PKQuest: capillary permeability limitation and plasma protein binding – application to human inulin,dicloxacillin and ceftriaxone pharmacokinetics

Background  

It is generally assumed that the tissue exchange of antibiotics is flow limited (complete equilibration between the capillary and the tissue water). This assumption may not be valid if there is a large amount of plasma protein binding because the effective capillary permeability depends on the product of the intrinsic capillary permeability (PS) and the fraction of solute that is free in the blood (fw_B). PKQuest, a new generic physiologically based pharmacokinetic software routine (PBPK), provides a novel approach to modeling capillary permeability in which the only adjustable parameter is the PS of muscle.     

Effects of red cell permeability on transcapillary tracer transport: The case of negligible back diffusion

Estimates of capillary tracer permeability calculated using multiple indicator data depend upon the particular model adopted to describe blood tissue exchange. The model proposed by Crone (1963) is appropriate when some of the injected tracer diffuses into the tissue but does not return appreciably to the bloodstream before data collection is terminated. Under these conditions extraction of tracer by the tissue depends on a single dimensionless parameter, α_cap, defined as the ratio of capillary permeability surface area to water flow. The effects of finite red cell tracer permeability on the Crone model estimate of capillary permeability are examined in the present study. The results indicate that even when back diffusion from the extravascular space is negligible, significant errors in the Crone model estimate can be expected when capillary permeability is relatively high and the ratio of red cell to capillary permeability is less than unity. However, when an aliquot of blood is equilibrated with tracer prior to injection and the dimensionless capillary permeability is relatively low (i.e. α_cap ≦ 0.25 for a haematocrit≦50%), the whole blood Crone model estimate of α_cap will be within 10% of the actual value, irrespective of red cell permeability. Red cell-plasma exchange for commonly used tracer-organ combinations should not significantly affect Crone estimates of capillary permeability under normal physiological conditions, but may be important in low flow situations. Supported by Grant No. HL 19153 (SCOR in Pulmonary Vascular Diseases). This work was done during Dr. Roselli’s tenure as an NHLBI Training Grant Fellow (NHLBI Training Grant No. 07123).     

Total and shunting circulation in human central hemodynamics

The goal of the study was to develop a method for the separate measurement of capillary and metarteriolar circulation. Data on the cardiovascular system of 301 male patients (1–49 years of age) and 344 female patients (1–50 years of age) with a diagnosis of functional murmur were used. In the process of heart and major vessel diagnostic catheterization, the diagnosis of heart defect was excluded. The cardiac output (Q) was estimated. The calculated oxygen consumption was converted using the Hüfner’s coefficient to the equivalent quantity of hemoglobin (Hb) delivering this oxygen into exchange capillaries. The Hb content per milliliter of blood is known; therefore, by dividing the total quantity of Hb that passed through capillaries by its content per milliliter of blood, one can obtain the blood volume (in milliliters) that passed through the capillary bed (Q _cap). A shunt in the microvasculature was found as the difference between Q and Q _cap). Thus, there exist in the microvascular module two parallel bloodstreams: a slow one, which goes through true capillaries, where the exchange happens, and a fast shunting stream through metarterioles, direct channels, and arteriolevenous anastomoses. The latter not only takes part in the tissue thermal exchange, but are also channels that ensure the free transfer of white blood cells through the microcirculatory module, especially of those whose characteristic sizes exceed the diameter of the metabolic capillaries. The contribution of these two parallel streams in the microcirculatory module into Q is different. According to other results of this study, the slow capillary stream makes up approximately 20%, whereas the fast shunting bloodstream, 80% of Q.     

Morphology and function of capillary networks in subregions of the rat tuber cinereum

Summary The differentiated cytology, cytochemistry, and functions within subdivisions of the tuber cinereum prompted this morphometric and physiological investigation of capillaries in the median eminence and arcuate nucleus of albino rats. Morphometric studies established that the external zone of the median eminence had 3–5 times the number and surface area of true and sinusoidal capillaries than the internal or subependymal median eminence zones, or either of two subdivisions examined in the arcuate nucleus. Type-I true capillaries, around which Virchow-Robin spaces comprise 1% of arcuate tissue area, were situated proximally to the median eminence border. This finding is consistent with a premise that confluent pericapillary spaces enable infiltration of arcuate neurons by factors from capillary blood from the median eminence or Virchow-Robin spaces. Physiologically, the rate of penetration across the median eminence capillaries by blood-borne [¹⁴C]-aminoisobutyric acid (a neutral amino acid used as a capillary permeability tracer) was 142 times greater than for capillaries in the distal arcuate nucleus within 12 s of tracer administration. A new finding was that the proximal arcuate nucleus had a permeability x surface area product of 69 l g^–1 min^–1, 34 times greater than that in more distal aspects of the tuber where blood-brain barrier properties exist. We also found that the microcirculatory transit time of a plasma space marker, [¹⁴C]sucrose, was considerably longer (1.2 s) in the median eminence and proximal arcuate nucleus than in the distal arcuate or ventromedial nucleus (0.4 s). By virtue of its high capillary permeability and extensive blood-tissue surface area, including the wide Virchow-Robin spaces, the median eminence external zone could be a gateway for flooding other tuberal compartments with blood-borne factors. This effect may be compounded by capillary bed specializations in the proximal arcuate nucleus where Type-I true capillaries, Type-III sinusoids, and pericapillary spaces are confluent with those in the median eminence. The results indicate that the proximal arcuate parenchyma could be exposed to circulating neuroactive substances on a moment-to-moment basis.Dedicated to Dr. Milton W. Brightman of Bethesda, Maryland, USA on the occasion of his 67th birthday and tribute as Craigie scholar at the First Craigie Conference on Brain Capillaries, Toronto, Ontario, June 24, 1990     

Dynamic oscillatory circuit of regulation of capillary hemodynamics

We used laser Doppler flowmetry with wavelet analysis of blood flow oscillations, computer capillaroscopy, and thermometry of the nail bed in 30 subjects to show an important role of the oscillatory circuit in the regulation of capillary hemodynamics, number of functioning capillaries, and linear and volumetric velocity of blood flow. The number of functioning capillaries is regulated by oscillations of myogenic and sensory peptidergic origin. The appearance of sensory oscillations, especially high-amplitude oscillations, is an adaptive neurotrophic mechanism that significantly increases the number of functioning capillaries and intensity of blood flow from arterioles to capillaries. The linear velocity of blood flow depends on both the tone of microvessels and changes in the dynamic component of blood pressure. Under conditions of skin hypoperfusion, the mean linear velocity of capillary blood flow may be inversely related to the extracapillary perfusion, including the amplitude of heart rate (A _h) and oscillations of the tone of precapillary sphincters, whereas under conditions of vasodilation and increased skin perfusion, it may be inversely related to the amplitude of arteriolar oscillations of endothelial or neurogenic sympathetic origin (A _maxe + n) and the shunting index. The A _h affects the linear velocity of blood flow in the arterial part of capillaries, whereas the A _maxe + n influences the same factor in the venous part. The contribution of oscillations to the regulation of the linear velocity varies depending on the perfusion and skin temperature. The resultant tone of distributing microvessels is determined by the competition between the stationary and oscillatory components. In addition to changes in the amplitude, the frequency of vasomotions may also be important. The regulatory importance of the oscillatory circuit is increased with a decrease in the skin blood flow.     

Circulatory system in chicken skeletal muscle in the second half of embryogenesis: Shape,blood flow,and vascular reactivity

A restructuring of the capillary bed—from the embryonic structure with a three-dimensional network of wide and long protocapillaries to the mature structure with high density of thin and short capillaries along the fibers—has been demonstrated in the chick skeletal muscle on embryonic days 10–19 by morphometric analysis. In this case, the specific blood flow and capillary luminal area per cm³ of the muscle remained unaltered, while the blood volume in it significantly dropped. The response of muscle circulation to nitroprusside (increase) and noradrenaline (decrease) appeared in 19-day-old embryos, but this response could develop only under conditions of initially low or high blood flow, respectively. We propose that the arterial trunk lumen area to the total capillary lumen area remains constant as the intraorganic circulation is formed, which provides for the required linear blood velocity in capillaries.     

EFFECTS OF FLOWING WATER ON NITROGEN- AND PHOSPHORUS-LIMITED PHOTOSYNTHESIS AND OPTIMUM N:P RATIOS BY SPIROGYRA FLUVIATILIS (CHAROPHYCEAE)1,2

The effects of flowing water on net photosynthesis, dark respiration, specific growth rate, and optimum N:P ratios by Spirogyra fluviatilis Hilse were assessed. The alga was cultivated under nitrogen or phosphorus limitation in laboratory streams at three flow velocities: 3, 12, and 30 cm·s^?1. The Droop equation adequately described respiration and photosynthesis (PS_net) as a function of N or P cell quota (Q^N or Q^p). The data show that for N- or P-limited Spirogyra fluviatilis, flowing water is physiologically costly. Generally, flowing water had little effect on respiration rates; however, the proportion of gross photosynthesis devoted to dark respiration did increase with flow velocity. For photosynthesis, the minimum N and P cell quotas increased with velocity, and the theoretical PS_net maxima for N and P both appeared greatest at 12 cm·s^?1. The Droop models showed that for any given Q^N or Q^p, PS_net, was reduced by the 30-cm·s^?1 treatment. Consistent with this finding, independent estimates of specific growth rates for P-limited S. fluviatilis in the laboratory streams were inversely related to flow velocity when ambient PO₄^?3 was undetectable. However, growth was not diminished at the fastest velocity when PO₄^?3 was available for uptake. Thus, the increase in cellular phosphorus demand can be offset by flow-enhanced P uptake when conditions permit; otherwise, growth will be impaired. The optimum N:P ratios for S. fluviatilis at 3, 12, and 30 cm·s^?1 were 50, 58, and 52 by atoms, respectively, when calculated for PS_net= 0. The optimum ratios were inversely related to PS_net and decreased to approximately 20 when PS_net was near maximum. The potential for flowing water to mediate nutrient partitioning among lotic algae by altering growth rates and optimum nutrient ratios is discussed.     

The flow of sickle blood in glass capillaries: Fundamentals and potential applications

We have characterized the imbibed horizontal flow of sickle blood into 100-μm-diameter glass capillaries. We find that blood containing sickled cells typically traverses the capillaries between three and four times as slowly as oxygenated cells from the same patient for all genotypes tested, including SS, AS, SC and Sβ⁺ thalassemia blood. Blood from SS patients treated with hydroxyurea has a viscosity intermediate between the SS and AA values. Blood containing cells that are not rigidified, such as normal red cells or oxygenated sickle cells, follows a simple Lucas-Washburn flow throughout the length of the 3-cm capillary. By fitting the flexible-cell data to the Lucas-Washburn model, a viscosity can be derived that is in good agreement with previous measurements over a range of volume fractions and is obtained using an apparatus that is far more complex. Deoxygenation sickles and thus rigidifies the cells, and their flow begins as Lucas-Washburn, albeit with higher viscosity than flexible cells. However, the flow further slows as a dense mass of cells forms behind the meniscus and increases in length as flow progresses. By assuming that the dense mass of cells exerts a frictional force proportional to its length, we derive an equation that is formally equivalent to vertical imbibition, even though the flow is horizontal, and this equation reproduces the observed behavior well. We present a simple theory using activity coefficients that accounts for this viscosity and its variation without adjustable parameters. In the course of control experiments, we have found that deoxygenation increases the flexibility of normal human red cells, an observation only recently published for mouse cells and previously unreported for human erythrocytes. Together, these studies form the foundation for an inexpensive and rapid point-of-care device to diagnose sickle cell disease or to determine blood viscosity in resource-challenged settings.     

Microvascular Regulation of Cutaneous Gas Exchange in Amphibians

SYNOPSIS. Gas exchange across amphibian skin is regulated bythe cutaneous microcirculation. Parameters involved in regulatinggas exchange are capillary density, radius and blood flow. Changesin capillary density and radius should affect gas exchange byaltering the cutaneous diffusing capacity (D₂) while changesin capillary blood flow affect the perfusive conductance ofthe skin. A simple model predicts that the effect of capillary densitychanges on D₂ will become more pronounced as capillary densityand epidermal thickness decrease. Changes in capillary radiusshould have only a minor effect on D₂ Previous analyses havesuggested that cutaneous gas exchange is not significantly affectedby the perfusive conductance of the skin. Consequently, it hasbeen thought that changes in total capillary blood flow havelittle impact on cutaneous gas exchange. Earlier analyses, however,may have underestimated the importance of perfusive conductancein amphibian skin, primarily because functional heterogeneitiesin the microcirculation were not considered. The density of perfused capillaries is regulated in the footweb of Rana esculenta by environmental Po₂ and PCO₂, and alsoby lung ventilation. In Rana catesbeiana, capillary densityin the web decreases during air exposure. Chronic exposure toenvironmental hypoxia increases total capillary density in bullfrogtadpole skin. In Rana pipiens, regulation of cutaneous gas exchangeby environmental and pulmonary O₂ probably involves changesin total capillary blood flow.     

Regional measurements of pulmonary edema by using magnetic resonance imaging

Athree-dimensional magnetic resonance imaging (MRI) method to measurepulmonary edema and lung microvascular barrier permeability wasdeveloped and compared with conventional methods in nine mongrel dogs.MRIs were obtained covering the entire lungs. Injury was induced byinjection of oleic acid (0.021-0.048 ml/kg) into a jugularcatheter. Imaging followed for 0.75-2 h. Extravascular lung waterand permeability-related parameters were measured from multiple-indicator dilution curves. Edema was measured as magnetic resonance signal-to-noise ratio (SNR). Postinjury wet-to-dry lung weight ratio was 5.30 ± 0.38 (n = 9). Extravascular lung water increased from 2.03 ± 1.11 to 3.00 ± 1.45 ml/g(n = 9, P < 0.01). Indicatordilution studies yielded parameters characterizing capillary exchangeof urea and butanediol: the product of the square root of equivalentdiffusivity of escape from the capillary and capillary surface area(D^1/2S)and the capillary permeability-surface area product(PS). The ratio ofD^1/2Sfor urea toD^1/2Sfor butanediol increased from 0.583 ± 0.027 to 0.852 ± 0.154 (n = 9, P < 0.05). Whole lung SNR atbaseline, before injury, correlated withD^1/2Sand PS ratios (both P < 0.02). By using rate of SNR change, the mismatch of transcapillaryfiltration flow and lymph clearance was estimated to be0.2-1.8 ml/min. The filtration coefficient was estimated fromthese values. Results indicate that pulmonary edema formation duringoleic acid injury can be imaged regionally and quantified globally, andthe results suggest possible regional quantification by usingthree-dimensional MRI.

     

Quantitative analyses of ultrastructure and vascularization of the slow muscle fibres of the anchovy

A quantitative study has been made of the ultrastructure and vascularization of slow fibres in the lateral muscles of the European anchovy (Engraulis encrasicolus). Mitochondria and myofibrils occupy 45.5 and 44.3% of total fibre volume respectively. More than 95% of all myofibrils are adjacent to mitchondria. A total of 51 % of the sarcolemma is in direct contact with capillaries with a mean of 12.9 capillaries per fibre. In transverse sections anchovy slow fibr es are considerably flattened (long to short axis 12:1) such that the surface to volume ratio is more than twice that of a cylindrical fibre of the same area (1115 μm²). The capillary surface required to supply l μm³ of mitochondria is 0.18 μm² and the maximum distance between any capillary and mitochondrion 8 μm. T-system and sarcoplasmic reticulum occupy 0.43 and 2.7% of fibre volume respectively. Adaptations for increasing the capacity of skeletal muscle for aerobic work are discussed.     

Dynamic contrast enhanced MRI of mouse fibrosarcoma using small-molecular and novel macromolecular contrast agents

The aim of the study was a comparison of 2 novel macromolecular contrast agents, Gadomer-17 and Polylysine-Gd-DTPA, with commercially available Gd-DTPA in determining the quality of tumor microvasculature by dynamic contrast enhanced MRI. Three groups of 5 mice with SA-1 tumors were studied. To each group of animals one contrast agent was administered; i.e. the first group got Gd-DTPA, the second group Gadomer-17 and the third group Polylysine-Gd-DTPA. To perform dynamic contrast enhanced MRI a standard keyhole approach was used by which consecutive signal intensity change due to contrast agent accumulation in the tumor was measured. From the obtained data, tissue permeability surface area product PS and fractional blood volume BV were calculated on a pixel-by-pixel basis. PS and BV values were calculated for each contrast agent. Based on the values, contrast agents were classified according to their performance in characterizing tumor microvasculature. Results of our study suggest that Gadomer-17 and Polylysine-Gd-DTPA are significantly superior to Gd-DTPA in characterizing tumor microvasculature.     

Prostacyclin and prostagladin synthesis in isolated brain capillaries

The synthesis of prostacyclin and prostaglandins was examined in isolated blood-free brain capillaries of guinea-pigs and rats using 1-¹⁴C-arachidonic acid as a precursor. The main prostaglandins synthesized by guinea-pig microvessels were prostaglandin D₂ and prostaglandin E₂. Substantially less prostaglandin F_2α or the prostacyclin stable metabolite, 6-oxo-prostaglandin F_1α was synthesized. Rat capillary prostaglandin distribution differed substantially from that of the guinea-pigs although the principle prostaglandin was also PGD₂. Total prostaglandin conversion was greater in guinea-pig capillaries than in the rat.Norepinephrine stimulated the prostaglandin forming capacity of blood free cerebral microvasculature of guinea-pigs. Prostacyclin and prostaglandins could be involved in the activity dependent regulation of regional cerebral blood flow and permeability.     

The Functional Unit of Neisseria meningitidis 3-Deoxy-?-Arabino-Heptulosonate 7-Phosphate Synthase Is Dimeric

Neisseria meningitidis 3-deoxy-d-arabino-heptulosonate 7-phosphate synthase (NmeDAH7PS) adopts a homotetrameric structure consisting of an extensive and a less extensive interface. Perturbation of the less extensive interface through a single mutation of a salt bridge (Arg126-Glu27) formed at the tetramer interface of all chains resulted in a dimeric DAH7PS in solution, as determined by small angle X-ray scattering, analytical ultracentrifugation and analytical size-exclusion chromatography. The dimeric NmeDAH7PS^R126S variant was shown to be catalytically active in the aldol-like condensation reaction between d-erythrose 4-phosphate and phosphoenolpyruvate, and allosterically inhibited by l-phenylalanine to the same extent as the wild-type enzyme. The dimeric NmeDAH7PS^R126S variant exhibited a slight reduction in thermal stability by differential scanning calorimetry experiments and a slow loss of activity over time compared to the wild-type enzyme. Although NmeDAH7PS^R126S crystallised as a tetramer, like the wild-type enzyme, structural asymmetry at the less extensive interface was observed consistent with its destabilisation. The tetrameric association enabled by this Arg126-Glu27 salt-bridge appears to contribute solely to the stability of the protein, ultimately revealing that the functional unit of NmeDAH7PS is dimeric.     

Dependence of electroosmotic flow in capillary electrophoresis on Group I and II metal ions

The effect of Group I and II metal ions on electroosmotic flow in capillary electrophoresis in fused-silica capillaries is characterized. The electroosmotic mobility of aqueous mobile phases of lithium, sodium, potassium, calcium and barium acetates in fused-silica capillaries is measured as a function of pH at constant voltage. Cross contamination is avoided by using separate columns for each study and pH control is maintained with the aid of He sparging. The shape of a plot of pH vs. electroosmotic mobility depends on the particular cation used which in turn depends on the surface sorption properties of the ions. Column history is demonstrated to have an effect on electroosmotic flow and therefore retention times. The resolution of a test mixture is optimal in the lithium-based buffer.     

Respiratory vasculatures of the intertidal air-breathing eel goby, <Emphasis Type="Italic">Odontamblyopus lacepedii</Emphasis> (Gobiidae: Amblyopinae)

Lacking a propensity to emerge over the mud surface, the eel goby, Odontamblyopus lacepedii, survives low tide periods by continuously breathing air in burrows filled with hypoxic water. As with most marine air-breathing fishes, O. lacepedii does not possess an accessory air-breathing organ, but holds air in the buccal–opercular cavity. The present study aimed to clarify how the respiratory vasculature has been modified in this facultative air-breathing fish. Results showed that the gills apparently lacked structural modifications for air breathing, whereas the inner epithelia of the opercula were richly vascularized. Comparison with two sympatric gobies revealed that the density of blood capillaries within 10μm from the inner opercular epithelial surface in O. lacepedii (14.5 ± 3.0 capillaries mm⁻¹; mean ± s.d., n = 3) was significantly higher than in the aquatic non-air-breathing Acanthogobius hasta (0.0 ± 0.0) but significantly lower than in the amphibious air-breathing mudskipper, Periophthalmus modestus (59.1 ± 8.5). The opercular capillary bed was supplied predominantly by the 1st efferent branchial arteries (EBA1) and drained by the opercular veins, which open into the anterior cardinal vein. Deep invaginations at the distal end of the EBA1 and the junction with EBA2 are suggestive of blood flow regulatory sites during breath-holding and apnoeic periods. It remains to be investigated how blood flow through the gills is maintained during breath holding when the buccal–opercular cavity is filled with air.     

Phosphatidylserine exposure by Toxoplasma gondii is fundamental to balance the immune response granting survival of the parasite and of the host

Phosphatidylserine (PS) exposure on the cell surface indicates apoptosis, but has also been related to evasion mechanisms of parasites, a concept known as apoptotic mimicry. Toxoplasma gondii mimics apoptotic cells by exposing PS, inducing secretion of TGF-beta1 by infected activated macrophages leading to degradation of inducible nitric oxide (NO) synthase, NO production inhibition and consequently persisting in these cells. Here PS⁺ and PS⁻ subpopulation of tachyzoites were separated and the entrance mechanism, growth and NO inhibition in murine macrophages, and mice survival and pathology were analyzed. Infection index in resident macrophages was similar for both PS subpopulations but lower when compared to the total T. gondii population. Growth in resident macrophages was higher for the total T. gondii population, intermediate for the PS⁺ and lower for the PS⁻ subpopulation. Production of NO by activated macrophages was inhibited after infection with the PS⁺ subpopulation and the total populations of tachyzoites. However, the PS⁻ subpopulation was not able to inhibit NO production. PS⁺ subpopulation invaded macrophages by active penetration as indicated by tight-fitting vacuoles, but the PS⁻ subpopulation entered macrophages by phagocytosis as suggested by loose-fitting vacuoles containing these tachyzoites. The entrance mechanism of both subpopulations was confirmed in a non-professional phagocytic cell line where only the PS⁺ tachyzoites were found inside these cells in tight-fitting vacuoles. Both subpopulations of T. gondii killed mice faster than the total population. Clear signs of inflammation and no tachyzoites were seen in the peritoneal cavity of mice infected with the PS⁻ subpopulation. Moreover, mice infected with the PS⁺ subpopulation had no sign of inflammation and the parasite burden was intense. These results show that PS⁺ and PS⁻ subpopulations of T. gondii are necessary for a successful toxoplasma infection indicating that both subpopulations are required to maintain the balance between inflammation and parasite growth.     

A critical parameter for transcapillary exchange of small solutes in countercurrent systems

Small solute transport by a countercurrent capillary loop was studied using a theoretical model. In the model, the afferent and the efferent limbs of the loop share a common interstitial space, with which exchange of solute occurs. Sources of solute, epithelial cells, exist near capillaries and secret solute into the interstitial fluid. Parameters based on experimental measurements on young Sprague-Dawley rats were used in the model, and asymptotic solutions were derived. Comparison of the solute distribution in the interstitium between a capillary loop and a single capillary reveals that the ratio of the product of permeability (P(1)) and surface area (A(1)) to flow (F(1)) of the afferent limb, gamma(1)=P(1)A(1)/F(1) is a critical parameter for the countercurrent exchange system. It alone determines whether the countercurrent arrangement of capillaries facilitates clearance of solute from the interstitial fluid, a greater axial gradient of solute in the interstitium from the base to the tip of the capillary loop and a greater effect of flow, F, upon this gradient. The properties of the efferent limb affect the results, but it is gamma(1) that determines the characteristic difference between a capillary loop and a single capillary.     

Two-Electron Reactions S2QB → S0QB and S3QB → S1QB are Involved in Deactivation of Higher S States of the Oxygen-Evolving Complex of Photosystem II

The oxygen-evolving complex of Photosystem II cycles through five oxidation states (S₀-S₄), and dark incubation leads to 25% S₀ and 75% S₁. This distribution cannot be reached with charge recombination reactions between the higher S states and the electron acceptor Q_B⁻. We measured flash-induced oxygen evolution to understand how S₃ and S₂ are converted to lower S states when the electron required to reduce the manganese cluster does not come from Q_B⁻. Thylakoid samples preconditioned to make the concentration of the S₁ state 100% and to oxidize tyrosine Y_D were illuminated by one or two laser preflashes, and flash-induced oxygen evolution sequences were recorded at various time intervals after the preflashes. The distribution of the S states was calculated from the flash-induced oxygen evolution pattern using an extended Kok model. The results suggest that S₂ and S₃ are converted to lower S states via recombination from S₂Q_B⁻ and S₃Q_B⁻ and by a slow change of the state of oxygen-evolving complex from S₃ and S₂ to S₁ and S₀ in reactions with unspecified electron donors. The slow pathway appears to contain two-electron routes, S₂Q_B → S₀Q_B, and S₃Q_B → S₁Q_B. The two-electron reactions dominate in intact thylakoid preparations in the absence of chemical additives. The two-electron reaction was replaced by a one-electron-per-step pathway, S₃Q_B → S₂Q_B → S₁Q_B in PS II-enriched membrane fragments and in thylakoids measured in the presence of artificial electron acceptors. A catalase effect suggested that H₂O₂ acts as an electron donor for the reaction S₂Q_B → S₀Q_B but added H₂O₂ did not enhance this reaction.