Protein leak from normal vasculature due to human malignant ascites

Malignant ascites is an accumulation of protein rich fluid (a filtrate of whole blood) in the peritoneal cavity of patients with abdominal malignancies. The normal peritoneal microvasculature of the cremaster muscle of rats, with the nerve and blood supply intact, was visualized before and after exposure of the tissue to human malignant ascites fluid and to human plasma. In vivo fluorescent microscopy was used to quantitate leakage of fluorescent-tagged albumin. Exposure of the abluminal side of the vasculature to malignant ascitic fluid and plasma causes significant protein leakage from the small veins to the interstitial space. This suggests that the continued production of malignant ascites may be caused by a positive feedback system, which is related to factors present in a normal plasma filtrate. These factors can induce leakage of protein by an effect on the abluminal side of the normal peritoneal microvasculature.