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Medical Forum / General / Cardiology / May 2006

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Can altered vascular permeability effect glocose levels?

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Kumar - 09 May 2006 05:45 GMT
"Increased vascular permeability

--------------------------------------------------------------------------------

Small blood vessels are lined by a single layer of endothelial cells.
In some tissues, these form a complete layer of uniform thickness
around the vessel wall, while in other tissues there are areas of
endothelial cell thinning, known as fenestrations. The walls of small
blood vessels act as a microfilter, allowing the passage of water and
solutes but blocking that of large molecules and cells . Oxygen, carbon
dioxide and some nutrients transfer across the wall by diffusion, but
the main transfer of fluid and solutes is by ultrafiltration, as
described by Starling. The high colloid osmotic pressure inside the
vessel, due to plasma proteins, favours fluid return to the vascular
compartment. Under normal circumstances, high hydrostatic pressure at
the arteriolar end of capillaries forces fluid out into the
extravascular space, but this fluid returns into the capillaries at
their venous end, where hydrostatic pressure is low. In acute
inflammation, however, not only is capillary hydrostatic pressure
increased, but there is also escape of plasma proteins into the
extravascular space, increasing the colloid osmotic pressure there.
Consequently, much more fluid leaves the vessels than is returned to
them. The net escape of protein-rich fluid is called exudation; hence,
the fluid is called the fluid exudate
http://medweb.bham.ac.uk/http/mod/3/1/a/permeability.html "

Hello,

Vascular permeability is related to allowing the passage of water and
solutes but blocking that of large molecules and cells. Any change or
defect in it can effect passage of many bio-substances to the
extravascular tissues. Vasoconstriction, vasodialation, damages to
vascular walls, gaps between cells to cells in vascular walls, cells
adhesions, inflammatory conditions, regulatory machemisms, medications
etc. can effect such vascular permeability resulting into abnormal
movement of bio-substances between vascular and extravascular
compartments. I have few questions:-

1. Can some abnormailities in  vascular permeability effect movements
of biosubstances in between vascular and extravascular compartments?

2. Can vasoconstriction cause such movements in lesser quantity of
bigger moleculaes , vaso-dilation opposite?

3. Can glucose, lipids, protiens and insulin molecules be considered as
bigger molecules in this respect and so their passage to extravascular
compartments be reduced due to vasoconstriction, contracted conditions,
vascular wall's cells size and their adhesions?

4. Can it cause hyper-such biosubstances which can't be passed due to
decreased   vascular permeability, hyperglycemia, insulin resistance
etc?

5. Can unstability bio-substances in blood, blood tonicity/viscosity
effect vascular permeability?

6. Whether heat and cold, quantity of water intake, contracted or
relaxed conditions of vascular wall muscles, pH etc. can effect
vascular permeability?

Best wishes.
Kumar - 10 May 2006 04:37 GMT
How can we check extravascular availability of glucose and insulin as
compared with intra vascular readings?

How weight can stay constant or increase without normal or more
insulin, glucose and fats?
Kumar - 14 May 2006 05:49 GMT
"Glycosylation may play a role in cell-cell adhesion (a mechanism
employed by cells of the immune system), as well.
http://en.wikipedia.org/wiki/Glycosylation
Glycation is the result of a sugar molecule, such as fructose or
glucose, bonding to a protein or lipid molecule without the controlling
action of an enzyme. All blood sugars are reducing molecules. Glycation
may occur either inside (endogenous) or outside (exogenous) the body.
Enzyme-controlled addition of sugars to protein or lipid molecules is
termed glycosylation; this process is less haphazard than glycation.
Much of early laboratory research work on fructose glycations used
inaccurate assay techniques that drastically understated the importance
of fructose in glycation formation
http://en.wikipedia.org/wiki/Glycation "
It looks above conditions are meant to control exposure of excess
exposure of glucose, insulin etc. to target cells in extravascular
compartments. These may also have such effect by lowering cardiac
output and BP due to diastolic dysfunction.

In what way, exposure of excess glucose and excess insulin can be
harmful to target cells?
Kumar - 16 May 2006 09:31 GMT
"Insulin also increases the permiability of many cells to potassium,
magnesium and phosphate ions. The effect on potassium is clinically
important. Insulin activates sodium-potassium ATPases in many cells,
causing a flux of potassium into cells. Under certain circumstances,
injection of insulin can kill patients because of its ability to
acutely suppress plasma potassium concentrations.
http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/insulin_phys.html
"

"". In vitro and in vivo studies have demonstrated that insulin may
modulate the shift of Mg from extracellular to intracellular space.
Intracellular Mg concentration has also been shown to be effective in
modulating insulin action (mainly oxidative glucose metabolism), offset
calcium-related excitation-contraction coupling, and decrease smooth
cell responsiveness to depolarizing stimuli. A poor intracellular Mg
concentration, as found in noninsulin-dependent diabetes mellitus
(NIDDM) and in hypertensive patients, may result in a defective
tyrosine-kinase activity at the insulin receptor level and exaggerated
intracellular calcium concentration. Both events are responsible for
the impairment in insulin action and a worsening of insulin resistance
in noninsulin-dependent diabetic and
hhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12537988
&dopt=Abstractypertensive

patients. "'

The above quotes indicate the Mg relations with insulin action. I think
lack of Mg may be related to calcium-related excitation-contraction
coupling, and decrease smooth cell responsiveness to depolarizing
stimuli....contracted conditions. ?? It may be important to understand
effect of hyperglycemia on mediating Mg defficiencies and
calcium-related excitation-contraction coupling, and decrease smooth
cell responsiveness to depolarizing stimuli...contracted condition.
Kumar - 20 May 2006 12:09 GMT
"E coli - Friend or Foe?
In 1978, a company named Genentech was the first to exploit genetic
engineering technology to make human insulin. Before Genentech, medical
insulin had to be extracted from pig pancreas, a costly and undesirable
procedure. Genentech took the human gene responsible for insulin,
inserted it into a plasmid and transformed our friend E coli. The
bacteria happily synthesised huge amounts of pure human insulin, making
this life-saving compound affordable and accessible. Genentech went on
to clone and synthesis the human growth hormone, Activase (a product
for dissolving blood clots in heart attack victims), Factor VIII (for
haemophilia therapy) and other products, with the same technology.
E coli is a vital inhabitant of our intestines, both aiding digestion
and protecting us from other infections. E coli is a keystone of the
world's ecosystems. E coli is a very useful tool for the biological
sciences, most notably the remarkable technique of genetic engineering,
which ushered in a new dawn in pharmaceutical research and development.
"
http://www.bbc.co.uk/dna/h2g2/A1061308

E.Coli is used in genetic engineering of insulin.

Whether E.Coli can also have some natural role on insulin production
and its secretions?

Whether people with E.Coli infections are non-diabetic or with less
complicated diabetes?
Kumar - 27 May 2006 10:30 GMT
There are some intestinal secrations which can enhance more insulin
secrations. Whether E.Coli infection effect such effect of enhanced
insulin(may be more secration)?

"Local blood flow control can be divided into two phases;
1)Acute - rapid change constriction/dilatation of arteriols,
metarteriol et spincters.
2)Long-term control provides a better control by increasing/decreasing

the physical size and number of blood vessels supplying the tissues. "

Diabetic2 patients can have persistent hyperglycemia due to excess
craving and overeating. They can also opt for sed. lifestyle due to
predisposition or due to diabetic pathology.Consequently, supply of
glucose and nutrients can be more to tissues and demand/need of them
may be less. As such excess glucose, nutrients etc. may cause some
toxicity to target tissues. To save from this and in view of above, can
chronically elevated blood glucose levels and of other nutrients in
blood cause some morphological changes by decreasing the physical size
and number of blood vessels supplying the tissues as "long term blood
flow regulation", naturally?

How added insulin--medicated or injected, can behave in opposite to
above natural body's mechanism of restricting excess exposure of
nutrients to cells, in view of dilating effect mediated by added
insulin? Can such added insulin cause gluco/nutrient toxicity or excess
exposure to target cells?

Btw, whether such added insulin, is exposed to blood and target cells,
for prolonged time or for whole day (long acting) persistently ? If
yes, what can be its impact?
 
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