The basic mechanism of increased microvascular permeability

The increased microvascular permeability appears mainly in venule during inflammation, shock, and burns. Endothelial cells play an important role in venule permeability enhancement. There are two kinds of pathway for macromolecule extravasation. One is paracellular pathway and another is transcellular pathway, which are related to the formation of endothelial gap or transcellular openings seperately. The alteration of intercellular related protein, such as occludin, claudin, zona occludens (ZO), junctional adhesion molecule (JAM), VE cadherin, catenin, integrin, etc, and the alteration of endothelial cytoskeleton, such as rearrangement of actin filament, formation of stress fiber and focal adhesion, etc, involve in the pathogenesis of increased microvascular permeability.