Name: assessment of human adipose tissue microvascular function using videomicroscopy
Uploaded: 2017-09-29T13:00:00
Description: Watch this Scientific Journal Video about Assessment of Human Adipose Tissue Microvascular Function Using Videomicroscopy at JoVE.com

The authors would like to thank the volunteers for their participation in these studies and the surgical staff at the Boston Medical Center for providing adipose tissue biopsies. Dr. Gokce is supported by National Institutes of Health (NIH) grants HL081587, HL114675, and HL126141. Dr. Farb is supported by NIH grant K23 HL135394.

The protocol and examples described here were approved by Boston University School of Medicine Institutional Review Board (IRB, protocol #H-25644) and were conducted in accordance with the Declaration of Helsinki. All subjects provided written informed consent before participation.
1. Preparation of Solutions and Micro-glass Cannulas
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	<li>Prepare the 4-2-hydrosyethyl-1-piperazineethanesulfonic acidic saline (HEPES) solution. For 1 L, dissolve 8.059 g NaCl, 0.298 g KCl, 0.296 g MgSO...

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	<li>Schubert, R., Mulvany, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+myogenic+response:+established+facts+and+attractive+hypotheses.">The myogenic response: established facts and attractive hypotheses.</a> Clin Sci (Lond). 96 (4), 313-326 (1999).</li><li>Jadeja, R. N., Rachakonda, V., Bagi, Z., Khurana, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessing+Myogenic+Response+and+Vasoactivity+In+Resistance+Mesenteric+Arteries+Using+Pressure+Myography.">Assessing Myogenic Response and Vasoactivity In Resistance Mesenteric Arteries Using Pressure Myography.</a> J Vis Exp. (101), e50997 (2015).</li><li>Gutterman, D. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Human+Microcirculation:+Regulation+of+Flow+and+Beyond.">The Human Microcirculation: Regulation of Flow and Beyond.</a> Circ Res. 118 (1), 157-172 (2016).</li><li>Fuster, J. J., Ouchi, N., Gokce, N., Walsh, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Obesity-Induced+Changes+in+Adipose+Tissue+Microenvironment+and+Their+Impact+on+Cardiovascular+Disease.">Obesity-Induced Changes in Adipose Tissue Microenvironment and Their Impact on Cardiovascular Disease.</a> Circ Res. 118 (11), 1786-1807 (2016).</li><li>Farb, M. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reduced+adipose+tissue+inflammation+represents+an+intermediate+cardiometabolic+phenotype+in+obesity.">Reduced adipose tissue inflammation represents an intermediate cardiometabolic phenotype in obesity.</a> J Am Coll Cardiol. 58 (3), 232-237 (2011).</li><li>Farb, M. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=WNT5A-JNK+regulation+of+vascular+insulin+resistance+in+human+obesity.">WNT5A-JNK regulation of vascular insulin resistance in human obesity.</a> Vasc Med. 21 (6), 489-496 (2016).</li><li>Durand, M. J., Phillips, S. A., Widlansky, M. E., Otterson, M. F., Gutterman, D. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+vascular+renin-angiotensin+system+contributes+to+blunted+vasodilation+induced+by+transient+high+pressure+in+human+adipose+microvessels.">The vascular renin-angiotensin system contributes to blunted vasodilation induced by transient high pressure in human adipose microvessels.</a> Am J Physiol Heart Circ Physiol. 307 (1), H25-H32 (2014).</li><li>Farb, M. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cyclooxygenase+inhibition+improves+endothelial+vasomotor+dysfunction+of+visceral+adipose+arterioles+in+human+obesity.">Cyclooxygenase inhibition improves endothelial vasomotor dysfunction of visceral adipose arterioles in human obesity.</a> Obesity (Silver Spring). 22 (2), 349-355 (2014).</li><li>Park, S. Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Impact+of+age+on+the+vasodilatory+function+of+human+skeletal+muscle+feed+arteries.">Impact of age on the vasodilatory function of human skeletal muscle feed arteries.</a> Am J Physiol Heart Circ Physiol. 310 (2), H217-H225 (2016).</li><li>Ives, S. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+skeletal+muscle+feed+arteries+studied+in+vitro:+the+effect+of+temperature+on+alpha(1)-adrenergic+responsiveness.">Human skeletal muscle feed arteries studied in vitro: the effect of temperature on alpha(1)-adrenergic responsiveness.</a> Exp Physiol. 96 (9), 907-918 (2011).</li><li>Grizelj, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reduced+flow-and+acetylcholine-induced+dilations+in+visceral+compared+to+subcutaneous+adipose+arterioles+in+human+morbid+obesity.">Reduced flow-and acetylcholine-induced dilations in visceral compared to subcutaneous adipose arterioles in human morbid obesity.</a> Microcirculation. 22 (1), 44-53 (2015).</li><li>Farb, M. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Arteriolar+function+in+visceral+adipose+tissue+is+impaired+in+human+obesity.">Arteriolar function in visceral adipose tissue is impaired in human obesity.</a> Arterioscler Thromb Vasc Biol. 32 (2), 467-473 (2012).</li><li>Tanner, M. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dynamin-Related+Protein+1+Mediates+Low+Glucose-Induced+Endothelial+Dysfunction+in+Human+Arterioles.">Dynamin-Related Protein 1 Mediates Low Glucose-Induced Endothelial Dysfunction in Human Arterioles.</a> Am J Physiol Heart Circ Physiol. , (2016).</li><li>Ives, S. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=alpha1-Adrenergic+responsiveness+in+human+skeletal+muscle+feed+arteries:+the+impact+of+reducing+extracellular+pH.">alpha1-Adrenergic responsiveness in human skeletal muscle feed arteries: the impact of reducing extracellular pH.</a> Exp Physiol. 98 (1), 256-267 (2013).</li><li>Dharmashankar, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nitric+oxide+synthase-dependent+vasodilation+of+human+subcutaneous+arterioles+correlates+with+noninvasive+measurements+of+endothelial+function.">Nitric oxide synthase-dependent vasodilation of human subcutaneous arterioles correlates with noninvasive measurements of endothelial function.</a> Am J Hypertens. 25 (5), 528-534 (2012).</li><li>Truran, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adipose+and+leptomeningeal+arteriole+endothelial+dysfunction+induced+by+beta-amyloid+peptide:+a+practical+human+model+to+study+Alzheimer's+disease+vasculopathy.">Adipose and leptomeningeal arteriole endothelial dysfunction induced by beta-amyloid peptide: a practical human model to study Alzheimer's disease vasculopathy.</a> J Neurosci Methods. 235, 123-129 (2014).</li><li>Karki, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Forkhead+box+O-1+modulation+improves+endothelial+insulin+resistance+in+human+obesity.">Forkhead box O-1 modulation improves endothelial insulin resistance in human obesity.</a> Arterioscler Thromb Vasc Biol. 35 (6), 1498-1506 (2015).</li><li>Shahid, M., Buys, E. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessing+murine+resistance+artery+function+using+pressure+myography.">Assessing murine resistance artery function using pressure myography.</a> J Vis Exp. (76), (2013).</li></ol>

The dissection and isolation of adipose arterioles from surrounding tissues can be a time-consuming and labor-intensive process with careful attention to detail and technical protocol. The microdissection procedure requires meticulous skills and specialized dissection utensils to prevent potential damage to the smooth muscle or endothelial cell layers of the microvasculature. Even tiny accidental punctures in the arteriolar wall can prevent intraluminal pressurization and results in an unsuccessful experiment. Additional...

Videomicroscopy is a useful technique utilized to examine the vasomotor function of small arterioles removed from living human subjects ex vivo. Our laboratory has focused on dissecting out tiny microvessels from different adipose tissue compartments to characterize the effects of various adipose microenvironments on the microvasculature. A major advantage of this technique is that blood vessels removed from the human body remain functional and can be examined readily within minutes to hours following biopsy. Physiological conditions are mimicked and steady transmural pressure maintained in the intraluminal space via micro-glass cannulas which recapitulate many in vivo characteristics.1,2 Additionally, a reliable videomicroscopy set-up with automated edge detection software allows for both qualitative and quantitative assessment of endothelium-dependent and -independent vasodilator and vasoconstrictor capacity of isolated vessels in real-time, permitting rapid physiological assessment in response to physical and pharmacological stimuli.3 Other microvascular techniques are also available such as wire myography which tends to be less time consuming and measure tension responses to various agonists by a force transducer.
Our laboratory has applied videomicroscopy to examine the relationship between obesity and vascular dysfunction, focusing on the effects of different adipose tissue domains on the vasculature. Central adiposity with accumulation of intra-abdominal visceral fat has been most closely linked to adipocytokine production, metabolic dysfunction, and cardiometabolic risk. It has been postulated that adipose tissue dysfunction with over-production of pro-atherogenic cytokines and adipokine dysregulation are strongly implicated in these processes, but specific regulatory molecules and treatment targets remain largely undiscovered.4 Moreover, at the local adipose tissue level, capillary rarefaction and impaired perfusion have been linked to adipose tissue pseudohypoxia and metabolic dysregulation. The hypothesis that cardiovascular disease may be the consequence of adipose tissue dysfunction is evolving. Pro-atherogenic mediators released from fat, particularly in association with central/visceral adiposity, likely promote endothelial dysfunction and pathogenic vascular changes that can be manifest locally in the adipose vasculature and detected using the herein described methodology.5
The functional assessment of isolated adipose tissue arterioles is a useful approach to gain understanding of the pathophysiology and molecular mechanisms that contribute to vascular dysfunction in human obesity. To investigate mechanisms that contribute to fat depot-specific dysfunction, we have developed methods to examine endothelium-dependent and -independent vasodilatory responses of the microvasculature, and evaluate the expression of various regulatory candidates in paired visceral and subcutaneous (SC) fat tissue specimens obtained from obese subjects at the time of bariatric surgery.

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	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">Chemical Name</td>
			<td style="width:159px;"></td>
			<td style="width:132px;"></td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">Acetylcholine</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">A6625</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="25">
			<td height="25" style="height:25px;width:352px;">Calcium chloride (CaCl2)</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td>223506</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">D-(+)-Glucose</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">G5767</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">Endothelin-1</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">E7764</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:352px;">Ethylene glycol-bis(2-aminoethylether)-N,N,N&#8217;,N&#8217;-tetra acetic acid (EGTA)</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">E3889</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">Ethylene diamine tetra acetic acid (EDTA)</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">E9884</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">HEPES</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">H3784</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="46">
			<td height="46" style="height:46px;width:352px;">Nw-nito-L-arginine methyl ester hydrochloride</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">N5751</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="25">
			<td height="25" style="height:25px;width:352px;">Magnesium sulfate (MgSO4)</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">M7506</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">Potassium chloride (KCL)</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">P3911</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="25">
			<td height="25" style="height:25px;width:352px;">Potassium phosphate (KH2PO4)</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">P5655</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">Papaverine</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">P3510</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="25">
			<td height="25" style="height:25px;width:352px;">Sodium bicarbonate (NaHCO3 )</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">S6014</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:352px;">Sodium chloride (NaCl)</td>
			<td style="width:159px;">Sigma Aldrich</td>
			<td style="width:132px;">S7653</td>
			<td style="width:127px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:352px;">Sodium phosphate monobasic monohydrate (NaH2Po4)</td>
			<td>Sigma Aldrich</td>
			<td>S9638</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Name</td>
			<td style="width:159px;">Company</td>
			<td style="width:132px;">Catalog Number</td>
			<td style="width:127px;">Comments</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Equipment</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Forceps</td>
			<td>Finescience tools</td>
			<td>15000-08</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Inverted microscope</td>
			<td>Zeiss Achromat</td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Laboratory tubing</td>
			<td>Euro-Pharm</td>
			<td>250100306F999</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Needle/pippette puller</td>
			<td>David kopf instruments</td>
			<td>720</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Ophthalmic monofilament nylon suture</td>
			<td>Surgical specialties</td>
			<td>A7756N</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Scissors</td>
			<td>Finescience tools</td>
			<td>150000-08</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Vessel Chamber</td>
			<td>DMT</td>
			<td>VAS v.2.1</td>
			<td></td>
		</tr>
	</tbody>
</table>

assessment of human adipose tissue microvascular function using videomicroscopy

While obesity is closely linked to the development of metabolic and cardiovascular disease, little is known about mechanisms that govern these processes. It is hypothesized that pro-atherogenic mediators released from fat tissues particularly in association with central/visceral adiposity may promote pathogenic vascular changes locally and systemically, and the notion that cardiovascular disease may be the consequence of adipose tissue dysfunction continues to evolve. Here, we describe a unique method of videomicroscopy that involves analysis of vasodilator and vasoconstrictor responses of intact small human arterioles removed from the adipose depot of living human subjects. Videomicroscopy is used to examine functional properties of isolated microvessels in response to pharmacological or physiological stimuli using a pressured system that mimics in vivo conditions. The technique is a useful approach to gain understanding of the pathophysiology and molecular mechanisms that contribute to vascular dysfunction locally within the adipose tissue milieu. Moreover, abnormalities in the adipose tissue microvasculature have also been linked with systemic diseases. We applied this technique to examine depot-specific vascular responses in obese subjects. We assessed endothelium-dependent vasodilation to both increased flow and acetylcholine in adipose arterioles (50 - 350 &#181;m internal diameter, 2 - 3 mm in length) isolated from two different adipose depots during bariatric surgery from the same individual. We demonstrated that arterioles from visceral fat exhibit impaired endothelium-dependent vasodilation compared to vessels isolated from the subcutaneous depot. The findings suggest that the visceral microenvironment is associated with vascular endothelial dysfunction which may be relevant to clinical observation linking increased visceral adiposity to systemic disease mechanisms. The videomicroscopy technique can be used to examine vascular phenotypes from different fat depots as well as compare findings across individuals with different degrees of obesity and metabolic dysfunction. The method can also be used to examine vascular responses longitudinally in response to clinical interventions.

Our laboratory has used videomicroscopy to examine endothelium-dependent and -independent vasodilation, as well as vasocontractile function of adipose tissue arterioles isolated from subcutaneous and visceral fat of obese humans. The characteristic experimental set-up is displayed in Figure 1A. Adipose tissue arterioles are suspended between two glass capillary pipettes and secured in place with sutures within the organ chamber as shown in <strong class="xfig...

Watch this Scientific Journal Video about Assessment of Human Adipose Tissue Microvascular Function Using Videomicroscopy at JoVE.com

Assessment of Human Adipose Tissue Microvascular Function Using Videomicroscopy

Videomicroscopy systems are used to examine functional properties of isolated adipose tissue arterioles in response to physiological and pharmacological stimuli. This technique can be used to examine microvascular phenotypes in different adipose tissue domains in obese humans.

While obesity is closely linked to the development of metabolic and cardiovascular disease, little is known about mechanisms that govern these processes. ...

The overall goal of this videomicroscopy technique is to examine the functional properties of isolated microvessels in response to pharmacological and physiological stimuli, providing insight into the pathophysiology and molecular mechanisms that contribute to vascular dysfunction in humans. This method is useful for understanding the molecular mechanisms that contribute to dysfunction of the local microvasculature within fat, which has been linked to systemic diseases. The main advantages of this technique are that blood vessels remain functional after removal from the human body for a period of time and are easily examined for their physiologic properties.Clinical relevance of this experimental approach is that it allows us to identify pathways that are differentially altered in disease conditions and to potentially discover novel therapeutic targets. Under a tissue dissecting microscope, use microscissors and microforceps to carefully remove the surrounding fat and connective tissue from the small arterials within the adipose sample. It is essential to distinguish the arterials from the venules.Arterials are typically smaller in diameter, demonstrate a greater tone, and respond more robustly than do venules. When the arterial has been isolated, use nylon or silk sutures to tie off any branches. Next, use a 10 milliliter syringe to slowly fill the tubing with fresh Krebs solution.Then, attach rubber tubes to the pressure reservoirs and glass capillary pipettes within the chamber. Next, move the dissected arterial to the organ chamber and cannulate the vessel onto the glass capillary pipettes. Carefully secure both ends of the arterial on the pipettes with nylon sutures.Once the vessel is secure, slowly remove the Krebs buffer from the chamber and add two milliliters of fresh Krebs solution to the chamber. Next, attach the organ chamber to the stage of an inverted microscope equipped with a video camera. Turn on the edge detection software at a sampling rate of one kilohertz.Connect the remaining pressurized tubing to the second Krebs solution-filled pressure reservoir and then connect the pressure reservoirs to the pressure transducer. When all of the tubing has been connected, set the heating block to 37 degrees celsius. Next, use the pressure control unit to gradually increase the intraluminal pressure to five milliliters of mercury every five minutes to achieve the appropriate experimental pressure within the lumen of the isolated blood vessel.Allow the vessel to equilibrate for 20 to 30 minutes once the pressure reaches 60 milliliters of mercury and record the diameter of the adipose arterial at rest. At the end of the equilibration period, pre-constrict the blood vessel to approximately 55%of the resting baseline diameter by adding one microliter of endothelin 1 directly to the bath every five minutes until vessel diameter has been appropriately constricted. For flow-induced endothelial dependent vasodilation, induce continuous flow into the intraluminal space of the arterial in equal and opposite directions so that a pressure difference can be developed across the vessel without altering the mean intraluminal pressure of 60 millimeters mercury.After three to five minutes, measure the flow-mediated dilation. Increase each increment of pressure gradient by a 10 centimeter of water change every five to six minutes up to a maximum of 100 centimeters of water. After assessing the flow-mediated vessel dilation, return the pressure reservoirs to the same height to stop the induction of flow.Then immediately, but carefully replace the chamber solution with fresh Krebs solution without disturbing the suspended arterial and allow the vessel to begin to return to the baseline diameter for 20 to 30 minutes. Once the arterial has returned to the resting baseline diameter, a subtle choline-mediated endothelial dependent vasodilation can be assessed. This begins by pre-constricting the vessel to approximately 55%of its resting diameter with endothelin 1, as previously demonstrated.Once pre-constriction is achieved, add two microliters of increasing doses of acetylcholine directly to the bath. Record the change in arterial diameter five minutes following administration of each dose. Upon completion of the acetylcholine dose response, assess the endothelium independent vasodilation and vessel viability by the sequential administration of papaverine and endothelium independent vasodilator directly to the bath.Endothelium dependent vasodilation responses to increased flow and sheer stress or acetylcholine are significantly blunted in visceral versus subcutaneous adipose arterials in human obesity. Endothelium independent vasodilation in response to papaverine, however, is not differentially altered between the two dipose, suggesting that vascular dysfunction in visceral domains is largely a result of dysfunction at the level of the endothelium, at least in the early stages of the disease. Once mastered, this technique can be completed in three to five hours, if performed properly.While attempting this procedure, it's important to remember to take your time and be diligent, as even minor damages to the blood vessels may skew the results. Following this procedure, other methods like siRNA transfection of the blood vessels can be performed to answer additional questions about the impact of specific genes on vasomotor function in human disease. After it's development, this technique paved the way for researchers in the field of adipose tissue biology and microcirculation to explore the impact of the adipose tissue microenvironment on local vascular health in human obesity.After watching this video, you should have a good understanding of how to directly probe the pathophysiology of whole intact segments of human blood vessels, which are removed from living subjects, a process that cannot be replicated by non-invasive imaging.

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Medicine

Non-invasive Assessment of Microvascular and Endothelial Function

The authors have utilized capillaroscopy and forearm blood flow techniques to investigate the role of microvascular dysfunction in pathogenesis of cardiovascular disease. Capillaroscopy is a non-invasive, relatively inexpensive methodology for directly visualizing the microcirculation. Percent capillary recruitment is assessed by dividing the increase in capillary density induced by postocclusive reactive hyperemia (postocclusive reactive hyperemia capillary density minus baseline capillary density), by the maximal capillary density (observed during passive venous occlusion). Percent perfused capillaries represents the proportion of all capillaries present that are perfused (functionally active), and is calculated by dividing postocclusive reactive hyperemia capillary density by the maximal capillary density. Both percent capillary recruitment and percent perfused capillaries reflect the number of functional capillaries. The forearm blood flow (FBF) technique provides accepted non-invasive measures of endothelial function: The ratio FBFmax/FBFbase is computed as an estimate of vasodilation, by dividing the mean of the four FBFmax values by the mean of the four FBFbase values. Forearm vascular resistance at maximal vasodilation (FVRmax) is calculated as the mean arterial pressure (MAP) divided by FBFmax. Both the capillaroscopy and forearm techniques are readily acceptable to patients and can be learned quickly.
The microvascular and endothelial function measures obtained using the methodologies described in this paper may have future utility in clinical patient cardiovascular risk-reduction strategies. As we have published reports demonstrating that microvascular and endothelial dysfunction are found in initial stages of hypertension including prehypertension, microvascular and endothelial function measures may eventually aid in early identification, risk-stratification and prevention of end-stage vascular pathology, with its potentially fatal consequences.

Capillaroscopy is a non-invasive, relatively inexpensive methodology for directly visualizing the microcirculation. The forearm blood flow technique provides accepted non-invasive measures of endothelial function.

The authors have utilized capillaroscopy and forearm blood flow techniques to investigate the role of microvascular dysfunction in pathogenesis of ...

Murine Spinotrapezius Model to Assess the Impact of Arteriolar Ligation on Microvascular Function and Remodeling

The murine spinotrapezius is a thin, superficial skeletal support muscle that extends from T3 to L4, and is easily accessible via dorsal skin incision. Its unique anatomy makes the spinotrapezius useful for investigation of ischemic injury and subsequent microvascular remodeling. Here, we demonstrate an arteriolar ligation model in the murine spinotrapezius muscle that was developed by our research team and previously published1-3. For certain vulnerable mouse strains, such as the Balb/c mouse, this ligation surgery reliably creates skeletal muscle ischemia and serves as a platform for investigating therapies that stimulate revascularization. Methods of assessment are also demonstrated, including the use of intravital and confocal microscopy. The spinotrapezius is well suited to such imaging studies due to its accessibility (superficial dorsal anatomy) and relative thinness (60-200 &mu;m). The spinotrapezius muscle can be mounted en face, facilitating imaging of whole-muscle microvascular networks without histological sectioning. We describe the use of intravital microscopy to acquire metrics following a functional vasodilation procedure; specifically, the increase in arterilar diameter as a result of muscle contraction. We also demonstrate the procedures for harvesting and fixing the tissues, a necessary precursor to immunostaining studies and the use of confocal microscopy.

We demonstrate a novel arterial ligation model in murine spinotrapezius muscle, including a step-by-step procedure and description of required instrumentation. We describe the surgery and relevant outcome measurements relating to vascular network remodeling and functional vasodilation using intravital and confocal microscopy.

The murine spinotrapezius is a thin, superficial skeletal support muscle that extends from T3 to L4, and is easily accessible via dorsal skin incision. ...

In vivo Imaging of Tumor Angiogenesis using Fluorescence Confocal Videomicroscopy

Fibered confocal fluorescence in vivo imaging with a fiber optic bundle uses the same principle as fluorescent confocal microscopy. It can excite fluorescent in situ elements through the optical fibers, and then record some of the emitted photons, via the same optical fibers. The light source is a laser that sends the exciting light through an element within the fiber bundle and as it scans over the sample, recreates an image pixel by pixel. As this scan is very fast, by combining it with dedicated image processing software, images in real time with a frequency of 12 frames/sec can be obtained.
We developed a technique to quantitatively characterize capillary morphology and function, using a confocal fluorescence videomicroscopy device. The first step in our experiment was to record 5 sec movies in the four quadrants of the tumor to visualize the capillary network. All movies were processed using software (ImageCell, Mauna Kea Technology, Paris France) that performs an automated segmentation of vessels around a chosen diameter (10 &mu;m in our case). Thus, we could quantify the 'functional capillary density', which is the ratio between the total vessel area and the total area of the image. This parameter was a surrogate marker for microvascular density, usually measured using pathology tools.
The second step was to record movies of the tumor over 20 min to quantify leakage of the macromolecular contrast agent through the capillary wall into the interstitium. By measuring the ratio of signal intensity in the interstitium over that in the vessels, an 'index leakage' was obtained, acting as a surrogate marker for capillary permeability.

In vivo Imaging of Tumor Angiogenesis using Fluorescence Confocal Videomicroscopy

In this paper, we present a method to analyze tumor microvessels in vivo using dynamic contrast-enhanced fluorescence videomicroscopy. Two quantitative parameters were acquired: functional capillary density reflecting the vascularity of the tumor, and index leakage reflecting the leakiness of the endothelial wall.

Fibered confocal fluorescence in vivo imaging with a fiber optic bundle uses the same principle as fluorescent confocal microscopy. It can excite ...

Cerenkov Luminescence Imaging of Interscapular Brown Adipose Tissue

Brown adipose tissue (BAT), widely known as a &#8220;good fat&#8221; plays pivotal roles for thermogenesis in mammals. This special tissue is closely related to metabolism and energy expenditure, and its dysfunction is one important contributor for obesity and diabetes. Contrary to previous belief, recent PET/CT imaging studies indicated the BAT depots are still present in human adults. PET imaging clearly shows that BAT has considerably high uptake of 18F-FDG under certain conditions. In this video report, we demonstrate that Cerenkov luminescence imaging (CLI) with 18F-FDG can be used to optically image BAT in small animals. BAT activation is observed after intraperitoneal injection of norepinephrine (NE) and cold treatment, and depression of BAT is induced by long anesthesia. Using multiple-filter Cerenkov luminescence imaging, spectral unmixing and 3D imaging reconstruction are demonstrated. Our results suggest that CLI with 18F-FDG is a practical technique for imaging BAT in small animals, and this technique can be used as a cheap, fast, and alternative imaging tool for BAT research.

In this video report, we show the application of Cerenkov Luminescence Imaging (CLI) for interscapular brown adipose tissue in mice under activated and depressed conditions.

Brown adipose tissue (BAT), widely known as a &#8220;good fat&#8221; plays pivotal roles for thermogenesis in mammals. This special tissue is closely ...

Encapsulation Thermogenic Preadipocytes for Transplantation into Adipose Tissue Depots

Cell encapsulation was developed to entrap viable cells within semi-permeable membranes. The engrafted encapsulated cells can exchange low molecular weight metabolites in tissues of the treated host to achieve long-term survival. The semipermeable membrane allows engrafted encapsulated cells to avoid rejection by the immune system. The encapsulation procedure was designed to enable a controlled release of bioactive compounds, such as insulin, other hormones, and cytokines. Here we describe a method for encapsulation of catabolic cells, which consume lipids for heat production and energy dissipation (thermogenesis) in the intra-abdominal adipose tissue of obese mice. Encapsulation of thermogenic catabolic cells may be potentially applicable to the prevention and treatment of obesity and type 2 diabetes. Another potential application of catabolic cells may include detoxification from alcohols or other toxic metabolites and environmental pollutants.

Here, we present a protocol for encapsulation of catabolic cells, which consume lipids for heat production in intra-abdominal adipose tissue and increase energy dissipation in obese mice.

Cell encapsulation was developed to entrap viable cells within semi-permeable membranes. The engrafted encapsulated cells can exchange low molecular ...

Characterization of Immune Cells in Human Adipose Tissue by Using Flow Cytometry

Infiltration of immune cells in the subcutaneous and visceral adipose tissue (AT) deposits leads to a low-grade inflammation contributing to the development of obesity-associated complications such as type 2 diabetes. To quantitatively and qualitatively investigate the immune cell subsets in human AT deposits, we have developed a flow cytometry approach. The stromal vascular fraction (SVF), containing the immune cells, is isolated from subcutaneous and visceral AT biopsies by collagenase digestion. Adipocytes are removed after centrifugation. The SVF cells are stained for multiple membrane-bound markers selected to differentiate between immune cell subsets and analyzed using flow cytometry. As a result of this approach, pro- and anti-inflammatory macrophage subsets, dendritic cells (DCs), B-cells, CD4+ and CD8+ T-cells, and NK cells can be detected and quantified. This method gives detailed information about immune cells in AT and the amount of each specific subset. Since there are numerous fluorescent antibodies available, our flow cytometry approach can be adjusted to measure various other cellular and intracellular markers of interest.

This article describes a method to analyze immune cell content of adipose tissue by isolation of immune cells from adipose tissue and subsequent analysis using flow cytometry.

Infiltration of immune cells in the subcutaneous and visceral adipose tissue (AT) deposits leads to a low-grade inflammation contributing to the ...

Whole Body and Regional Quantification of Active Human Brown Adipose Tissue Using 18F-FDG PET/CT

In endothermic animals, brown adipose tissue (BAT) is activated to produce heat for defending body temperature in response to cold. BAT&#39;s ability to expend energy has made it a potential target for novel therapies to ameliorate obesity and associated metabolic disorders in humans. Though this tissue has been well studied in small animals, BAT&#39;s thermogenic capacity in humans remains largely unknown due to the difficulties of measuring its volume, activity, and distribution. Identifying and quantifying active human BAT is commonly performed using 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography and computed tomography (PET/CT) scans following cold-exposure or pharmacological activation. Here we describe a detailed image-analysis approach to quantify total-body human BAT from 18F-FDG PET/CT scans using an open-source software. We demonstrate the drawing of user-specified regions of interest to identify metabolically active adipose tissue while avoiding common non-BAT tissues, to measure BAT volume and activity, and to further characterize its anatomical distribution. Although this rigorous approach is time-consuming, we believe it will ultimately provide a foundation to develop future automated BAT quantification algorithms.

Whole Body and Regional Quantification of Active Human Brown Adipose Tissue Using 18F-FDG PET/CT

Using free, open-source software, we have developed an analytical approach to quantify total and regional brown adipose tissue (BAT) volume and metabolic activity of BAT using 18F-FDG PET/CT.

In endothermic animals, brown adipose tissue (BAT) is activated to produce heat for defending body temperature in response to cold. BAT&#39;s ability to ...

A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program.
Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation.
51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p&#60;0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t&#60;1.66, all p&#62;0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t&#60;1.64, all p&#62;0.11).
Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training.

This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a ...

In Vitro Assessment of Cardiac Function Using Skinned Cardiomyocytes

In this article, we describe the steps required to isolate a single permeabilized (&#34;skinned&#34;) cardiomyocyte and attach it to a force-measuring apparatus and a motor to perform functional studies. These studies will allow measurement of cardiomyocyte stiffness (passive force) and its activation with different calcium (Ca2+)-containing solutions to determine, amongst others: maximum force development, myofilament Ca2+-sensitivity (pCa50), cooperativity (nHill) and the rate of force redevelopment (ktr). This method also enables determination of the effects of drugs acting directly on myofilaments and of the expression of exogenous recombinant proteins on both active and passive properties of cardiomyocytes. Clinically, skinned cardiomyocyte studies highlight the pathophysiology of many myocardial diseases and allow in vitro assessment of the impact of therapeutic interventions targeting the myofilaments. Altogether, this technique enables the clarification of cardiac pathophysiology by investigating correlations between in vitro and in vivo parameters in animal models and human tissue obtained during open heart or transplant surgery.

This protocol aims to describe step-by-step the technique of extraction and assessment of cardiac function using skinned cardiomyocytes. This methodology allows measurement and acutemodulation of myofilament function using small frozen biopsies that can be collected from different cardiac locations, from mice to men.

In this article, we describe the steps required to isolate a single permeabilized (&#34;skinned&#34;) cardiomyocyte and attach it to a force-measuring ...

Fat-Covered Islet Transplantation Using Epididymal White Adipose Tissue

Islet transplantation is a cellular replacement therapy for severe diabetes mellitus. The intraperitoneal cavity is typically the transplant site for this procedure. However, intraperitoneal islet transplantation has some limitations, including poor transplant efficacy, difficult graft detection ability, and a lack of graftectomy capability for post-transplant analysis. In this paper, "fat-covered islet transplantation", an intraperitoneal islet transplantation method that utilizes epididymal white adipose tissue, is used to assess the therapeutic effects of bioengineered islets. The simplicity of the method lies in the seeding of islets onto epididymal white adipose tissue and using the tissue to cover the islets. While this method can be categorized as an intraperitoneal islet transplantation technique, it shares characteristics with intra-adipose tissue islet transplantation. The fat-covered islet transplantation method demonstrates more robust therapeutic effects than intra-adipose tissue islet transplantation, however, including the improvement of blood glucose and plasma insulin levels and the potential for graft removal. We recommend the adoption of this method for assessing the mechanisms of islet engraftment into white adipose tissue and the therapeutic effects of bioengineered islets.

This fat-covered islet transplantation method is suitable for the detection of engrafted islets in the intraperitoneal cavity. Notably, it does not require the use of biobinding agents or suturing.

Islet transplantation is a cellular replacement therapy for severe diabetes mellitus. The intraperitoneal cavity is typically the transplant site for this ...