Postjunctional alpha 1- and alpha 2-adrenoceptors mediating contraction in isolated human groin arteries and veins

Dexmedetomidine as an Alternative Anesthetic Agent for Flap Surgery: An Intravital Evaluation in the Cremaster Muscle Flap

INTRODUCTION

Flap surgery is one of the most commonly used techniques of reconstructive surgery for effective repair of damaged tissue. Optimal anesthetic technique and anesthetic agent plays an important role in flap perfusion. This study aimed to evaluate the effects of dexmedetomidine infusion on the microcirculation in the cremaster muscle flap by direct in vivo monitoring.

MATERIALS AND METHODS

We randomly divided 9 Wistar albino rats into 3 groups. The rats in the control group underwent the surgical procedure (isolation of the cremaster muscle) alone; the rats in the experimental groups 1 and 2 received an infusion of dexmedetomidine (10 and 30 min) after the surgical procedure.

RESULTS

The means of vessel diameters, number of functional capillaries, and movements of leukocytes in all groups were evaluated using intravital microscopic examination. The diameters of the arterioles and venules of the cremaster muscle significantly increased in the dexmedetomidine groups. The number of functional capillaries was higher in the dexmedetomidine groups than in the control group. No difference was observed in the movements of leukocytes between the control and experimental groups. Dexmedetomidine significantly increased the diameters of the arterioles and venules of the cremaster flap and the number of functional capillaries.

CONCLUSION

On the basis of the effects of dexmedetomidine on microcirculation, we suggest that dexmedetomidine continue to be used as an anesthetic agent, and may be considered also for reconstructive procedures, particularly flap surgery.

Pharmacological normalization of circulation after acute brain death

BACKGROUND

Circulatory instability is a serious problem after brain death in organ donors. The hypotension is often counteracted with infusion of large amounts of crystalloid solutions, which may impair lung function leading to rejection of the lungs as donor organs. The aim was to show that the circulation can be normalized pharmacologically for 24 h in pigs after total removal of the brain and brainstem by decapitation (between C2 and C3).

METHODS

Twenty-four 40-kg pigs (n = 8 × 3) were included: non-decapitated, decapitated, and decapitated with pharmacological treatment. All animals got the same basal fluid supply and ventilation. The pharmacological treatment consisted of the neuronal monoamine reuptake blocker cocaine and low doses of noradrenaline and adrenaline. Desmopressin, triiodothyroxine, thyroxine and cortisol were also given.

RESULTS

After decapitation, a catecholamine storm occurred, with an increase of noradrenaline and adrenaline by a factor of 79 and 298, respectively. Thirty minutes later, the pigs were hypotensive. The median time to the aortic pressure that was less than 40 mmHg was 9:09 h (range 5:50 to 22:01). After 6 h, the concentration of thyroid hormones and cortisol was significantly reduced. With pharmacological treatment of decapitated animals, the aortic pressure, renal blood flow, creatinine, urine production, liver function and blood gases did not differ significantly from the non-decapitated control animals.

CONCLUSION

Pharmacological substitution of pituitary gland function, blockade of peripheral catecholamine neuronal reuptake and low doses of catecholamines normalize circulation in decapitated pigs throughout a 24-h observation period, whereas untreated decapitated pigs all develop severe circulatory collapse within 12 h.

Phenylpropanolamine constricts mouse and human blood vessels by preferentially activating alpha2-adrenoceptors

Phenylpropanolamine (dl-norephedrine) was one of the most widely used therapeutic agents to act on the sympathetic nervous system. Because of concerns regarding incidents of stroke, its use as a nasal decongestant was discontinued. Although considered an alpha1-adrenergic agonist, the vascular adrenergic pharmacology of phenylpropanolamine was not fully characterized. Unlike most other circulations, the vasculature of the nasal mucosa is highly enriched with constrictor alpha2-adrenoceptors. Therefore, experiments were performed to determine whether phenylpropanolamine activates vascular alpha2-adrenoceptors. Mouse tail and mesenteric small arteries and human small dermal veins were isolated and analyzed in a perfusion myograph. The selective alpha1-adrenergic agonist phenylephrine caused constriction of tail and mesenteric arteries and human veins. The selective alpha2-adrenergic agonist UK14,304 [5-bromo-N-(4,5-dihydro-1H-imidazol-2-yl)-6-quinoxalinamine] caused constriction in tail arteries and in human veins, but not mesenteric arteries. The lack of constriction to UK14,304 was also observed in endothelium-denuded mesenteric arteries. Phenylpropanolamine constricted both types of artery but was 62-fold more potent in tail arteries. In mesenteric arteries, constriction to phenylpropanolamine was not affected by the selective alpha2-adrenergic antagonist, rauwolscine (10(-7) M) but was abolished by the selective alpha1-adrenergic antagonist, prazosin (3 x 10(-7) M). In contrast, constriction to phenylpropanolamine in tail arteries and in human veins was inhibited by rauwolscine but not prazosin. Therefore, phenylpropanolamine is a preferential alpha2-adrenergic agonist. At low concentrations, it constricts blood vessels that express functional alpha2-adrenoceptors, whereas at much higher concentrations, phenylpropanolamine also activates vascular alpha1-adrenoceptors. This action likely contributed to phenylpropanolamine's therapeutic activity, namely constriction of the nasal vasculature.

Orthostatic hypotension occurs following α2-adrenoceptor blockade in chronic prazosin-pretreated conscious spontaneously hypertensive rats

1. Studies were performed to evaluate whether chronic prazosin treatment alters the alpha 2-adrenoceptor function for orthostatic control of arterial blood pressure in conscious spontaneously hypertensive rats (SHR). 2. Conscious SHR (male 300-350 g) were subjected to 90 degrees head-up tilts for 60 s following acute administration of prazosin (0.1 mg kg-1 i.p.) or rauwolscine (3 mg kg-1 i.v.). Orthostatic hypotension was determined by the average decrease (%) in mean arterial pressure (MAP femoral) over the 60-s tilt period. The basal MAP of conscious SHR was reduced to a similar extent by prazosin (-23%(-)-26% MAP) and rauwolscine (-16%(-)-33% MAP). However, the head-up tilt induced orthostatic hypotension in the SHR treated with prazosin (-16% MAP, n = 6), but not in the SHR treated with rauwolscine (less than +2% MAP, n = 6). 3. Conscious SHR were treated for 4 days with prazosin at 2 mg kg-1 day-1 i.p. for chronic alpha 1-adrenoceptor blockade. MAP in conscious SHR after chronic prazosin treatment was 14% lower than in the untreated SHR (n = 8). Head-up tilts in these rats did not produce orthostatic hypotension when performed either prior to or after acute dosing of prazosin (0.1 mg kg-1 i.p.). Conversely, administration of rauwolscine (3 mg kg-1 i.v.) in chronic prazosin treated SHR decreased the basal MAP by 12-31% (n = 4), and subsequent tilts induced further drops of MAP by 19-23% in these rats. 4. The pressor responses and bradycardia to the alpha 1-agonist cirazoline (0.6 and 2 micrograms kg-1 i.v.), the alpha 2-agonist Abbott-53693 (1 and 3 micrograms kg-1 i.v.), and noradrenaline (0.1 and 1.0 micrograms kg-1 i.v.) were determined in conscious SHR with and without chronic prazosin pretreatment. Both the pressor and bradycardia effects of cirazoline were abolished in chronic prazosin treated SHR (n = 4) as compared to the untreated SHR (n = 4). On the other hand, the pressor effects of Abbott-53693 were similar in both groups of SHR, but the accompanying bradycardia was greater in SHR with chronic prazosin treatment than without such treatment. Furthermore, the bradycardia that accompanied the noradrenaline-induced pressor effect in SHR was similar with and without chronic prazosin treatment despite a 47-71% reduction of the pressor effect in chronic alpha 1-receptor blocked SHR.(ABSTRACT TRUNCATED AT 400 WORDS)

Effects of alpha-adrenoceptor active drugs, prostaglandin F2 alpha and vasopressin on cystic and hepatic arteries of pig and man

Human and pig cystic and pig hepatic arteries were suspended in tissue baths and the effect of alpha-adrenoceptor selective drugs, prostaglandin F2 alpha (PGF2 alpha) and vasopressin were investigated. Prazosin fulfilled the criteria for competitive antagonism in concentrations 10(-9)-10(-7) M. The pA2-values were 9.53 in human cystic, 9.74 in pig cystic, and 9.57 in pig hepatic artery. Rauwolscine had no significant effect in the different arteries. In human cystic artery noradrenaline had significantly (P less than 0.05) higher Emax and pEC50-values (135% of the preceding K(+)-induced contraction and 6.4, respectively) compared with pig cystic (106% and 5.7, respectively) and pig hepatic artery (116% and 5.9, respectively). Vasopressin had no effect in the cystic arteries, whereas it had a high potency (pEC50 was 8.5) but low intrinsic activity (Emax was 14%) in pig hepatic artery. Prostaglandin F2 alpha had a significantly higher Emax in human than in pig arteries. No differences were found in pEC50-values. This study indicates a similarity in pharmacological characteristics of some vasoactive drugs especially between pig cystic and hepatic arteries. If this is also true in man, the easily obtainable cystic artery can be used for screening the effect of drugs on the hepatic artery.

Responses to noradrenaline in human subcutaneous resistance arteries are mediated by both alpha 1- and alpha 2-adrenoceptors

1. In vitro experiments in a microvascular myograph were designed to characterize postjunctional alpha-adrenoceptors of human subcutaneous resistance arteries (normalised internal diameter 143-313 microns). 2. Both the alpha 1-selective agonist phenylephrine in the presence of 0.3 microM yohimbine and the alpha 2-selective agonist B-HT 933 in the presence of 0.3 microM prazosin elicited prominent and concentration-dependent contractions. The maximum response to phenylephrine and B-HT 933 was not different from the response to high K physiological salt solution (125 mM K+), and the pD2 values (-log EC50) were 5.90 and 6.11, respectively. 3. In the presence of the alpha 2-selective antagonist yohimbine (0.3 microM), the alpha 1-selective antagonist prazosin competitively antagonised the responses to phenylephrine; the pA2 of prazosin for the receptor which mediated the response to phenylephrine was 8.41. 4. Blockade of either alpha 2-adrenoceptors with 0.1 microM yohimbine or alpha 1-adrenoceptors with 0.1 microM prazosin caused shifts to the right of the noradrenaline concentration-response curves and the shifts in pD2 were 0.69 and 0.61, respectively. The combination of the two antagonists at the above-mentioned concentrations caused a marked, parallel shift to the right of the noradrenaline concentration-response curve, the shift of the pD2 was 2.68. 5. These results suggest that activation of both alpha 1- and alpha 2-adrenoceptors produces contractions in human subcutaneous resistance arteries, and that responses to noradrenaline in these vessels are mediated by both alpha-adrenoceptor subtypes.

Postjunctional alpha 2-adrenoceptors mediate vasoconstriction in human subcutaneous resistance vessels

1. In vitro studies have been performed on human medium-sized muscular arteries (internal diameter 1-4 mm) in a classical organ bath and with human subcutaneous resistance arteries (internal diameter 103-626 microns) in a microvascular myograph. 2. Although the medium-sized muscular arteries showed no response to either of the alpha 2-agonists B-HT 933 or UK 14304 in concentrations up to 10 microM, the subcutaneous resistance arteries from all regions examined showed well-pronounced and concentration-dependent responses to B-HT 933, the pD2 (-log EC50) being 5.11 +/- 0.09. 3. In the resistance arteries the alpha 2-antagonist yohimbine caused a parallel shift to the right of the B-HT 933 concentration-response curve; the yohimbine pA2 for the B-HT 933 receptor was 7.86 +/- 0.12. 4. There was an inverse relationship between the maximum response to B-HT 933 and the calibre of the resistance vessels. 5. These results indicate the presence of a postjunctional alpha 2-adrenoceptor in human subcutaneous resistance arteries and not in medium sized muscular arteries.

Theoretical and functional studies on alpha 1-and alpha 2-adrenoreceptors: an examination using the Schild plot

1 The influence on the shape of the Schild plot by a two-receptor system was studied in both functional and theoretical studies. In the functional studies, the alpha-adrenoreceptors in cat lingual arteries were studied since both alpha 1- and alpha 2-adrenoreceptors have been suggested to contribute to the noradrenaline-induced contractile response in this tissue. 2 The Schild plots constructed using noradrenaline (NA) as agonist and prazosin as antagonist gave a straight line with a slope close to unity. In contrast, the corresponding Schild plot constructed for rauwolscine appeared to be biphasic. 3 The results obtained in the functional study were discussed in view of Schild plots obtained from a theoretical model which was designed to take into consideration the presence of two distinct types of receptor, the percentile proportions of which could be altered. 4 The theoretical model indicates that the shape of the Schild plot can vary considerably depending on the relative contribution of each receptor subtype to the contractile response, the selectivity of the antagonist, and the range and number of antagonist concentrations used. 5 It is suggested that a response is predominantly mediated by alpha 1-adrenoreceptors and less by alpha 2-adrenoreceptors when the Schild plot for prazosin gives a slope close to unity and has a pA2-value representative for alpha 1-adrenoreceptors, and rauwolscine gives a slope less than unity and a significant shift of the NA concentration-response curve in concentrations around 10(-8) M. When the reverse is true (but with a significant shift caused by prazosin already at a concentration around 10(-9) M) the contraction elicited by NA is proposed to be predominantly mediated by alpha 2-adrenoreceptors and less by alpha 1-adrenoreceptors.

Comparative effects of some calcium-channel blockers on human peripheral arteries and veins

We investigated the effects of five different calcium-channel blockers (CCBs), verapamil, nifedipine, diltiazem, flunarizine and lidoflazine, on contractions evoked in vitro by noradrenaline (NA) in small human arteries and veins from the epigastric region. Vessels were obtained from patients without obvious vascular diseases undergoing surgery because of inguinal hernias. The human superficial epigastric artery has previously been shown to contain mainly alpha 1-adrenoceptors, whereas in the vein alpha 2-adrenoceptors predominate. In experiments where NA (10(-5) M) was added non-cumulatively, it was found that nifedipine was the most potent relaxant agent in both arteries and veins, but that this drug showed no preference for any type of vessel. In contrast verapamil (10(-6) M) and (10(-5) M) diltiazem, flunarizine and lidoflazine inhibited the NA-induced contractions to a significantly greater extent in the arteries than in the veins. Comparison between diltiazem and nifedipine on contractions induced by cumulative addition to NA showed that both drugs had significantly more depressive effects on arteries than on veins if the vessels were contracted by relatively high concentrations of NA (10(-6) and 10(-5) M). The results thus confirm the clinical finding that CCBs have more pronounced effects on the arterial than on the venous side of the circulation. They do not support the view that CCBs are more effective inhibitors of alpha 2- than alpha 1-adrenoceptor mediated contraction in isolated human blood vessels.

Postjunctional alpha-adrenoceptors in human superficial epigastric arteries and veins

A pharmacological characterization of the postjunctional alpha-adrenoceptors in human superficial epigastric artery and vein was performed, using several alpha-adrenoceptor subtype selective agonists, and the antagonists prazosin (alpha 1) and rauwolscine (alpha 2). In the arteries prazosin fulfilled the criteria for a competitive antagonism in concentrations 10(-9)-10(-7) M, giving a pA2-value of 9.17 in the Schild plot. Rauwolscine in concentrations 10(-8)-10(-6) M caused less pronounced but significant dextral shifts of the noradrenaline (NA) concentration-response curves. In the veins rauwolscine behaved like a competitive antagonist (10(-8)-10(-7) M). The pA2-value was 9.16. Prazosin 10(-9) M displaced the NA concentration-response curve, but higher concentrations (10(-8) and 10(-7) M) caused no further displacement. Prazosin reduced the Emax-values in the veins. In the arteries the rank order of potency for the agonists was: cirazoline (alpha 1) greater than NA greater than naphazoline (alpha 2) greater than guanfacine (alpha 2) greater than phenylephrine (alpha 1). The intrinsic activities of clonidine (alpha 2), ST 587 (alpha 1), B-HT 920 (alpha 2) and B-HT 933 (alpha 2) were too low to allow meaningful comparisons to be made. The rank order of potency in the veins was: NA greater than clonidine (alpha 2) greater than naphazoline (alpha 2) greater than guanfacine (alpha 2) greater than phenylephrine (alpha 1) greater than B-HT 920 (alpha 2) greater than cirazoline (alpha 1) greater than B-HT 933 (alpha 2). The intrinsic activity of ST 587 was low.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of adrenoceptor mechanisms in isolated guinea-pig uterine arteries

The adrenoceptors of the guinea-pig uterine artery were characterized pharmacologically. Circular segments of the artery, approximately 2 mm long, and with an external diameter of 250 micron, were mounted in miniaturized tissue baths. Noradrenaline, methoxamine and phenylephrine (concentrations ranging from 10 nM to 1 mM), in the presence of propranolol (0.1 microM) and cocaine (1 microM), induced concentration-dependent contractions of the arterial segments. Clonidine (10 nM to 0.1 mM) was less effective in producing contraction of the vessel. Prazosin (10 nM to 1 microM) antagonized noradrenaline-induced contractions; its pA2 was 7.68. Rauwolscine (10 nM to 1 microM) had no effect on noradrenaline-induced contractions. Isoprenaline (10 nM to 0.1 mM) in the presence of prazosin (1 microM) and cocaine (1 microM) had no relaxant effect on arteries contracted submaximally by prostaglandin F2 alpha (5 microM). Cocaine or normetanephrine treatment did not influence the noradrenaline-induced contractions. It is concluded that in guinea-pig uterine arteries, amine-induced contractions are mediated predominantly by alpha 1-adrenoceptors and that in this arterial preparation, relaxant beta-adrenoceptor effects and neuronal or extraneuronal uptake are of minor if any importance.

Postsynaptic alpha 1- and alpha 2-adrenergic receptors in adrenergic control of capacitance vessel tone in vivo

The involvement of postsynaptic alpha 2-adrenergic receptors in the adrenergic constriction of the capacitance vessels was studied in anesthetized, spontaneously breathing dogs under ganglionic blockade (hexamethonium, 10 mg/kg + 10 mg/kg/hr; methylatropine, 0.5 mg/kg). Effective vascular compliance was measured as an indicator of venous tone (blood volume was varied by +/- 4 ml/kg in an 11-minute cycle of infusion, withdrawal, withdrawal, and reinfusion) and was calculated from the correlation between the observed changes in central venous pressure and the changes in blood volume. Sympathetic activity and central venous pressure were lower and effective vascular compliance was higher than values in untreated conscious dogs. The alpha 2-agonist UK 14,304 (5-bromo-6-[imidazolin-2-ylamino]-quinoxaline; 0.04 and 0.12 micrograms/kg/min; n = 6) dose-dependently lowered compliance and increased central venous pressure to levels found in conscious dogs, as did the alpha 1-agonist methoxamine (10 and 30 micrograms/kg; n = 6). Rauwolscine (alpha 2-antagonist), 0.3 mg/kg, significantly attenuated the effects of UK 14,304, but not those of methoxamine, while prazosin (alpha 1-antagonist), 0.12 mg/kg, attenuated the effects of methoxamine, but not those of UK 14,304 (n = 6 each). Under beta-blockade (nadolol, 2 mg/kg; n = 12) venous tone was increased to about physiological levels by norepinephrine, 0.15 micrograms/kg/min i.v., or by neuronal norepinephrine release induced by tyramine, 10 micrograms/kg/min i.v. These increases were significantly attenuated by prazosin as well as by rauwolscine and were abolished by a combination of both. These results indicate that postsynaptic alpha 2-adrenergic receptors (in addition to alpha 1-adrenergic receptors) are functional in the venous system in vivo and contribute substantially to adrenergic sympathetic and humoral regulation of venous tone.

Contractile effects of noradrenaline and 5-hydroxytryptamine in human hand veins: a pharmacological receptor characterization

The postjunctional receptors mediating contractile responses to noradrenaline (NA) and 5-hydroxytryptamine (5-HT) were characterized in ring segments of human hand veins by using subtype selective agonists and antagonists. The mechanical characteristics of the preparations were also examined by length-tension measurements. The length-active wall tension curve was bell-shaped and reached a maximum at a length corresponding to a passive distending pressure of approximately 14 mmHg. (-)-Phenylephrine consistently contracted the veins and was 24 times less potent than (+/-)-NA whereas clonidine produced a contraction in only two out of 11 vessel segments. Neither prazosin nor rauwolscine competitively inhibited the contractile response to NA, and large inter-individual differences were found in the degree of inhibition produced by the antagonists. However, application of both prazosin and rauwolscine almost abolished the NA-induced contraction. Ketanserin and methergoline inhibited the contractile response to 5-HT; the former in an apparently competitive manner with a pA2 value of 8.94, whereas the latter substantially reduced the maximum 5-HT response. It is suggested that NA elicits contraction in human hand veins by acting at a mixed population of alpha 1- and alpha 2-adrenoreceptors. The contractile response to 5-HT, on the other hand, appears to be mediated predominantly by 5-HT2 receptors.

Effects of alpha-adrenoceptor subtype-selective antagonists on the human saphenous vein in vivo

The effects of the alpha-adrenoceptor subtype-selective antagonists prazosin (alpha 1) and yohimbine (alpha 2) on the saphenous vein of six healthy male subjects were investigated in vivo. The drugs were infused locally into the congested (40 mmHg), long saphenous vein constricted by simultaneous local infusion of noradrenaline (NA). Prazosin 10(-9) M (concentration in the infusion solution, infusion rate 0.3 ml min-1) did not reduce the NA-induced venoconstriction, but at a concentration of 10(-8) M there was a significant reduction; in two subjects no response to NA could be elicited in the presence of 10(-8) M prazosin. Prazosin 10(-7) M caused no further reduction of the NA effect compared to that produced by 10(-8) M in three of the subjects, whereas in one, prazosin 10(-9), 10(-8) and 10(-7) M caused a dose-dependent blockade. Yohimbine, 10(-9), 10(-8) and 10(-7) M caused a dose-dependent reduction of the NA-induced venoconstriction in all subjects. The results suggest that the human saphenous vein is endowed with functionally important populations of both alpha 2- and alpha 1-adrenoceptors.

Cellular mechanisms in the actions of antiglaucoma drugs

There are several classes of drugs currently in use for the therapeutic management of the glaucomas. Although the ocular hypotensive effects of these agents have been well characterized and described, little is known of their site of action and cellular mechanism. This review attempts to describe those cellular mechanisms that may be linked to the actions of several classes of antiglaucoma drugs. Special emphasis was placed on drug actions and 1) the adenylate cyclase system; 2) receptor-coupled phosphoinositide turnover; 3) prostaglandins and 4) ion transport processes. Models are presented depicting proposed cellular sites of the interaction of the antiglaucoma drugs with these cellular processes.