Autoregulation, a balancing act between supply and demand
Autoregulation, a balancing act between supply and demand
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DOI：
10.3129/i08-056
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发表时间：
2008-06-01
影响因子：
4.2
通讯作者：
Mozaffarieh, Maneli
中科院分区：
文献类型：
--
作者：
Flammer, Josef;Mozaffarieh, Maneli
调节血流是必要的，以适应不同的条件。眼血流量（OBF）的调节补偿了不同的灌注压（自动调节），适应视网膜活动（神经血管耦合），并使眼睛后部保持恒定的温度（体温调节）。虽然所有血管都在血管内皮细胞的控制下，但视网膜血管还在神经和神经胶质细胞的控制下，脉络膜血管受自主神经系统的影响。视神经乳头还受到循环激素的控制。如果调节不发生根据组织的需要，它被称为血管失调。这种失调在本质上可以是继发性的，例如在多发性硬化症中，其中高水平的内皮素减少了OBF失调，然而，也可以在没有任何潜在疾病的情况下发生，并且其特征在于对各种刺激（例如低温或机械或情绪应激）有不同反应的先天倾向。这些特征的集合被称为原发性血管失调（PVD）。PVD受试者的自动调节功能紊乱，导致OBF不稳定。这种不稳定性，反过来，诱导反复轻度再灌注损伤。由此产生的氧化应激有助于青光眼性视神经病变的发病机制。
Regulation of blood flow is necessary to adapt to different conditions. Regulation of ocular blood flow (OBF) compensates for varying perfusion pressures (autoregulation), adapts to the retinal activity (neurovascular coupling), and keeps the back of the eye at constant temperature (thermoregulation). While all vessels are under the control of the vascular endothelial cells, the retinal vessels are additionally under the control of the neural and glial cells, and the choroidal vessels are influenced by the autonomic nervous system. The optic nerve head is additionally controlled by circulating hormones. If the regulation does not occur according to the needs of the tissue, it is referred to as vascular dysregulation. Such a dysregulation can be secondary in nature, as, for example, in multiple sclerosis, in which the high level of endothelin reduces OBF Dysregulation, however, can also occur without any underlying disease and is characterized by an inborn tendency to respond differently to various stimuli, such as cold temperatures or mechanical or emotional stress. The constellation of these features is known as primary vascular dysregulation (PVD). Subjects with PVD have disturbed autoregulation leading to an unstable OBF. This instability, in turn, induces a repeated mild reperfusion injury. The resulting oxidative stress contributes to the pathogenesis of glaucomatous optic neuropathy.