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IMMUNITY AND SUSCEPTIBILITY TOWARD CHEEK POUCH TRANSPLANTS OF A MOUSE LEUKEMIA.

Intravenous sensitization with spleen or leukemic cells of mice and certain rats immunized Syrian hamsters toward cheek pouch heterografts of a mouse leukemia. By contrast, sensitized hamsters given cortisone became more susceptible to the challenging leukemic graft. Neither response was elicited by sensitization with cells of the guinea pig, Syrian hamster, rabbit, or human being.

Animals↗

Erythema infectiosum: an outbreak of "slapped cheek" disease in north Devon.

An outbreak of erythema infectiosum (fifth disease; megalerythema epidemicum) which occurred in a small north Devon town (population 3600) during the spring of 1975 is reported. All fifty-eight cases displayed the diagnostic "slapped cheek" appearance. Virological studies gave disappointingly negative results.

Adolescent↗

Lesions that manifest as medial cheek and nasolabial fold masses.

Seventeen cases were collected in which the patient presented with a medial cheek or nasolabial fold mass. Most of these lesions were uncommon, and some were rare. The most reliable differentiating finding was the type of associated bone involvement. The malignancies had bone erosion and as a group could be distinguished from the other masses. Computed tomographic attenuation and magnetic resonance imaging signal intensities were nonspecific and did not allow a definitive diagnosis to be made. The types of pathologic conditions and their sectional imaging findings are reviewed.

Cheek↗

Multiple mechanisms of reactive hyperemia in arterioles of the hamster cheek pouch.

To investigate mechanisms of reactive hyperemia, single arterioles of the hamster cheek pouch were occluded for periods of 1 s-3 min. Arteriolar diameters were measured upstream and downstream from the occlusion. O2 availability to the tissue was controlled by equilibrating the suffusate with low (0% O2) or high (10% O2) O2 gas mixtures. After very brief occlusions downstream sites dilated transiently, but upstream diameters did not change. Upstream and downstream diameters both increased during longer occlusions with O%-O2 and 10%-O2 suffusion. Microvascular pressure decreased at downstream sites and increased at upstream sites within 1-2 s of occlusion. During 0%-O2 suffusion tissue and periarteriolar O2 tensions (PO2's) began to decrease within 2 s of occlusion and had decreased halfway to their minimum value by 7 s. PO2's decreased only slightly during 10%-O2 suffusion. Calculated first-order rate constants for arteriolar diameter recovery decreased and total recovery time increased as occlusion duration was prolonged. This study suggests that multiple mechanisms (metabolic, myogenic, and passive) contribute to reactive hyperemia.

Animals↗

Ca2+ sensitivity of isolated arterioles from the hamster cheek pouch.

When isolated from the hamster cheek pouch, cannulated, and perfused, 60- to 90-microns arterioles spontaneously contracted to 67 +/- 4% of maximum diameter. Vessel sensitivity to variations in extracellular Ca2+ was then evaluated. Tone, regardless of its source, was highly dependent on the concentration of Ca2+ in the bathing solution. The magnitude of responses to changing Ca2+ depended upon which vessel surface (luminal or abluminal) the change was made. For K(+)-induced tone the Ca2+ concentration-response curve was right shifted 60-fold for luminal vs. abluminal changes. These results suggest that restricted diffusion of Ca2+ from lumen to smooth muscle dramatically reduces smooth muscle Ca2+ concentration and that under standard in vitro conditions the smooth muscle layer is effectively isolated from luminal contents. Both the cytosolic and stored Ca2+ in these microvessels were dependent on the Ca2+ concentration in the bathing solution. Abrupt removal of Ca2+ from bath produced a rapid maximal dilation with a mean time to half-maximal response (t1/2 max) of 14 +/- 4 s. Ca2+ replacement induced a return to the previous level of tone with a mean t1/2 max of 8 +/- 3 s. The magnitude of transient responses to caffeine (10 mM) was inversely related to the time of exposure to zero Ca2+ with a rapid decay in magnitude (t1/2 max = 2.7 +/- 0.8 min). These data suggest that the smooth muscle cells of arterioles have a particularly rapid transmembrane Ca2+ flux that is tightly controlled by an intracellular regulatory mechanism, which may explain the generally increased dependence of smaller vessels on extracellular Ca2+.

Animals↗

Spontaneous vasomotion in hamster cheek pouch arterioles in varying experimental conditions.

The spontaneous rhythmic motor activity (vasomotion) of arterioles was studied in vivo in the hamster cheek pouch by means of intravital microscopy. In control conditions, arteriolar vasomotion was regularly present in healthy preparations, independent of anesthesia (pentobarbital sodium or alpha-chloralose), composition of the superfusate [tris(hydroxymethyl)aminomethane-buffered or N-2-hydroxy-ethylpiperazine-N'-2-ethanesulfonic acid-supported HCO3(-)-buffered saline solutions) or a combined nerve, alpha- and beta- receptor blockade. In arterioles with internal diameters between 13 and 52 microns, the vasomotion frequency (3-15 cycles/min) and amplitude (2-10 microns) were not significantly correlated to vessel size. The frequency and amplitude of the spontaneous arteriolar vasomotion could be modified by changes in the physical and chemical environment of the preparation. Thus, addition of pinacidil, a K+ channel activator, to the superfusate dose dependently decreased and finally suppressed vasomotion, in combination with an increase of the vessel diameter. These effects could be counteracted if glibenclamide (10(-6) M), a K+ channel blocker, was added to the superfusing solution. In the absence of any major changes in vessel diameter, vasomotion was also abolished by increasing the PO2 (from approximately 15 to 30 mmHg), varying the pH (from 7.40 to 7.22 or 7.65), and lowering the temperature to 15 degrees C in the superfusion solution. The abolition of vasomotion observed because of increased PO2 and changes in pH could be reversed by addition of glibenclamide (10(-6) M) or tetraethylammonium chloride (TEA, 5 x 10(-3) M), another K+ channel blocker, to the superfusion solution; in the case of lowered temperature only glibenclamide was effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Microvascular pressure and albumin extravasation after leukocyte activation in hamster cheek pouch.

The effects of leukotriene B4 (LTB4) and N-formyl-methionyl-leucylphenylalanine (FMLP) on transmicrovascular exchange of fluorescein isothiocyanate (FITC)-labeled serum albumin and dextran (molecular mass, 150,000 Da) were evaluated in hamster cheek pouch utilizing measurements of microvascular pressure and global efflux of the macromolecular markers into the tissue suffusate. Exposure of the suffused pouch to 1.0 microM LTB4 failed to alter microvascular pressure from its control level. The microvascular clearance of FITC-albumin rose to a peak value of 1.7 times the control value at a LTB4 concentration of 1.0 microM; the rate of albumin extravasation did not change from the normal level at a concentration of 0.1 microM. The extravasation rate of FITC-dextran was elevated with both doses of LTB4; the leukocyte chemotactic agent elicited 2.4- and 9.7-fold increments in peak clearance of dextran at concentrations of 0.1 and 1.0 microM, respectively. FMLP elicited a twofold increase in venular and terminal arteriolar pressures at a concentration of 1 microM; at the same concentration, the albumin clearance rose 3.5-fold. The results suggest that albumin transport remains near the normal level after LTB4 elicits massive migration of leukocytes across the venular membrane. By contrast, albumin transport is greatly accelerated following exposure to the chemotactic peptide FMLP; ultrastructural and physiological evidence suggests that the leakage of albumin is augmented by increases in microvascular permeability and filtration pressure. The results also reinforce previous ultrastructural observations from our laboratory indicating that diapedesis per se is not a cause of microvascular hyperpermeability in inflammatory reactions.

Animals↗

Platelet-activating factor stimulates protein tyrosine kinase in hamster cheek pouch microcirculation.

We studied the interactions between platelet-activating factor (PAF) and protein tyrosine kinase (PTK) in the modulation of microvascular responses in the hamster cheek pouch using intravital microscopy and computer-assisted image analysis. Changes in arteriolar diameter and in integrated optical intensity (IOI; an index of vascular permeability) were measured. Fluorescein isothiocyanate-labeled dextran 150 (FITC-Dx 150) served as a tracer for macromolecular transport. Genistein and tyrphostin 25, two PTK inhibitors, were applied topically in separate experiments. Pretreatment with 10(-4), 10(-6), and 10(-8) M genistein and with tyrphostin 25 at 10(-5) and 10(-7) M attenuated the maximal increment in mean IOI (+/- SE) induced by PAF at 10(-7) M (19.9 +/- 5.3, 21.5 +/- 4.5, 58.5 +/- 11.4, 28.7 +/- 7.6, and 35.0 +/- 10.9 vs. 70.7 +/- 8.9 units, respectively). Pretreatment with PTK inhibitors resulted in vasodilation but did not inhibit PAF-induced vasoconstriction. Our results suggest that PTK represents a biochemical pathway involved in the PAF modulation of microvascular permeability but not PAF modulation of arteriolar tone.

Amino Acid Oxidoreductases↗

Cellular pathways of the conducted electrical response in arterioles of hamster cheek pouch in vitro.

We have previously shown that conducted vasomotor responses follow patterns that are consistent with a passive spread of electrical current along the length of the arterioles [(Xia and Duling, Am. J. Physiol. 269 (Heart Circ. Physiol. 38): H2022-H2030, 1995]. In this study, we define the cells through which the current flows. Isolated arterioles of hamster cheek pouch were used. The mean resting membrane potential (RMP) for randomly sampled arteriolar cells was -67 mV. When cell types were identified by dye injection, the RMPs were -68 and -67 mV for smooth muscle (SM) and endothelium (EC), respectively. Pulses of KCl induced transient, monophasic depolarizations at the site of stimulation (local), which were conducted decrementally along the length of the arteriole over several millimeters. During electrical conduction, three patterns of responses could be observed, but identical patterns of the conducted electrical responses were always observed in SM and EC. Phenylephrine stimulation also caused transient local and conducted depolarizations in both SM and EC. As with KCl stimuli, shapes of conducted electrical responses were identical in records made in both cell types. The results suggest that SM and EC are electrically coupled both homocellularly and heterocellularly.

Alcohols↗

Capillaries and arterioles are electrically coupled in hamster cheek pouch.

In this report we demonstrate electrical communication in the microcirculation between arterioles and capillary networks in situ. Microvessel networks in the hamster cheek pouch, which included capillaries and their feeding arterioles, were labeled with the voltage-sensitive dye di-8-ANEPPS by intraluminal perfusion through a micropipette. Pulses of 140 mM potassium solution were applied by pressure ejection from micropipettes positioned on arterioles several hundred micrometers upstream from capillaries. Potassium caused membrane potential changes of 3-11 mV in capillary segments up to 1,200 micrometers distal to the stimulation site, with time delays of <1 s. Capillary membrane potential changes were biphasic, with initial depolarizations followed by hyperpolarizations. The size of the response decreased exponentially with the distance between the arteriole and capillary, with a 1/e distance of 590 micrometers. The time to peak depolarization of both arteriolar and capillary segments was similar. The time to peak response was significantly faster than that for responses from direct stimulation of capillaries. Capillary responses were also obtained when blood flow was either blocked or directed toward sites of stimulation. Acetylcholine (10(-4) M) and phenylephrine (10(-5) M) applied to the arterioles by iontophoresis produced monophasic hyperpolarizing and depolarizing responses, respectively, in capillaries with <1-s delay between stimulus and onset of the membrane potential change. These results provide evidence in situ of a pathway for electrical communication between arteriolar and capillary levels of the microcirculation.

Animals↗

Role of EDHF in conduction of vasodilation along hamster cheek pouch arterioles in vivo.

We tested whether local and conducted responses to ACh depend on factors released from endothelial cells (EC) in cheek pouch arterioles of anesthetized hamsters. ACh was delivered from a micropipette (1 s, 500 nA), while arteriolar diameter (rest, approximately 40 microm) was monitored at the site of application (local) and at 520 and 1,040 microm upstream (conducted). Under control conditions, ACh elicited local (22-65 microm) and conducted (14-44 microm) vasodilation. Indomethacin (10 microM) had no effect, whereas N(omega)-nitro-L-arginine (100 microM) reduced local and conducted vasodilation by 5-8% (P < 0.05). Miconazole (10 microM) or 17-octadecynoic acid (17-ODYA; 10 microM) diminished local vasodilation by 15-20% and conducted responses by 50-70% (P < 0.05), suggesting a role for cytochrome P-450 (CYP) metabolites in arteriolar responses to ACh. Membrane potential (E(m)) was recorded in smooth muscle cells (SMC) and in EC identified with dye labeling. At rest (control E(m), typically -30 mV), ACh evoked local (15-32 mV) and conducted (6-31 mV) hyperpolarizations in SMC and EC. Miconazole inhibited SMC and EC hyperpolarization, whereas 17-ODYA inhibited hyperpolarization of SMC but not of EC. Findings indicate that ACh-induced release of CYP metabolites from arteriolar EC evoke SMC hyperpolarization that contributes substantively to conducted vasodilation.

Animals↗

Neutral endopeptidase modulates VIP-induced vasodilation in hamster cheek pouch vessels in situ.

The purpose of this study was to determine whether vasoactive intestinal peptide (VIP) dilates resistance arterioles in the in situ systemic circulation and whether inhibitors of neutral endopeptidase (NEP) and angiotensin I-converting enzyme (ACE), two membrane-bound metalloenzymes that are widely distributed in the microcirculation and cleave and inactive VIP, potentiate this response. Using intravital microscopy, we found that VIP (0.05 and 0.1 nmol) induced significant vasodilation in the hamster cheek pouch (13 +/- 1 and 20 +/- 2% increase from baseline, respectively; mean +/- SE; P < 0.05). These responses were significantly potentiated by topical application of phosphoramidon and thiorphan, two relatively selective NEP inhibitors, but not by captopril, a relatively selective ACE inhibitor. Furthermore, suffusion of a mixture of proteinase inhibitors consisting of leupeptin, Bestatin, and DL-2-mercaptomethyl-3-guanidinoethylthiopropanoic acid to inhibit serine proteinases, including mast cell tryptase, aminopeptidases, and carboxypeptidase N, respectively, had no significant effects on VIP-induced responses. These data indicate that VIP elicits vasodilation in the in situ systemic microcirculation and that NEP modulates this response.

Angiotensin-Converting Enzyme Inhibitors↗

Vasodilation elicited by liposomal VIP is unimpeded by anti-VIP antibody in hamster cheek pouch.

The purpose of this study was to determine whether a monoclonal anti-vasoactive intestinal peptide (VIP) antibody, which binds VIP with high affinity and specificity and catalyzes cleavage of the peptide in vitro, attenuates VIP vasorelaxation in vivo and, if so, whether insertion of VIP on the surface of sterically stabilized liposomes (SSL), which protects the peptide from trypsin- and plasma-catalyzed cleavage in vitro, curtails this response. Using intravital microscopy, we found that suffusion of monoclonal anti-VIP antibody (clone c23.5, IgG2ak), but not of nonimmune antibody (myeloma cell line UPC10, IgG2ak) or empty SSL, significantly attenuates VIP-induced vasodilation in the in situ hamster cheek pouch (P < 0.05). By contrast, anti-VIP antibody has no significant effects on vasodilation elicited by isoproterenol, nitroglycerin, and calcium ionophore A-23187, agonists that activate intracellular effector systems in blood vessels that mediate, in part, VIP vasoreactivity. Suffusion of VIP on SSL, but not of empty SSL, restores the vasorelaxant effects of VIP in the presence of anti-VIP antibody. Collectively, these data suggest that VIP catalysis by high affinity and specific VIP autoantibodies displaying protease-like activity constitutes a novel mechanism whereby VIP vasoreactivity is regulated in vivo.

Animals↗

Stable VIP analogue Ro-24-9981 potentiates substance P-induced plasma exudation in hamster cheek pouch.

The purpose of this study was to determine whether vasoactive intestinal peptide (VIP; 300 nM) and a stable cyclic analogue of VIP, Ro-24-9981 (226 nM), modulated neurogenic plasma exudation in the oral cavity in situ and, if so, to determine the mechanisms that mediated these responses. With the use of intravital microscopy, we found that suffusion of substance P induced a significant concentration-dependent formation of fluorescein-isothiocyanate-dextran (mol wt 70 kDa) leaky sites in the hamster cheek pouch (P < 0.05). These effects were significantly and stereospecifically attenuated by NG-nitro-L-arginine methyl ester, an inhibitor of NO synthase, and restored by L-arginine, the substrate for NO synthase (P < 0.05). Topical application of human VIP and Ro-24-9981 had no significant effects of leaky site formation. In addition, human VIP had no significant effects on substance P-induced responses. By contrast, Ro-24-9981 significantly potentiated substance P- and capsaicin-induced leaky site formation (P < 0.05). The effects of Ro-24-9981 on substance P-induced responses were significantly attenuated by NG-nitro-L-arginine methyl ester and restored by L-arginine (P < 0.05). Indomethacin had no significant effects on Ro-24-9981-induced responses. Ro-24-9981 had no significant effects on adenosine- and calcium ionophore A-23187-induced leaky site formation. Collectively, these data suggest that VIP plays no significant role in modulating neurogenic plasma exudation in the oral mucosa. By contrast, Ro-24-9981 amplified this response in a specific receptor-mediated fashion.

Animals↗

Regulation of flow and wall shear stress in arteriolar networks of the hamster cheek pouch.

Our purpose was to define arteriolar network hemodynamics during moderate increases in interstitial adenosine or nitric oxide in the hamster (n = 34, pentobarbital sodium 70 mg/kg) cheek pouch tissue. The network consists of a feed arteriole (approximately 12-microm diameter, approximately 800-microm length) with three to six branches. Observations of diameter, red blood cell flux, and velocity were obtained at the feed before the branch and within the branch. A comparison of baseline with suffused adenosine or sodium nitroprusside (SNP) 10(-9) to 10(-5) M showed the following. First, diameter change was heterogeneous by agonist, did not reflect the expected dilatory response, and was related to location within the network. With adenosine, upstream branch points constricted and those downstream dilated, even at 10(-5) M. With SNP, upstream branch points dilated, whereas those downstream constricted. Second, with adenosine, changes in diameter, flux, and velocity together resulted in no change in wall shear stress until 10(-5) M. Wall shear stress was not maintained at a constant level with Nomega-nitro-L-arginine (10(-5) M), suggesting a role for flow-dependent diameter changes with adenosine. With SNP, diameter change correlated with the baseline (before SNP) shear stress conditions.

Adenosine↗

Arteriolar smooth muscle Ca2+ dynamics during blood flow control in hamster cheek pouch.

Intracellular calcium concentration ([Ca2+]i) governs the contractile status of arteriolar smooth muscle cells (SMC). Although studied in vitro, little is known of SMC [Ca2+]i dynamics during the local control of blood flow. We tested the hypothesis that the rise and fall of SMC [Ca2+]i underlies arteriolar constriction and dilation in vivo. Aparenchymal segments of second-order arterioles (diameter 35 +/- 2 microm) were prepared in the superfused cheek pouch of anesthetized hamsters (n = 18) and perifused with the ratiometric dye fura PE-3 (AM) to load SMC (1 microM, 20 min). Resting SMC [Ca2+]i was 406 +/- 37 nM. Elevating superfusate O2 from 0 to 21% produced constriction (11 +/- 2 microm) that was unaffected by dye loading; [Ca2+]i increased by 108 +/- 53 nM (n = 6, P < 0.05). Cycling of [Ca2+]i during vasomotion (amplitude, 150 +/- 53 nM; n = 4) preceded corresponding diameter changes (7 +/- 1 microm) by approximately 2 s. Microiontophoresis (1 microm pipette tip; 1 microA, 1 s) of phenylephrine (PE) transiently increased [Ca2+]i by 479 +/- 64 nM (n = 8, P < 0.05) with constriction (26 +/- 3 microm). Flushing blood from the lumen with saline increased fluorescence at 510 nm by approximately 45% during excitation at both 340 and 380 nm with no difference in resting [Ca2+]i, diameter or respective responses to PE (n = 7). Acetylcholine microiontophoresis (1 microA, 1 s) transiently reduced resting SMC [Ca2+]i by 131 +/- 21 nM (n = 6, P < 0.05) with vasodilation (17 +/- 1 microm). Superfusion of sodium nitroprusside (10 microM) transiently reduced SMC [Ca2+]i by 124 +/- 18 nM (n = 6, P < 0.05), whereas dilation (23 +/- 5 microm) was sustained. Resolution of arteriolar SMC [Ca2+]i in vivo discriminates key signaling events that govern the local control of tissue blood flow.

Animals↗

Leukocyte adhesion after oxidant challenge in the hamster cheek pouch microcirculation.

Oral administration of S-5682 (Daflon 500 mg, 90% diosmin, 10% hesperidin) inhibits oxidant-induced increase in macromolecular permeability in the postcapillary venules of the hamster cheek pouch microcirculation. In this study, the effect of S-5682 on leukocyte-endothelium interaction was evaluated using the same experimental model. Hamsters kept on a standard diet were divided into 5 groups (n = 6) and treated orally, twice a day, with placebo (10% lactose solution), S-5682, 5, 20 or 80 mg/kg/day (suspended in 10% lactose solution) or alpha-tocopherol, 1 mg/kg/day, for 10 days prior to the oxidant challenge with tert-butylhydroperoxide (TBOOH). Topical application of TBOOH (10(-4) M for 5 min) to hamsters given acridine orange prior to TBOOH resulted in increases in the number of rolling and sticking (no movement for at least 30 s) leukocytes in postcapillary venules. No changes in the number of rolling leukocytes could be observed in the treated groups compared with the placebo group (p > 0.05). On the contrary, leukocyte adhesion was inhibited in groups treated with S-5682 (5, 20 and 80 mg/kg/day) or alpha-tocopherol: placebo 105 +/- 3/6 mm(2) (mean +/- SEM); S-5682, 5 mg/kg/day 68 +/- 3/6 mm(2) (p < 0.01), 20 mg/kg/day 55 +/- 3/6 mm(2) (p < 0.001) and 80 mg/ kg/day 39 +/- 2/6 mm(2) (p < 0.001) and alpha-tocopherol 36 +/- 1/6 mm(2) (p < 0.001). The inhibition of oxidant-induced leukocyte adhesion by S-5682 was similar to that seen for ischemia-reperfusion and the higher dose of S-5682 was as effective as alpha-tocopherol in inhibiting it.

Animals↗

Protective effects of insulin during ischemia-reperfusion injury in hamster cheek pouch microcirculation.

OBJECTIVE: The effects of insulin (0.18 nM-0.18 microM) on reduced capillary perfusion, microvascular permeability increase and leukocyte adhesion induced by ischemia-reperfusion injury were investigated in the hamster cheek pouch microcirculation. To gain insight into the insulin's mechanism of action, the effects of its higher concentration (0.18 microM) were investigated after inhibition of tyrosine kinase (TK), nitric oxide synthase (NOS), protein kinase C (PKC), phosphatidylinositol 3-kinase and K+(ATP) channels, alone or in combination. Two concentrations for each inhibitor were used. METHODS: Microcirculation was visualized by fluorescence microscopy. Perfused capillary length, microvascular permeability, leukocyte adhesion to venular walls, vessel diameter and capillary red blood cell velocity were assessed by computer-assisted methods. Measurements were made at baseline (B), after 30 min of ischemia (I), and after 30 min of reperfusion (R). RESULTS: In control animals, perfused capillary length decreased by 63 +/- 5% of baseline at R. Microvascular permeability increased at I and R, while leukocyte adhesion was most pronounced in V1 postcapillary venules at R. Insulin dose-dependently preserved capillary perfusion at R (-28 +/- 6 and -15 +/- 6% of baseline), but was unable to prevent the increase in permeability at I (0.25 +/- 0.05 and 0.29 +/- 0.06 Normalized Grey Levels, NGL) and R (0.49 +/- 0.10 and 0.53 +/- 0.09 NGL), according to the concentrations. Adhesion of leukocytes was observed mostly in V3 venules at R (9 +/- 2 and 10 +/- 2/100 microm venular length, with the lower and higher concentration, respectively). Nitric oxide synthase inhibition by N(G)-nitro-L-arginine-methyl ester prior to insulin did not affect capillary perfusion at R (-18 +/- 3% of baseline with higher concentration), but prevented permeability increase (0.20 +/- 0.04 NGL, according to higher concentration) and reduced leukocyte adhesion in V3 venules at R (1.5 +/- 1.0/100 microm of venular length, with higher concentration). Blockade of K+(ATP) channels by glibenclamide prior to insulin decreased perfused capillary length at R (-58 +/- 6% of baseline with higher concentration), attenuated leakage at R (0.30 +/- 0.04 NGL, according to higher concentration) and caused leukocyte adhesion mainly in V1 venules at R (9.0 +/- 1.5/100 microm of venular length, with higher concentration). Inhibition of either TK, PKC or phosphatidylinositol 3-kinase did not affect microvascular responses to insulin. Simultaneous inhibition of TK and NOS did not increase protection. CONCLUSIONS: Insulin prevents ischemia-reperfusion injury by promoting capillary perfusion through an apparent activation of K+(ATP) channels and increase in nitric oxide release.

Alkaloids↗