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Permeability of the fetal villous microvasculature in the isolated perfused term human placenta.

1. Capillary permeability‐surface area (PS) products for the low molecular weight radioactive tracers, 22Na, 51Cr‐EDTA (relative molecular mass 357) and 57Co‐cyanocobalamin (relative molecular mass 1353) were measured in the fetal circulation of isolated dually perfused lobules of normal term human placentae using the single circulation, multiple‐tracer dilution technique. 2. In lobules perfused with M199 medium, containing dextran and 5 g l‐1 bovine albumin, the extractions of all three tracers decreased as the flow was increased over the range of 2‐8 ml min‐1, and PS products for 51Cr‐EDTA and 57Co‐cyanocobalamin, but not for 22Na, reached constant values at flows above 0.1 ml min‐1 g‐1. 3. Flow‐independent PS products in the presence of albumin were 0.025 +/‐ 0.002 ml min‐1 g‐1 (mean +/‐ S.E.M., n = 25) for 57Co‐cyanocobalamin and 0.057 +/‐ 0.003 ml min‐1 g‐1 (n = 25) for 51Cr‐EDTA. The ratio of PS values (51Cr‐EDTA/57Co‐cyanocobalamin) was 2.28, while the ratio of the corresponding free diffusion coefficients was 1.79, indicating substantial restriction to the diffusion of the 57Co‐cyanocobalamin. 4. In another series of lobules perfused in the absence of albumin, extraction values for all three test tracers were constant over the same flow range. Values at high flow rates were therefore about twice those measured in the presence of albumin, and PS products for all three tracers failed to reach diffusion‐limited values. 6. Lobules perfused with and without albumin were fixed using a glutaraldehyde fixative containing 1% Alcian Blue dye. An ultrastructural examination of the endothelium showed no significant changes in cell or cleft morphology, or in the glycocalyx, in the absence of albumin which might account for the observed permeability change. 7. These data are the first physiological measurements specifically characterizing fetal microvascular permeability in the human placenta. The results suggest that permeability resembles that found in skeletal muscle and, as such, the endothelium presents a significant barrier to the diffusion of large solutes. The observed ‘protein effect’ indicates that albumin can interact with elements of the solute pathway to increase its restrictiveness.