Crecelius Anne R, Kirby Brett S, Hearon Christopher M, Luckasen Gary J, Larson Dennis G, Dinenno Frank A
Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, 80523, USA.
Medical Centre of the Rockies Foundation, University of Colorado Health, Loveland, CO, 80538, USA.
J Physiol. 2015 Jun 15;593(12):2735-51. doi: 10.1113/JP270461. Epub 2015 May 20.
During exercise there is a balance between vasoactive factors that facilitate increases in blood flow and oxygen delivery to the active tissue and the sympathetic nervous system, which acts to limit muscle blood flow for the purpose of blood pressure regulation. Functional sympatholysis describes the ability of contracting skeletal muscle to blunt the stimulus for vasoconstriction, yet the underlying signalling of this response in humans is not well understood. We tested the hypothesis that activation of inwardly rectifying potassium channels and the sodium-potassium ATPase pump, two potential vasodilator pathways within blood vessels, contributes to the ability to blunt α1 -adrenergic vasoconstriction. Our results show preserved blunting of α1 -adrenergic vasconstriction despite blockade of these vasoactive factors. Understanding this complex phenomenon is important as it is impaired in a variety of clinical populations.
Sympathetic vasoconstriction in contracting skeletal muscle is blunted relative to that which occurs in resting tissue; however, the mechanisms underlying this 'functional sympatholysis' remain unclear in humans. We tested the hypothesis that α1 -adrenergic vasoconstriction is augmented during exercise following inhibition of inwardly rectifying potassium (KIR ) channels and Na(+) /K(+) -ATPase (BaCl2 + ouabain). In young healthy humans, we measured forearm blood flow (Doppler ultrasound) and calculated forearm vascular conductance (FVC) at rest, during steady-state stimulus conditions (pre-phenylephrine), and after 2 min of phenylephrine (PE; an α1 -adrenoceptor agonist) infusion via brachial artery catheter in response to two different stimuli: moderate (15% maximal voluntary contraction) rhythmic handgrip exercise or adenosine infusion. In Protocol 1 (n = 11 subjects) a total of six trials were performed in three conditions: control (saline), combined enzymatic inhibition of nitric oxide (NO) and prostaglandin (PG) synthesis (l-NMMA + ketorolac) and combined inhibition of NO, PGs, KIR channels and Na(+) /K(+) -ATPase (l-NMMA + ketorolac + BaCl2 + ouabain). In Protocol 2 (n = 6) a total of four trials were performed in two conditions: control (saline), and combined KIR channel and Na(+) /K(+) -ATPase inhibition. All trials occurred after local β-adrenoceptor blockade (propranolol). PE-mediated vasoconstriction was calculated (%ΔFVC) in each condition. Contrary to our hypothesis, despite attenuated exercise hyperaemia of ∼30%, inhibition of KIR channels and Na(+) /K(+) -ATPase, combined with inhibition of NO and PGs (Protocol 1) or alone (Protocol 2) did not enhance α1 -mediated vasoconstriction during exercise (Protocol 1: -27 ± 3%; P = 0.2 vs. control, P = 0.4 vs. l-NMMA + ketorolac; Protocol 2: -21 ± 7%; P = 0.9 vs. control). Thus, contracting human skeletal muscle maintains the ability to blunt α1 -adrenergic vasoconstriction during combined KIR channel and Na(+) /K(+) -ATPase inhibition.
在运动过程中,促进血液流动增加以及向活跃组织输送氧气的血管活性因子与交感神经系统之间存在平衡,交感神经系统为调节血压会限制肌肉血流量。功能性交感神经抑制描述了收缩的骨骼肌减弱血管收缩刺激的能力,但这种反应在人体中的潜在信号传导尚不清楚。我们检验了以下假设:内向整流钾通道和钠钾ATP酶泵(血管内两种潜在的血管舒张途径)的激活有助于减弱α1 -肾上腺素能血管收缩。我们的结果表明,尽管这些血管活性因子被阻断,但α1 -肾上腺素能血管收缩的减弱仍然存在。理解这一复杂现象很重要,因为它在多种临床人群中受损。
与静息组织相比,收缩的骨骼肌中的交感神经血管收缩减弱;然而,这种“功能性交感神经抑制”的潜在机制在人体中仍不清楚。我们检验了以下假设:在抑制内向整流钾(KIR)通道和钠/钾-ATP酶(BaCl2 +哇巴因)后,运动期间α1 -肾上腺素能血管收缩会增强。在年轻健康受试者中,我们通过肱动脉导管测量了静息状态、稳态刺激条件下(去氧肾上腺素前)以及在输注去氧肾上腺素(PE;一种α1 -肾上腺素能受体激动剂)2分钟后(通过两种不同刺激:中度(最大自主收缩的15%)有节奏的握力运动或腺苷输注)的前臂血流量(多普勒超声),并计算了前臂血管传导率(FVC)。在方案1(n = 11名受试者)中,在三种条件下共进行了六项试验:对照(生理盐水)、一氧化氮(NO)和前列腺素(PG)合成的联合酶抑制(L-NMMA +酮咯酸)以及NO、PG、KIR通道和钠/钾-ATP酶的联合抑制(L-NMMA +酮咯酸+ BaCl2 +哇巴因)。在方案2(n = 6)中,在两种条件下共进行了四项试验:对照(生理盐水)以及KIR通道和钠/钾-ATP酶的联合抑制。所有试验均在局部β-肾上腺素能受体阻断(普萘洛尔)后进行。计算每种条件下PE介导的血管收缩(%ΔFVC)。与我们的假设相反,尽管运动性充血减弱了约30%,但抑制KIR通道和钠/钾-ATP酶,联合抑制NO和PG(方案1)或单独抑制(方案2)在运动期间并未增强α1 -介导的血管收缩(方案1:-27±3%;与对照相比,P = 0.2,与L-NMMA +酮咯酸相比,P = 0.4;方案2:-21±7%;与对照相比,P = 0.9)。因此,在联合抑制KIR通道和钠/钾-ATP酶期间,收缩的人体骨骼肌保持了减弱α1 -肾上腺素能血管收缩的能力。