Microvascular endothelial activation in the skeletal muscles of patients with multiple organ failure

Journal of the Neurological Sciences
T R HelliwellJ M Bone

Abstract

The relationship between microvascular damage and the presence of muscle fibre atrophy and necrosis has been investigated in skeletal muscle biopsies taken from 57 patients with multiple organ failure. Immunohistochemical studies showed no loss of capillaries and no luminal thrombosis, while neutrophil leucocytes were more prevalent in the patients' biopsies than in controls. Deposition of the complement membrane attack complex (C5-9MAC) in capillaries was observed in 41% of cases. Endothelial activation was suggested by an increased intensity of expression of ICAM-1, and by an increased proportion of capillaries expressing P selectin and E selectin, although this was not directly associated with neutrophil accumulation. Endothelial swelling was present in many biopsies with 38% of the biopsies having larger capillary profiles on immunohistochemical labelling for von Willebrand factor (vWF), thrombomodulin and CD34, and on Ulex europaeus agglutinin 1 binding. Endothelial swelling was confirmed by image analysis and morphometric evaluation of capillary ultrastructure, however, the capillary luminal area was not reduced as the capillaries were dilated. Increased vWF labelling was associated with C5-9MAC deposition and with fibre ...Continue Reading

References

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Citations

Jan 6, 2010·Critical Care Medicine·Richard D Griffiths, Jesse B Hall
Oct 14, 2006·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·L H Visser
Feb 24, 2000·The Journal of Pathology·D L Carden, D N Granger
Sep 1, 2007·Current Opinion in Critical Care·Richard D Griffiths, Christina Jones
Jul 13, 2006·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Michael A FlierlMarkus S Huber-Lang
Dec 8, 2000·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Y MisawaK Fuse

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