Barrier stabilizing mediators in regulation of microvas-cular endothelial permeability

Abstract

【Abstract】Increase of microvascular permeability is one of the most important pathological events in the pathogenesis of trauma and burn injury. Massive leakage of fluid from vascular space leads to lose of blood plasma and decrease of effective circulatory blood volume, result-ing in formation of severe tissue edema, hypotension or even shock, especially in severe burn injury. Fluid resusci-tation has been the only valid approach to sustain patient’s blood volume for a long time, due to the lack of overall and profound understanding of the mechanisms of vascular hyperpermeability response. There is an emerging concept in recent years that some so-called barrier stabilizing media-tors play a positive role in preventing the increase of vascu-lar permeability. These mediators may be released in re-sponse to proinflammatory mediators and serve to restore endothelial barrier function. Some of these stabilizing me-diators are important even in quiescent state because they preserve basal vascular permeability at low levels. This re-view introduces some of these mediators and reveals their underlying signaling mechanisms during endothelial bar-rier enhancing process. Key words: Permeability; Endothelium, vascular; Mediator complex; Receptors, cyclic AMP; RAC1 protein, human