Effects of Ca2+ entry blockers on CaCl2-, KCl- and noradrenaline-induced contractions of goat cerebral arteries

Low-Frequency (20 kHz) Ultrasonic Modulation of Drug Action

We tested the effect of low-frequency ultrasound (LUS, 20 kHz, 4 W/cm²) on the function of rat mesentery and human pulmonary arteries with wire myography. The vessels were induced to contract with either noradrenaline or physiologic saline solution (PSS) with a high potassium concentration (KPSS) and then incubated with capsaicin (2.1 × 10^-7 M, TRPV1 [transient receptor potential vanilloid 1] activator), dopamine (1 × 10^-4 M, dopamine and α₂-receptor activator), or fenoldopam (dopamine_A1 receptor agonist, 1 × 10^-4 M) with and without glibenclamide (1 μM, KATP [adenosine triphosphate {sensitive potassium channel (ATP)}-sensitive potassium channel] inhibitor and α₂-receptor modulator), and insonated. Vessels were incubated in Ca²⁺-free PSS and induced to contract with added extracellular Ca²⁺ and noradrenaline. Pulmonary arteries were induced to contract with KPSS and dopamine. Then the vessels were insonated. LUS inhibited the influx of external Ca²⁺, inhibited the dopamine-induced vasoconstriction in the KPSS (glibenclamide reversible), reduced the capsaicin-induced vasorelaxation, increased the gentamicin-induced vasorelaxation and increased the dopamine-induced contraction in the KPSS in human pulmonary arteries.

Nimodipine-Induced Blood Pressure Changes Can Predict Delayed Cerebral Ischemia

Background: Early diagnosis of delayed cerebral ischemia (DCI) in patients after aneurysmal subarachnoid hemorrhage (aSAH) still poses a leading problem in neurointensive care. The aim of this study was to analyze the effect of oral Nimodipine administration on systemic blood pressure in patients with evolving DCI compared to patients without DCI.

Methods: Systolic (SBP), mean (MAP), and diastolic (DBP) blood pressures were analyzed at the time of Nimodipine administration and additionally 30, 60, and 120 min thereafter on days 1, 3, and 5 after aSAH. Additionally, the 24 h period preceding DCI and in patients without DCI day 10 after aSAH were analyzed. Statistical analysis was performed for SBP, MAP and DBP at time of Nimodipine administration and for the maximal drop in blood pressure after Nimodipine administration.

Results: Thirty patients with aSAH were retrospectively analyzed with 17 patients developing DCI (“DCI”) and 13 patients who did not (“Non-DCI”). DCI patients showed a more pronounced rise in MAP and DBP over the examined time period as well as a higher decrease in SBP following Nimodipine administration. A fall of 18 mmHg in SBP after Nimodipine administration showed a sensitivity of 82.4% and specificity of 92.3% for occurrence of DCI.

Conclusion: An increase of MAP and DBP after aSAH and a heightened sensitivity to Nimodipine administrations may serve as additional biomarkers for early detection of evolving DCI.

Role of Ca(2+) channels in NE-induced increase in [Ca(2+)](i) and tension in fetal and adult cerebral arteries

In vascular smooth muscle, elevation of agonist-induced intracellular Ca(2+) concentration ([Ca(2+)](i)) occurs via both Ca(2+) release from intracellular stores and Ca(2+) influx across the plasma membrane. In the cerebral vasculature of the fetus and adult the relative roles of these mechanisms have not been defined. To test the hypothesis that plasma membrane L-type and receptor-operated Ca(2+) channels play a key role in NE-induced vasoconstriction via alterations in plasma membrane Ca(2+) flux and that this may change with developmental age, we performed the following study. In main branch middle cerebral arteries (MCA) from near-term fetal ( approximately 140 days) and nonpregnant adult sheep, we quantified NE-induced responses of vascular tension and [Ca(2+)](i) (by use of fura 2) under standard conditions in response to several Ca(2+) channel blockers and in response to zero extracellular Ca(2+). In fetal and adult MCA, maximal NE-induced tensions (g) were 0.91 +/- 0.12 (n = 10) and 1.61 +/- 0.13 (n = 12), respectively. The pD(2) values for NE-induced tension were both 6.0 +/- 0.1, whereas the fetal and adult maximum responses (%K(max)) were 107 +/- 16 and 119 +/- 7, respectively. The fetal and adult pD(2) values for NE-induced increase of [Ca(2+)](i) were 6.2 +/- 0.1 and 6.4 +/- 0.1, respectively, whereas maximum [Ca(2+)](i) responses were 81 +/- 9 and 103 +/- 15% of K(max), respectively. After 10(-5) M NE-induced contraction, nifedipine resulted in dose-dependent decrease in vessel tone and [Ca(2+)](i) with pIC(50) values for fetal and adult tensions of 7.3 +/- 0.1 and 6.6 +/- 0.1, respectively (P < 0.01; n = 4 each), whereas pIC(50) for [Ca(2+)](i) responses were 7.2 +/- 0.1 and 6.9 +/- 0.1, respectively. The pIC(50) values for tension for diltiazem and verapamil were somewhat lower but showed a similar relationship. The receptor-operated Ca(2+) channel blocker 2-nitro-4 carboxyphenyl-N,N-diphenyl carbamate showed little effect on NE-induced vessel contractility or [Ca(2+)](i). In the absence of extracellular Ca(2+) for 2 min, 10(-5) M NE resulted in markedly attenuated responses of adult MCA tension and [Ca(2+)](i) to 39 +/- 7 and 73 +/- 8% of control values (n = 4). For fetal MCA, exposure to extracellular Ca(2+) concentration resulted in essentially no contractile or [Ca(2+)](i) response (n = 4). Similar blunting of NE-induced tension and [Ca(2+)](i) was seen in response to 10(-3) M lanthanum ion. These findings provide evidence to suggest that especially in fetal, but also in adult, ovine MCA, Ca(2+) flux via L-type calcium channels plays a key role in NE-induced contraction. In contrast, Ca(2+) flux via receptor-operated Ca(2+) channels is of less importance. This developmental difference in the role of cerebrovascular plasma membrane Ca(2+) channels may be an important association with increased Ca(2+) sensitivity of the fetal vessels.

Effects of magnesium sulphate on the noradrenaline-induced cerebral vasoconstrictor and pressor responses in the goat

OBJECTIVE

To examine the ability of magnesium sulphate to counteract the noradrenaline-induced cerebral vasoconstrictor and pressor responses in goats by using both in vivo and in vitro techniques.

DESIGN

Cerebral blood flow was measured in vivo by means of an electromagnetic flow probe around the internal maxillary artery. Isometric tension was recorded in vitro from rings of goat middle cerebral artery maintained in an organ bath.

RESULTS

1. In vivo. Continuous infusion of noradrenaline (10 micrograms/min) directly into the cerebral arterial supply elicited sustained decrease in cerebral blood flow (61% [SEM 3] of control values) and increase in cerebral vascular resistance (178% [SEM 9] of control values). Magnesium sulphate, injected directly into the cerebral arterial supply (10-300 mg) or infused intravenously (0.3 g and 3 g during 15 min) at the noradrenaline-induced steady state, increased cerebral blood flow by decreasing cerebral vascular resistance in a dose-dependent manner. A similar result was obtained when intravenous magnesium sulphate (3 g/15 min) was tested against the cerebral vasoconstrictor and pressor responses induced by intravenous infusion of noradrenaline (30 micrograms/min). 2. In vitro. When compared with the response obtained in a control medium (1 mmol/L Mg2+), 10 mmol/L Mg2+ significantly inhibited the maximum contraction elicited by noradrenaline (10(-8) to 3 x 10(-3) mol/L) from 45% [SEM 4] to 26% [SEM 4].

CONCLUSIONS

Magnesium sulphate reverses the noradrenaline-induced cerebral vasoconstrictor and pressor responses by a direct inhibitory action of Mg2+ on the actions of noradrenaline in the cerebral and peripheral vascular beds, which leads to a decrease in vascular resistance. These results could explain, at least in part, the beneficial effects of magnesium sulphate in the management of preeclampsia and eclampsia.

Effects of cocaine on human and goat isolated cerebral arteries

Cocaine abuse has been increasingly associated with cerebrovascular disease. We have studied the vasoactive properties of cocaine in branches of human middle cerebral artery and in goat middle cerebral artery isolated in an organ bath for isometric tension recording. Cocaine (10(-5) - 3 x 10(-4) M) induced small contractions, while higher concentrations (10(-3) - 3 x 10(-3) M) induced relaxation of human arteries at resting tension. In human arteries precontracted with KCl (50 mM), prostaglandin F- (10(-5) M) or endothelin-1(10(-9) M), cocaine (10(-6) - 3 x 10(-3) M) induced concentration-dependent relaxations which differed in terms of EC50 or maximum effect (Emax). With regard to goat arteries, cocaine (10(-6) - 3 x 10(-3) M) induced almost negligible changes in resting tension, and induced concentration-dependent relaxations of the arterial tone induced with KCl (50 mM). By contrast, goat arteries precontracted with prostaglandin F2 alpha (10(-5) M) or endothelin-1 (10(-9) M) showed biphasic concentration-response curves with concentration-dependent contractions to cocaine (10(-5) - 10(-3) M) and relaxation to the highest concentration (3 x 10(-3) M). Preincubation with cocaine (10(-4) - 10(-3) M) inhibited the contractile responses to CaCl2 (10(-6) - 10(-2) M) in depolarizing, Ca(2+)-free medium, and this inhibition was reversed by preincubation with the Ca2+ entry activator Bay K8644 (10(-10) - 10(-8) M). Therefore, cocaine induces tension changes in cerebral arteries which depend on the species, the arterial tone and the contractile agent inducing it. The relaxant effects could be attributed to the interference of cocaine with the role of Ca2+ in the maintenance of arterial tone, at least in part by blocking Ca2+ entry through membrane channels.

Calcium channels in cerebral arteries

Electrophysiological evidence shows the existence of voltage-operated Ca2+ channels of the L- and, in some cases, T- and B-, type in the smooth muscle cells of major cerebral arteries and arterioles. Current intensity through L-type Ca2+ channels is higher in cerebral than in peripheral arteries, which points to a greater dependence on extracellular Ca2+ of contractile responses in cerebral arteries. The increase in cytosolic Ca2+ concentration is the key event leading both to maintenance of basal cerebrovascular tone and to contraction of cerebral arteries in response to depolarization and agonist-receptor interaction. Such an increase results from increased transmembrane influx of Ca2+ through L-type Ca2+ channels, as well as from the release of Ca2+ from intracellular Ca2+ stores. Ca2+ entry modulators (dihydropyridines, phenylalkylamines, benzothiazepines, and diphenylpiperazines) bind to allosterically coupled sites in the Ca2+ channel, thus inhibiting (Ca2+ entry blockers) or stimulating (Ca2+ entry activators) Ca2+ influx and, therefore, contractile responses of the cerebral arteries. In vivo, Ca2+ entry blockers increase pial vascular caliber and cerebral blood flow by their direct action on the cerebroarterial wall. However, such an action also takes place on several peripheral vascular beds, which leads to hypotension. Therefore, the brain cannot be considered a "privileged" organ when the vasodilatatory action of Ca2+ entry blockers is considered. Since increased cytosolic Ca2+ concentration (and, therefore, activation of Ca2+ channels) plays a crucial role in the pathogenesis of ischemic brain damage (e.g., acute stroke and subarachnoid hemorrhage), Ca2+ entry blockers could be useful cytoprotective drugs. However, with the exception of nimodipine in the management of subarachnoid hemorrhage, clinical trials have yielded results that are not so promising as one could expect from those obtained in experimental research.

Innervation of cerebral arteries by nerves containing 5-hydroxytryptamine and noradrenaline

Noradrenaline (NA)-containing nerves, mainly originating in the sympathetic superior cervical ganglia, supply large and small cerebral arteries. In large cerebral arteries, nerves containing serotonin (5-hydroxytryptamine, 5-HT) may represent neuronal uptake of circulating 5-HT by sympathetic nerves. 5-HT-containing nerves supplying small pial vessels probably have a central origin in the dorsal raphe nucleus. In most species, NA is a weak vasoconstrictor (alpha 1- or alpha 2-adrenoceptors), while 5-HT is a potent vasoconstrictor (5-HT2 or 5-HT1-like receptors) of large cerebral arteries. In contrast, both NA and 5-HT tend to cause vasodilatation in small pial vessels and arterioles. Adrenergic and serotonergic transmission can be modulated by pH, a range of putative neurotransmitters and neuromodulators, and by the endothelium. Sumatriptan, a 5-HT1-like receptor agonist, has been shown to be effective in the treatment of migraine. Changes in NA- or 5-HT-containing nerves and/or in the responses of cerebral vessels to NA and 5-HT have been observed in a variety of vascular disorders, including cerebral vasospasm following subarachnoid haemorrhage, hypertension, and atherosclerosis.

Contraction of the sheep middle cerebral, pulmonary and coronary arteries initiated by release of intracellular calcium

The aim of the study was to compare contraction initiated by intracellular Ca2+ release in the middle cerebral, coronary and pulmonary arteries of the sheep. With all three arteries from the sheep, incubation in Ca(2+)-free physiological salt solution (PSS) reduced agonist-induced contraction much more than occurred with the rabbit aorta. The intracellular Ca2+ store appeared to be of limited capacity, since contraction was transient in Ca(2+)-free conditions with most agonists. In the middle cerebral artery, contraction in Ca(2+)-free conditions was much reduced if a previous contraction had been obtained (for 5-hydroxytryptamine, 5-HT, from 11 +/- 4 to 1 +/- 0.5% of control contraction in 2.5 mM Ca2+), suggesting that the previous contraction had partly discharged the intracellular Ca2+ store. Contraction was less affected in the pulmonary artery and almost unaffected in the coronary artery (for 5-HT, from 15 +/- 1 to 11 +/- 1%) by a previous contraction in Ca(2+)-free conditions. Rings prepared from small branches of the pulmonary and coronary arteries were affected by Ca2+ deprivation in a similar manner to large diameter pulmonary and coronary artery rings. In Ca(2+)-free PSS, contraction induced by prostaglandin E2 was almost eliminated (3 +/- 1% of control contraction in 2.5 mM Ca2+), contractions induced by 5-HT and noradrenaline were reduced, and contraction induced by the thromboxane mimetic U46619 was least affected (up to 73 +/- 8%). Increasing agonist concentration from EC50 to the maximally effective concentration raised the percentage contraction remaining in the middle cerebral artery (for noradrenaline from 7 +/- 2% to 12 +/- 3%) but not in the pulmonary artery (for noradrenaline from 22 +/- 2% to 24 +/- 6%). The present study has revealed notable differences, in coupling to intracellular Ca2+ release between the three vascular territories studied.

Changes in the cerebrovascular effects of endothelin-1 and nicardipine after experimental subarachnoid hemorrhage

The role of endothelium-related factors in the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage (SAH) has gained interest since the discovery of endothelin-1 (ET-1). We have examined, before and after SAH, the responsiveness of the cerebrovascular bed of the goat to ET-1, the sources of Ca2+ in ET-1-induced responses, and the ability of the Ca2+ entry blocker nicardipine to counteract them. Before SAH, injection of ET-1 into the cerebral circulation increased cerebrovascular resistance, thereby producing dose-dependent reductions in cerebral blood flow (CBF), which were prevented by nicardipine. In isolated middle cerebral arteries, ET-1 induced concentration-dependent contractions, which were equally inhibited in Ca(2+)-free medium (without or with ethylene glycol tetraacetic acid) and by the Ca2+ entry blocker nicardipine. On the third day after SAH, CBF was reduced by 28% and cerebrovascular resistance increased by 39%. At the same time, both ET-1-induced reductions in CBF and the constricting effects of ET-1 in vitro were enhanced. The ability of nicardipine to increase CBF and to inhibit the effects of ET-1 was impaired as a result of reduced dependence of cerebral arteries on extracellular Ca2+. On the seventh day after SAH, CBF and cerebrovascular resistance returned to control values, and effects of ET-1 became normal. It is suggested that the hyperreactivity to ET-1 of the cerebrovascular bed induced by SAH could have a role in the development of vasospasm, which could reduce the vascular effects of Ca2+ entry blockers after SAH.

Different effects of L-, N- and T-type calcium channel blockers on striatal dopamine release measured by microdialysis in freely moving rats

Using a microdialysis method, we have investigated effects of the voltage-dependent calcium channel blockers, verapamil, nicardipine, omega-conotoxin and flunarizine on the dopamine release and metabolism in the striatum of freely moving rat. Perfusion of verapamil (1-300 microM) and nicardipine (1-100 microM), an L-type calcium channel blocker, into the striatum through the dialysis membrane showed a dose-dependent decrease of dopamine release in the dialysate and slight increase of 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) levels. Treatment of omega-conotoxin (0.1, 1 microM), an N-type channel blocker, decreased about 50% basal dopamine release and slightly decreased DOPAC and HVA levels. Treatment with flunarizine (10 microM), an T-type channel blocker, did not affect the dopamine release and metabolism. From these data, it appears that treatments of the L- and N-type voltage-dependent calcium channel blockers in rat striatum suppress basal dopamine release, but T-type blocker does not suppress it, suggesting that L-, N- and T-type calcium channels regulate in vivo dopamine release in a different mechanism.

Comparison of the contractile effects of endothelin-1 and sarafotoxin S6b in goat isolated cerebral arteries

1. The effects of endothelium-derived endothelin-1 and snake venom-derived sarafotoxin S6b, peptides with striking structural and functional similarities, were examined and compared in isolated middle cerebral arteries of goats. 2. Endothelin-1 and sarafotoxin S6b contracted cerebral arteries in a concentration-dependent manner. The potency of endothelin-1 (EC50 = 4.9 (3.9-6.2) x 10(-10) M) was about ten times higher than that of sarafotoxin S6b (EC50 = 5.5 (4.4-6.9) x 10(-9) M). The tension returned to basal values after repeated washings and contraction with endothelin-1 could be reproduced. Endothelin-1 and sarafotoxin S6b induced further contraction in arteries precontracted with prostaglandin F2 alpha (10(-5) M). 3. Mechanical removal of the endothelium or incubation with indomethacin (10(-5) M) displaced the concentration-response curves to endothelin-1 and, more pronouncedly, to sarafotoxin S6b to the left. The maximum response to sarafotoxin S6b was also increased by either of these two treatments. 4. Incubation in 'nominally' Ca(2+)-free medium attenuated the vasoconstrictor response to endothelin-1 but not to sarafotoxin S6b, which was inhibited after incubation in Ca(2+)-free medium to which EGTA (10(-4) M) had been added. Pretreatment with caffeine (2 x 10(-2) M) in Ca(2+)-free medium abolished responses to endothelin-1 and sarafotoxin S6b. 5. Bay K 8644 (10(-10) M, 10(-8) M) enhanced and nicardipine (10(-10) M, 10(-8) M) inhibited in a concentration-dependent manner vasoconstrictor response to endothelin-1. Response to sarafotoxin S6b was only affected by 10(-8) M Bay K 8644 or nicardipine.6. It is concluded that endothelin-1 and sarafotoxin S6b are potent vasoconstrictors of goat cerebral arteries, having direct effects on smooth muscle which are counteracted by the endothelium through the release of a vasodilatator substance, probably prostacyclin. Both endothelin-l and sarafotoxin S6b depend on extracellular Ca2+ and on intracellular, caffeine-sensitive Ca2+ stores to develop vasoconstriction.However, endothelin-l depends to a larger extent than sarafotoxin S6b on free extracellular Ca2+.

In vivo and in vitro effects of magnesium sulfate in the cerebrovascular bed of the goat

The effects of magnesium sulfate in the cerebrovascular bed were studied both in vivo, by measuring cerebral blood flow in conscious nonpregnant goats, and in vitro, by recording isometric tension in isolated goat middle cerebral arteries. Injections of increasing doses (10 to 300 mg) of magnesium sulfate directly into the cerebral circulation elicited transient and dose-dependent increases in cerebral blood flow and decreases in cerebral vascular resistance. Similar results were obtained when increasing doses (0.3 to 3 gm/15 min) of magnesium sulfate were infused intravenously, although the vasodilatations reached a stable plateau that remained when the infusions finished. Cumulative addition of magnesium sulfate (10(-5) to 3 x 10(-2) mol/L) did not change the isometric tension of isolated arterial segments at resting tone, but relaxed in a concentration-dependent manner the arterial segments preconstricted with 10(-5) mol/L prostaglandin F2 alpha. These results demonstrate that magnesium sulfate acts as a dilator in the cerebral circulation by acting directly on the cerebral arteries. This could explain, at least in part, its beneficial effects on preeclampsia-eclampsia.

Ca2+ entry blockers inhibit prostaglandin F2 alpha-induced cerebrovascular contractile responses in goats

We examined the effects of extracellular Ca2+ withdrawal and of Ca2+ entry blockers on goat cerebrovascular responses to prostaglandin F2 alpha (PGF2 alpha). We measured isometric tension in isolated middle cerebral arteries, and cerebral blood flow (CBF) in unanesthetized animals. PGF2 alpha produced concentration-dependent contractions of isolated arteries. The contractions were partially inhibited by incubation in Ca(2+)-free medium (by 63.1 +/- 1.8% without ethyleneglycol-bis-(beta-amino-ethylether)-N,N,N',N'-tetra-a cetate (EGTA), and by 82.4 +/- 3.7% with EGTA). The Ca2+ entry blockers inhibited PGF2 alpha-elicited contraction and relaxed PGF2 alpha-precontracted arteries (nicardipine, 91.4 +/- 9.8%; nimodipine, 73.1 +/- 2.0%; and verapamil, 50.5 +/- 4.5% relaxation of the active tone). Injection of PGF2 alpha into the cerebral circulation produced dose-dependent reductions in CBF (34.4 +/- 2.1% after 30 micrograms) which were inhibited during infusion of Ca2+ entry blockers (nicardipine 10 micrograms/min, 14.7 +/- 1.5%; nimodipine 10 micrograms/min, 13.6 +/- 1.3%; and verapamil 100 micrograms/min, 13.7 +/- 2.3% of flow reduction). We conclude that PGF2 alpha-elicited contraction of goat cerebral arteries is mainly mediated by extracellular Ca2+ influx through Ca2+ channels sensitive to Ca2+ entry blockers. The anticonstrictor effects of Ca2+ entry blockers observed in vitro are consistent with their inhibitory effect on the PGF2 alpha-induced CBF reductions.

Effects of endothelin-1 on the cerebrovascular bed of the goat

The aim of the present study was to analyze the effects of endothelin-1 (ET-1) in the cerebrovascular bed of the goat, the importance of endothelial integrity and the contribution of extracellular Ca2+ to these responses. We measured isometric tension and 45Ca2+ uptake in isolated middle cerebral arteries, and cerebral blood flow (CBF) in unanesthetized animals. ET-1 elicited concentration-dependent contractions which were potentiated in arteries without endothelium. Ca2(+)-free medium and nicardipine inhibited, and Bay K 8644 potentiated the ET-1-induced contractions. ET-1 enhanced 45Ca2+ uptake in isolated arteries. Injections of ET-1 directly into the cerebral circulation decreased CBF and increased cerebrovascular resistance in a dose-dependent manner. Infusion of nicardipine inhibited the ET-1-induced reductions in CBF. These results suggest that ET-1 reduces CBF of goats because of contraction of cerebral arteries by a direct action on smooth muscle, which is modulated by the endothelium and depends partially on the activation of Ca2+ influx through dihydropyridine-sensitive channels.