Plasma proteins in a standardised skin mini-erosion (I): permeability changes as a function of time

BACKGROUND: A standardised technique using a suction-induced mini-erosion that allows serial sampling of dermal interstitial fluid (IF) for 5 to 6 days has been described. In the present study, we studied permeability changes as a function of time. METHODS: We examined IF concentrations of total protein concentration and the concentration of insulin (6.6 kDa), prealbumin (55 kDa), albumin (66 kDa), transferrin (80 kDa), IgG (150 kDa) and alpha-2-macroglobulin (720 kDa) as a function of time, using an extraction pressure of 200 mmHg below atmospheric. RESULTS: At 0 h after forming the erosion, mean total IF protein content (relative to plasma) was 26 ± 13% (SD). For the individual proteins, the relative mean concentrations were 65 ± 36% for insulin, 48 ± 12% for albumin, 30 ± 19% for transferrin, 31 ± 15%for IgG and 19.5 ± 10% for alpha-2-macroglobulin. At 24 h, the total IF protein content was higher than at 0 h (56 ± 26% vs 26 ± 13%; p < 0.05, diff: 115%), as were some of the individual protein concentrations: prealbumin (50 ± 24 vs 25 ± 13%; p < 0.05), albumin (68 ± 21 vs 48 ± 12%; p < 0.05) and IgG (55 ± 30 vs 31 ± 15%; p = 0.05). ln the interval 24 h to 96 h the concentrations were relatively unchanged. CONCLUSIONS: The results indicate that fluid sampled at 0 h after forming the erosion represents dermal IF before the full onset of inflammation. From 24 h onward, the sampled fluid reflects a steady state of increased permeability induced by inflammation. This technique is promising as a tool for clinically sampling substances that are freely distributed in the body and as a model for studying inflammation and vascular permeability.