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Placental anticoagulant protein-I: measurement in extracellular fluids and cells of the hemostatic system.

Placental anticoagulant protein-I (PAP-I), a member of the lipocortin protein family, is a potent in vitro anticoagulant whose in vivo function is unknown. Very low levels of PAP-I were present in plasma of normal volunteers (0 to 5 ng/ml) and in randomly chosen plasma specimens from hospitalized patients (0 to 28 ng/ml). Review of selected hospital records did not reveal any single clinical entity that correlated with plasma levels. PAP-I was also found in amniotic fluid (12 to 107 ng/ml) and in conditioned medium of cultured endothelial cells (49 +/- 20 ng/ml). Gel filtration experiments showed that PAP-I was intact and uncomplexed in plasma and amniotic fluid. The protein was fairly abundant intracellularly: 4080 +/- 2560 ng/mg total protein in cultured umbilical vein endothelial cells; 178 +/- 109 ng/mg in platelets; 564 +/- 384 ng/mg in leukocytes; and 8.4 +/- 4.3 ng/mg in erythrocytes. The levels of PAP-I increased in platelet-rich plasma after stimulation of platelets with arachidonic acid but not after stimulation with ADP, epinephrine, thrombin, ristocetin, or collagen. These data suggest that PAP-I probably does not function as a circulating natural anticoagulant in normal persons.

Amniotic Fluid↗

[Determination of dry weight of hemodialyzed patients on the basis of the ratio of extracellular fluid volume to total body fluid volume as measured by multifrequency impedance].

Whole body impedometry is relatively new non-invasive method to measure the distribution of total body water (TBW) between extra- and intracellular compartment (VEC, VIC). Having applied linear regression analysis onto the relation of the ratio of the extracellular volume to the volume of total body water (VEC/TBW) and the age in a group of healthy individuals very narrow scatter from the regression line was found. This line can thus be used as an indicator of normohydration status with respect to age. Assuming that the relation of VEC/TBW vs. age is the same in dialysed patients and that the state of normohydration corresponds to the so called dry weight, the VEC/TBW value can be used as a novel indicator of dry weight. Any deviation of the pre-dialysis VEC/TBW value from normal could easily be used to establish the desired ultrafiltration and dry weight. With regard to the known inaccuracy with which the dry weight is determined from purely clinical assessment this approach may lead to substantial objectivisation in determination of this principal parameter. It may be especially helpful in case of newly admitted patients. The suggested new approach to dry weight determination is supported by the finding of statistically significant relation between post-dialysis deviation of the VEC/TBW ratio from the normal value vs. blood volume reduction at the end of the dialysis session. Patients classified at the end of a dialysis session as still overhydrated by their VEC/TBW deviation from normal showed little or no reduction in their blood volume. An investigation of the Vena Cava Inferior diameter in a subgroup of these patients confirmed this finding showing no decrease at the end of dialysis. On the contrary, the patients whose post-dialysis VEC/TBW value was normal or below normal showed both significant reduction in their blood volume as well as decrease in the Vena Cava Inferior diameter.

Adult↗

Extracellular fluid conditioned during peripheral nerve regeneration stimulates Schwann cell adhesion, migration and proliferation.

Schwann cell movement and proliferation occur during peripheral nerve regeneration and remyelination. We asked whether soluble factors promoting these activities were present in fluid surrounding rat sciatic nerves regenerating across a 10-mm gap bridged by a silicone tube. In this model, regenerated and remyelinated axons extend across the gap by 28 days following nerve transection and tube implantation. Fluid conditioned by cells participating in nerve regeneration (RCF) was assayed for its ability to promote Schwann cell adhesion, migration and proliferation in vitro. RCFs collected at post-transectional days 1-28 were equally effective in promoting Schwann cell-substratum adhesion. In contrast, the motility-promoting activity of RCF was minimal at 1-2 days following nerve-transection, peaked at 7 days and remained elevated through 21 days. The RCF peak response was 87-fold greater than control. Schwann cell proliferative activity of RCF exhibited peaks of activity at 1 and 14 days post-transection. The biological potency of this fluid for each activity assayed in vitro correlated well with the behavior of Schwann cells chronicled during nerve repair in vivo. These findings suggest that soluble factors promoting Schwann cell adhesion, migration, and proliferation accumulate extracellularly during peripheral nerve regeneration and remyelination.

Animals↗

Effect of maternal intravenous infusions on fetal extracellular fluid composition in pregnant ewes.

Infusion of intravenous solutions to women in labor is common clinical practice. Since these infusions may change the volume and electrolyte balance between the mother and fetus, we investigated the influence of acute maternal volume expansion upon fetal and maternal fluid and electrolyte equilibrium in the chronically catheterized fetal lamb. Paired measurements of maternal and fetal plasma sodium and potassium concentrations, osmolality, and colloid osmotic pressure (COP), plus measurements in the fetal-placental plasma volume were obtained following rapid maternal infusions with saline, dextrose, and dextran solutions. Maternal infusions resulted in changes in fetal electrolyte concentrations as well as alterations in transplacental COP differences. Despite these changes, however, no changes in fetal plasma volume were noted.

Animals↗