of endothelial tissue and a basal membrane lining the lumen of the vessel, concentric smooth muscle layers on top of endothelial tissue, and an adventitia over the smooth muscle layers. Relaxation of the smooth muscle layer allows the blood vessel to dilate, as it is held in a semi-constricted state by sympathetic nervous system activity. Vasodilation is the opposite of vasoconstriction, which is the narrowing of blood vessels.
An arteriole is a small-diameter blood vessel in the microcirculation that extends and branches out from an artery and leads to capillaries.
Cerebral circulation is the movement of blood through a network of cerebral arteries and veins supplying the brain. The rate of cerebral blood flow in an adult human is typically 750 milliliters per minute, or about 15% of cardiac output. Arteries deliver oxygenated blood, glucose and other nutrients to the brain. Veins carry "used or spent" blood back to the heart, to remove carbon dioxide, lactic acid, and other metabolic products. The neurovascular unit regulates cerebral blood flow so that activated neurons can be supplied with energy in the right amount and at the right time. Because the brain would quickly suffer damage from any stoppage in blood supply, the cerebral circulatory system has safeguards including autoregulation of the blood vessels. The failure of these safeguards may result in a stroke. The volume of blood in circulation is called the cerebral blood flow. Sudden intense accelerations change the gravitational forces perceived by bodies and can severely impair cerebral circulation and normal functions to the point of becoming serious life-threatening conditions.
Perfusion is the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue. Perfusion may also refer to fixation via perfusion, used in histological studies. Perfusion is measured as the rate at which blood is delivered to tissue, or volume of blood per unit time per unit tissue mass. The SI unit is m3/(s·kg), although for human organs perfusion is typically reported in ml/min/g. The word is derived from the French verb perfuser, meaning to "pour over or through". All animal tissues require an adequate blood supply for health and life. Poor perfusion (malperfusion), that is, ischemia, causes health problems, as seen in cardiovascular disease, including coronary artery disease, cerebrovascular disease, peripheral artery disease, and many other conditions.
Pericytes are multi-functional mural cells of the microcirculation that wrap around the endothelial cells that line the capillaries throughout the body. Pericytes are embedded in the basement membrane of blood capillaries, where they communicate with endothelial cells by means of both direct physical contact and paracrine signaling. The morphology, distribution, density and molecular fingerprints of pericytes vary between organs and vascular beds. Pericytes help in the maintainenance of homeostatic and hemostatic functions in the brain, where one of the organs is characterized with a higher pericyte coverage, and also sustain the blood–brain barrier. These cells are also a key component of the neurovascular unit, which includes endothelial cells, astrocytes, and neurons. Pericytes have been postulated to regulate capillary blood flow and the clearance and phagocytosis of cellular debris in vitro. Pericytes stabilize and monitor the maturation of endothelial cells by means of direct communication between the cell membrane as well as through paracrine signaling. A deficiency of pericytes in the central nervous system can cause increased permeability of the blood–brain barrier.
Hypoxic pulmonary vasoconstriction (HPV), also known as the Euler-Liljestrand mechanism, is a physiological phenomenon in which small pulmonary arteries constrict in the presence of alveolar hypoxia. By redirecting blood flow from poorly-ventilated lung regions to well-ventilated lung regions, HPV is thought to be the primary mechanism underlying ventilation/perfusion matching.
Cerebral perfusion pressure, or CPP, is the net pressure gradient causing cerebral blood flow to the brain. It must be maintained within narrow limits because too little pressure could cause brain tissue to become ischemic, and too much could raise intracranial pressure (ICP).
A metarteriole is a short microvessel in the microcirculation that links arterioles and capillaries. Instead of a continuous tunica media, they have individual smooth muscle cells placed a short distance apart, each forming a precapillary sphincter that encircles the entrance to that capillary bed. Constriction of these sphincters reduces or shuts off blood flow through their respective capillary beds. This allows the blood to be diverted to elsewhere in the body.
Autoregulation is a process within many biological systems, resulting from an internal adaptive mechanism that works to adjust that system's response to stimuli. While most systems of the body show some degree of autoregulation, it is most clearly observed in the kidney, the heart, and the brain. Perfusion of these organs is essential for life, and through autoregulation the body can divert blood where it is most needed.
The Anrep effect describes the rapid increase in myocardial contractility in response to the sudden rise in afterload, the pressure the heart must work against to eject blood. This adaptive mechanism allows the heart to sustain stroke volume and cardiac output despite increased resistance. It operates through homeometric autoregulation, meaning that contractility adjustments occur independently of preload or heart rate.
Transient receptor potential cation channel, subfamily C, member 6 or Transient receptor potential canonical 6, also known as TRPC6, is a protein encoded in the human by the TRPC6 gene. TRPC6 is a transient receptor potential channel of the classical TRPC subfamily.
Cerebral autoregulation is a process in mammals that aims to maintain adequate and stable cerebral blood flow. While most systems of the body show some degree of autoregulation, the brain is very sensitive to over- and underperfusion. Cerebral autoregulation plays an important role in maintaining an appropriate blood flow to that region. Brain perfusion is essential for life, since the brain has a high metabolic demand. By means of cerebral autoregulation, the body is able to deliver sufficient blood containing oxygen and nutrients to the brain tissue for this metabolic need, and remove CO2 and other waste products.
Precapillary resistance is the modulation of blood flow by capillaries through vasomotion, either opening (dilating) and letting blood pass through, or by constricting their lumens, reducing bloodflow through the capillary bed. It is not entirely clear how precapillary resistance is created in many parts of the body. Precapillary sphincters are smooth muscle structures that mediate the precapillary resistance in the mesenteric microcirculation.
A resistance artery is small diameter blood vessel in the microcirculation that contributes significantly to the creation of the resistance to flow and regulation of blood flow. Resistance arteries are usually small arteries or arterioles and include precapillary sphincters. Having thick muscular walls and narrow lumen they contribute the most to the resistance to blood flow. Degree of the contraction of vascular smooth muscle in the wall of a resistance artery is directly connected to the size of the lumen.
Cerebral blood volume is the blood volume in a given amount of brain tissue.
Martin Johannes Lauritzen is a Danish neuroscientist. He is a Professor of Translational Neurobiology at the Department of Neuroscience, University of Copenhagen, Denmark and also a Professor of Clinical Neurophysiology at the Department of Neurophysiology, Rigshospitalet.