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CGRP (8-37) reduces the duration but not the maximal increase of antidromic vasodilation in dental pulp and lip of the rat.

In this study the newly developed blockers of substance P (CP-96,345) and calcitonin gene-related peptide (CGRP8-37) were used to examine whether substance P and CGRP are involved in the afferent nerve induced vasodilation in the rat lower incisor pulp and lip. Electrical stimulation of the inferior alveolar nerve (10 V, 2 ms, 10 Hz, 30 s) in the presence of phenoxybenzamine (3 mg kg-1) induced an immediate vasodilation in the pulp and lip (52 and 186% increase in blood flow respectively, n = 12) with a long duration. Infusion of 2 mg kg-1 CP-96,345, a dose that inhibited the vasodilator effects of substance P (5-25 ng kg-1) in oral tissues, did not have any effect on antidromic vasodilation in either tissue. After infusion of CGRP8-37 (0.3 mg kg-1) the duration of the antidromic vasodilation in the pulp and lip was significantly reduced by 72 and 67% respectively (P < 0.05, n = 4), whereas the maximal increase of the response was unaffected. The blocking effect of the drug was short-lasting. When combined infusions of CP-96,345 and CGRP8-37 were given, a similar reduction in the duration of antidromic vasodilation in the pulp and lip occurred but in this case the amplitude of vasodilation in the pulp was reduced (from 35 +/- 9 to 12 +/- 3%, P < 0.05, n = 4). However, in the lip, the amplitude of vasodilation was not significantly reduced. The present findings indicate an involvement of CGRP in the mediation of the late phase of antidromic vasodilation in rat oral tissues and a role of substance P in the initiation of antidromic vasodilation in the incisor pulp.

Afferent Pathways↗

Ascorbate restores endothelium-dependent vasodilation impaired by acute hyperglycemia in humans.

BACKGROUND: Endothelium-dependent vasodilation is impaired in patients with insulin-dependent and non-insulin-dependent diabetes mellitus and restored by vitamin C administration, implicating a causative role for oxidant stress. Hyperglycemia per se attenuates endothelium-dependent vasodilation in healthy subjects. Accordingly, this study investigated whether impaired endothelium-dependent vasodilation caused by hyperglycemia in nondiabetic humans is restored by administration of the antioxidant vitamin C. METHODS AND RESULTS: Endothelium-dependent vasodilation was measured by incremental brachial artery administration of methacholine chloride (0.3 to 10 microg/min) during euglycemia, after 6 hours of hyperglycemia (300 mg/dL) created by dextrose (50%) intra-arterial infusion, and with coadministration of vitamin C (24 mg/min) during hyperglycemia. Endothelium-dependent vasodilation was significantly diminished by hyperglycemia (P:=0.02 by ANOVA) and restored by vitamin C (P:=0.04). In contrast, endothelium-dependent vasodilation was not affected by equimolar infusions of mannitol, with and without vitamin C coinfusion (P:=NS). Endothelium-independent vasodilation was measured by incremental infusion of verapamil chloride (10 to 300 microg/min) without and with coadministration of N:(G)-monomethyl-L-arginine (L-NMMA). In the absence of L-NMMA, endothelium-independent vasodilation was not significantly altered during hyperglycemia (P:=NS) but was augmented by vitamin C (P:=0.04). The coadministration of L-NMMA eliminated the vitamin C-related augmentation in verapamil-mediated vasodilation. CONCLUSIONS: Vitamin C administration restores endothelium-dependent vasodilation impaired by acute hyperglycemia in healthy humans in vivo. These findings suggest that hyperglycemia may contribute in part to impaired vascular function through production of superoxide anion.

Acute Disease↗

Aging progressively impairs endothelium-dependent vasodilation in forearm resistance vessels of humans.

Studies in experimental models suggest that endothelium-derived nitric oxide is reduced with aging, and this circumstance may be relevant to atherogenesis. The aim of this study was to determine whether increasing age resulted in altered endothelium-dependent vasodilation in the forearm resistance vessels of healthy humans. Forearm blood flow was measured in 119 healthy subjects, aged 19 to 69 years, by venous occlusion plethysmography. Brachial artery infusions of methacholine chloride (0.03 to 10.0 microgram/min) were used to assess endothelium-dependent vasodilation and of sodium nitroprusside (0.03 to 10.0 microgram/min) to assess endothelium-independent vasodilation. The slope of the dose-blood flow response relation was calculated in each subject for each drug. Univariate and multiple stepwise regression analyses were used to relate vascular reactivity to selected variables, including age, lipids, and blood pressure. Endothelium-dependent vasodilation was progressively impaired with increasing age, assessed as a reduction in slope from 2.25 +/- 0.16 to 0.34 +/- 0.11 (mL/100 mL tissue per minute)/(microgram/min) (P <.001). The decline in endothelium-dependent vasodilation was already evident by the fourth decade (age 30 to 39 years). Endothelium-independent vasodilation did not change with age. Age, total cholesterol, and low-density lipoprotein cholesterol were univariate predictors of endothelium-dependent vasodilation. Age remained the most significant predictor of endothelium-dependent vasodilator responses by multiple stepwise regression analysis. From these observations, it can be concluded that endothelium-dependent vasodilation declines steadily with increasing age in healthy human subjects. Age is a strong univariate and multivariate predictor of endothelium-dependent vasodilation. This finding may be a marker for more widespread endothelial dysfunction.

Adult↗

Evidence for a role of nitric oxide in hindlimb vasodilation induced by hypothalamic stimulation in anesthetized rats.

Electrical stimulation of the hypothalamus produces cardiovascular adjustments consisting of hypertension, tachycardia, visceral vasoconstriction and hindlimb vasodilation. Previous studies have demonstrated that hindlimb vasodilation is due a reduction of sympathetic vasoconstrictor tone and to activation of beta2-adrenergic receptors by catecholamine release. However, the existence of a yet unidentified vasodilator mechanism has also been proposed. Recent studies have suggested that nitric oxide (NO) may be involved. The aim of the present study was to investigate the role of NO in the hindquarter vasodilation in response to hypothalamic stimulation. In pentobarbital-anesthetized rats hypothalamic stimulation (100 Hz, 150 microA, 6 s) produced hypertension, tachycardia, hindquarter vasodilation and mesenteric vasoconstriction. Alpha-adrenoceptor blockade with phentolamine (1.5 mg/kg, iv) plus bilateral adrenalectomy did not modify hypertension, tachycardia or mesenteric vasoconstriction induced by hypothalamic stimulation. Hindquarter vasodilation was strongly reduced but not abolished. The remaining vasodilation was completely abolished after iv injection of the NOS inhibitor L-NAME (20 mg/kg, iv). To properly evaluate the role of the mechanism of NO in hindquarter vasodilation, in a second group of animals L-NAME was administered before alpha-adrenoceptor blockade plus adrenalectomy. L-NAME treatment strongly reduced hindquarter vasodilation in magnitude and duration. These results suggest that NO is involved in the hindquarter vasodilation produced by hypothalamic stimulation.

Adjuvants, Anesthesia↗

Endothelium-dependent, shear-induced vasodilation is rate-sensitive.

OBJECTIVES: To quantify the relative contributions of the rate of change and the magnitude of shear stress to endothelium-mediated arteriolar dilation. METHODS: A feedback control system was designed in which shear stress (tau) and the temporal shear gradient (TSG) were prescribed and dynamically controlled in isolated rat cremaster 1A arterioles. The TSG was the quotient of the maximum shear stress and the ramp duration. This system was used to assess the roles of tau and TSG in the initial, transient vasodilations and the secondary, sustained vasodilations in response to steps and ramps in shear stress. RESULTS: Both step- and ramp-shear experiments revealed time-dependent hiphasic vasodilations that we report for the first time. Application of a step-shear stress of 20 dynes/cm2 elicited an initial transient vasodilation that peaked at about 4 min. When the shear stress was applied as a ramp that reached the maximum value of 20 dynes/cm2 over 5 min, a vasodilation was observed over the ramp period, which reached a peak at the end of the ramp period that was much lower than that observed after step shear. After 20 dynes/cm2 was attained, the vessel diameter decreased despite constant maintenance of the maximum shear stress. In both step- and ramp-shear experiments, after the decrease of the initial vasodilation, a second phase of vasodilation began approximately 15 min after the beginning of the shear application. The second phase of vasodilation reached a steady state that was essentially the same for both the step and the ramp shear. By refining the ramping apparatus further, we varied the TSG up to 40 dynes/cm2 per second and showed that the early vasodilation was highly rate sensitive to TSGs greater than 5 dynes/cm2 per second for a given intermediate value of final shear stress (20 dynes/cm2) and was magnitude sensitive when shear was increased gradually (TSG < 5 dynes/cm2 per second). CONCLUSIONS: Our results suggest that two fundamentally different responses to shear stress are mediated by microvascular endothelium: one vasodilation is elicited by shear stress changes on a time scale of a few seconds or less and another is elicited by shear stress changes on a longer time scale. The former response is potent, transient, and rate sensitive; the latter is more modest, sustained, and magnitude sensitive.

Animals↗

[Methods for evaluating vasodilator agents in cardiac failure].

Invasive cardiac catheterisation remains the reference technique for the evaluation of the effects of vasodilator drugs in cardiac failure. The arterial, venous or mixed site of action can be determined. Venous vasodilators induce a fall in left ventricular end diastolic volume (EVD), left ventricular end diastolic pressure (EDP), and stroke volume (SV). Arterial vasodilators decrease left ventricular end systolic pressure (ESP), end systolic volume (ESV) and increase the stroke volume. Mixed vasodilators associate the effects of both, leading to a fall in left ventricular filling pressures and an increase in SV. It is not always easy to determine the exact site of action of a given vasodilator drug. Arterial vasodilatation can only be confirmed when peripheral arterial resistances and systemic blood pressure decrease simultaneously. Venous vasodilatation can only be formally confirmed by using other techniques such as pethysmography. Hemodynamic investigations have other fundamental objectives in the evaluation of the effects of a vasodilator, especially the demonstration of possible associated positive inotropic effects. This would be relatively easy in the case of a venous vasodilator which induces an increase in SV but more difficult in the assessment of an arterial vasodilator. Studying the distribution of regional blood flow after the administration of a vasodilator is another important objective of cardiac catheterisation. Although coronary flow can be studied properly, the hemodynamics of other regions can only be assessed approximatively. The phenomenon of tolerance at an early or late stage of vasodilator therapy can also be demonstrated by hemodynamic monitoring.

Arteries↗

Neurons intrinsic to arterioles initiate postcontraction vasodilation.

UNLABELLED: Ganglion cells exist in muscle arterioles. To determine the role of these intrinsic neurons in postcontraction vasodilation, isolated dog gracilis muscles were studied. A single twitch elicited vasodilation, but no vasodilator metabolites appeared in the venous effluent. Contraction at 2/s lowered resistance within 1 s whereas dilator metabolites were not demonstrable in the effluent until 15-20 s. During contraction the magnitude and time course of vasodilation were the same during constant and variable flow, and at various values of PaO2 and PVO2. In contrast, resistance was strongly correlated with flow and PO2 during recovery. Some resting muscles were perfused with venous blood from contracting donors. The rate of metabolic vasodilation in recipient muscles was about 10 times less than the rate of vasodilation in the donors. Lidocaine and procaine blocked postcontraction vasodilation but did not influence postocclusion vasodilation, metabolic vasodialtion, or autoregulation. The degree of block was the same in acutely and chronically denervated muscles. The effect of local anesthetics could not be accounted for by properties of skeletal or vascular smooth muscles. CONCLUSIONS: 1) intrinsic neurons initiate postcontraction vasodilation; 2) metabolites account for sustained vasodilation during recovery.

Animals↗

Vasodilation in black Americans: attenuated nitric oxide-mediated responses.

BACKGROUND: Attenuated vasodilation in response to the intra-arterial administration of the beta-adrenergic agonist isoproterenol (INN, isoprenaline), an endothelium-independent vasodilator, has previously been observed in normotensive black Americans. To determine whether this reflected a more generalized attenuation of responses to vasodilators, we compared forearm blood flow responses to the endothelium-dependent vasodilator methacholine and the endothelium-independent vasodilator sodium nitroprusside in young normotensive black men and white men. METHODS: Forearm blood flow responses to the intra-arterial administration of isoproterenol (10 to 400 ng/min), methacholine (0.25 to 8 micrograms/min), and sodium nitroprusside (0.25 to 8 micrograms/min) were measured with use of venous occlusion plethysmography in 11 normotensive black men (mean +/- SE age, 30.5 +/- 2.2 years) and nine normotensive white men (mean age, 28.0 +/- 3.2 years). RESULTS: Baseline characteristics, including baseline forearm blood flow, were similar in the black and the white subjects. Vasodilation in response to isoproterenol, sodium nitroprusside, and methacholine was significantly attenuated in black subjects, resulting respectively in a 3.7-fold, 3.6-fold, and 5.0-fold increase in forearm blood flow in black subjects and a 7.5-fold, 5.2-fold, and 6.9-fold increase in forearm blood flow in white subjects (ANOVA; isoproterenol, p < 0.0001; sodium nitroprusside, p < 0.0001; methacholine, p = 0.01). CONCLUSIONS: Our finding of attenuated nitric oxide-mediated vasodilation in response to methacholine and sodium nitroprusside in healthy black American men suggests that attenuated vasodilation in black subjects is a relatively generalized phenomenon, resulting in attenuated responses to multiple vasodilators that act through different receptor- and nonreceptor-mediated mechanisms.

Adrenergic beta-Agonists↗

Maximal vasodilation does not eliminate the vascular waterfall in the canine hindlimb.

Previous studies have shown that blood flow through skeletal muscle is regulated by changes in an arteriolar vascular waterfall [critical pressure (Pcrit)] and a proximal (arterial) resistance (Ra) element. To determine whether Pcrit still exists during maximal vasodilation, we pump perfused vascularly isolated canine hindlimbs. We set outflow pressure to zero and measured Pcrit, perfusion pressure (Pper), and regional elastic recoil pressure (Pcl; by a stop-flow technique) and calculated both Ra and venous resistance before and after maximal vasodilation with adenosine and nitroprusside. Pcrit was 56.4 +/- 5.1 mmHg before vasodilation and decreased to 11.0 +/- 0.6 mmHg after vasodilation, which was less than the downstream pressure in the venous compliant region (Pel). Therefore, Pcrit should not have affected flow at normal Pper levels under vasodilated conditions. However, we could still measure Pcrit because our technique allowed Pel to decline and Pcrit becomes apparent once Pel < Pcrit. With vasodilation, Ra decreased to < 8.1 +/- 2.6% and Rv decreased to 41 +/- 6% of control values. In contrast to the nonvasodilated vasculature, increases in venous pressure during maximal vasodilation caused immediate increases in Pper. This also suggests that the vascular waterfall is inactive under conditions of maximal vasodilation. We conclude that a small arteriolar Pcrit is still present in the maximally vasodilated hindlimb but is less than the downstream pressure and does not affect flow under these conditions.

Adenosine↗

Prostacyclin and acetylcholine as screening agents for acute pulmonary vasodilator responsiveness in primary pulmonary hypertension.

Epoprostenol sodium (prostacyclin) administered intravenously is considered the standard for assessing the ability of the pulmonary circulation to vasodilate. At present, epoprostenol sodium is an investigational drug that has limited availability. In contrast, acetylcholine, also a pulmonary vasodilator, is readily available. Therefore, we assessed the feasibility of using acetylcholine as an alternative to prostacyclin in testing for the capacity of the pulmonary vasculature to vasodilate. Twenty-three patients with primary pulmonary hypertension (mean pulmonary arterial pressure, 58.5 +/- 13.4 mm Hg) received incremental infusions of prostacyclin and acetylcholine to predetermined maximal infusion rates as part of a battery of vasodilator agents administered according to standard protocols (mean, 5.4 +/- 1.2 agents/patient; range, 3-8 agents/patient); the administration of the different agents was timed to avoid synergistic effects. Of all the agents tested, prostacyclin and acetylcholine were most consistently effective in evoking acute pulmonary vasodilation, and both seemed to distinguish patients capable of manifesting acute pulmonary vasodilation from those who were not. However, at maximal doses set by protocol, prostacyclin generally elicited a greater vasodilator response than acetylcholine. The difference in magnitude of response may have been due to use of prescribed dosages of acetylcholine that were submaximal. In other respects, the two agents were similar; both were equally well-tolerated, and side effects were mild and resolved rapidly when the vasodilator infusions were stopped. We conclude that in the majority of patients with primary pulmonary hypertension, acetylcholine appears to be an effective and available substitute for prostacyclin in screening for pulmonary vasodilator responsiveness.

Acetylcholine↗

A comparison of brachial artery flow-mediated vasodilation using upper and lower arm arterial occlusion in subjects with and without coronary risk factors.

BACKGROUND: The ultrasound assessment of brachial artery flow-mediated vasodilation provides a noninvasive means for measuring endothelial function. The test is performed using either upper or lower arm blood pressure cuff arterial occlusion to induce hyperemia. Upper arm occlusion produces a greater hyperemic stimulus. Brachial artery flow-mediated vasodilation is abnormal in the presence of coronary risk factors. HYPOTHESIS: The study sought to compare the ability of the upper and lower arm occlusion techniques to differentiate endothelial function in subjects with and without risk factors. METHODS: We measured brachial artery flow-mediated vasodilation in 20 subjects, 10 without and 10 with a single risk factor (hypertension, hypercholesterolemia, or cigarette smoking) using both the upper and lower arm occlusion techniques (5 min blood pressure cuff occlusion). Using 11 MHz ultrasound, Doppler blood flow velocities were measured before and immediately after cuff deflation. Brachial artery vasodilation was measured 1 min after cuff deflation, compared with baseline, and expressed as a percent increase. RESULTS: The immediately postocclusion hyperemia (% increase in flow) was significantly greater (p < 0.01) using the upper versus the lower arm technique in both the normal (530 +/- 152 vs. 383 +/- 51%) and the risk factor (583 +/- 153 vs. 409 +/- 114%) groups. Flow-mediated vasodilation was significantly greater (p < 0.01) using the upper arm versus the lower arm occlusion technique in both the normal (13.4 +/- 5.3 vs. 5.6 +/- 3.4%) and risk factor (7.9 +/- 3.6 vs. 3.9 +/- 2.2%) groups. Vasodilation was significantly greater (p < 0.01) in the normal subjects than in the risk factor subjects (13.4 +/- 5.3 vs. 7.9 +/- 3.6%) using the upper arm technique, but was not statistically different in the two groups using the lower arm technique. CONCLUSIONS: Our study demonstrates that upper arm compared with lower arm cuff occlusion undertaken to induce hyperemia for the assessment of brachial artery flow-mediated vasodilation results in significantly greater hyperemia and vasodilation. Flow-mediated vasodilation obtained using the upper arm technique better separates subjects with and without coronary risk factors.

Adult↗

Calcium-induced pulmonary vasodilation: modification by meclofenamate and ouabain.

Based on work with isolated arteries, we hypothesized that elevation of the extracellular calcium concentration would cause pulmonary vasodilation by stimulation of the Na+K+ATPase. If so, ouabain should inhibit the "membrane stabilizing" effect of a high calcium concentration. Addition of CaCl2 to the perfusate of rat isolated lungs to give a final concentration of 10(-2)M caused vasodilation when the lungs were vasoconstricted by KCl, angiotensin II or hypoxia. Ouabain addition to the perfusate increased pulmonary artery perfusion pressure and the magnitude of angiotensin II-induced vasoconstriction delayed vasodilation and transformed the CaCl2-induced vasodilation into rapid vasoconstriction accompanied by edema formation. Meclofenamate reduced the calcium-induced vasodilation suggesting that part of the high calcium vasodilation may be due to the action of a vasodilator prostaglandin. The vasodilation due to prostacyclin was blocked in lungs treated with ouabain. The results taken together suggest that high calcium vasodilation operates by mechanisms which may be prostaglandin-dependent and prostaglandin-independent, both of which can be blocked by ouabain.

Animals↗

Endothelium-dependent vasodilation of peripheral conduit arteries in patients with heart failure.

Endothelium-dependent vasodilation of peripheral resistance vessels is abnormal in patients with heart failure, but there are little in vivo data on endothelium-dependent vasodilation of peripheral conduit vessels. This study assessed endothelium-dependent vasodilation of forearm conduit and resistance vessels in normal subjects and patients with heart failure. The effects of intraarterial endothelium-dependent and endothelium-independent vasodilators on both forearm conduit (brachial artery) and resistance vessels were assessed in 9 patients with New York Heart Association class II-III heart failure and 11 normal subjects of similar age. Brachial artery diameter was measured by two-dimensional, moderate-frequency (8 MHz) ultrasound, and forearm blood flow was measured by strain gauge plethysmography. The endothelium-dependent vasodilator, methacholine (0.3 and 1.5 micrograms/min), increased brachial artery diameter by 7.6 +/- 1.3% and 12.2 +/- 1.5% in normal subjects as compared to 6.9 +/- 2.1% and 10.4 +/- 2.4% in patients with heart failure (P = NS, normal vs heart failure). The endothelium-independent vasodilator, nitroglycerin (0.15 microgram), also produced similar increases in brachial artery diameter in the two groups (8.2 +/- 1.3% in normal subjects vs 11.1 +/- 1.4% in patients with heart failure, P = NS). In contrast, forearm blood flow responses to methacholine were significantly (P < .05) greater in normal subjects (4.1 +/- 0.5 and 9.2 +/- 1.4 mL/min/100 mL forearm volume) than in patients with heart failure (2.0 +/- 0.8 and 5.1 +/- 1.3 mL/min/100 mL forearm volume). Forearm blood flow responses to the endothelium-independent vasodilator, sodium nitroprusside, were similar between the two groups. This study suggests that endothelium-dependent and endothelium-independent vasodilation of the brachial artery is not impaired in patients with class II-III heart failure. This finding contrasts with abnormal endothelium-dependent vasodilation of forearm resistance vessels. These data suggest that there are regional differences in endothelial function in patients with heart failure.

Adult↗

Hemodynamic effects of vasodilators and long-term response in heart failure.

Hemodynamic responses to vasodilators are commonly assessed when starting long-term vasodilator treatment in patients with chronic left ventricular failure, although the relation between short- and long-term responses is not established. Thus, short- and long-term hemodynamic responses to placebo and vasodilators (isosorbide dinitrate, minoxidil and enalapril or captopril) were measured and long-term clinical efficacy was assessed by changes in exercise capacity after 1 to 5 months of vasodilator administration (plus digitalis and diuretic agents) in 46 patients with New York Heart Association functional class II to IV heart failure caused by cardiomyopathy. There were no significant changes in hemodynamics or exercise capacity during placebo treatment. After initial doses and during long-term administration of vasodilator drugs, hemodynamics were significantly improved. After long-term vasodilator treatment, maximal oxygen uptake during exercise increased by 2.9 +/- 5.7 ml/min per kg from a control value of 14.1 +/- 5.6 ml/min per kg (p less than 0.01), and exercise duration also increased by 1.8 +/- 3.5 minutes (p less than 0.01). Changes in maximal oxygen uptake, however, did not correlate with short-term changes in pulmonary wedge pressure (correlation coefficient [r] = -0.14), cardiac index (r = -0.01) or systemic vascular resistance (r = -0.20). Long-term hemodynamic changes also failed to correlate with changes in exercise capacity. Baseline hemodynamics, cardiac dimensions and left ventricular ejection fraction before vasodilator administration all failed to correlate with baseline exercise capacity or with long-term changes in exercise capacity. Thus, hemodynamic measurements at initiation or during follow-up of vasodilator therapy do not relate to long-term clinical efficacy assessed by exercise capacity in patients with chronic left ventricular failure. Therefore, the rationale for making invasive hemodynamic measurements before initiating long-term vasodilator therapy for heart failure is questioned.

Antihypertensive Agents↗

Vitamin C improves endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus.

OBJECTIVES: We sought to determine whether the antioxidant vitamin C improves endothelium-dependent vasodilation of forearm resistance vessels in patients with insulin-dependent diabetes mellitus. BACKGROUND: Endothelium-dependent vasodilation is impaired in patients with diabetes mellitus. Oxidatively mediated degradation of endothelium-derived nitric oxide contributes to abnormal endothelium-dependent vasodilation in animal models of diabetes mellitus. METHODS: The study group included 10 patients with insulin-dependent diabetes mellitus and 10 age-matched control subjects. Forearm blood flow was determined by venous occlusion plethysmography. Endothelium-dependent vasodilation was assessed by intraarterial infusion of methacholine (0.3 to 10 microg/min). Endothelium-independent vasodilation was assessed by intraarterial infusion of nitroprusside (0.3 to 10 microg/min). Forearm blood flow dose-response curves were determined for each drug infusion before and during concomitant infusion of vitamin C (24 mg/min). RESULTS: In diabetic subjects, endothelium-dependent vasodilation was augmented by the concomitant infusion of vitamin C (p = 0.001). Endothelium-independent vasodilation was not affected by the concomitant infusion of vitamin C (p = NS). In control subjects, vitamin C infusion did not affect endothelium-dependent vasodilation (p = NS). CONCLUSIONS: Vitamin C selectively restores the impaired endothelium-dependent vasodilation in the forearm resistance vessels of patients with insulin-dependent diabetes mellitus. These findings indicate that nitric oxide degradation by oxygen-derived free radicals contributes to abnormal vascular reactivity in humans with insulin-dependent diabetes mellitus.

Adult↗

Rostral ventrolateral medulla: an integrative site for muscle vasodilation during defense-alerting reactions.

1. Evidence gathered over the last 30 years has firmly established that the rostral ventrolateral medulla (RVLM) is a major vasomotor center in the brainstem, harboring sympathetic premotor neurons responsible for generating and maintaining basal vasomotor tone and resting levels of arterial blood pressure. Although the RVLM has been almost exclusively classified as a vasopressor area, in this report we review some evidence suggesting a prominent role of the RVLM in muscle vasodilation during defense-alerting responses. 2. Defense-alerting reactions are a broad class of behavior including flexion of a limb, fight/flight responses, apologies, etc. They comprise species-distinctive motor and neurovegetative adjustments. Cardiovascular responses include hypertension, tachycardia, visceral vasoconstriction, and muscle vasodilation. Since defense-alerting reactions generally involve intense motor activation, muscle vasodilation is regarded as a key feature of these responses 3. In anesthetized or unanesthetized-decerebrate animals, natural or electrical stimulation of cutaneous and muscle afferents produced hypertension, tachycardia, and vasodilation restricted to the stimulated limb. 4. Unilateral inactivation of the RVLM contralateral to the stimulated limb abolished cardiovascular adjustments to stimulation of cutaneous and muscle afferents. Within the RVLM glutamatergic synapses mediate pressor responses, whereas GABAergic synapses mediates muscle vasodilation. 5. In urethane-anesthetized rats, electrical stimulation of the hypothalamus elicited hypertension, tachycardia, visceral vasoconstriction, and hindlimb vasodilation. The hindlimb vasodilation induced by hypothalamic stimulation is a complex response, involving reduction of sympathetic vasoconstrictor tone, release of catecholamines by the adrenal medulla, and a still unknown system that may use nitric oxide as a mediator. 6. Blockade of glutamatergic transmission within the RVLM selectively blocks muscle vasodilation induced by hypothalamic stimulation. 7. The results obtained suggest that, besides its role in the generation and maintenance of the sympathetic vasoconstrictor drive, the RVLM is also critical for vasodilatory responses during defense reactions. The RVLM may contain several, distinctive mechanisms for muscle vasodilation. Anatomical and functional characterization of these pathways may represent a breakthrough in our understanding of cardiovascular control in normal and/or pathological conditions.

Animals↗

Developmental changes in endothelium-dependent vasodilation and the influence of superoxide anions in perinatal rabbit pulmonary arteries.

ACh-induced vasodilation was investigated in pulmonary arteries from 8 and 2 day pre-term foetal, neonatal (0-12 h and 4 day old) and adult rabbits. The effects of superoxide anion generation [with hypoxanthine (HX, 0.1 mM)/xanthine oxidase (XO, 15 mu ml(-1))], endogenous superoxide dismutase (SOD) inhibition [with the Cu-Zn SOD inhibitor triethylenetetramine (TETA, 1 mM)], endogenous superoxide anion scavenging [by superoxide dismutase (SOD, 50 u ml(-1))] and inhibition of endothelial nitric oxide synthase (eNOS) [with, Nomega-nitro-L-arginine methylester (L-NAME, 0.1 mM)], on basal and ACh-induced NO activity were studied by examining phenylephrine-induced contraction and ACh-induced vasodilation respectively. L-NAME and endothelium removal abolished all ACh-induced vasodilation and 1 microM sodium nitroprusside fully dilated all vessels. ACh-induced vasodilation was absent in the 8 day pre-term foetus and 0-12 h neonate but present at all other ages. L-NAME itself contracted 2 day pre-term foetal vessels. At 0 12 h, SOD, but not the phosphodiesterase 5 inhibitor zaprinast (1 microM), uncovered ACh-induced vasodilation. At this age SOD reduced phenylephrine-induced contraction which was not influenced by TETA, L-NAME or HX/XO, and L-NAME itself did not cause contraction. This suggests both ACh-induced and basal NO activity are compromise in these vessels by endogenous superoxide anion production and deficiencies in endogenous SOD activity. In 4 day vessels, but not adult vessels, L-NAME, TETA and HX/XO augmented contractions to phenylephrine, and L-NAME itself induced vasoconstriction, suggesting that basal NO and SOD activities were present by 4 days but were not evident in the adult. ACh-induced NO activity, and the influence of endogenous SOD on this, were present in the adult (and 4 day) vessels as superoxide generation with HX/XO significantly reduced ACh-induced vasodilation and this effect was inhibited by SOD and augmented by TETA. Increased oxygen tensions > 500 mmHg attenuated ACh-induced vasodilation in the foetal but not neonatal rabbits. Raising the oxygen tension from approximately 20 to approximately 120 mmHg revealed ACh-induced vasodilation in the 8 day pre-term vessels. In summary, superoxide anion accumulation combined with deficiencies in SOD activity may transiently compromise basal and ACh-induced NO activity at birth. Experimental oxygen tensions markedly influence ACh-induced vasodilation in foetal rabbit pulmonary arteries.

Acetylcholine↗

Vasoactive intestinal polypeptide in cholinergic neurons of exocrine glands: functional significance of coexisting transmitters for vasodilation and secretion.

By a combination of the indirect immunofluorescence technique with acetylcholinesterase (acetylcholine acetylhydrolase, EC 3.1.1.7) staining, it was shown that vasoactive intestinal polypeptide (VIP) is present in cholinergic (acetylcholinesterase-rich) neurons involved in control of secretion and vasodilation in exocrine glands of cat. The submandibular salivary gland was used as a functional model. Preganglionic nerve stimulation induced an atropine-resistant, hexamethonium-sensitive vasodilation and release of VIP into the venous outflow from the gland and an atropine- and hexamethonium-sensitive secretion. Infusion of VIP antiserum reduced both the vasodilation and secretion. Infusion of VIP caused vasodilation only, whereas acetylcholine caused both vasodilation and secretion. Simultaneous infusion of VIP and acetylcholine in low doses resulted in a marked potentiation of both vasodilation and secretion. The present morphological and functional data support the following hypothesis for regulation of vasodilation and secretion in exocrine glands. Preganglionic cholinergic nerves activate, via nicotinic receptors, postganglionic neurons, causing concomitant release from the same nerve endings of two coexisting putative transmitters, acetylcholine and VIP. Acetylcholine produces mainly secretion by a muscarinic action and VIP causes mainly vasodilation, but the two substances seem to cooperate directly or indirectly in both types of response. Thus, the coexistence of two putative neurotransmitters, VIP and acetylcholine, in one neuron may explain the dual effector response (i.e., the cholinergic secretion and the atropine-resistant vasodilation) caused by nerve stimulation in exocrine glands.

Acetylcholinesterase↗