Leukocyte endothelium adhesion and microvascular hemodynamics.

In the present study we have attempted to provide quantitative details of hemodynamic determinants of leukocyte to endothelium adhesion in the microvasculature. To this end, several hypotheses have been advanced to suggest that the preferential adhesion of leukocytes in the larger venules (30-50 microns diameter) rests upon the inherent ability of the microvasculature to compensate for small perturbations in resistance and that WBC deformability may play a significant role in this process. Flow redistribution and attendant arteriolar vasomotor adjustments may forestall LEA in the larger collecting venules of the network, where venous obstruction may be countered by bringing the full weight of the arteriovenous pressure gradient to oppose WBC adhesion. Direct measurements of the force of adhesion suggest that with diminishing vessel diameter, as for example in the immediate post-capillary venules, WBC dispersal forces will be greatest due to dramatic increases in the proportionality between force and wall shear stress. This event would tend to preclude adhesion in the smallest venular microvessels. It has also been shown that there is a strong potential for WBC deformability to affect the adhesion process by modification of the shear stresses acting on the WBC surface, as evidenced by an inverse relationship between force and wall shear stress and direct observations of WBC shape changes with increasing shear.