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Klin Monbl Augenheilkd 2015; 232(2): 127-132
DOI: 10.1055/s-0034-1383394
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Physiologische Grundlagen der Mikrozirkulation: vaskuläre Adaptation

Physiological Basis of the Microcirculation: Vascular Adaptation
A. R. Pries
Physiologie, Charité, Berlin
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Publication History

eingereicht 22 October 2014

akzeptiert 27 October 2014

Publication Date:
20 February 2015 (online)

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Zusammenfassung

Die Mikrozirkulation ist die funktional entscheidende Endstrecke des Kreislaufs. In den Gefäßen mit Durchmessern unter ca. 300 µm finden die Durchblutungsregulation, der Stoffaustausch und wesentliche Vorgänge der Immunabwehr statt. Hierbei spielt eine Vielzahl einzelner Komponenten eine große Rolle, wie z. B. Mikrorheologie, endotheliale Oberflächenschicht, Gefäßpermeabilität, Endothelfunktion, Regulation des Gefäßmuskeltonus, Leukozyten-Endothel-Interaktion, vaskuläre Adaptation und Angiogenese. Der vorliegende Artikel ist primär auf die Rolle vaskulärer Anpassungsphänomene fokussiert. Viel stärker als größere Gefäße zeigt die Mikrozirkulation konstant Anpassungen an lokale hämodynamische und metabolische Signale. In Reaktion auf Änderungen des Bedarfs der Parenchymzellen erfolgen Änderungen des Gefäßdurchmessers existierender Gefäße (Tonusänderungen oder strukturelles „remodeling“), aber auch Neubildung oder Rückbildung von Mikrogefäßen (Angiogenese oder „pruning“). Diese Vorgänge werden unter dem Begriff „Angioadaptation“ zusammengefasst, die klinisch große Bedeutung z. B. für pathophysiologische Implikationen der Hypertonie und der altersbedingten Makuladegeneration besitzen.

Abstract

The microcirculation is the functional “business end” of the cardiovascular system. In vessels with diameters below about 300 µm processes including the regulation of perfusion, exchange processes and relevant components of the immune system are localised. A large number of individual mechanisms are involved, including micro-rheology, the endothelial surface layer, vascular permeability, endothelial function, regulation of smooth muscle tone, leukocyte endothelial interaction, vascular adaptation and angiogenesis. The present article focusses mainly on the role of vascular adaptation. Much more than in large vessels, the microcirculation is characterised by constant adaptation to haemodynamic and metabolic signals. In reaction to changes in parenchymal demand, changes of the diameter of existing vessels (by changes in tone or by structural remodelling) as well as generation of new vessels (angiogenesis) or the pruning of vessels are elicited. These mechanisms are part of the so-called “angioadaptation” which is of great clinical relevance for the pathophysiological consequences of hypertension and age-related macular degeneration.

Schlüsselwörter

Retina - Mikrozirkulation - Sauerstoffversorgung

Key words

retina - microcirculation - oxygen delivery
 

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