Medical Forum / General / Cardiology / May 2006
Can altered vascular permeability effect glocose levels?
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Kumar - 09 May 2006 05:45 GMT "Increased vascular permeability
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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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