LRRK2 knockdown in zebrafish causes developmental defects, neuronal loss, and synuclein aggregation

Although mutations in the leucine-rich repeat kinase 2 (LRRK2) gene are the most common cause of genetic Parkinson's disease, their function is largely unknown. LRRK2 is pleiotropic in nature, shown to be involved in neurodegeneration and in more peripheral processes, including kidney functions, in rats and mice. Recent studies in zebrafish have shown conflicting evidence that removal of the LRRK2 WD40 domain may or may not affect dopaminergic neurons and/or locomotion. This study shows that ∼50% LRRK2 knockdown in zebrafish causes not only neuronal loss but also developmental perturbations such as axis curvature defects, ocular abnormalities, and edema in the eyes, lens, and otic vesicles. We further show that LRRK2 knockdown results in significant neuronal loss, including a reduction of dopaminergic neurons. Immunofluorescence demonstrates that endogenous LRRK2 is expressed in the lens, brain, heart, spinal cord, and kidney (pronephros), which mirror the LRRK2 morphant phenotypes observed. LRRK2 knockdown results further in the concomitant upregulation of β-synuclein, PARK13, and SOD1 and causes β-synuclein aggregation in the diencephalon, midbrain, hindbrain, and postoptic commissure. LRRK2 knockdown causes mislocalization of the Na(+) /K(+) ATPase protein in the pronephric ducts, suggesting that the edema might be linked to renal malfunction and that LRRK2 might be associated with pronephric duct epithelial cell differentiation. Combined, our study shows that LRRK2 has multifaceted roles in zebrafish and that zebrafish represent a complementary model to further our understanding of this central protein. © 2016 Wiley Periodicals, Inc.

Enhancement of noradrenergic neural transmission: an effective therapy of myasthenia gravis: a report on 52 consecutive patients

Neurochemical, neuroautonomic and neuropharmacological assessments carried out on all our myasthenia gravis (MG) patients showed that they presented a neural sympathetic deficit plus excessive adrenal-sympathetic activity. These abnormalities were registered during the basal (supine-resting) state, as well as after several stress tests (orthostasis, exercise, oral glucose and buspirone). In addition, MG patients showed increased levels of free-serotonin (f5HT) in the plasma, supposedly associated with the increased platelet aggregability which we found in all MG patients. As the above trio of neurochemical disorders (low noradrenergic-activity + high adrenergic-activity + increased f-5HT plasma levels) is known to favor Th-1 immunosuppression + Th-2 predominance, we outlined a neuropharmacological strategy for reverting the above neurochemical disorder. This treatment provoked sudden (acute), and late sustained improvements. Acute effects have been attributed to the increase of alpha-1 activity at the spinal motoneuron level. Late improvements always paralleled a significant normalization of immunological disorders. Complete normalization was registered only in non-thymectomized MG patients.

The possible role of one-electron reduction of aminochrome in the neurodegenerative process of the dopaminergic system

We present for discussion a possible molecular mechanism explaining the formation of reactive oxygen species involved in the neurodegenerative process of dopaminergic system in Parkinson's disease. This new hypothesis involves one-electron reduction of aminochrome to o-semiquinone radical, which seems to be the reaction responsible for neurodegenerative process of dopaminergic system. Leukoaminochrome o-semiquinone is extremely reactive with oxygen, which reoxidizes by reducing oxygen to superoxide radicals. Superoxide radicals enzymatically or spontaneously dismutate to dioxygen and hydrogen peroxide which is a precursor of hydroxyl radicals. ESR-experiments have showed that aminochrome o-semiquinone is extremely reactive in the presence of oxygen compared to dopamine o-semiquinone. In addition, the antioxidant enzymes superoxide dismutase and catalase play a prooxidant role by increasing the autoxidation rate and formation of superoxide radicals. One electron reduction of aminochrome to o-semiquinone can be performed by flavoenzymes which use NADPH and NADH as electron donator. The ability of aminochrome o-semiquinone to autoxidize in the presence of oxygen gives rise to a redox cycling process which will continue until oxygen, NADH and/or NADPH are depleted. Depletion of NADPH will prevent glutathione reductase from reducing glutathione, which is one of the main antioxidants in the cell. In addition depletion of NADH will prevent the formation of ATP in the electron transport chain in the mitochondria. Two antioxidants, probably, neuroprotective reactions are also discussed.

Glutathione transferase M2-2 catalyzes conjugation of dopamine and dopa o-quinones

Human glutathione transferase M2-2 prevents the formation of neurotoxic aminochrome and dopachrome by catalyzing the conjugation of dopamine and dopa o-quinone with glutathione. NMR analysis of dopamine and dopa o-quinone-glutathione conjugates revealed that the addition of glutathione was at C-5 to form 5-S-glutathionyl-dopamine and 5-S-glutathionyl-dopa, respectively. Both conjugates were found to be resistant to oxidation by biological oxidizing agents such as O(2), H(2)O(2), and O(*-)(2), and the glutathione transferase-catalyzed reaction can therefore serve a neuroprotective antioxidant function.

Effects of buspirone on plasma neurotransmitters in healthy subjects

Buspirone is an anxiolytic drug which exerts several central effects. It antagonizes presynaptic inhibitory DA2 autoreceptors at dopaminergic neurons and acts as an agonist for 5-HT1A inhibitor autoreceptors at serotonergic cells. Thus, buspirone respectively enhances and depresses the firing rates of both type of neurons. At doses which correlate with dopaminergic stimulation, but not 5-HT inhibition, buspirone also increases the firing rates of the central noradrenergic cells. We measured levels of circulating neurotransmitters before and up to 240 minutes after the oral administration of 20 mg of buspirone in 32 healthy volunteers. Buspirone significantly increased levels of noradrenaline, dopamine, and free serotonin but did not affect levels of adrenaline, tryptophane, or platelet serotonin. Small but significant drops in systolic blood pressure and heart rate were observed after buspirone ingestion. Atropine administration before buspirone ingestion annulled the free serotonin increase as well as systolic blood pressure-heart rate decrease. We found significant positive correlations between noradrenaline and dopamine levels. The strength and significance of these correlations were increased by using the noradrenaline/adrenaline ratio instead of noradrenaline absolute values. This finding indicates that increases in both noradrenaline and dopamine arise from sympathetic nerves rather than the adrenal glands. We also found significant negative correlations between free serotonin increases and systolic blood pressure-heart rate decreases. Our results indicate that buspirone stimulates central sympathetic activity. These acute effects of buspirone are reflected in an increased peripheral neural sympathetic activity, but not adrenal sympathetic activity in healthy individuals. In addition, buspirone increases free serotonin plasma concentrations and decreases systolic blood pressure plus heart rate levels through mechanisms associated with parasympathetic activation.

Glutathione transferases catalyse the detoxication of oxidized metabolites (o-quinones) of catecholamines and may serve as an antioxidant system preventing degenerative cellular processes

o-Quinones are physiological oxidation products of catecholamines that contribute to redox cycling, toxicity and apoptosis, i.e. the neurodegenerative processes underlying Parkinson's disease and schizophrenia. The present study shows that the cyclized o-quinones aminochrome, dopachrome, adrenochrome and noradrenochrome, derived from dopamine, dopa, adrenaline and noradrenaline respectively, are efficiently conjugated with glutathione in the presence of human glutathione transferase (GST) M2-2. The oxidation product of adrenaline, adrenochrome, is less active as a substrate for GST M2-2, and more efficiently conjugated by GST M1-1. Evidence for expression of GST M2-2 in substantia nigra of human brain was obtained by identification of the corresponding PCR product in a cDNA library. Glutathione conjugation of these quinones is a detoxication reaction that prevents redox cycling, thus indicating that GSTs have a cytoprotective role involving elimination of reactive chemical species originating from the oxidative metabolism of catecholamines. In particular, GST M2-2 has the capacity to provide protection relevant to the prevention of neurodegenerative diseases.

Human class Mu glutathione transferases, in particular isoenzyme M2-2, catalyze detoxication of the dopamine metabolite aminochrome

Human glutathione transferases (GSTs) were shown to catalyze the reductive glutathione conjugation of aminochrome (2, 3-dihydroindole-5,6-dione). The class Mu enzyme GST M2-2 displayed the highest specific activity (148 micromol/min/mg), whereas GSTs A1-1, A2-2, M1-1, M3-3, and P1-1 had markedly lower activities (<1 micromol/min/mg). The product of the conjugation, with a UV spectrum exhibiting absorption peaks at 277 and 295 nm, was 4-S-glutathionyl-5,6-dihydroxyindoline as determined by NMR spectroscopy. In contrast to reduced forms of aminochrome (leucoaminochrome and o-semiquinone), 4-S-glutathionyl-5, 6-dihydroxyindoline was stable in the presence of molecular oxygen, superoxide radicals, and hydrogen peroxide. However, the strongly oxidizing complex of Mn3+ and pyrophosphate oxidizes 4-S-glutathionyl-5,6-dihydroxyindoline to 4-S-glutathionylaminochrome, a new quinone derivative with an absorption peak at 620 nm. GST M2-2 (and to a lower degree, GST M1-1) prevents the formation of reactive oxygen species linked to one-electron reduction of aminochrome catalyzed by NADPH-cytochrome P450 reductase. The results suggest that the reductive conjugation of aminochrome catalyzed by GSTs, in particular GST M2-2, is an important cellular antioxidant activity preventing the formation of o-semiquinone and thereby the generation of reactive oxygen species.

[Risk factors for gallbladder cancer in Chilean females]

A case-control study of gallbladder cancer was conducted with 90 Chilean cases registered at one hospital in Santiago city, Chile from January, 1992 to August, 1994. Controls were selected among outpatients of the hospital who received abdominal echography. Each case was assigned 2 age- and sex-matched controls; either with or without gallstone(s). Study subjects were all directly interviewed by well-trained medical students. The present study focused on 74 female pairs and the following findings were obtained: 1) Odds Ratio(OR)s were significantly high for education years less than or equal to 6, body mass index greater than or equal to 24.0, constipation, and consumption of egg, fried meals, green and red chili. Chili pepper consumption of both types in cases showed significantly elevated risks with higher frequency. 2) While high ORs were observed, biliary symptoms such as dyspepsia and past history of cholelithiasis were strongly involved with present gallstone(s) and may not be independent factors for gallbladder cancer. 3) Significantly low ORs were seen for past history of intestinal parasitosis and surgical operation, hormone therapy, all industrial workers and workers in clothes & textile industry. However results may be influenced by more years of education or recall bias. 4) When a conditional logistic model was applied and controls with gallstone(s) were taken as reference, those with the habit of constipation showed a significantly high risk of 2.10 (95% CI: 1.01-4.38), and the consumers of red chili with a frequency > or = 1 time/day had elevated risks of 2.16 (1.27-3.66) vs those < 1 time/day and 4.66 (1.63-13.40) vs non-consumers, respectively. From the above results, the occurrence of gallbladder cancer in Chilean females may be related to constipation and chili pepper consumption, based on the presence of gallstone(s). Further investigations are needed to elucidate whether these are actual risk factors or whether only a false association was detected.

Plasma neurotransmitters, blood pressure and heart rate during supine resting, orthostasis and moderate exercise in severely ill patients: a model of failing to cope with stress

BACKGROUND

Previous clinical research has shown that severely ill (somatic) as well as many psychosomatic patients show raised noradrenaline (NA), adrenaline (AD), cortisol, free serotonin (f5HT) and platelet aggregability. Conversely, they show reduced NA/AD plasma ratio and platelet serotonin (p5HT). They also show adrenal hyperresponsiveness to an oral glucose load. These findings are opposed to those observed in depressed patients who show adrenal gland sympathetic hyporesponsiveness and neural sympathetic hyperactivity.

OBJECTIVE

To investigate adrenal gland and neural sympathetic systems as well as the other parameters in nondrepressed severely ill patients through the orthostasis exercise stress test which in normals triggers NA but no AD rise.

METHODS

We investigated 35 severely ill patients and their age- and sex-paired controls. Systolic, diastolic pulse pressure (PP), heart rate and neuroendocrine parameters were measured supine (0 min), at orthostasis (1 min) and exercise (5 min). A second test was performed 2 weeks later, after atropine injection. Multivariate analysis of variance, paired t test and Pearson product-moment test were employed.

RESULTS

The normal PP orthostasis fall was not observed in patients. At this period, an abnormal AD peak substituted the normal NA peak. The normal p5HT-f5HT orthostasis-exercise peaks were absent in patients. Cortisol and platelet aggregability were raised in patients.

CONCLUSIONS

Severely ill (somatic) patients responded to the orthostasis-exercise stress test with adrenal and corticosuprarenal but not neural sympathetic activity. They did not show the normal parasympathetic activity at orthostasis. This adrenal gland sympathetic hyperactivity registered in somatic patients is similar to that observed in mammals which fail to cope with stress and contrary to the profile registered in depressed subjects who show NA but not AD rise.

Effects of superoxide dismutase and catalase during reduction of adrenochrome by DT-diaphorase and NADPH-cytochrome P450 reductase

NADPH-cytochrome1 P450 reductase and DT-diaphorase catalyze and one- and two-electron reduction of adrenochrome to its o-semiquinone and o-hydroquinone, respectively. Under aerobic conditions both adrenochrome o-semiquinone and o-hydroquinone proved to be unstable, undergoing autoxidation with concomitant oxygen consumption and continuous NADPH and NADH oxidation. Molecular oxygen was found to play a predominant role in autoxidation of o-semiquinone during reduction of adrenochrome catalyzed by NADPH-cytochrome P450 reductase. In addition, molecular oxygen, in the presence of manganese, was found to be responsible for the majority of autoxidation of o-semiquinone. However, the role of superoxide radicals in the autoxidation of leucoadrenochrome during the reduction of adrenochrome by DT-diaphorase was found to be predominant. Catalase different significantly with respect to NADPH and NADH oxidation during reduction of adrenochrome catalyzed by NADPH-cytochrome P450 reductase and DT-diaphorase. Catalase increased NADPH oxidation slightly, while NADH oxidation was inhibited during reduction of adrenochrome by NADPH cytochrome P450 reductase and DT-diaphorase, respectively. The presence of manganese in the incubation mixture was found to increase the prooxidant role of catalase on autoxidation during one-electron reduction of aminochrome catalyzed by NADPH cytochrome P450 reductase. A marked difference in the inhibitory effect of superoxide dismutase on oxygen consumption during adrenochrome reduction catalyzed by NADPH-cytochrome P450 reductase and DT-diaphorase was also observed. A possible mechanism for reduction of adrenochrome by NADPH-cytochrome P450 reductase and DT-diaphorase and a role for superoxide dismutase and catalase are proposed.

Superoxide dismutase and catalase enhance autoxidation during one-electron reduction of aminochrome by NADPH-cytochrome P-450 reductase

NADPH-cytochrome P-450 reductase catalyzes one-electron reduction of aminochrome to the corresponding ortho-semiquinone, which was found to be unstable as indicated by the occurrence of NADPH oxidation and oxygen consumption. The addition of superoxide dismutase and catalase, alone or together, to the incubation mixture, during reduction of aminochrome catalyzed by NADPH-cytochrome P-450 reductase, did not prevent the autoxidation of ortho-semiquinone, but instead they increased NADPH oxidation. These results contrast with the almost complete inhibition of autoxidation (NADH oxidation) of ortho-hydroquinone during reduction of aminochrome catalyzed by DT-diaphorase in the presence of both superoxide dismutase and catalase. However, the effect of superoxide dismutase and catalase on oxygen consumption was found to differ from the effect on NADH or NADPH oxidation, since these enzymes, alone or together, inhibited the oxygen consumption during the reduction of aminochrome catalyzed by both NADPH-cytochrome P-450 reductase and DT-diaphorase. These results support the proposed role of NADPH-cytochrome P-450 reductase in neurodegeneration as a consequence of activation of aminochrome to reactive oxygen species. In addition, they also support the protective and antioxidant role of DT-diaphorase, together with superoxide dismutase and catalase, by competing with NADPH-cytochrome P-450 reductase to reduce aminochrome to ortho-hydroquinone and prevent the formation of reactive oxygen species. A possible mechanism is proposed.

Superoxide dismutase and catalase prevent the formation of reactive oxygen species during reduction of cyclized dopa ortho-quinone by DT-diaphorase

Dopa was oxidized by Mn(3+)-pyrophosphate complex to the corresponding o-quinone, accompanied by the cyclization of the amino chain to form cyclized dopa ortho-quinone (cDoQ) with absorption maxima at wavelengths of 305 and 475 nm. The cyclization was found to proceed in a single step from DoQ to cDoQ without formation of cDoQH2 and oxygen consumption. DT-diaphorase catalyzes the reduction of cDoQ to the corresponding hydroquinone (cDoQH2), which was found to be unstable in the presence of oxygen. The autoxidation of the cDoQH2 was followed by recording the constant oxidation of NADH and oxygen consumption and reduction of cDoQ at a wavelength of 475 nm. It was found that three different oxidizing agents were involved in autoxidation of cDoQH2. The addition of DETAPAC resulted in a strong inhibition of NADH oxidation (65% inhibition) during the reduction of cDoQ by DT-diaphorase, suggesting that manganese was responsible for 65% of the autoxidation of cDoQH2. The addition of SOD to the incubation mixture resulted in the inhibition of NADH oxidation (79%) during the reduction of cDoQ by DT-diaphorase. In the presence of DETAPAC, the addition of SOD inhibited NADH oxidation during cDoQH2 autoxidation 75%, suggesting that superoxide radicals are responsible for 75% of the oxygen-dependent autoxidation. The remaining NADH oxidation, which was not inhibited by DETAPAC and SOD, was accompanied by a constant oxygen consumption, suggesting that this autoxidation of cDoQH2 proceeds by reducing oxygen to superoxide radical. The effect of SOD and catalase in the presence of DETAPAC was also studied. A nearly complete inhibition (90%) of oxygen consumption during the reduction of cDoQ by DT-diaphorase was observed when SOD alone or SOD and catalase were added to the incubation mixture containing DETAPAC. We conclude that SOD and catalase constitute a protective cellular system against formation of reactive oxygen species during reduction of cDoQ by DT-diaphorase.

The protective effect of superoxide dismutase and catalase against formation of reactive oxygen species during reduction of cyclized norepinephrine ortho-quinone by DT-diaphorase

Norepinephrine was oxidized by the Mn(3+)-pyrophosphate complex to the corresponding o-quinone at pH 6.5. Cyclized norepinephrine ortho-quinone showed an absorption maximum at 289 and 483 nm. No oxygen consumption was observed during oxidation of norepinephrine to o-quinone by Mn3+ and subsequent cyclization. The reduction of cyclized norepinephrine ortho-quinone to the corresponding hydroquinone was catalyzed by DT-diaphorase. However, the hydroquinone formed proved to be unstable in the presence of oxygen, since reduction of cyclized norepinephrine o-quinone by DT-diaphorase was accompanied by continuous oxidation of NADH and oxygen consumption. Addition of the chelator DETAPAC or SOD to the incubation mixture during reduction of cyclized norepinephrine ortho-quinone by DT-diaphorase strongly inhibited NADPH oxidation and oxygen consumption, suggesting that manganese and superoxide radicals were involved in hydroquinone autoxidation. Elimination of the effects of superoxide radicals, manganese and H2O2 on autoxidation of hydroquinone by addition of SOD, catalase and DETAPAC to the incubation mixture resulted in a 79% inhibition of NADH oxidation, suggesting that 21% of the autoxidation is oxygen-dependent. However, the effect of these additions on oxygen consumption was even more pronounced (93% inhibition).

Sodium nitroprusside (SNP) hypotension: intracranial pressure (ICP) and hemodynamics in pial arteriole in the rat

A detailed description is made of an acute closed cranial window method. The method is used for the study of cerebral pial microcirculation by intravital microscopy in the rat. Using these methods and techniques, the effects of systemic hypotension by SNP, i.v., on pial microvessel hemodynamics and on ICP were simultaneously measured and characterized under normophysiological conditions. The pH, PO2, PCO2 and temperature of the artificial cerebrospinal fluid (CSF) in the closed cranial window, intermittently measured, remained relatively constant, 30 to 60 min following the period of stabilization of the preparation. The infusion of SNP (6.2-35.0 micrograms/kg/min, 0.02% sol., i.v.) significantly decreased BP (52.1 +/- 13.4 mm Hg, mean +/- SD). From measurement of microvessels internal diameter (I. D.) and microhemodynamics, significant increases in pial arteriolar I.D. (from 35.4 +/- 10.1, microns, to 47.1 +/- 5.7, microns, mean and S.D., 33.0%) and estimated bulk flow (51.2%), occurred during the hypotension. The changes in hemodynamic parameter were predominantly in the arteriolar system. Only minimal changes in the venular diameter occurred during the SNP hypotension. The observed moderate (22.0%) increase in ICP during SNP hypotension in pentobarbital anesthetized rat correlates well with the microhemodynamic changes of the cerebral microcirculatory system.

Microvascular reactivity of the myopathic Syrian hamster cremaster muscle

The myopathic Syrian hamster is a genetic model of congestive heart failure that exhibits focal myocytolytic necrosis in both heart and skeletal muscle. Previous investigations of microvascular morphology in heart and skeletal muscle have shown severe arteriolar constrictions without fixed anatomical vessel lesions. This study tested the hypothesis that these constrictions indicate a hyperreactivity of the myopathic microvasculature in vivo and that the reactivity corresponds to the developmental course of myocyte pathology. The microcirculation of the cremaster muscle was studied in eight myopathic and six control hamsters in the active stage of necrosis (39-81 days of age) and five myopathic and six control hamsters in the later stage of muscle healing (150-213 days of age). The internal diameter of second order arterioles was measured during topically applied noradrenaline. The myopathic arterioles of the younger group constricted at significantly lower concentrations of noradrenaline (p less than 0.01) and constricted to 35-50% of their resting internal diameter over a narrower range of noradrenaline (p less than 0.01). This indicated both a reduced threshold to noradrenaline and an enhanced response to the agonist. Active myocytolytic necrosis was found in the contralateral cremaster muscle of each myopathic hamster. The older myopathic and control hamsters showed no significant differences in arteriolar responsiveness to applied noradrenaline and no active necrosis. These results indicate a relation between a hyperreactive microvasculature and active necrosis and a normal reacting microvasculature and diminished necrosis in the two phases of the disease. Thus a general correspondence between vascular responsiveness and myocyte pathology exists in this model of heart failure and muscular dystrophy.

Pressure effects on the flow behavior of sickle (HbSS) red cells in isolated (ex-vivo) microvascular system

The effect of varying arterial perfusion pressure (Pa) on flow behavior of human normal (HbAA) and sickle (HbSS) erythrocytes was evaluated in isolated rat mesoappendix vasculature. Red cell velocity (Vrbc) and wall shear rate in single arterioles (i.d. 20.4 +/- 4.5 Microns means and SD) were determined and total peripheral vascular resistance (PRU) calculated. The vasculature initially perfused with Ringer's solution was then perfused with red cells suspended (HCT 2%) in the same medium. At Pa of 100 mm Hg, oxy HbSS cells resulted in higher (50%) PRU and lower Vrbc (7.1 +/- 2.2 mm/sec) and wall shear rates (1800 +/- 490 sec-1) than those recorded with HbAA cells which show a more rapid microvascular passage, i.e., Vrbc (14.4 +/- 2.8 mm/sec) and wall shear rates (3810 +/- 360 sec-1). At the same Pa, partial deoxygenation (PO2 40 mm Hg) of HbSS cells caused marked (300%) increase in PRU, and decrease in Vrbc (3.2 +/- 0.9 mm/sec), and wall shear rates (820 +/- 440 sec-1). During stepwise decrement of Pa (100-30 mm Hg), PRU for oxy HbSS cells remains elevated but the overall trend is similar to that for HbAA cells and Ringer's perfusion. At Pa of 30 mm Hg, oxy HbSS cells caused some microvascular obstruction. In contrast, with decrement in Pa below 80 mm Hg partially deoxy HbSS cells resulted in progressive increase in PRU and drastic decrease in Vrbc, coupled with progressive capillary obstruction and stasis. An increased propensity of these cells to cause irreversible vasoocclusion is demonstrated when low-pressure conditions prevail.

Erythrocytes in sickle cell anemia are heterogeneous in their rheological and hemodynamic characteristics

To understand the contribution to the pathophysiology of sickle cell anemia of the different erythrocyte density types present in the blood of these patients, we have studied the viscosimetric and hemodynamic characteristics of four major classes of hemoglobin SS erythrocytes. We have isolated reticulocytes, discocytes, dense discocytes, and irreversibly sickled cells (fractions I-IV) on Percoll-Renografin density gradients. Bulk viscosity was studied in a coneplate viscosimeter and the hemodynamic studies were performed on the isolated, artificially perfused mesoappendix vasculature of the rat (Baez preparation). Bulk viscosity measurements at shear rates of 230 S-1 demonstrate that when the cells are oxygenated, fraction I (reticulocyte rich) has a higher viscosity than expected from its low intracellular hemoglobin concentration. The rest of the fractions exhibit moderate increases in bulk viscosity pari-passu with the corresponding increases in density (mean corpuscular hemoglobin concentration). When deoxygenated, all cell fractions nearly doubled their bulk viscosity and the deoxy-oxy differences remained constant. The Baez preparation renders a different picture: oxygenated fractions behave as predicted by the viscosimetric data, but, when deoxygenated, cell fractions exhibit dramatically increased peripheral resistance and the deoxy-oxy difference are directly proportional to cell density, thus, the largest increases were observed for fractions III and IV. The differences between the rheological and the hemodynamic measurements are most probably due to the different sensitivity of the two methods to the extent of intracellular polymerization. These results also demonstrate that the hitherto unrecognized fraction III cells (very dense discocytes that change shape very little on deoxygenation) are as detrimental to the microcirculation as the irreversibly sickled cell-rich fraction IV. They may, however, induce obstruction by a different mechanism. As the extent to which these fractions are populated by erythrocytes varies considerably from patient to patient, the distribution function of cell densities in each sickle cell anemia patient might have consequences for the type of pathophysiological events occurring in their microcirculation.

Some aspects of the pathophysiology of homozygous Hb CC erythrocytes

We have studied erythrocytes from homozygous CC patients in vitro and in perfused rat mesoappendix vasculature to answer some long-standing questions. By examination of wet whole blood preparations, and by comparing the cell distribution on isopycnic continuous density gradients of whole blood samples from a splenectomized CC patient with those from three intact CC patients, we have demonstrated the presence of a distinct crystal-containing band of cells that is present in the former, but totally absent from the latter. We conclude that Hb CC cells containing crystals circulate in Hb CC individuals, but in intact patients they are effectively removed by the spleen. By use of 31P nuclear magnetic resonance and viscosity measurements on cells, we have demonstrated that intracellular aggregation of hemoglobin C occurs on deoxygenation even when no crystal formation is detectable by morphological methods. These two observations are in apparent contradiction with the absence of clinical microcirculatory impairment found in both intact and splenectomized CC patients. The contradiction was resolved by rheological studies on isolated rat mesoappendix preparations and erythrocyte diameter measurements that lead to the conclusion that the hemorheological properties of CC cells in the microcirculation are nearly normal because their increased viscosity is offset by their smaller diameter and size.

Microvascular responses to norepinephrine and vasopressin during halothane anesthesia in the rat

This experiment was designed to determine the microvascular responses to the two known naturally occurring vasoconstrictors, norepinephrine (NE) and vasopressin, at known levels of central vasomotor activity before, during and after halothane anesthesia. The responses to topical application of NE and vasopressin were studied in the microvasculature of the mesentery and cremaster muscle, using microscopic methods. Neural (CNS) stimulation was accomplished through electrodes chronically implanted in vasoactive sites of the forebrain and midbrain. The increase in blood pressure in response to CNS stimulation was decreased during halothane anesthesia (32.4 +/- 5.4 per cent before and 24.7 +/- 6.1 per cent during; P less than 0.001). There was no significant change in the steady-state diameter of the microvasculature under study during or after halothane anesthesia. Marked abatement of arteriolar vasoconstriction in response to CNS stimulation was seen prior to halothane. However, the same target vessel showed increased constriction in response to topically applied NE (from 32.3 +/- 4.7 to 53.2 +/- 7.8 per cent; P less than 0.01) during halothane anesthesia. By contrast, the response to vasopressin decreased (from 42.4 +/- 5.7 to 1.0 +/- 6 per cent; P less than 0.001) with halothane. The precise mechanism(s) underlying the described hypersensitivity to NE and hyposensitivity to vasopressin in the same vascular structure during halothane anesthesia remains undetermined.

Central neural influence on precapillary microvessels and sphincter

The responses to central nervous system (CNS) stimulation of consecutive segments of arterioles down to the precapillary sphincter were measured in the mesoappendix and/or cremaster of nine male rats with indwelling electrodes. Under pentobarbital sodium anesthesia, vasoactive sites were stimulated at threshold for maximal constriction or lumen closure of the precapillary sphincter and/or immediately preceding precapillary arteriole (metarteriole). In all experiments, CNS stimulation induced blood pressure elevation and constriction of three consecutive segments of precapillary vessels and of the sphincter. A threefold increase in rate of vasomotion of precapillary sphincter and metarteriole was the rule, but this was noted infrequently in larger arterioles. In addition to an overall influence of the CNS on microcirculation, the data show a gradient of responses to stimulation, the slope of which is negatively related to the size of the vessels and sphincter, in both tissues studied. A complete lumen closure of the metarteriole and precapillary sphincter (when present) in response to CNS stimulation implies active participation in the regulation of local blood flow. No evidence was foun for central neural regulation of the precapillary sphincter independent of arteriolar control.

Pial microcirculation in subarachnoid hemorrhage

Microsurgical and microscopic methods were employed in guinea pigs to expose, observe, and measure response characteristics of cerebral cortical pial microvessels and microcirculation to traumatic and nontraumatic experimental subarachnoid hemorrhage. Bleeding produced by vascular micropuncture was associated with a 44.3% arteriolar constriction. Topical application of homologous blood alone produced a 33.2% vasoconstriction. Observed microcirculatory flow characteristics subsequent to such microvascular changes were consistent with those known to be associated with cerebral cortical infarction. These changes could be prevented or reversed by topical application of the alpha adrenergic blocker, phenoxybenzamine. Topical pretreatment with the beta adrenergic blocker, propranolol, prevented blood-induced spasm, but did not reverse such spasm once it had been established. A chemo-mechanical mechanism is suggested as underlying the vasoconstriction association with rupture of pial microvessels. It is thought that consideration of such microvascular characteristics, in conjunction with those known to be associated with larger intracranial vessels, adds to current knowledge of the pathophysiology of subarachnoid hemorrhage and may be extrapolated to bear future clinical import.

On the relationship of brain vasculature to production of neurological deficit and morphological changes following acute unilateral common carotid artery ligation in gerbils

The known susceptibility of the Mongolian gerbil to cerebral infarction following unilateral carotid artery ligation has been attributed in the past to the demonstrated absences of an anastomotic supply between the anterior and posterior cerebral circulations. In a study of 34 adult gerbils exposed to such a procedure, 11, or 33%, developed severe neurological sequelae and succumbed to the procedure in less than 30 hr, whereas 23 animals survived with only minor or transient neurological signs. All animals displayed the expected lack of an anastomosis between the anterior and posterior circulations, but in addition the animals which survived the procedure were found to have a prominent early cross-connection between the anterior cerebral arteries, whereas the animals which succumbed had no such connection. Neuropathological changes in susceptible animals were apparent as early as 3 and one-half hr after ligation and consisted of edema, initially perivascular and then intraneuronal, slowed by acute necrosis. A variety of other vascular anomalies was encountered. We conclude that the peculiar susceptibility of Mongolian gerbils to cerebral infarction following acute unilateral common carotid artery ligation is not related primarily to lack o adequate collaterals between the anterior and the anterior cerebral arteries, but to the degree of adequate adequacy of communication between the anterior cerebral arteries. The critical difference may be more one of degree, i.e. the point at which the medial branches of the anterior cerebral artery fust to become anazygos vessel, rather than an actual difference in the pattern of distribution of the anterior cerebral arteries. The presence of other variation in vascular supply in a relatively small series suggests that results of similar studies of infarction and response to treatment be interpreted with caution.

Reactivity of aorta and portal vein in germfree rats

The responsiveness of conventional and germfree rat aortas and portal veins to vasoactive agents were compared in vitro. The results indicate: (1) aortas and portal veins from germfree rats exhibit an attenuated reactivity to angiotensin, vasopressin and epinephrine but not to KC1; (2) the dose-response curves for epinephrine and the peptides were shifted to the right concomitant with a decrease in maximum contractile tension, and (3) CaC12 dose-response curves obtained on potassium-depolarized aorta were not different from one another, whereas those obtained on portal veins from germfree animals were shifted to the right with a concomitant decrease in maximum response. In addition, aortas and portal veins from germfree rats were found to exhibit a higher total Ca content (but not Mg or water) when compared to conventional animals.

Localization and measurement of microvascular and microcirculatory responses to venous pressure elevation in the rat

The effect of increase in regional draining venous pressure on the response of mesoappendix microvasculature and microcirculation was studied by direct microscopic methods <i>in vivo</i>. In 9 out of 21 experiments in pentobarbital anesthetized rats, elevation of ileo-colic vein pressure (13.0 ± 1.3 mm Hg; mean and SE) above resting levels (9.9 ± 2.2 mm Hg) resulted in persistent lumen expansion of small venular microvessels (18-68 <i>µ</i>m<i>, </i>i.d.) and evoked a vasoconstrictor response of consecutive segments of pre-capillary vessels and the sphincter. The vasoconstricor response was stimulus-dependent and reversible. The lumen reductions in percent for 9 arterioles (21.0 ± 4.37 <i>µ</i>m<i>, </i>i.d.) 9 metarterioles (9.3 ± 1.57 <i>µ</i>m<i>, </i>i.d.), and 5 precapillary sphincters (5.7 ± 1.23 <i>µ</i>m<i>, </i>i.d.) were: 17.9 ± 6.60, 43.6 ± 4.20, and 96.0 ± 3.81, respectively. In none of the experiments did the response propagate to larger arteriolar segments ( > 35–38 <i>µ</i>m, i.d.) in the tissue under observation. These microscopic studies confirmed the presence of a venous-pre-capillary and sphincter constrictor response in splanchnic vasculature in the rat.

Tone and reactivity of vascular smooth muscle in germfree rat mesentery

Microcirculatory observations and measurements were made by in vivo microscopy in 35 germfree and 26 conventional rats. The rate of vasomotor activity, "vasomotion," of precapillary arterioles was found markedly decreased in the germfree animals. All precapillary vessels in the germfree rats were markedly hyporeactive to the catecholamines, epinephrine and norepinephrine, as compared to similar vessels of conventional rats. The vessels in the germfree animals were also less responsive to vasopressin but not angiotensin. A greater lumen:wall ratio of primary arterioles, but not of secondary arterioles and metarterioles, found in germfree animals is related to change in vessel lumen alone without concomitant change in wall thickness. The germfree rat is characterized by possessing a hypotonic, catecholamine-refractory mesoappendix microvasculature.

Simultaneous measurements of radii and wall thickness of microvessels in the anesthetized rat

The purpose of this investigation was to measure the radius and wall thickness of small blood vessels in mesentery and striated (cremaster) muscle in the anesthestized rat. Using the method of image-splitting, the vessel images were sheared at magnifications of 3,OOOx and 6,500x on the video screen.

In the resting state, the mean lumen values for the thinnest portion of endothelial capillary were 4.1 ± 1.2µ (SD) in cremaster and 5.6 ± 1.3µ (SD) in mesentery. Lumen and total diameter were also greater at several levels of precapillary arterioles in mesentery than similar vessels in cremaster, suggesting that smaller vessel size in cremaster might be characteristic of this tissue. Vasoconstriction of up to 50% from resting state is associated with an increase in wall thickness and a decrease in lumen to wall ratio due to a disproportional decrease in radius (inner greater than outer radius). Similarly, an increase in vessel radius in a proportion 4 to 1 (inner greater than outer) was sustained up to about 60% of vasodilatation.

In 13 out of 14 vessels, little or no change in wall cross-sectional area occurred in the face of marked changes in lumen cross-sectional area (–95%,+205%). This strongly suggests that other modifications such as changes in length, swelling, or shrinkage would be relatively unimportant during dynamic changes in wall thickness.

Vascular smooth muscle: quantitation of cell thickness in the wall of arterioles in the living animal in situ

The wall of microarterial vessels, in the living animal in situ, was examined at magnification up to x 6500 on the television screen. The optical resolution af the cell components of the wall was sufficiently clear to permit image formation and splitting for permanent recording and quantitation. Thickness of single smooth muscle cells at rest was estimated to be 2.08 microns (S.D. +/- 0.24 micron) and 2.78 microns (S.D. +/- 0.59 micron) by two different approaches. Changes in cell thickness during activity were also recorded and quantitated.

Microvascular hypersensitivity subsequent to chemical denervation

Microscopic observation and micrometric measurements of microarterial vessels in the mesentery of the anesthetized rat, during chemical interference with the vasomotor nerve supply, showed (A) marked (average 25x) hypersensitization to epinephrine; (B) persistent vasoconstriction; and (C) depression or cessation of vasomotion. These and concomitant similar reactions of the precapillary sphincter resulted in relative ischemia and frequent reversal of blood flow through the endothelial capillary network. A comparable hypersensitization to epinephrine, observed in six isolated perfused microarterial vessels, upon shift in internal static pressure strongly suggests that the change in reactivity of the vascular smooth muscle cell seen in vivo might also be related to a local change in transmural pressure. The plot of the logarithm of epinephrine threshold concentration vs. the approximate circumferential wall tension (computed for selected in vivo and in vitro experiments neglecting wall thickness) showed a steep rise in vessel sensitivity occurring concomitantly with decrease in wall tension. Thus it appears that hypersensitization of microarterial muscle cells which develops during the hypotensive episode of acute chemical nerve blockade in the rat may be primarily related to a modification in wall tension.

Dibenzyline protection against shock and preservation of hepatic ferritin systems

Pretreatment with Dibenzyline, an adrenergic blocking agent, markedly increased the survival rate of normal, arenal or adrenalectomized rats subjected to drum trauma, and of normal rats subjected to prolonged hemorrhagic hypotension. In the latter a larger residual circulating blood volume was not responsible for the increased survival since average maximal blood loss was equal in treated and control rats. Congestion of the liver and gut, regularly seen in the controls, was notably absent in the Dibenzyline-protected rats. Direct microscopic observation of the terminal vascular bed in the mesoappendix, throughout the hemorrhagic procedure, revealed earlier appearance of decompensatory changes and increased vascular fragility in the controls. In livers removed at the end of the hemorrhagic and traumatic procedures, ferritin systems were preserved in treated rats, in contrast to their deterioration in controls. It is suggested that the protection conferred by pretreatment with Dibenzyline may not be due solely to its adrenergic blocking properties, but in part to a direct cellular action in the liver, exemplified by its in vitro protection of the ferritin systems against hypoxic damage.

Cellular sites of hepatic ferritin activation and inactivation

Studies with viable reticulo-endothelial (RE) and parenchymal cells separated from the liver show that the parenchymal cells contain most of the liver ferritin. This ferritin is vasoinert, and anaerobic incubation of the parenchymal cells does not release it in vasoactive form. Aerobic parenchymal cells readily inactivate exogenous vasoactive ferritin. Parenchymal cells isolated from the liver of normal rats subjected to traumatic shock contain vasoactive ferritin and have lost their ferritin inactivating capacity, whereas those from resistant rats subjected to the same trauma contain only vasoinert ferritin and are still able to inactivate added ferritin. On the other hand, RE cells contain smaller amounts of vasoinert ferritin but readily release it in vasoactive form on anaerobic incubation. RE cells are not able to inactivate exogenous ferritin. When a small amount of a vasoinert, clear extract, prepared from homogenized RE cells, is added to parenchymal cells during anaerobic incubation, the parenchymal cells release their ferritin in vasoactive form. The ‘activator’ obtained from the RE cells has not been identified.