Commentary on Viewpoint: The human cutaneous circulation as a model of generalized microvascular function

Abstract

VIEWPOINTCommentary on Viewpoint: The human cutaneous circulation as a model of generalized microvascular functionLacy A. Holowatz, Caitlin S. Thompson-Torgerson, and W. Larry KenneyLacy A. Holowatz, Caitlin S. Thompson-Torgerson, and W. Larry KenneyPublished Online:01 Jul 2008https://doi.org/10.1152/japplphysiol.90436.2008MoreSectionsPDF (28 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInEmailWeChat to the editor: We thank the commentators for their insightful remarks and for engaging in important dialog on this issue. In our viewpoint article, we asserted that the cutaneous circulation is an accessible microvascular bed that has utility for examining mechanisms underlying microvascular function and dysfunction (3). Microvascular dysfunction a systemic disease process that occurs and progresses in a similar fashion in multiple tissue beds throughout the body (1). Therefore, assessing the mechanisms mediating impaired cutaneous vasoreactivity in clinical populations may provide insights into systemic disease process as well as the underlying mechanisms of lifestyle and pharmacological treatment modalities. Using in vivo skin specific techniques, we and others have demonstrated that cutaneous vascular responsiveness is attenuated in several systemic pathologies, including hypertension, diabetes, heart disease, hypercholesterolemia, aging, renal disease, peripheral vascular disease, and systemic sclerosis. Furthermore, these mechanistic investigations have uncovered similar alterations in specific signaling pathways remarkably similar to those observed in other nutritive vascular beds. The available pharmacological interventions, coupled with skin-specific methodologies to induce vasoconstriction and vasodilation (2), allow for the targeted manipulation of specific vascular signaling pathways in healthy and clinical populations with a degree of insight and rigor not previously available.Each regional circulation possesses autonomic and localized control mechanisms unique to their underlying functions. It is naive to think that one could simply extrapolate specific findings from one regional circulation to another or from the microcirculation to macrocirculation. While the underlying mechanisms mediating vasoreactivity to specific stimuli can be different in different vascular beds (e.g., reactive hyperemia in skin vs. muscle; Refs. 4, 5), we and others have been able to systematically delineate to signaling mechanisms involved in the skin and how they are altered with various pathologies. It is clear that additional rigorous mechanistic research is necessary to more fully understand the impact of the local tissue environment on microvascular control and the generalizability of findings about specific impairments in vascular signaling in the cutaneous circulation to other microcirculations.REFERENCES1 Abularrage CJ, Sidawy AN, Aidinian G, Singh N, Weiswasser JM, Arora S. Evaluation of the microcirculation in vascular disease. J Vasc Surg 42: 574–581, 2005.Crossref | PubMed | ISI | Google Scholar2 Cracowski JL, Minson CT, Salvat-Melis M, Halliwill JR. Methodological issues in the assessment of skin microvascular endothelial function in humans. Trends Pharmacol Sci 27: 503–508, 2006.Crossref | PubMed | ISI | Google Scholar3 Holowatz LA, Thompson-Torgerson CS, Kenney WL. Viewpoint: The human cutaneous circulation as a model of generalized microvascular function. J Appl Physiol; doi:10.1152/japplphysiol.00858.2007.Link | ISI | Google Scholar4 Medow MS, Taneja I, Stewart JM. Cyclooxygenase and nitric oxide synthase dependence of cutaneous reactive hyperemia in humans. Am J Physiol Heart Circ Physiol 293: H425–H432, 2007.Link | ISI | Google Scholar5 Wong BJ, Wilkins BW, Holowatz LA, Minson CT. Nitric oxide synthase inhibition does not alter the reactive hyperemic response in the cutaneous circulation. J Appl Physiol 95: 504–510, 2003.Link | ISI | Google ScholarAUTHOR NOTESAddress for reprint requests and other correspondence: L. A. Holowatz, 204 Noll Laboratory, Univ. Park, PA 16802 (e-mail: [email protected]) Download PDF Previous Back to Top Next FiguresReferencesRelatedInformationCited ByIn vivo photoacoustic microscopy of human cuticle microvasculature with single-cell resolutionJournal of Biomedical Optics, Vol. 21, No. 5Opportunities and limitations of laser Doppler flowmetry in the assessment of skin microcirculation in patients with arterial hypertenstion30 March 2015 | Regional blood circulation and microcirculation, Vol. 14, No. 1 More from this issue > Volume 105Issue 1July 2008Pages 389-389 Copyright & PermissionsCopyright © 2008 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.90436.2008History Published online 1 July 2008 Published in print 1 July 2008 Metrics