Local Skin Heating Research Articles

Computational influences of convection micropolar fluid influx and permeability on characteristics of heating rate and skin friction over vertical plate

This manuscript merits at examining of an embedded orthogonal plate inside porous domain exposed to uniform heat influx to elaborate on how micro polar fluid factors and permeability characteristic affect the local skin friction, heating rate, and angular velocity inside boundary layer. The plate is subjected to forced convective micro polar fluid influx under steady, incompressible, and viscous circumstances. To facilitate dependable numerical solution, similarity approach is implemented to mutate set of coupled governing equations relevant to the adopted study into a constrained dimensionless differential equations. Computational analysis has been executed hiring Runge-Kutta scheme by Matlab function bvp4c to settle the governing equations. Study's results are highlighted graphically the impact of micro polar fluid factors on the local skin friction, heating rate, and angular velocity curves. High degree of acceptability of present findings compare with prior research results. It is found that the rising of Darcy parameter drives to decrease linearly both heating rate and local skin friction. Among the examined factors, the benchmark parameter of decreasing skin friction is the porosity. Additionally, it is found that an increasing of Prandtl number and micro rotation element lead to enhance Nusselt number. Once curves of micro rotation are interfered at certain distance from the plate due to increase in porosity, Darcy, Forchheimer's, and microelement rotation, the micro rotation curves are inverted.

Dietary NO3− does not enhance endothelial dependent cutaneous vascular conductance in older women

Prior work has yet to determine whether the reduction of dietary nitrate (NO3−) to NO, via the enterosalivary pathway, may modify cutaneous vascular conductance (CVC) responses to local heating in older women. Changes occurring with the transition to menopause related to hormonal flux, increased adiposity, and/or decreased physical activity may further compound the negative influence of aging on nitric oxide (NO)-dependent CVC. Herein, we characterized changes in NO-dependent CVC following acute ingestion of 140 mL of NO3−-rich beetroot juice in 24 older women (age: 65 ± 5 y, BMI: 31.2 ± 3.7 kg/m2). Red blood cell (RBC) flux was measured continuously via laser-Doppler flowmetry on the dorsal aspect of the forearm during local skin heating to 39 °C/44 °C before and 3 h after NO3− ingestion. NO-dependent changes in CVC were calculated as RBC flux/mean arterial blood pressure at 39 °C and normalized as a proportion of maximal CVC at 44 °C (%CVCmax). Changes (Δ) in fractional exhaled NO (FeNO) following NO3− ingestion were used an index of NO bioavailability. Despite increased FeNO (+81 ± 70 %, P < 0.001), %CVCmax at 39 °C was reduced (−16 ± 10 %, P < 0.001) following NO3− ingestion. A greater reduction in %CVCmax was weakly to moderately associated with higher body fat% (r = 0.45 [0.05–0.72], P = 0.029), central adiposity% (r = 0.50 [0.13–0.75], P = 0.012), neutrophil% (r = 0.42 [0.02–0.70], P = 0.041), and higher neutrophil to lymphocyte ratio (r = 0.49 [0.11–0.75], P = 0.016). These findings demonstrate a single dose of dietary NO3− does not promote CVC responses to local heating in sedentary older women with overweight and obesity. Correlation with multiple biomarkers suggest systemic inflammation may be involved.

Impaired microvascular reactivity in patients treated with 5-fluorouracil chemotherapy regimens: Potential role of endothelial dysfunction

Background5-fluorouracil (5-FU) is the second most common cancer chemotherapy associated with short- and long-term cardiotoxicity. Although the mechanisms mediating these toxicities are not well understood, patients often present with symptoms suggestive of microvascular dysfunction. We tested the hypotheses that patients undergoing cancer treatment with 5-FU based chemotherapy regimens would present with impaired microvascular reactivity and that these findings would be substantiated by decrements in endothelial nitric oxide synthase (eNOS) gene expression in 5-FU treated human coronary artery endothelial cells (HCAEC). MethodsWe first performed a cross-sectional analysis of 30 patients undergoing 5-FU based chemotherapy treatment for cancer (5-FU) and 32 controls (CON) matched for age, sex, body mass index, and prior health history (excluding cancer). Cutaneous microvascular reactivity was evaluated by laser Doppler flowmetry in response to endothelium-dependent (local skin heating; acetylcholine iontophoresis, ACh) and -independent (sodium nitroprusside iontophoresis, SNP) stimuli. In vitro experiments in HCAEC were completed to assess the effects of 5-FU on eNOS gene expression. Results5-FU presented with diminished microvascular reactivity following eNOS-dependent local heating compared to CON (P = 0.001). Iontophoresis of the eNOS inhibitor L-NAME failed to alter the heating response in 5-FU (P = 0.95), despite significant reductions in CON (P = 0.03). These findings were corroborated by lower eNOS gene expression in 5-FU treated HCAEC (P < 0.01) compared to control. Peak vasodilation to ACh (P = 0.58) nor SNP (P = 0.39) were different between groups. ConclusionsThe present findings suggest diminished microvascular function along the eNOS-NO vasodilatory pathway in patients with cancer undergoing treatment with 5-FU-based chemotherapy regimens and thus, may provide insight into the underlying mechanisms of 5-FU cardiotoxicity.

Severity of depressive symptoms moderates the sympathoinhibitory effect of local skin warming following exposure to a social stressor

Depression is the leading cause of disease burden globally. Existing antidepressant treatments that target the central nervous system have limited efficacy and come at the cost of significant side effects. Thus, there is growing interest in novel therapeutic interventions for the prevention and treatment of depression, including interventions that target interoceptive signaling. The thermosensory system may hold particular promise, given evidence that depression is associated with impairments in thermosensory functioning, and that whole-body hyperthermia produces an antidepressant effect in patients with major depressive disorder. In this study, we investigated whether the severity of depressive symptoms in a non-clinical population moderated the effect of local skin warming on subjective and physiological stress responses following exposure to an acute social stressor. Following exposure to the stressor, participants (N = 90) rested their arm on a heat blanket that was either turned on (local skin warming condition) or left off (control condition). We demonstrate that local skin warming increased fingertip temperature, a marker of reduced sympathetic nervous system activity, but only for participants with high levels of depressive symptoms. While local skin warming also inhibited salivary alpha amylase, severity of depressive symptoms did not moderate this effect, and no effect was found for electrodermal activity. These data highlight the importance of incorporating peripheral physiology in our conceptualization of the pathophysiology of depression and show that changes in sympathetic nervous system activity may underpin the antidepressant effect of warm stimuli.

No impact of biological sex on nitric oxide contribution to cutaneous vascular response to 39ºC local heating

Purpose: The contribution of endothelial nitric oxide (NO) to vasodilation (%NO contribution) is a significant indicator of risk of cardiovascular disease development. Local skin heating to either 42 ºC or 39 ºC is used to determine mechanisms of vasodilation in health and disease, specifically to investigate %NO contribution. Women have lower %NO contribution in the cutaneous vasculature than men in the early follicular phase of the menstrual cycle, when the circulating vasoactive reproductive hormones are at their lowest concentration. However, this phase represents only a brief portion of the menstrual cycle. We aimed to determine the overall impact of biological sex on %NO contribution to cutaneous vasodilation utilizing a 39ºC local heating protocol, which better isolates the endothelial NO-synthase pathway. We tested women randomly during any phase of the menstrual cycle. We hypothesized that women would demonstrate greater NO-dependent cutaneous vasodilation than men in response to 39ºC local heating. Methods: Data are represented as mean(SD). An intradermal microdialysis fiber was placed in the ventral forearms of 12 men and 13 women [24.2(4.6) years]. Local heaters and laser-Doppler flowmetry probes were used to measure red blood cell flux (perfusion units, PU). Cutaneous vascular conductance (CVC) was calculated as laser-Doppler PU/mean arterial pressure. A standard 39ºC local heating protocol was conducted wherein PU was continuously collected at rest (10 minutes), then the local temperature was increased to 39ºC. After PU reached a steady plateau (~40 minutes), the NO synthase inhibitor 15 mM NG-nitro-L-arginine methyl ester (L-NAME) was perfused. Maximal vasodilation was induced by heating to 43ºC and perfusing 28 mM sodium nitroprusside and normalized to %CVCmax. %NO contribution was calculated as the absolute percentage difference between %CVCmax of 39ºC plateau and %CVCmax of L-NAME steady-state. We compared both CVC and %CVCmax between groups with two-way ANOVA and the %NO contribution with unpaired t-tests. Results: The %NO contribution was not different between sexes [men 48(23)%, women 39(17)%; P = 0.26]. There was no effect of sex on either absolute CVC [men 0.717(0.29) PU, women 0.73(0.48) PU at 39ºC phase] or %CVCmax [men 69(31)%, women 54(20)% at 39ºC phase] at any stage of the 39ºC local heating protocol (main effects P ≥ 0.08). Conclusion: These data indicate there is no impact of biological sex on the vasodilatory response of the cutaneous vasculature to 39ºC local heating in young healthy adults when women are tested at random across the menstrual cycle. Funding: National Institutes of Health Grant T-32-5T32AG049676 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Reliability of laser-Doppler flowmetry derived measurements of forearm and calf cutaneous vasodilation during gradual local heating in young adults.

Evaluate reliability of laser-Doppler flowmetry derived cutaneous vasodilation on the upper and lower limbs during gradual local heating. In twenty-eight young adults (21 (SD 3) years, 14 females), absolute cutaneous vascular conductance (CVCabs) and CVC normalized to maximum vasodilation at 44 °C (%CVCmax) were assessed at two adjacent sites on each of the forearm and calf during gradual local skin heating (33-42 °C at 1 °C·5 min-1) for two identical trials (~1 week apart). Responses were assessed for baseline, the steady-state heating plateau at 42 °C and the span (i.e. plateau-baseline). Between-day reliability was characterized as measurement consistency across trials. Within-day reliability was characterized as within-limb measurement consistency across adjacent skin sites. Between- and within-day absolute reliability (coefficient of variation) generally improved with heating, from poor (>25 %) at baseline to good (<10 %) for %CVCmax and moderate (10-25 %) for CVCabs for plateau and span. However, relative reliability (intraclass correlation coefficient) was generally not acceptable (≤0.70) for any condition. Responses were generally consistent for females and males and there were no major forearm and calf differences. Consistency of CVC estimates improved during gradual local heating with negligible limb and sex differences, which are important considerations for experimental design and interpretation.

Acute impact of aerobic exercise on local cutaneous thermal hyperaemia.

Little is known about the acute changes in cutaneous microvascular function that occur in response to exercise, the accumulation of which may provide the basis for beneficial chronic cutaneous vascular adaptations. Therefore, we examined the effects of acute exercise on cutaneous thermal hyperaemia. Twelve healthy, recreationally active participants (11 male, 1 female) performed 30-minute cycling at 50% (low-intensity exercise, LOW) or 75% (high-intensity exercise, HIGH) maximum heart rate. Laser Doppler flowmetry (LDF) and rapid local skin heating were used to quantify cutaneous thermal hyperaemia before (PRE), immediately following (IMM) and 1-h (1HR) after exercise. Baseline, axon reflex peak, axon reflex nadir, plateau, maximum skin blood flow responses to rapid local heating (42°C for 30-min followed by 44°C for 15-min) at each stage were assessed and indexed as cutaneous vascular conductance [CVC=flux/mean arterial blood pressure (MAP), PU·mmHg-1], and expressed as a percentage of maximum (%CVCmax). Exercise increased heart rate (HR), MAP and skin blood flow (all P<0.001), and to a greater extent during HIGH (all P<0.001). The axon reflex peak and nadir were increased immediately and 1-h after exercise (all comparisons P<0.01 vs. PRE), which did not differ between intensities (peak: P=0.34, axon reflex nadir: P=0.91). The endothelium-dependent plateau response was slightly elevated after exercise (P=0.06), with no effect of intensity (P=0.58) nor any interaction effect (P=0.55). CONCLUSION: Exercise increases cutaneous microvascular axonal responses to local heating for up to 1-h, suggesting an augmented sensory afferent function post-exercise. Acute exercise may only modestly affect endothelial function in cutaneous microcirculation.

Novel Method to Assess Endothelial Function via Monitoring of Perfusion Response to Local Heating by Imaging Photoplethysmography.

Endothelial dysfunction is one of the most important markers of the risk of cardiovascular complications. This study is aimed to demonstrate the feasibility of imaging photoplethysmography to assess microcirculation response to local heating in order to develop a novel technology for assessing endothelial function. As a measure of vasodilation, we used the relative dynamics of the pulsatile component of the photoplethysmographic waveform, which was assessed in a large area of the outer surface of the middle third of the subject’s forearm. The perfusion response was evaluated in six healthy volunteers during a test with local skin heating up to 40–42 °C and subsequent relaxation. The proposed method is featured by accurate control of the parameters affecting the microcirculation during the prolonged study. It was found that in response to local hyperthermia, a multiple increase in the pulsation component, which has a biphasic character, was observed. The amplitude of the first phase of the perfusion reaction depends on both the initial skin temperature and the difference between the basal and heating temperatures. The proposed method allows the assessment of a reproducible perfusion increase in response to hyperthermia developed due to humoral factors associated with the endothelium, thus allowing detection of its dysfunction.

Home‐Based Leg Heat Therapy Does Not Improve Vascular Function in Patients with Symptomatic Peripheral Artery Disease

INTRODUCTIONPatients with peripheral artery disease (PAD) suffer from severe exercise intolerance and accelerated rates of functional decline, resulting, in part, from significant endothelial cell dysfunction and the consequent impairment in leg blood flow. Unfortunately, few non‐invasive therapeutic interventions have been shown to ameliorate the microvascular dysfunction in patients with PAD. Repeated exposure to heat therapy (HT) improves endothelial function in sedentary young individuals, but the effects of this therapy on vascular function in patients with PAD remain poorly defined. The objective of the present study was to test the hypothesis that 8 weeks of home‐based leg HT would improve leg vascular function in patients with symptomatic PAD.METHODSThirty‐four patients with symptomatic PAD (66 ± 8 years, ankle‐brachial index: 0.68 ± 0.12) were randomized into one of two groups: home‐based leg HT (HT, n=18) or a control treatment (CON, n=16). Patients in both groups were provided with identical water‐circulating trousers and a portable heating pump and were asked to apply the therapy daily (7 days/week, 90 min per session) for 8 consecutive weeks. The pump issued to participants circulated water through the trousers at 43ºC in the HT group and 33ºC in the control group. Laser‐Doppler flowmetry was used to measure red blood cell flux, an index of skin blood flow, during local skin heating to 39°C for 40 min, followed by 43ºC for 20 min. Cutaneous vascular conductance (CVC) was calculated as red blood cell flux divided by mean arterial pressure and expressed as a percentage of maximal vasodilation (%CVCmax). Calf skeletal muscle perfusion was assessed using arterial spin labeling magnetic resonance imaging (MRI) following circulatory occlusion of the thigh for 5 min.RESULTSFive participants were either withdrawn prior to study completion or failed to complete the 8‐week follow‐up visit. The remaining 29 participants were included in the final analysis (CON: n=14, HT: n=15). Two participants from CON and 4 from HT were unable to undergo the MRI scans. At baseline, local skin heating to 39ºC increased %CVCmax to 55.8 ± 12.9% in CON and 52.5 ± 18.7% in the HT group. The change from baseline to 8 weeks in %CVCmax was similar between CON and HT (CON: ‐2.6 ± 13.9%, HT: ‐0.7 ± 16.3%, p=0.74). Peak calf blood flow during reactive hyperemia was comparable between groups at baseline (CON: 48.0 ± 24.6 ml/min/100g, HT: 43.8 ± 20.4 ml/min/100g, p=0.76). The change from baseline to 8 weeks in peak calf perfusion was also similar between CON and HT (CON: ‐4.8±21.9 ml/min/100g, HT: ‐2.8±11.0 ml/min/100g, p=0.84).CONCLUSIONEight weeks of home‐based leg HT does not improve leg vascular function in patients with symptomatic PAD.

Calcium‐activated Chloride Channel TMEM16A/ANO1 Does Not Mediate the Regulation of Sweating and Cutaneous Vasodilation in Humans In Vivo

The regulation of human body temperature during a heat stress is dependent on the activation of the heat loss responses of cutaneous vasodilation and eccrine sweating. While significant advancements have been made in our understanding of the mechanisms governing their regulation, new potential modifiers such as transmembrane member 16A (TMEM16A), a Ca2+‐activated Cl‐ channel also known as anoctamin 1 (ANO1), continue to be identified. In vitro and animal studies suggest a role for TMEM16A in the regulation of sweat secretion and vascular tone. For example, Ca2+ induced Cl‐current was abolished in TMEM16A deficit, but not BEST2 deficit, NCL‐SG3 human eccrine sweat gland cell lines. Further, animal models showed the activation of TMEM16A on vascular smooth muscle cells blunts vasodilation. However, direct evidence supporting a role of TMEM16 in mediating cutaneous vasodilation as well as eccrine sweating in humans in vivo remains to be established. Therefore, we evaluated the hypothesis that TMEM16A mediates the regulation of sweating and cutaneous vasodilation during a whole‐body heat stress in young adults.Twelve young (24 ± 2 years) adults (6 females) underwent a whole‐body heat stress induced by a water‐perfused suit to raise core temperature 1.1±0.1ºC above baseline resting levels. Sweat rate (ventilated capsule) and cutaneous vascular conductance (assessed as skin blood flow/mean arterial pressure and normalised to maximal conductance achieved via simultaneous local skin heating to 44°C and administration of sodium nitroprusside) were assessed at four skin sites on the forearm treated with 1) lactated Ringers (control), 2) 5 % dimethyl sulfoxide serving as a vehicle control, 3) 1 mM T16Ainh‐A01 (a TMEM16A blocker) or 4) 2 mM benzbromarone (another TMEM16A blocker). All drugs were administered continuously via intradermal microdialysis.Sweat rate increased as heating continued at all skin sites (P &lt; 0.001 for a main effect of heating stage). Neither the main effect of treatment site nor the interaction between treatment site and heating stage was significant (both P ≥ 0.318). Cutaneous vascular conductance increased in parallel to elevations in core temperature (P &lt; 0.001 for a main effect of heating stage). Although no main effect of treatment site was observed (P = 0.109), a significant interaction between heating stage and treatment site was measured (P &lt; 0.001). Post‐hoc analysis revealed that cutaneous vascular conductance at the DMSO‐treated site was higher than the control site at baseline (P = 0.047). By contrast, cutaneous vascular conductance at moderate elevations in core temperature (i.e., ≥0.4‐0.8 °C) was greater at the control site relative to the DMSO‐treated site (all P ≤ 0.013). Importantly, no differences were measured in cutaneous vascular conductance between the DMSO‐treated site and TMEM16A blocker‐treated sites (all P ≥ 0.073).Taken together, our findings demonstrate for the first time that TMEM16A does not contribute to the regulation of sweating and cutaneous vasodilation during whole‐body heating in young adults in vivo.

Cutaneous microvascular vasodilatory consequences of acute consumption of a caffeinated soft drink sweetened with high-fructose corn syrup.

This study tested the hypotheses that compared to drinking water, consumption of a caffeinated soft drink sweetened with high‐fructose corn syrup (HFCS) attenuates the cutaneous vasodilatory response to local skin heating without (Protocol 1) and following ischemia‐reperfusion injury (Protocol 2). In a randomized, counterbalanced crossover design, 14 healthy adults (25 ± 3 year, 6 women) consumed 500 ml of water (water) or a caffeinated soft drink sweetened with HFCS (Mtn. Dew, DEW). Thirty minutes following beverage consumption local skin heating commenced on the right forearm (Protocol 1), while on the left forearm ischemia‐reperfusion commenced with 20 min of ischemia followed by 20 min of reperfusion and then local skin heating (Protocol 2). Local skin heating involved 40 min of heating to 39℃ followed by 20 min of heating to 44℃. Skin blood flow (SkBf, laser Doppler) data were normalized to mean arterial pressure and are presented as a cutaneous vascular conductance (CVC) and as percentage of the CVC response during heating to 44℃ (%CVCmax). Protocol 1: During local heating at 39℃, no differences were observed in CVC (water: 2.0 ± 0.6 PU/mmHg; DEW: 2.0 ± 0.8 PU/mmHg, p = 0.83) or %CVCmax (water: 59 ± 14%; DEW 60 ± 15%, p = 0.84) between trials. Protocol 2: During local skin heating at 39℃, no differences were observed in CVC (water: 1.7 ± 0.5 PU/mmHg; DEW: 1.5 ± 0.5 PU/mmHg, p = 0.33) or %CVCmax (water: 64 ± 15%; DEW 61 ± 15% p = 0.62) between trials. The cutaneous microvascular vasodilator response to local heating with or without prior ischemia‐reperfusion injury is not affected by acute consumption of a caffeinated soft drink sweetened with HFCS.

Na+-K+-ATPase plays a major role in mediating cutaneous thermal hyperemia achieved by local skin heating to 39°C.

Na+-K+-ATPase is integrally involved in mediating cutaneous vasodilation during an exercise-heat stress, which includes an interactive role with nitric oxide synthase (NOS). Here, we assessed if Na+-K+-ATPase also contributes to cutaneous thermal hyperemia induced by local skin heating, which is commonly used to assess cutaneous endothelium-dependent vasodilation. Furthermore, we assessed the extent to which NOS contributes to this response. Cutaneous vascular conductance (CVC) was measured continuously at four forearm skin sites in 11 young adults (4 women). After baseline measurement, local skin temperature was increased from 33°C to 39°C to induce cutaneous thermal hyperemia. Once a plateau in CVC was achieved, each skin site was continuously perfused via intradermal microdialysis with either: 1) lactated Ringer solution (control), 2) 6 mM ouabain, a Na+-K+-ATPase inhibitor, 3) 20 mM l-NAME, a NOS inhibitor, or 4) a combination of both. Relative to the control site, CVC during the plateau phase of cutaneous thermal hyperemia (∼50% max) was reduced by the lone inhibition of Na+-K+-ATPase (-19 ± 8% max, P = 0.038) and NOS (-32 ± 4% max, P < 0.001), as well as the combined inhibition of both (-37 ± 9% max, P < 0.001). The magnitude of reduction was similar between NOS inhibition alone and combined inhibition (P = 1.000). The administration of both Na+-K+-ATPase and NOS inhibitors fully abolished the plateau of CVC with values returning to preheating baseline values (P = 0.439). We show that Na+-K+-ATPase contributes to cutaneous thermal hyperemia during local skin heating to 39°C, and this response is partially mediated by NOS.NEW & NOTEWORTHY Cutaneous thermal hyperemia during local skin heating to 39°C, which is highly dependent on nitric oxide synthase (NOS), is frequently used to assess endothelium-dependent cutaneous vasodilation. We showed that Na+-K+-ATPase mediates the regulation of cutaneous thermal hyperemia partly via NOS-dependent mechanisms although a component of the Na+-K+-ATPase modulation of cutaneous thermal hyperemia is NOS independent. Thus, as with NOS, Na+-K+-ATPase may be important in the regulation of cutaneous endothelial vascular function.

ACUTE DIETARY NITRATE MAY IMPAIR CUTANEOUS VASCULAR CONDUCTANCE DURING LOCAL SKIN HEATING IN POSTMENOPAUSAL WOMEN

Declining estradiol production during menopause is linked to increased oxidative stress and reduced endothelial-dependent vasodilation. It is unknown whether supplementation with dietary nitrate may improve nitric oxide (NO) bioactivity and microvascular function in postmenopausal women. PURPOSE: To determine the effects of acute dietary nitrate ingestion on NO-mediated cutaneous vascular conductance (CVC) in a cohort of postmenopausal women. METHODS: In eight women (mean ± SD: age = 62 ± 4 y, BMI = 31 ± 2 kg/m2), two laser-Doppler flowmetry probes were affixed to the dorsal aspect of the forearm for measurement of red blood cell (RBC) flux during local skin heating to 39 °C and 44 °C. Assessments were made before and 3 h after ingesting 140 mL of beetroot juice containing 12.9 mmoL of inorganic nitrate. Fractional exhaled nitric oxide (FeNO) concentrations were measured at the same time points. Cutaneous vascular conductance (CVC) at 39 °C was calculated as RBC flux/ mean arterial pressure then normalized as a proportion of maximal CVC at 44°C. During the plateau phase at 39 °C, median spectral power of the endothelial NO-dependent frequency interval was analyzed using a Morlet wavelet transform. Pre-post comparisons were performed using within-sample t-tests. RESULTS: Following beetroot juice ingestion, FeNO concentrations (mean ± SD: 18 ± 8 ppb vs. 35 ± 16 ppb; p = 0.006, dz = 1.4) and spectral power of the NO-dependent frequency interval (0.01 - 0.02 Hz; p = 0.018, dz = 1.1) increased. Despite evidence for greater NO bioavailability, CVC at 39 °C was reduced (76 ± 12% vs. 50 ± 18%; p < 0.001, dz = 2.3). There was no change in maximal CVC at 44 °C (p = 0.287). CONCLUSION: A functional consequence of increased NO-bioavailability with acute dietary nitrate ingestion appears to be a diminished NO-mediated CVC response to local skin heating in our cohort of postmenopausal women with overweight and obesity. Future research should consider the effects of dietary nitrate coupled with an antioxidant supplement as means to further support NO-mediated endothelial function in such populations.

Regional variation in nitric oxide-dependent cutaneous vasodilatation during local heating in young adults.

What is the central question of this study? Are regional differences in nitric oxide (NO)-dependent cutaneous vasodilatation during local skin heating present in young adults? What is the main finding and its importance? NO-dependent cutaneous vasodilatation varied across the body. The abdomen demonstrated larger NO contributions, while the chest demonstrated smaller NO contributions, compared to other regions. This exploratory work is an important first step in characterizing regional heterogeneity of cutaneous microvascular control across the torso and limbs. Equally, it serves to generate hypotheses for future studies examining regional cutaneous microvascular control in ageing and disease. Regional variations in cutaneous vasodilatation during local skin heating exist across the body. While nitric oxide (NO) is a well-known modulator of this response, the extent of regional differences in NO-dependent cutaneous vasodilatation during local skin heating remains uncertain. In 16 habitually active young adults (8 females; 25±5years), cutaneous vascular conductance, normalized to maximum vasodilatation (% CVCmax ), was assessed at the upper chest, abdomen, dorsal forearm, thigh and lateral calf during local skin heating. Across all regions, local skin temperatures were simultaneously increased from 33 to 42°C (1°Cper 10s), and held until a stable heating plateau was achieved (∼40min). Next, with local skin temperature maintained at 42°C, 20mM of NG -nitro-l-arginine methyl ester (l-NAME) was continuously infused at each site until a stable l-NAME plateau was achieved (∼40min). The difference between heating and l-NAME plateaus was identified as the NO contribution for each region. There was no evidence for region-specific responses at baseline (P=0.561), the heating plateau (P=0.351) or l-NAME plateau (P=0.082), but there was for the NO contribution (P=0.048). Overall, point estimates for between-region differences in the NO contribution varied across the body from 0 to 19% CVCmax . The greatest effects were observed for the abdomen, wherein the NO contribution was consistently greater than for the other regions (range: 9-19% CVCmax ). The chest was consistently lower than the other regions (range: 7-19% CVCmax ). The smallest effects were observed between limb regions (range: 0-2% CVCmax ). These findings advance our understanding of the mechanisms influencing regional variations in the cutaneous vasodilator response to local skin heating in young adults.

Acute Consumption of a Caffeinated Soft Drink Sweetened with High Fructose Corn Syrup Does Not Modify the Cutaneous Microvascular Response to Ischemia‐Reperfusion Injury

Background Copious intake of soft drinks sweetened with high fructose corn syrup (HFCS) is associated with a heightened risk of cardiovascular disease, which is likely contributed to by chronic HFCS mediated endothelial dysfunction occurring secondary to decreased nitric oxide (NO) bioactivity. Acute consumption of a soft drink sweetened with HFCS does not affect cutaneous vasodilation during local heating, a functional test of NO bioactivity in the cutaneous microvasculature. However, this study was undertaken in the absence of a basal reduction in NO bioactivity, such as is speculated to occur with chronic intake of HFCS. Therefore, the present study tested the hypothesis that the cutaneous vasodilatory response to local skin heating following ischemia-reperfusion injury, which acutely reduces NO bioactivity, is attenuated following acute consumption of a caffeinated soft drink sweetened with HFCS compared to water. Methods In a randomized, counter-balanced crossover design, fourteen healthy young adults (six women) consumed 500 mL of either tap water (H2O) or a caffeinated soft drink sweetened with HFCS (Mtn. Dew®, DEW). 30 min following consumption, participants underwent 20 min of forearm ischemia and 20 min of reperfusion. Local skin heating at the forearm to 39⁰C was performed for 40 min and increased to 44⁰C for 20 min. Skin blood flow (SkBF) was measured on the dorsal forearm using laser Doppler flowmetry, blood pressure was measured using the Penaz method, and heart rate was measured via 3-lead electrocardiogram. Cutaneous vascular conductance (CVC) was calculated as the quotient of SkBF and mean arterial pressure (MAP). SkBF and CVC data during local heating to 39⁰C, which is mostly a NO mediated response, were normalized as a percentage of maximal values obtained during local skin heating to 44⁰C. Data are presented as mean ± SD. Results During local skin heating at 44⁰C, there were no differences observed between H20 and DEW trials for SkBF (H2O: 252 ± 37 PU; DEW: 240 ± 35 PU, p = 0.317), CVC (H2O: 2.6 ± 0.4 PU/mmHg; DEW: 2.4 ± 0.5 PU/mmHg, p =0.215), MAP (H2O: 96 ± 6 mmHg; DEW: 101 ± 10 mmHg, p = 0 .162), and heart rate (H2O: 59 ± 7 bpm; DEW 60 ± 10 bpm, p = 0.654). During local skin heating to 39°C, no differences were observed in absolute SkBF (H2O: 154 ± 44 PU; DEW: 152 ± 44 PU, p = 0.879), percent of maximal SkBF (H20: 60.6 ± 12.2%; DEW 62.4 ± 12.7% p = 0.272), absolute CVC (H2O: 2 ± 0.5 PU/mmHg; DEW: 1.5 ± 0.5 PU/mmHg, p = 0.368), or percent of maximal CVC (H2O): 63.8 ± 13.9%; DEW 62.6 ± 13.7% p = 0.787) in the DEW and H2O trials. However, during local heating at 39°C DEW did result in a higher MAP (H2O: 92 ± 7 mmHg; DEW: 100 ± 12 mmHg, p = 0.022) and heart rate (H2O: 56 ± 7 bpm; DEW 59 ± 8 bpm, p = 0.032) compared to H2O. Conclusion Under conditions of ischemia-reperfusion injury, these data indicate that, compared to an equivalent volume of water, consumption of 500 mL of a caffeinated soft drink sweetened with HFCS does not affect the cutaneous vasodilatory response to local heating, a mostly nitric oxide mediated response.

Regional cutaneous vasodilator responses to rapid and gradual local heating in young adults.

To examine the extent of regional variations in cutaneous vasodilatation during rapid and gradual local thermal hyperaemia (LTH) in young adults. In thirty young adults (21±3 years, 15 females), cutaneous vascular conductance, normalized to maximum local skin heating at 44°C (%CVCmax), was assessed at the upper chest, abdomen, dorsal arm, dorsal forearm, thigh, and medial calf during rapid (33-42°C at 1°C·20 s-1) and gradual (33-42°C at 1°C·5 min-1) LTH on separate days. For both protocols, local temperatures were held at 42°C for up to 35min, followed by 20-30min at 44°C. During rapid LTH, between-region responses were evaluated at baseline, the initial vasodilator peak, and 42°C plateau. During gradual LTH, responses were assessed at baseline and the 42°C plateau. There were significant main effects of body region on %CVCmax for the initial peak and plateau during rapid LTH and for the plateau during gradual LTH (all P<0.001) Conversely, main effects of sex and the sex by region interaction were not significant (all P>0.05). The magnitudes of between-region differences varied across the body (~1-17% range). The greatest effects were observed for the abdomen, wherein responses were consistently lower compared to other regions. Further, responses were consistent between males and females across all body regions and heating phases. Regional variations in the cutaneous vasodilator response to local heating are evident for rapid and gradual LTH in young adults, with the largest effects observed for the abdomen, albeit regional differences were similar between sexes.

Myths and methodologies: Reliability of forearm cutaneous vasodilatation measured using laser-Doppler flowmetry during whole-body passive heating.

Laser-Doppler flowmetry (LDF) is commonly used to assess cutaneous vasodilatation responses, but its reliability (i.e. consistency) during whole-body passive heating is unknown. We therefore assessed the reliability of LDF-derived indices of cutaneous vasodilatation during incremental whole-body heating. Fourteen young men (age: 24 (SD 5) years) completed three identical trials, each separated by 1week. During each trial, a water-perfused suit was used to raise and clamp oesophageal temperature at 0.6°C (low-heat strain; LHS) and 1.2°C (moderate-heat strain; MHS) above baseline. LDF-derived skin blood flow (SkBF) was measured at three dorsal mid-forearm sites, with local skin temperature clamped at 34°C. Data were expressed as absolute cutaneous vascular conductance (CVCabs ; SkBF/mean arterial pressure) and normalised to maximal conductance (%CVCmax ) achieved via simultaneous local skin heating to 44°C and increasing oesophageal temperature to 1.8°C above baseline. Between-day reliability was characterised as measurement consistency across trials, while within-day reliability was characterised as measurement consistency across adjacent skin sites during each trial. Between- and within-day absolute reliability (coefficient of variation) generally improved with increasing heat strain, changing from poor (>25%) at baseline, poor-to-moderate (15-34%) at LHS, and moderate (10-25%) at MHS. Generally, these estimates were more consistent when expressed as %CVCmax . Conversely, relative reliability was mostly acceptable (intraclass correlation coefficient ≥0.70) during LHS and when data were expressed as CVCabs . These findings indicate that the consistency of LDF-derived CVC estimates during heat stress depends on the level of heat strain and method of data expression, which should be considered when designing and interpreting experiments.

KCa channels are major contributors to ATP-induced cutaneous vasodilation in healthy older adults

ObjectiveTo examine the contributions of calcium-activated K+ (KCa) channels and nitric oxide synthase (NOS) to adenosine triphosphate (ATP)-induced cutaneous vasodilation in healthy older adults. MethodsIn eleven older adults (69 ± 2 years, 5 females), cutaneous vascular conductance, normalized to maximum vasodilation (%CVCmax) was assessed at four dorsal forearm skin sites that were continuously perfused with either 1) lactated Ringer solution (Control), 2) 50 mM tetraethylammonium (TEA, KCa channel blocker), 3) 10 mM Nω-nitro-L-arginine (L-NNA, NOS inhibitor), or 4) combined 50 mM TEA +10 mM L-NNA, via microdialysis. Local skin temperature was fixed at 33 °C at all sites with local heaters throughout the protocol while the cutaneous vasodilator response was assessed during coadministration of ATP (0.03, 0.3, 3, 30, 300 mM; 20 min per dose), followed by 50 mM sodium nitroprusside and local skin heating to 43 °C to achieve maximum vasodilation (20–30 min). ResultsBlockade of KCa channels blunted %CVCmax relative to Control from 0.3 to 300 mM ATP (All P < 0.05). A similar response was observed for the combined KCa channel blockade and NOS inhibition site from 3 to 300 mM ATP (All P < 0.05). Conversely, NOS inhibition alone did not influence %CVCmax across all ATP doses (All P > 0.05). ConclusionIn healthy older adults, KCa channels play an important role in modulating ATP-induced cutaneous vasodilation, while the NOS contribution to this response is negligible.

Optical coherence tomography: a novel imaging approach to visualize and quantify cutaneous microvascular structure and function in patients with diabetes

IntroductionThe pathophysiology of microvascular disease is poorly understood, partly due to the lack of tools to directly image microvessels in vivo.Research design and methodsIn this study, we deployed a novel...

Effects of local forearm skin heating on skin properties

This study investigated impacts of local skin heating on skin properties and tested whether skin changes depended on heat-induced hyperaemia. It was reasoned that heat-induced vasodilation impacts accompanying interstitial fluid changes. Forearm skin was locally heated from a baseline of 35°C to 40-42°C in 30 young adults (15 females, 15 males, 24.9±2.1years) and non-heated in 10 others (5 females, 5 males, 25.2±1.3years. Skin blood flow (SBF) was continuously measured using a laser Doppler method and skin tissue dielectric constant (TDC), stratum corneum capacitance (SCC) and transepidermal water loss (TEWL) were measured before and after maintained heat for 12min. TDC values were determined to effective measurement depths of 1.5mm (TDC15) and 2.5mm (TDC25). Results showed a large heat-induced hyperaemia, with SBF increasing on average 8.8-fold from its baseline of 35°C. Heating also caused significant increases in TDC, SCC and TEWL that, compared to preheating, increased approximately 1.1-fold, 3.1-fold and 4.5-fold. None of these skin changes correlated with the magnitude of the SBF hyperaemic response. Absence of this correlation may indicate that in young healthy adults, increased capillary filtration due to heat-induced arteriolar vasodilation is rapidly accommodated by postcapillary reabsorption, enhanced lymphatic activity and TEWL processes. An alternate explanation is that heating caused increased red cell oscillations that were detected as part of the laser Doppler increase without representing increased capillary flux. The major determinant of the Increases in TDC, SCC and TEWL is likely a consequence of heat-induced eccrine gland activation. Studies of older persons or those with depressed function are warranted.