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Objective: To assess the cerebral and vascular development in fetuses with hypoplastic left heart syndrome (HLHS)., Methods: Pregnant women carrying fetuses diagnosed with HLHS who decided to interrupt their pregnancies were included in our study. Aortic size and blood flow were assessed based from fetal echocardiography. Immunohistochemical staining was performed in brain sections obtained from pathology in fetuses with HLHS and control fetuses without heart disease., Results: Twenty-seven midgestation fetal HLHS were included (gestational age, 23.3 ± 3.4 weeks). Head circumference z scores were lower in HLHS fetuses. Middle cerebral artery pulsatility index, a measure of cerebrovascular resistance, was inversely correlated with the ascending aortic z score (P < 0.05). Fetuses with HLHS had lower capillary density in the germinal matrix and their capillaries were larger compared with control fetuses with (P < 0.05). The expression of neuronal differentiation marker, FGFR1, and oligodendrocyte precursor, O4, were lower in HLHS brains compared with controls (P < 0.05)., Conclusion: Our study identified abnormalities of vascular flow and structural brain abnormalities in fetal HLHS associated with impaired neuronal and oligodendrocyte differentiation, as well as cerebral growth impairment, early in gestation. These findings may be related in part to early vascular abnormalities., (© 2018 The Authors Prenatal Diagnosis Published by John Wiley & Sons Ltd.)

Ramification of blood circulation is relevant in a number of physiological and pathological conditions. The oxygen exchange occurs largely in the capillary bed, and the cancer progression is closely linked to the angiogenesis around the tumor mass. Optical microscopy has made impressive improvements in in vivo imaging and dynamic studies based on correlation analysis of time stacks of images. Here, we develop and test advanced methods that allow mapping the flow fields in branched vessel networks at the resolution of 10 to 20  μm. The methods, based on the application of spatiotemporal image correlation spectroscopy and its extension to cross-correlation analysis, are applied here to the case of early stage embryos of zebrafish., ((2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).)

The vertebrate pancreas is comprised of a highly branched tubular epithelium, which is intimately associated with an extensive and specialized vasculature. While we know a great deal about basic vascular anatomy of the adult pancreas, as well as islet capillaries, surprisingly little is known about the ontogeny of its blood vessels. Here, we analyze development of the pancreatic vasculature in the mouse embryo. We show that pancreatic epithelial branches intercalate with the fine capillary plexus of the surrounding pancreatic mesenchyme. Endothelial cells (ECs) within this mesenchyme are heterogeneous from the onset of organogenesis. Pancreatic arteries take shape before veins, in a manner analogous to early embryonic vessels. The main central artery forms during mid-gestation, as a result of vessel coalescence and remodeling of a vascular plexus. In addition, we show that vessels in the forming pancreas display a predictable architecture that is dependent on VEGF signaling. Over-expression of VEGF disrupts vascular patterning and arteriovenous differentiation within the developing pancreas. This study constitutes a first-time in-depth cellular and molecular characterization of pancreatic blood vessels, as they coordinately grow along with the pancreatic epithelium., Competing Interests: The authors declare no competing or financial interests., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Development of effective vascular therapies requires the understanding of all modes of vessel formation involved in angiogenesis (here termed "hemangiogenesis") and lymphangiogenesis. Two major modes of vessel morphogenesis include sprouting of a new vessel from a preexisting vessel and splitting of a preexisting parent vessel into two offspring vessels. In the quail chorioallantoic membrane (CAM) during mid-development (embryonic days E6-E9), lymphangiogenesis progressed primarily via blind-ended vessel sprouting. Isolated lymphatic endothelial progenitor cells were recruited to the tips of growing vessels. During concurrent hemangiogenesis, parent blood vessels expanded from the capillary network and split into offspring vessels, accompanied by transient capillary expression of alpha smooth muscle actin (alphaSMA) and recruitment of polarized mural progenitor cells. Lymphatics and blood vessels were identified by confocal/fluorescence microscopy of vascular endothelial growth factor (VEGF) receptor VEGFR-2, alphaSMA (specific to CAM blood vessels), homeobox transcription factor Prox1 (specific to lymphatics), and the quail hematopoetic marker, QH-1. VEGFR-2 was expressed intensely in isolated cells and lymphatics, and moderately in blood vessels. Prox1 was absent from isolated progenitor cells prior to lymphatic recruitment. Exogenous vascular endothelial growth factor-165 (VEGF165) increased blood vessel density and anastomotic frequency without changing endogenous modes of vascular/lymphatic vessel formation or marker expression. Although VEGF165 is a key cellular regulator of hemangiogenesis and vasculogenesis, the role of VEGF165 in lymphangiogenesis is less clear. Interestingly, VEGF165 increased lymphatic vessel diameter and density as measured by novel Euclidean distance mapping, and the antimaturational dissociation of lymphatics from blood vessels, accompanied by lymphatic reassociation into homogeneous networks.

This review shall familiarize the reader with the various aspects of intussusceptive angiogenesis (IA). The basic event in IA is the formation of transvascular tissue pillars. Depending on location, timing, and frequency of pillar emergence, the IA process has different outcomes. In capillaries, a primary IA function is to expand the capillary bed in size and complexity (intussusceptive microvascular growth). It represents an alternative to capillary sprouting. Highly ordered pillar formation in a developing capillary network leads to the formation of vascular trees (intussusceptive arborization). In small arteries and veins, pillar formation at the vessels' branching angles leads either to remodeling of the branching geometry or even to vascular pruning (intussusceptive branching remodeling). It appears essential that future angiogenic research considers always both phenomena, sprouting and intussusception. Vascularization of tissues, organs, and tumors rely heavily on both mechanisms; neglecting one or the other would obscure our understanding of the angiogenesis process., ((c) 2004 Wiley-Liss, Inc.)

Intussusception (growth within itself) is an alternative to the sprouting mode of angiogenesis. The protrusion of opposing microvascular walls into the capillary lumen creates a contact zone between endothelial cells. The endothelial bilayer is perforated, intercellular contacts are reorganized, and a transluminal pillar with an interstitial core is formed, which is soon invaded by myofibroblasts and pericytes leading to its rapid enlargement by the deposition of collagen fibrils. Intussusception has been implicated in three processes of vascular growth and remodeling. (1) Intussusceptive microvascular growth permits rapid expansion of the capillary plexus, furnishing a large endothelial surface for metabolic exchange. (2) Intussusceptive arborization causes changes in the size, position, and form of preferentially perfused capillary segments, creating a hierarchical tree. (3) Intussusceptive branching remodeling (IBR) leads to modification of the branching geometry of supplying vessels, optimizing pre- and postcapillary flow properties. IBR can also lead to the removal of branches by pruning in response to changes in metabolic needs. None of the three modes requires the immediate proliferation of endothelial cells but rather the rearrangement and plastic remodeling of existing ones. Intussusception appears to be triggered immediately after the formation of the primitive capillary plexus by vasculogenesis or sprouting. The advantage of this mechanism of growth over sprouting is that blood vessels are generated more rapidly in an energetically and metabolically more economic manner, as extensive cell proliferation, basement membrane degradation, and invasion of the surrounding tissue are not required; the capillaries thereby formed are less leaky. This process occurs without disrupting organ function. Improvements in our understanding of the process should enable the development of novel pro- and anti-angiogenic therapeutic treatments.

Major congenital malformations, many of which result from abnormal cardiovascular patterning, remain the leading cause in infant mortality and morbidity. Targeted mutations of several genes (including VEGF and VEGF receptors) and certain teratogenic agents (including excess alpha-D-glucose) give rise to embryonic lethal phenotypes associated with failure in the formation of a functional vitelline circulation and aberrant organogenesis. Our work to date has demonstrated that yolk sac vasculopathy and failure of endocardial cushion epithelial-mesenchymal transformation occurs in hyperglycemic conditions in murine whole conceptus culture and in embryos from streptozotocin-induced diabetic mice. These cardiovascular abnormalities are associated with changes in expression and phosphorylation state of adhesion molecules such as platelet endothelial growth factor-1 and expression of growth factors such as vascular endothelial growth factor (VEGF-A). Further understanding of the effects of maternal diabetes on yolk sac and embryonic vasculogenesis/angiogenesis and organogenesis may lead to novel approaches in treating and preventing major birth defects.

Intussusceptive angiogenesis is a novel mode of blood vessel formation and remodeling, which occurs by internal division of the preexisting capillary plexus without sprouting. In this study, the process is demonstrated in developing chicken eye vasculature and in the chorioallantoic membrane by methylmethacrylate (Mercox) casting, transmission electron microscopy, and in vivo observation. In a first step of intussusceptive angiogenesis, the capillary plexus expands by insertion of numerous transcapillary tissue pillars, ie, by intussusceptive microvascular growth. In a subsequent step, a vascular tree arises from the primitive capillary plexus as a result of intussusceptive pillar formation and pillar fusions, a process we termed "intussusceptive arborization." On the basis of the morphological observations, a 4-step model for intussusceptive arborization is proposed, as follows: phase I, numerous circular pillars are formed in rows, thus demarcating future vessels; phase II, formation of narrow tissue septa by pillar reshaping and pillar fusions; phase III, delineation, segregation, growth, and extraction of the new vascular entity by merging of septa; and phase IV, formation of new branching generations by successively repeating the process, complemented by growth and maturation of all components. In contrast to sprouting, intussusceptive angiogenesis does not require intense local endothelial cell proliferation; it is implemented primarily by rearrangement and attenuation of the endothelial cell plates. In summary, transcapillary pillar formation, ie, intussusception, is a central and probably widespread process, which plays a role not only in capillary network growth and expansion (intussusceptive microvascular growth), but also in vascular plexus remodeling and tree formation (intussusceptive arborization).

The present study was performed to provide data to support the notion previously believed but not proved experimentally or theoretically, that blood vessels are formed by the selection of capillaries in the network. In an attempt to understand the mechanism of formation of blood vessel branching structures, the transformation of a capillary network to a branching system in the wall of quail yolk sac was successively recorded by a series of photographs, and a computer simulation was carried out for the process of in vivo vascularization based on the photographs. The simulation demonstrated that a positive feedback system participated in the formation of a branching structure. That is, vessels which had been much used were enlarged, whereas less used vessels were reduced in their size and finally extinguished. The enlarged vessels became major components of the branching system. As the body of an embryo grew, it was observed that polygonal capillary networks enlarged, which led each polygon of the network to divide into a few finer polygons. Then, some of the capillary vessels were again selected and formed a branching system. This process repeated during the body growth, indicating that the vascular system developed adaptively to the body growth. A region where the growth was fast, received much blood flow and produced finer networks of capillaries. Thus, it was experimentally demonstrated for the first time that capillaries in the network are successively selected by a positive feedback mechanism and form blood vessels.

In this article, we survey the mechanisms involved in early embryonic angiogenesis. The first embryonic blood vessels are formed exclusively by endothelial cells. Therefore, the emergence and behavior of this cell type is the center of this article. We discuss both intra- and extraembryonic angiogenesis and the various modes of capillary formation. The high plasticity and migratory potential of endothelial cells and their precursors, the angioblists, are outlined. The promoting and inhibiting influences of the extracellular matrix on the behavior of angioblasts are a matter of concern, as is also the question of embryonic angiogenic factors. Cell-cell interactions that may lead to organ-specific differentiation of endothelial cells are mainly discussed in the context of blood-brain barrier formation and development of fenestrated capillaries. The last section deals with the development of the vascular wall.

Succession in formation of blood bed of the greater omentum has been studied in human fetuses (42), in premature children with the body mass of 900-2,500 g (108) and in mature children up to 3 years of age (48). Vasculogenesis in the organ of 12-week-old fetuses and in older ones is demonstrated as an ansiform growth of the vessels. In the vascular loop the afferent geniculum contains differential signs of the arterial, and the different one--the venous part of the blood bed. The top of the loop contains a growth bud and is a zone of growth; it ensures proliferation of the vascular loops and their spreading in the growing tissue mass in the organ. This principle of growth provides a ramified system of arteries and veins, reiterating the course and branching of each other. Against the background of the ansiform growth of the vessels capillary formation begins, at first connective, and then true capillaries are formed. Basing on the data obtained a conception of vasculogenesis in ontogenesis is formulated. Its main stages are--period of ansiform growth of the vessels and period of capillary formation. In the latter should be distinguished appearance of connective capillaries and formation of truely capillary network.

The data on formation and construction principles of the blood supply system in the terminal sensitive apparatuses of the human forearm muscles during embryogenesis and early postnatal period are presented. During the intrauterine development, the formation of the vascular-receptor relations takes place in the sequence corresponding to the anlage of the receptors. The first blood vessels appear in the area of the nonencapsulated sensitive terminals and only after in the encapsulated receptors. The latter have their own blood supply system which is formed by the vessels of the intramuscular neural fasciculi and the surrounding muscular tissue. Around the sensitive terminals thick microvascular networks are formed, they often tightly adhere the external receptor capsule. The intrareceptor capillaries are situated in the mass of the neural terminals and sometimes form capillary loops in them.

In human fetuses with a gestation age of 12 to 22 weeks, the development of Haller's and Sattler's choroidal vascular layer was examined by both light and transmission electron microscopy. Even during week 12 arterioles could be identified. However, during this week they were only found in close association to the entrance of the optic nerve. Beginning with week 15/16, arterioles were also located outwards to the choriocapillary layer more anteriorly. When the arterioles first appeared, they exhibited the same ultrastructural features as those described in adults. Arteries first became apparent during week 22. They had not developed a complete internal elastic lamina. In contrast to those of the adult eye, smooth muscle cells of the fetal choroidal arteries exhibit glycogen granules. Haller's and Sattler's layer are both arterial and venous in nature.

Vascular bed and its relationship to differentiating muscular tissue was studied in a set of 104 upper limbs of human embryos and foetuses, gradually increasing from 10 to 120 mm C-R length. Knowledge obtained on the ontogeny of vascular bed was supplemented by findings in 75 limbs of adults treated by preparation technique. Embryonic and foetal material was treated histochemically a--to demonstrate vascular bed reaction for alkaline phosphatase (AP), ATPase, and dipeptidylpeptidase IV (DPP IV), b--to study differentiating muscular tissue for enzyme--ATPase and tetrazoliumreductase (NaDH2, c--to distinguish muscular tissue elements with toluidine blue staining for degree of maturity. Observations concerned several items, namely a--the ontogeny of main arterial trunks in the forearm and hand, b--muscle fibre type differentiation in antebrachial muscular primordia, c--formation of vascular bed as related to differentiating muscular tissue in the forearm and hand. Therefore our results are grouped as follows: ad a--Arterial trunks differentiate along with other limb structures in 12-18 mm C-R length embryos. Thus in embryos above 18 mm C-R length antebrachial and hand trunks are fully formed. Vascular trunks differentiate from deep vascular network via gradual reduction and magistralization in conformity with the general laws of haemodynamics. All arterial trunks forming in the limb during the ontogeny branch off the original axial artery in regio cubiti. In a. radialis trunk it has been ascertained that this blood vessel does not originate from a. brachialis superficialis, as generally reported, but its formation conforms to the same general principles as blood vessel trunks. So it branches off the original axial artery, as other trunks do. A. mediana formed during vascular trunks differentiation later in the ontogeny does not obliterate but changes into the constant a. comitans n. mediani. ad b--First involved in differentiation in antebrachial muscular primordia are the "fast" type fibres (according to Peter et al., 1972) (fast glycolytic-FG-type fibres followed by fast oxidative glycolytic-FOG-type fibres) in 27-30 mm C-R length embryos. "Slow" type fibres (slow oxidative-SO-type fibres) may not be demonstrated histochemically in antebrachial muscles earlier than 45 mm C-R length foetuses. The maturity of muscular elements may be demonstrated by staining with toluidine blue on cytoplasm basophilia of cells. Sarcolytic myotubes in muscular primordia histochemically display typical features which distinguish them markedly from other differentiating muscle fibres.(ABSTRACT TRUNCATED AT 400 WORDS)

A quantitative analysis of the modifications undergone by the vascular networks and the perivascular spaces in the rudiment of the adenohypophysis has been carried out in normally developing chick embryos from the 7th incubation day to hatching. The present results point to the existence, during the developmental period mentioned, of a relationship between the extent of the capillary bed and, respectively, of the perivascular spaces, the gradual increment of the former being paralleled by a decrease of the latter. The rate of these events appears to be higher between the 14th and the 16th incubation days, namely when the vessels begin to acquire some of the morphological features typical of sinusoids, their thin walls getting gradually into closer contact with the secretory epithelial cells.

Vascularization was examined in perfusion-fixed optic nerves from human embryos aged from 8 to 18 weeks post-conception. The volume density of blood vessels increased from 0.7% at 8 weeks to 24% at 18 weeks; the surface area of blood vessels increased from 2.1 mm2/mm3 at 8 weeks to 49.9 mm2/mm3 at 18 weeks. At all ages endothelial cells were joined by zonulae occludentes. Capillary basement membranes were present at all ages and blood vessels not lying in developing fibrous septa were invested with a complete glial sheath from 8 weeks of age. Only extremely rarely were parts of small capillary walls not covered by glial processes. Arterioles were absent from the optic nerves until 18 weeks post-conception. At first vascularization was most obvious in the central part of the nerve but there was no evidence for the presence of a central artery of the optic nerve. There did not appear to be a direct correlation between the degree of vascularization and increase in glial or axonal number.