Skin Vasoconstrictor Response Research Articles

Arousal electrical stimuli evoke sudomotor activity related to P300, and skin vasoconstrictor activity related to N140 in humans

ObjectiveArousal stimuli evoke bursts of skin sympathetic nerve activity (SSNA). SSNA usually contains sudomotor and vasoconstrictor neural spikes. The aim of this study was to elucidate which components of event-related potentials (ERPs) are related to sudomotor and vasoconstrictor responses comprising arousal SSNA bursts. MethodsWe recorded SSNA from the tibial nerve by microneurography, with corresponding sympathetic skin response (SSR), sympathetic flow response (SFR), and ERPs in 10 healthy subjects. Electrical stimulation of the median nerve was used to induce arousal responses. ERPs were classified by the occurrence of SSR and SFR. ResultsSSNA bursts followed by SSR were associated with larger P300 than SSNA bursts followed by no SSR. For N140, no difference in the amplitude was found between SSNA bursts with and without SSR. SSNA bursts followed by SFR were associated with larger N140 than SSNA bursts followed by no SFR. However, there were no differences in the amplitude of P300 between SSNA bursts with and without SFR. ConclusionsSudomotor and skin vasoconstrictor responses to arousal stimuli were differently associated with distinct ERP components. SignificanceThe possibility that sudomotor and skin vasoconstrictor activities comprising arousal SSNA reflect different stages of the cognitive process is suggested.

Does insulin resistance co-exist with glucocorticoid resistance in the metabolic syndrome? Studies comparing skin sensitivity to glucocorticoids in individuals with and without acanthosis nigricans

BackgroundThe metabolic syndrome is associated with increased risk for both diabetes and coronary artery disease, which insulin resistance alone does not satisfactorily explain. We propose an additional and complementary underlying mechanism of glucocorticoid resistance.ResultsUsing acanthosis nigricans (AN) and skin vasoconstrictor (SVC) response to topically applied beclomethasone dipropionate as markers of insulin and glucocorticoid resistance, respectively, we compared anthropometric, biochemical, pro-inflammatory markers and the SVC response in subjects with AN in two studies: STUDY 1 was used to compare subjects with AN (Grade 4, n = 32), with those without AN (n = 68) while STUDY 2 compared these responses among a cross-section of diabetic patients (n = 109) with varying grades of AN (grade 0, n = 30; grade 1, n = 24; grade 2, n = 18; grade 3, n = 25; grade 4, n = 12).FindingsIn both studies there was an inverse relationship between AN Grade 4 and the SVC response, (P < 0.001). In STUDY 1, AN Grade 4 was associated with age, waist circumference, BMI, fasting blood glucose, plasma lipids and hs-CRP (P < 0.05). SVC was an independent predictor of CRP and those with combined AN and a negative SVC response, CRP levels were highest. In Study 2 when the SVC response in subjects with type 2 diabetes mellitus with varying degrees of AN was studied, it showed that for any degree of AN, the SVC response is more likely to be negative and was independent of gender and ethnicity.ConclusionAn absent SVC response represents a new biomarker for the metabolic syndrome and the exaggerated inflammatory response, which characterizes the metabolic syndrome, may be an outcome of deficient glucocorticoid action in vascular tissue.

暑熱ストレスと人の血圧調節

Heat stress is a major environmental factor which perturbs working in safety. In humans, heat stress increases the occurrence of orthostatic syncope and induces marked reductions in orthostatic tolerance. Several mechanisms, including an altered baroreflex responsiveness in heart rate (HR) and peripheral vasomotion, are involved in orthostatic intolerance. In the present review, we discuss the effects of heat stress on the baroreflex function in controlling HR and peripheral vasomotion. The present findings from human studies suggest that (1) heat stress slows the arterial baroreflex responses in HR and peripheral vasomotion and decreases the responses to rapid hypotensive stimulation, (2) heat stress reduces the sensitivity of the spontaneous baroreflex control of HR during orthostasis but not during supine rest, (3) central blood volume decreases with increasing skin blood flow and the sensitivity of the integrative baroreflex control of total peripheral vascular resistance is reduced in heat-stressed humans, and (4) the reduced baroreflex sensitivity of total peripheral vascular resistance may be partly due to the reduction in skin vasoconstrictor response. The altered baroreflex responsiveness in HR and peripheral vasomotor control as well as central hypovolemia are related to orthostatic intolerance in a hot environment.

Cardiovascular and behavioral responses to conditioned fear after medullary raphe neuronal blockade

Conditioned fear to context in the rat leads to a host of sympathetically mediated physiological changes, including a marked rise in mean arterial pressure, a delayed rise in heart rate and a marked cutaneous vasoconstriction, along with the behavioral responses of freezing and ultrasonic vocalization. In this study we examine the role of the rostral ventromedial medulla (RVM), which includes raphe nuclei pallidus and magnus, in the expression of these changes. RVM is a major premotor sympathetic and somatic center and an important integrating center in the descending emotional motor system. To evaluate its role, conditioned fear was tested after temporary blockade with microinjections (0.4 μl) of the GABA-A receptor agonist muscimol (0.2 mM) or the glutamate receptor antagonist kynurenic acid (0.1 M). Changes in mean arterial pressure, heart rate and activity were recorded by radio-telemetry. Cutaneous vasoconstriction in the tail was recorded indirectly by infrared thermography. Muscimol and kynurenic acid had different, almost complementary effects. Muscimol abolished the skin vasoconstrictor response and significantly reduced the tachycardic response, but did not reduce the pressor response significantly and had little effect on the somatic motor components, freezing and ultrasonic vocalization. In contrast, kynurenic acid abolished ultrasonic vocalization and significantly reduced freezing but had no effect on the cardiovascular components. The results show that neurons in the rostral ventromedial medulla are implicated in the expression of some of the cardiac, vascular and somatic motor components of conditioned fear. Most importantly, these cardiovascular components are not under local glutamatergic control whereas the somatic motor components are.

Impaired defense of core temperature in aged humans during mild cold stress

Aged humans often exhibit an impaired defense of core temperature during cold stress. However, research documenting this response has typically used small subject samples and strong cold stimuli. The purpose of this study was to determine the responses of young and older subjects, matched for anthropometric characteristics, during mild cold stress. Thirty-six young (YS; 23 +/- 1 years, range 18-30) and 46 older (OS; 71 +/- 1 years, range 65-89) subjects underwent a slow transient cold air exposure from a thermoneutral baseline, during which esophageal (T(es)) and mean skin temperatures (T(sk)), O(2) consumption, and skin blood flow (SkBF; laser-Doppler flowmetry) were measured. Cold exposure was terminated at the onset of visible sustained shivering. Net metabolic heat production (M(net)), heat debt, predicted change in midregion temperature (DeltaT(mid)), and tissue insulation (I(t)) were calculated. Cutaneous vascular conductance (CVC) was calculated as laser-Doppler flux/mean arterial pressure and expressed as percent change from baseline (DeltaCVC(%base)). There were no baseline group differences for T(es), but OS M(net) was lower (OS: 38.0 +/- 1.1; YS: 41.9 +/- 1.1 W . m(-2), P < 0.05). T(es) was well maintained in YS but fell progressively in OS (P < 0.01 for all timepoints after 35 min). The skin vasoconstrictor response to mild cold stress was attenuated in OS (42 +/- 3 vs. 53 +/- 4 DeltaCVC(%base), P < 0.01). There were no group differences for T(sk) or I(t), while M(net) remained lower in OS (P < 0.05). The DeltaT(mid) did not account for the drop in T(es) in OS. Healthy aged humans failed to maintain T(es); however, the mechanisms underlying this response are not clear.

Whole-Body Heating Decreases Skin Vascular Response to Low Orthostatic Stress in the Lower Extremities

To elucidate the influence of heat stress on cutaneous vascular response in the lower extremities during orthostatic stress, a head-up tilt (HUT) test at angles of 15 degrees, 30 degrees, 45 degrees, and 60 degrees for 4 min each was conducted under normothermic control conditions followed by whole-body heat stress produced by a hot water-perfused suit in healthy volunteers. Skin blood flows (SkBF) in the forearm, thigh, and calf were monitored using laser-Doppler flowmetry throughout the experiment. Furthermore, to elucidate the effects of increased core and local skin temperatures on the local vascular response in calf skin under increasing orthostatic stress, the thigh was occluded at 20, 30, 50, 70, and 80 mmHg with a cuff in both the normothermic condition and the whole-body or local heating condition. Significant decreases in forearm SkBF during HUT were observed at an angle of 60 degrees during normothermia and at 30 degrees or more during heating. SkBF in the thigh and calf was decreased significantly by HUT at 15 degrees and above during normothermia, and there was no significant reduction of SkBF in these sites during HUT at the lower angles (15 degrees -45 degrees ) during whole-body heating. Significant decreases of calf SkBF were observed at cuff pressures of 20 mmHg and above during normothermia and of 30 mmHg and above during whole-body and local heating, respectively. These results suggest that SkBF in the lower extremities shows a marked reduction compared with the upper extremities during low orthostatic stress in normothermia, and the enhanced skin vasoconstrictor response in the lower extremities is diminished by both whole-body and local heat stress.

Measurement of skin vasoconstrictor response in healthy subjects

Objectives Laser Doppler flowmetry enables non-invasive quantification of skin blood flow and its sympathetically mediated change. Four different maneuvers were performed in 60 healthy subjects aged 20–78 years to investigate their variability, reproducibility and to determine the influence of gender, age and height. Material and methods Skin blood flow was measured on the pulp of both index fingers using laser Doppler flowmetry. Vasoconstriction was induced by deep inspiratory gasp, arm dependency, acoustic stimulation and a modified cold pressor test. Results More than 95% of normal subjects showed a vasoconstrictor response to cold pressure test and 100% to inspiratory gasp. In all other maneuvers vasoconstrictor response was less reliable. The magnitude of vasoconstrictor responses decreased with age in all maneuvers, while latencies remained unchanged. Only during inspiratory gasp men showed more pronounced vasoconstrictor response compared with women. Body height influenced latencies if peripheral stimuli were applied like in the cold pressor and arm dependency tests. Conclusions Inspiratory gasp and the modified cold pressor test were found to be more suitable maneuvers for routine clinical testing than arm dependency and acoustic stimulation. Normal data also for side differences are provided as a base for routine clinical testing in systemic and unilateral neurological disorders.

Impaired skin vasomotor reflexes in patients with erythromelalgia

Erythromelalgia (EM) is a chronic disorder characterized by intermittent burning pain, warmth and erythema of the extremities. Increasing the local temperature and dependency of the affected limb(s) precipitates the symptoms, whereas direct cooling and elevation of the limb(s) can provide partial relief. Our previous findings showed that patients with EM have enhanced cutaneous vascular tone at rest and during stimulation, which may be due to an increase in sympathetic neural activity. To test this, we measured skin vasoconstrictor responses to contralateral arm cold challenge (CC) and inspiratory gasp (IG) using laser Doppler flowmetry at the toe pulp and fingertip. These areas were chosen because of their dense sympathetic innervation. An index of the vasoconstrictor response (between 0 and 1) was calculated from the change in skin perfusion from baseline following CC and IG. In control subjects, vasoconstrictor responses to CC at the toe and fingertip were both 0. 70+/-0.02 (mean+/-S.E.M.), which were significantly greater (P<0. 001) than corresponding values in patients with EM (0.37+/-0.04 and 0.45+/-0.04 respectively). Similarly, vasoconstrictor responses to IG were significantly greater (P<0.001) at the toe and fingertip in control subjects (0.70+/-0.03 and 0.70+/-0.02 respectively) compared with values in EM patients (0.27+/-0.03 and 0.45+/-0.15 respectively). These data show that, in contrast with control subjects, patients with EM have diminished sympathetic vasoconstrictor responses to both CC and IG. Denervation supersensitivity may play a part by increasing vasoconstrictor responses to circulating catecholamines, leading to a reduction in skin blood flow. Therefore an interplay between neural and vasoactive agents may be involved in the pathophysiology of EM.

Impaired skin vasomotor reflexes in patients with erythromelalgia

Erythromelalgia (EM) is a chronic disorder characterized by intermittent burning pain, warmth and erythema of the extremities. Increasing the local temperature and dependency of the affected limb(s) precipitates the symptoms, whereas direct cooling and elevation of the limb(s) can provide partial relief. Our previous findings showed that patients with EM have enhanced cutaneous vascular tone at rest and during stimulation, which may be due to an increase in sympathetic neural activity. To test this, we measured skin vasoconstrictor responses to contralateral arm cold challenge (CC) and inspiratory gasp (IG) using laser Doppler flowmetry at the toe pulp and fingertip. These areas were chosen because of their dense sympathetic innervation. An index of the vasoconstrictor response (between 0 and 1) was calculated from the change in skin perfusion from baseline following CC and IG. In control subjects, vasoconstrictor responses to CC at the toe and fingertip were both 0.70±0.02 (mean±S.E.M.), which were significantly greater (P &lt; 0.001) than corresponding values in patients with EM (0.37±0.04 and 0.45±0.04 respectively). Similarly, vasoconstrictor responses to IG were significantly greater (P &lt; 0.001) at the toe and fingertip in control subjects (0.70±0.03 and 0.70±0.02 respectively) compared with values in EM patients (0.27±0.03 and 0.45±0.15 respectively). These data show that, in contrast with control subjects, patients with EM have diminished sympathetic vasoconstrictor responses to both CC and IG. Denervation supersensitivity may play a part by increasing vasoconstrictor responses to circulating catecholamines, leading to a reduction in skin blood flow. Therefore an interplay between neural and vasoactive agents may be involved in the pathophysiology of EM.

CORTICOSTEROIDS IN ESSENTIAL HYPERTENSION: MULTIPLE CANDIDATE LOCI AND PHENOTYPIC VARIATION

1. The role of genetically determined changes in adrenal steroid production, metabolism and action in the pathogenesis of cardiovascular disease in man is considered by studying three loci that are important in corticosteroid function. 2. Variation at the glucocorticoid receptor locus can be identified as a biallelic restriction fragment length polymorphism (Bcl1); subjects with contrasting genotypes show altered skin vasoconstrictor responses to topically applied budesonide without any significant change in leucocyte receptor binding characteristics. 3. In a case control study of patients with essential hypertension, we have shown evidence of reduced 11 beta-hydroxysteroid dehydrogenase activity, with an elevated ratio of cortisol to cortisone metabolites in urine. 4. The genes encoding 11 beta-hydroxylase and aldosterone synthase are highly homologous. Studies in the Milan hypertensive rat show variation at this locus, which may account for the increased steroid synthesis noted in the hypertensive strain; in man, a chimaeric gene comprising 5' regulatory regions from 11 beta-hydroxylase and 3' coding sequence from aldosterone synthase accounts for the autosomal dominant condition Dexamethasone Suppressible Hyperaldosteronism. Variation in the precise location of the crossover site between the two genes does not account for the observed phenotypic heterogeneity in this condition. 5. Measurement of basal plasma steroid levels in subjects with essential hypertension show an increased ratio of 11-deoxycortisol/cortisol, consistent with reduced activity of 11 beta-hydroxylase in the zona fasciculata. 6. In summary, three loci involved in corticosteroid synthesis, metabolism and action can independently affect cardiovascular phenotypes; their roles in determining pathophysiological changes, including hypertension, remain to be studied.

Skin blood flow and autonomic reactivity in human poikilothermia

Autonomic reactivity is pivotal in maintaining a constant body core temperature. Skin vasomotor reflexes and cardiovascular reactivity were investigated in four women (aged 28-37 years) with acquired poikilothermia, during steady-state spontaneous hypothermia (rectal temperature (Tr) = 33.7 +/- 1.0 degrees C [mean +/- SD]) and steady-state normothermia (Tr = 36.7 +/- 0.3 degrees C), as well as in 12 normothermic control subjects. Baseline finger temperature (Tf) during hypothermia was significantly lower than during normothermia (Tf = 32.4 +/- 1.2 compared with 36.2 +/- 0.3 degrees C, respectively), and than in the controls (Tf = 34.8 +/- 0.8 degrees C). No significant differences in baseline skin blood flow and forearm blood flow were found between subjects during hypothermia or normothermia and controls, suggesting a failure of sympathetic drive to counter-regulate hypothermia in the subjects. Skin vasoconstrictor responses to the contralateral cooling test and neck cooling test were markedly attenuated in three subjects, and to the finger cooling test in two subjects, during normothermia compared with hypothermia. Blood pressure responses to the Valsalva manoeuvre and head-up tilting were normal in all subjects, whereas the heart rate response to head-up tilting was blunted in three subjects during hypothermia. The responses of blood pressure and forearm blood flow to the cold pressor test in the subjects during both thermal conditions were comparable with the controls. We conclude that in our subjects, without generalized autonomic failure, poikilothermia has to be attributed predominantly to disorders of the central thermoregulatory pathways. Our findings during hypothermia and normothermia indicate that variations in core and skin temperature significantly affect skin vasomotor reactivity.

Effect of α1-adrenoceptor antagonists, prazosin and urapidil, on a finger skin vasoconstrictor response to cold stimulation

Cold stimulation causes a finger skin vasoconstrictor response, which is regulated by stimulation of alpha-adrenergic receptors and is reduced by administration of prazosin. The purpose of this study was to investigate, using a laser Doppler flowmeter, whether the decrease in the finger skin vasoconstrictor response to cold stimulation produced by administration of two different alpha 1-adrenoceptor antagonists, prazosin and urapidil, was correlated with the corresponding plasma drug concentration, and whether this method could be used to evaluate the relative potency of these alpha 1-adrenoceptor antagonists in human subjects. In thirteen healthy male subjects (20-42 y), finger tip skin blood flow was measured during cold stimulation before and 1, 2, 3, 6, and 9 h after administration of placebo, prazosin (1 mg) or urapidil (60 mg). Both prazosin and urapidil significantly decreased the vasoconstrictor response to cold stimulation. The degree of the decrement in the response indicated by the reduction ratio was significantly correlated with the plasma concentration of prazosin and urapidil. The alpha 1-adrenoceptor blocking activity of prazosin estimated by the regression lines was about 130-times more potent than that of urapidil. These findings suggest that the cold stimulation response of finger skin vasoconstriction may be used to evaluate the relative alpha 1-adrenoceptor blocking potency of drugs.

Decreased peripheral glucocorticoid sensitivity in Alzheimer's disease.

Both peripheral and central glucocorticoid sensitivity was examined in patients with Alzheimer's disease (AD; n = 13), glucocorticoid-treated patients (n = 8), healthy elderly controls (n = 10) and young controls (n = 9). We performed glucocorticoid receptor-mediated skin vasoconstrictor responses to clobetasol and low-dose dexamethasone suppression tests. Patients with AD showed skin blanching at a significantly higher clobetasol concentration than did healthy elderly controls (p = 0.002). There was no difference in skin blanching between patients with AD and patients treated with corticosteroids. Patients with AD had significantly higher post-dexamethasone serum cortisol levels than healthy elderly (p = 0.01). No association was found between skin blanching and dexamethasone suppressibility. Thus patients with AD have apparently independent reductions in both central nervous system and peripheral glucocorticoid sensitivity. These results predict an increase in glucocorticoid secretion in some patients, which might accelerate neuronal degeneration in the absence of features of overexposure to glucocorticoids in peripheral tissues.

Roles of absolute and relative load in skin vasoconstrictor responses to exercise

Systemic hemodynamic responses to exercise (e.g., heart rate, blood pressure) depend on the relative intensity, the active muscle mass, and the mode of exercise. It is not known whether regional vasomotor responses follow the same pattern. To answer this question, in five men we examined cutaneous vascular responses to dynamic and isometric exercise of two legs, one leg, one arm, and one hand, each at high and low work loads. Skin blood flow was monitored by laser-Doppler flowmetry (LDF) at the forearm. Mean arterial pressure (MAP) was measured each minute. Cutaneous vascular conductance (CVC) was indexed as LDF/MAP. Reductions in CVC during the 1st min of dynamic exercise were statistically significant for two-leg exercise at either level and for one-leg exercise at the higher level. Dynamic exercise of smaller muscle groups at either intensity was not associated with significant changes in CVC. The reduction in CVC correlated with external work load (r = 0.75). Work load relative to the capacity of a given muscle group had no identifiable role in the response of CVC to dynamic exercise but did have a role in the increase in MAP at the beginning of exercise. Isometric exercise did not have a measurable effect on CVC regardless of the muscle group or the intensity of the exercise. We conclude that the level of external work determines the redistribution of blood flow from skin to active muscle. Furthermore, absolute rather than relative work and dynamic rather than isometric modes of exercise are the dominant factors.

Interactions between local and reflex influences on human forearm skin blood flow

A three-part experiment was designed to examine interactions between local and reflex influences on forearm skin blood flow (SkBF). In part I locally increasing arm skin temperature (Tsk) to 42.5 degrees C was not associated with increases in underlying forearm muscle blood flow, esophageal temperature (Tes), or forearm blood flow in the contralateral cool arm. In part II whole-body Tsk was held at 38 or 40 degrees C and the surface temperature of one arm held at 38 or 42 degrees C for prolonged periods. SkBF in the heated arm rose rapidly with the elevation in body Tsk and arm Tsk continued to rise as Tes rose. SkBF in the arm kept at 32 degrees C paralleled rising Tes. In six studies, SkBF in the cool arm ultimately converged with SkBF in the heated arm. In eight other studies, heated arm SkBF maintained an offset above cool arm SkBF throughout the period of whole-body heating. In part III, local arm Tsk of 42.5 degrees C did not abolish skin vasoconstrictor response to lower body negative pressure. We conclude that local and reflex influences to skin interact so as to modify the degree but not the pattern of skin vasomotor response.