The blood-tendon barrier: identification and characterisation of a novel tissue barrier in tendon blood vessels.

Tissue barriers function as "gate keepers" between different compartments (usually blood and tissue) and are formed by specialised membrane-associated proteins, localising to the apicolateral plasma membrane domain of epithelial and endothelial cells. By sealing the paracellular space, the free diffusion of solutes and molecules across epithelia and endothelia is impeded. Thereby, tissue barriers contribute to the establishment and maintenance of a distinct internal and external environment, which is crucial during organ development and allows maintenance of an organ-specific homeostatic milieu. So far, various epithelial and endothelial tissue barriers have been described, including the blood-brain barrier, the blood-retina barrier, the blood-testis barrier, the blood-placenta barrier, and the cerebrospinal fluid (CSF)-brain barrier, which are vital for physiological function and any disturbance of these barriers can result in severe organ damage or even death. Here, we describe the identification of a novel barrier, located in the vascular bed of tendons, which we term the blood-tendon barrier (BTB). By using immunohistochemistry, transmission electron microscopy, and tracer studies we demonstrate the presence of a functional endothelial barrier within tendons restricting the passage of large blood-borne molecules into the surrounding tendon tissue. We further provide in vitro evidence that the BTB potentially contributes to the creation of a distinct internal tissue environment impacting upon the proliferation and differentiation of tendon-resident cells, effects which might be fundamental for the onset of tendon pathologies.

Tendons from non-diabetic humans and rats harbor a population of insulin-producing, pancreatic beta cell-like cells.

Diabetes mellitus is a risk factor for various types of tendon disorders. The mechanisms underlying diabetes associated tendinopathies remain unclear, but typically, systemic factors related to high blood glucose levels are thought to be causally involved. We hypothesize that tendon immanent cells might be directly involved in diabetic tendinopathy. We therefore analyzed human and rat tendons by immunohistochemistry, laser capture microdissection, and single cell PCR for pancreatic ß-cell associated markers. Moreover, we examined the short term effects of a single injection of streptozotocin, a toxin for GLUT2 expressing cells, in rats on insulin expression of tendon cells, and on the biomechanical properties of Achilles tendons. Tendon cells, both in the perivascular area and in the dense collagenous tissue express insulin and Glut2 on both protein and mRNA levels. In addition, glucagon and PDX-1 are present in tendon cells. Intraperitoneal injection of streptozotocin caused a loss of insulin and insulin mRNA in rat Achilles tendons after only 5 days, accompanied by a 40% reduction of mechanical strength. In summary, a so far unrecognized, extrapancreatic, insulin-producing cell type, possibly playing a major role in the pathophysiology of diabetic tendinopathy is described. In view of these data, novel strategies in tendon repair may be considered. The potential of the described cells as a tool for treating diabetes needs to be addressed by further studies.

New aspects of the molecular constituents of tissue barriers.

Epithelial and endothelial tissue barriers are based on tight intercellular contacts (Tight Junctions, TJs) between neighbouring cells. TJs are multimeric complexes, located at the most apical border of the lateral membrane. So far, a plethora of proteins locating at tight intercellular contacts have been discovered, the role of which has just partly been unraveled. Yet, there is convincing evidence that many TJ proteins exert a dual role: They act as structural components at the junctional site and they are involved in signalling pathways leading to alterations of gene expression and cell behaviour (migration, proliferation). This review will shortly summarize the classical functions of TJs and TJ-related proteins and will introduce a new category, termed the "non-classical" functions of junctional proteins. A particular focus will be directed towards the nuclear targeting of junctional proteins and the downstream effects elicited by their intranuclear activities.

Deposition of radon progeny on skin surfaces and resulting radiation doses in radon therapy.

In the Gastein valley, Austria, radon-rich thermal water and air have been used for decades for the treatment of various diseases. To explore the exposure pathway of radon progeny adsorbed to the skin, progeny activities on the skin of patients exposed to thermal water (in a bathtub) and hot vapour (in a vapour chamber) were measured by alpha spectrometry. Average total alpha activities on the patients' skin varied from 1.2 to 4.1 Bq/cm(2) in the bathtub, and from 1.1 to 2.6 Bq/cm(2) in the vapour bath. Water pH-value and ion concentration did affect radon progeny adsorption on the skin, whereas skin greasiness and blood circulation did not. Measurements of the penetration of deposited radon progeny into the skin revealed a roughly exponential activity distribution in the upper layers of the skin. Based on the radon progeny surface activity concentrations and their depth distributions, equivalent doses to different layers of the skin, in particular to the Langerhans cells located in the epidermis, ranged from 0.12 mSv in the thermal bath to 0.33 mSv in the vapour bath, exceeding equivalent doses to the inner organs (kidneys) by inhaled radon and progeny by about a factor 3, except for the lung, which receives the highest doses via inhalation. These results suggest that radon progeny attachment on skin surfaces may play a major role in the dosimetry for both thermal water and hot vapour treatment schemes.

[Jacksonian fits and threatened premature labour (the effect of valium, prepar and antiepileptic drugs on the fetus and uterine contractility ante and intra partum) (author's transl)]. / Jackson-Anfälle und drohende Frühgeburt (Der Einfluss von Valium, Prepar und Antiepileptika auf den Fetus und die Wehentätigkeit prae und intra partum)

The case is reported of a 30-year-old patient whose fifth pregnancy (para 2, no living children) was complicated by the necessity of surgical removal of a stage II astrocytoma. Threatened premature labour was averted by the continuous administration of Prepar as from the 25th week of pregnancy and spontaneous vaginal delivery of a live-born infant was achieved in the 35th week. The development of repeated Jacksonian fits necessitated the administration of high doses of Valium (215 mg i.v. over a 50-nour period) both pre and intra partum, over and above the long-term antiepileptic maintenance therapy which the patient had received throughout the entire pregnancy. The fetal heart rate was not affected by Valium even at such high dosage. This case serves to illustrate that if the indication arises, high doses of Valium may be given before and during labour in conjunction with long-term antiepileptic drugs and Prepar apparently without adverse effects on the fetus or on uterine activity.