Evaluation of sympathetic adrenergic branch of cutaneous neural control throughout thermography and its relationship to nitric oxide levels in patients with fibromyalgia.

BACKGROUND: Fibromyalgia syndrome is defined as a complex disease, characterized by chronic widespread musculoskeletal pain and other symptoms. The factors underlying physiopathology of fibromyalgia are not well understood, complicating its diagnosis and management. OBJECTIVES: To evaluate the peripheral vascular blood flow of the skin of the hands and the core body temperature as indirect measures of sympathetic adrenergic activity of the nervous system and its relationship to nitric oxide levels (NO) in women with fibromyalgia compared with healthy controls. METHODS: Forty-two women with fibromyalgia and 52 healthy women were enrolled in this observational pilot study. We used infrared thermography of the hands and an infrared dermal thermometer to evaluate the peripheral vascular blood flow and tympanic and axillary core body temperature, respectively. We measured NO levels using the ozone chemiluminescence-based method. RESULTS: Two-way analysis of covariance (ANCOVA) showed that the tympanic (P=0.002) and hand temperatures were significantly higher in the patients with fibromyalgia than in the controls (P≤0.001). Significant associations were also found between serum NO levels and minimum temperatures at the dorsal center of the dominant hand (ß=-3.501; 95% confidence interval [CI] -6.805, ­0.198; P= 0.038), maximum temperature (ß=-5.594; 95% CI ­10.106, ­1.081; P=0.016), minimum temperature (ß=-4.090; 95% CI ­7.905, ­0.275; P=0.036), and mean temperature (ß=-5.519; 95% CI ­9.933, ­1.106; P=0.015) of the center of the palm of the non-dominant hand, maximum temperature at the thenar eminence of the dominant hand (ß=-5.800; 95% CI ­10.508, ­1.092; P=0.017), and tympanic temperature (ß=-9.321; 95% CI ­17.974, ­0.669; P=0.035) in the controls. CONCLUSIONS: Our findings indicate that the women with fibromyalgia showed higher tympanic core body and hand temperature than the healthy controls. Moreover, there were negative associations between hand peripheral vasodilation and NO in the healthy women but not in those with fibromyalgia, suggesting a dysfunction of sympathetic cutaneous neural control.

Structural and microvascular changes of the peripapillary retinal nerve fiber layer in Von Hippel-Lindau disease: an OCT and OCT angiography study.

Von Hippel-Lindau (VHL) disease is an autosomal dominant genetic disease caused by VHL gene mutation. Retinal hemangioblastomas (RH) are vascularized tumors and represent the main ocular manifestation of the disease. Histopathologically, RH are composed of capillary vessels and stromal cells, the neoplastic population of the lesion. The origin of these stromal cells remains controversial, even if they are hypothesized to be glial cells. The aim of the present study was to investigate neuronal and microvascular changes of the peripapillary retinal nerve fiber layer, in which glial cells, neurons and capillaries (the radial peripapillary capillary plexus) interact. VHL patients with or without peripheral RH were enrolled and compared to healthy controls. Mean peripapillary retinal nerve fiber layer (pRNFL) thickness was measured by means of optical coherence tomography (OCT). The following vascular parameters of the radial peripapillary capillary plexus were quantified using OCT angiography: Vessel Area Density,Vessel Length Fraction, Vessel Diameter Index and Fractal Dimension. One hundred and nine eyes of 61 patients, and 56 eyes of 28 controls were consecutively studied. Mean pRNFL was significantly thinner in VHL eyes without RH versus eyes with RH and controls. Mean pRNFL thickness did not differ between VHL eyes with RH and controls. All OCTA vascular parameters were reduced in VHL eyes with or without RH versus controls, with significative difference for Vessel Diameter Index. The same OCTA parameters did not significantly differ between VHL eyes with or without RH. In VHL eyes without RH, pRNFL thinning may be the consequence of impaired perfusion of the radial peripapillary capillary plexus, while the increase of pRNFL thickness in VHL eyes with RH may depend on possible activation and proliferation of the other RNFL resident cells, the glial cells.

A novel method to quantify cutaneous vascular innervation.

INTRODUCTION: To develop a new method to quantify the density of nerves, vessels, and the neurovascular contacts, we studied skin biopsies in diabetes and control subjects. METHODS: Skin biopsies with dual immunofluorescent staining were used to visualize nerves and blood vessels. The density of nerves, vessels, and their neurovascular contacts were quantified with unbiased stereology. Results were compared with examination findings, validated questionnaires, and autonomic function. RESULTS: In tissue from 19 controls and 20 patients with diabetes, inter-rater and intra-rater intraclass correlation coefficients were high (>0.85; P < .001) for all quantitative methods. In diabetes, the nerve densities (P < .05), vessel densities (P < .01), and the neurovascular densities (P < .01) were lower compared with 20 controls. Results correlated with autonomic function, examination and symptom scores. DISCUSSION: We report an unbiased, stereological method to quantify the cutaneous nerve, vessel and neurovascular density and offer new avenues of investigation into cutaneous neurovascular innervation in health and disease.

Robust Increase in Supply by Vessel Dilation in Globally Coupled Microvasculature.

Neuronal activity induces changes in blood flow by locally dilating vessels in the brain microvasculature. How can the local dilation of a single vessel increase flow-based metabolite supply, given that flows are globally coupled within microvasculature? Solving the supply dynamics for rat brain microvasculature, we find one parameter regime to dominate physiologically. This regime allows for robust increase in supply independent of the position in the network, which we explain analytically. We show that local coupling of vessels promotes spatially correlated increased supply by dilation.

Glabrous and non-glabrous vascular responses to mild hypothermia.

This study examined cutaneous vasoconstriction to whole-body hypothermia, specifically contributions of neural and endothelial vasomotor responses in glabrous and non-glabrous skin. Eleven participants were semi-recumbent at an ambient temperature of 22 °C for 30 min, after which ambient temperature was decreased to 0 °C until rectal temperature (Tre) had decreased by 0.5 °C. Laser-Doppler fluxmetry was measured at the forehead and thigh for measures of glabrous and non-glabrous skin, respectively; wavelet analysis was performed on the laser-Doppler signal to determine endothelial and neural activities. Hypothermia took on average 97 ±â€¯7 min and caused marked decreases at glabrous (42 ±â€¯5%baseline, p < 0.001) and non-glabrous (69 ±â€¯4%baseline, p < 0.001) skin. In glabrous skin, neural activity increased from 11 ±â€¯1% at thermoneutral to 18 ±â€¯1% (p < 0.001). In non-glabrous skin there was an initial decrease (p = 0.001) in neural activity from 13 ±â€¯2% to 9 ±â€¯1% (-0.2 °C decrease in Tre) and then increased (p = 0.002) to 21 ±â€¯2% baseline at -0.5 °C Tre. Endothelial activity decreased in both glabrous (16 ±â€¯3% to 6 ±â€¯1%, p < 0.001) and non-glabrous (15 ±â€¯1% to 7 ±â€¯1%, p = 0.003) skin. Hypothermia elicits large decreases in skin blood flow in both glabrous and non-glabrous skin that are related to increases in neural activity and a reduction of endothelial activity.

Postsynaptic cutaneous vasodilation and sweating: influence of adiposity and hydration status.

INTRODUCTION: Obesity and hypohydration independently affect postsynaptic endothelial function, but it is unknown if hypohydration affects lean and obese individuals differently. PURPOSE: To examine the effect of hypohydration on postsynaptic cutaneous vasodilation and sweating in men with high and low adiposity (HI- and LO-BF, respectively). METHODS: Ten males with LO-BF and ten with HI-BF were instrumented for forearm microdialysis when euhydrated and hypohydrated. Changes in cutaneous vascular conductance (CVC) with intradermal infusion of sodium nitroprusside (SNP) and methacholine chloride (MCh) were assessed. Local sweat rate (LSR) was simultaneously assessed at the MCh site. At the end of the last dose, maximal CVC was elicited by delivering a maximal dose of SNP for 30 min to both sites with simultaneous local heating at the SNP site. The concentration of drug needed to elicit 50% of the maximal response (EC50) was compared between groups and hydration conditions. RESULTS: When euhydrated, EC50 of MCh-induced CVC was not different between LO- vs. HI-BF [- 3.04 ± 0.12 vs. - 2.98 ± 0.19 log (MCh) M, P = 0.841]. EC50 of SNP-induced CVC was higher in euhydrated HI- vs. LO-BF (- 1.74 ± 0.17 vs. - 2.13 ± 0.06 log (SNP) M, P = 0.034). Within each group, hydration status did not change MCh- or SNP-induced CVC (P > 0.05). LSR was not different between groups or hydration condition (P > 0.05). CONCLUSIONS: These data suggest reduced sensitivity of endothelium-independent vasodilation in individuals with high adiposity when euhydrated. However, hypohydration does not affect cutaneous vasodilation or local sweat rate differently between individuals with low or high adiposity.

Edward F. Adolph Distinguished Lecture: Skin-deep insights into vascular aging.

The skin is an accessible model circulation for studying vascular function and dysfunction across the lifespan. Age-related changes, as well as those associated with disease progression, often appear first in the cutaneous circulation. Furthermore, impaired vascular signaling and attendant endothelial dysfunction, the earliest indicators of cardiovascular pathogenesis, occur in a similar fashion across multiple tissue beds throughout the body, including the skin. Because microvascular dysfunction is a better predictor of long-term outcomes and adverse cardiovascular events than is large vessel disease, an understanding of age-associated changes in the control of the human cutaneous microcirculation is important. This review focuses on 1) the merits of using skin-specific methods and techniques to study vascular function, 2) microvascular changes in aged skin (in particular, the role of the endothelial-derived dilator nitric oxide), and 3) the impact of aging on heat-induced changes in skin vasodilation. While skin blood flow is controlled by multiple, often redundant, mechanisms, our laboratory has used a variety of distinct thermal provocations of this model circulation to isolate specific age-associated changes in vascular function. Skin-specific approaches and techniques, such as intradermal microdialysis coupled with laser-Doppler flowmetry (in vivo) and biochemical analyses of skin biopsy samples (in vitro), have allowed for the targeted pharmacodissection of the mechanistic pathways controlling skin vasoreactivity and study of the impact of aging and disease states. Aged skin has an attenuated ability to vasodilate in response to warm stimuli and to vasoconstrict in response to cold stimuli.

Impaired neurovascular reactivity in the microvasculature of pregnant women with preeclampsia.

INTRODUCTION: PE is associated with maternal vascular dysfunction, leading to serious cardiovascular risk both during and following pregnancy. OBJECTIVE: To assess microvascular reactivity in pregnant women with PE. METHODS: A cross-sectional study was performed in 36 pregnant women with PE and 36 normotensive pregnant women (C) in the third trimester. Skin microvascular blood flow was measured using LDF at rest (RF), during the maximum hyperemic response to brief arterial occlusion (MF) and during the sympathetically mediated constrictor response to deep IBH. RESULTS: In pregnant women with PE, RF was higher [C, 8.1 (4.6); PE, 12.0 (7.6), P<.001; PU perfusion units; median (IQR)] and MF/RF [C, 6.1 (3.7); PE, 3. 9 (4.9) P<.001] and peak CVC lower (P=.009) compared to normotensive controls. The constrictor response to IBH [C, 62.4% (27.9); PE, 33.0% (50.6), P=.008] was reduced in women with PE. In univariate analysis, MF/RF was associated with PE status (r=-.417, P=.0001), systolic (r=-.385, P=.001), and diastolic (r=-.388, P=.001) blood pressure, but not BMI (r=.077, P=.536). CONCLUSIONS: Women with PE are more than three times more likely to exhibit a reduced microvascular reactivity in the third trimester of pregnancy than normotensive pregnant controls. These differences may be attributable in part to an altered sympathetic neural microvascular tone in PE.

Treatment induced neuropathy of diabetes-Long term implications in type 1 diabetes.

AIMS/HYPOTHESIS: Aggressive glucose control can result in treatment induced neuropathy of diabetes (TIND) if glycemic control is achieved too quickly. The aim of the present study is to describe the 8-year follow-up data on a cohort of individuals with type 1 diabetes who developed TIND. METHODS: Twenty-six individuals with type 1 diabetes and TIND were followed longitudinally for 8years with regular quantitative measurement of pain, neurological examinations and evaluation of microvascular complications. Comprehensive neurological testing was performed after TIND and 7-8years later. RESULTS: Among the 26 individuals with TIND, 19/26 had stable glycemic control and 7/26 had unstable glycemic control in long-term follow up. Those 19/26 with stable glycemic control had improvement in neuropathy, pain and microvascular complications while the 7/26 with unstable glycemic control had significant worsening of neuropathy, pain and microvascular complications (P<0.01, all tests). CONCLUSION/INTERPRETATION: TIND is a poorly understood iatrogenic complication of aggressive glycemic control, although individuals with stable glycemic control tended to improve, while those with unstable glycemic control worsened. Additional studies of TIND are required to understand potential outcomes in an era of medical 'metrics' where physician reimbursement may be tied to achievement of excessively rapid glycemic control.

Quantitative 3D investigation of Neuronal network in mouse spinal cord model.

The investigation of the neuronal network in mouse spinal cord models represents the basis for the research on neurodegenerative diseases. In this framework, the quantitative analysis of the single elements in different districts is a crucial task. However, conventional 3D imaging techniques do not have enough spatial resolution and contrast to allow for a quantitative investigation of the neuronal network. Exploiting the high coherence and the high flux of synchrotron sources, X-ray Phase-Contrast multiscale-Tomography allows for the 3D investigation of the neuronal microanatomy without any aggressive sample preparation or sectioning. We investigated healthy-mouse neuronal architecture by imaging the 3D distribution of the neuronal-network with a spatial resolution of 640 nm. The high quality of the obtained images enables a quantitative study of the neuronal structure on a subject-by-subject basis. We developed and applied a spatial statistical analysis on the motor neurons to obtain quantitative information on their 3D arrangement in the healthy-mice spinal cord. Then, we compared the obtained results with a mouse model of multiple sclerosis. Our approach paves the way to the creation of a "database" for the characterization of the neuronal network main features for a comparative investigation of neurodegenerative diseases and therapies.

The reliability of a single protocol to determine endothelial, microvascular and autonomic functions in adolescents.

BACKGROUND: Impairments in macrovascular, microvascular and autonomic function are present in asymptomatic youths with clustered cardiovascular disease risk factors. This study determines the within-day reliability and between-day reliability of a single protocol to non-invasively assess these outcomes in adolescents. METHODS: Forty 12- to 15-year-old adolescents (20 boys) visited the laboratory in a fasted state on two occasions, approximately 1 week apart. One hour after a standardized cereal breakfast, macrovascular function was determined via flow-mediated dilation (FMD). Heart rate variability (root mean square of successive R-R intervals; RMSSD) was determined from the ECG-gated ultrasound images acquired during the FMD protocol prior to cuff occlusion. Microvascular function was simultaneously quantified as the peak (PRH) and total (TRH) hyperaemic response to occlusion in the cutaneous circulation of the forearm via laser Doppler imaging. To address within-day reliability, a subset of twenty adolescents (10 boys) repeated these measures 90 min afterwards on one occasion. RESULTS: The within-day typical error and between-day typical error expressed as a coefficient of variation of these outcomes are as follows: ratio-scaled FMD, 5·1% and 10·6%; allometrically scaled FMD, 4·4% and 9·4%; PRH, 11% and 13·3%; TRH, 29·9% and 23·1%; and RMSSD, 17·6% and 17·6%. The within- and between-day test-retest correlation coefficients for these outcomes were all significant (r > 0·54 for all). CONCLUSION: Macrovascular, microvascular and autonomic functions can be simultaneously and non-invasively determined in adolescents using a single protocol with an appropriate degree of reproducibility. Determining these outcomes may provide greater understanding of the progression of cardiovascular disease and aid early intervention.

Mechanisms and time course of menthol-induced cutaneous vasodilation.

Menthol is a vasoactive compound that is widely used in topical analgesic agents. Menthol induces cutaneous vasodilation, however the underlying mechanisms are unknown. Determining the rates of appearance and clearance of menthol in the skin is important for optimizing topical treatment formulation and dosing. The purpose of this study was to determine the mechanisms contributing to menthol-mediated cutaneous vasodilation and to establish a time course for menthol appearance/clearance in the skin. Ten young (23±1years, 5 males 5 females) subjects participated in two protocols. In study 1, four intradermal microdialysis fibers were perfused with increasing doses of menthol (0.1-500mM) and inhibitors for nitric oxide (NO), endothelium derived hyperpolarizing factors (EDHFs), and sensory nerves. Skin blood flow was measured with laser Doppler flowmetry and normalized to %CVCmax. In study 2, two intradermal microdialysis fibers were perfused with lactated Ringer's solution. 0.017mL·cm-2 of a 4% menthol gel was placed over each fiber. 5µL samples of dialysate from the microdialysis fibers were collected every 30min and analyzed for the presence of menthol with high performance gas chromatography/mass spectrometry. Skin blood flow (laser speckle contrast imaging) and subjective ratings of menthol sensation were simultaneously obtained with dialysate samples. In study 1, menthol induced cutaneous vasodilation at all doses ≥100mM (all p<0.05). However, inhibition of either NO, EDHFs, or sensory nerves fully inhibited menthol-mediated vasodilation (all p>0.05). In study 2, significant menthol was detected in dialysate 30min post menthol application (0.89ng, p=0.0002). Relative to baseline, cutaneous vasodilation was elevated from minutes 15-45 and ratings of menthol sensation were elevated from minute 5-60 post menthol application (all p<0.05). Menthol induces cutaneous vasodilation in the skin through multiple vasodilator pathways, including NO, EDHF, and sensory nerves. Topical menthol is detectable in the skin within 30min and is cleared by 60min. Skin blood flow and perceptual measures follow a similar time course as menthol appearance/clearance.

Nerve growth factor facilitates perivascular innervation in neovasculatures of mice.

It is well known that blood vessels including arterioles have a perivascular innervation. It is also widely accepted that perivascular nerves maintain vascular tone and regulate blood flow. Although there are currently prevailing opinions, unified views on the innervation of microcirculation in any organs have not been established. The present study was designed to investigate whether there are perivascular nerves innervated in microvessels and neovessels. Furthermore, we examined whether nerve growth factor (NGF) can exert a promotional effect on perivascular nerve innervation in neovessels of Matrigel plugs. A Matrigel was subcutaneously implanted in mouse. The presence of perivascular nerves in Matrigel on Day 7-21 after the implantation was immunohistochemically studied. NGF or saline was subcutaneously administered by an osmotic mini-pump for a period of 3-14 days. The immunostaining of neovasculatures in Matrigel showed the presence of perivascular nerves on Day 21 after Matrigel injection. Perivascular nerve innervation of neovessels within Matrigel implanted in NGF-treated mice was observed in Day 17 after Matrigel implantation. However, NGF treatment did not increase numbers of neovessels in Matrigel. These results suggest that perivascular nerves innervate neovessels as neovasculatures mature and that NGF accelerates the innervation of perivascular nerves in neovessels.

Microvascular reactivity during sympathetic stimulations in Raynaud's phenomenon.

BACKGROUND: The objective of the study was to assess skin autonomic microvascular reactivity to sympathetic stimulations and its association with primary and secondary Raynaud's phenomenon (RP). METHODS: Laser-Doppler recorded finger pulp skin blood flow was monitored during orthostatic and deep breathing tests of 4 subjects groups, each of them composed of 20 subjects: group 1, healthy controls; group 2, vibration-induced secondary RP (vRP); group 3, primary RP (pRP); group 4, systemic sclerosis-related secondary RP (sclRP). Within groups comparisons by Wilcoxon matched pairs rank test and between groups by Bonferroni's multiple test for unpaired data were done using SPSS Statistics software. RESULTS: Reliably lower initial perfusion values were established in all the RP patients. The local sympathetic axon-reflex mediated responses to orthostasis were reduced in all RP groups with increased perfusions in upright posture instead of decreased. The vasoconstrictor responses to deep breathing tended to increase instead of decreasing in the vRP and pRP groups, while in the sclRP group the perfusions decreased. Strong correlations between the initial finger pulp perfusions and the orthostatic and deep breathing perfusion responses were found in the control, pRP and vRP groups (P<0.0001) and a modest correlation between the initial perfusions and the deep breathing perfusion responses in the sclRP group. CONCLUSIONS: Abnormal cutaneous microvascular reactivity to central and local axon-reflex sympathetic stimulations was established in RP patients reflecting self-regulatory dysfunctions which might contribute to the manifestations of the ischemic microcirculatory paroxysms. Laser Doppler flowmetry with functional orthostatic and deep breathing tests contribute to the diagnosis of RP.

[MODULATION OF LACTATE PRODUCTION, TRANSPORT AND RECEPTION BY CELLS IN THE MODEL OF BRAIN NEUROVASCUL. UNIT I.]

Metabolic activity of cells within a neurovascular unit is among the factors determining structural and functional integritY of the blood-brain barrier and the an- giogenesis process. in order to verify the hypothesis about the role Of g1YcolYtic activity in the perivascula astroglialcells associated with lactate release in the development of functioning of cerebral microvessel endothelial cells, we have used a three-component model of the brain neurovascular unit in vitro. The cells o f n o n -en d o th elia l o rig in w ere in c u b a te d in th e p rese n ce o f m o d u la to rs o f la c ta te pro d u c n ago ni glu c ose ta a G ly c o s o) , bas t h e oe t a n t a at- blocker of monocarboxylate transporters MCTlprCT and recepltiors of3Ctate0produasan (2-donisyoflactate G e8 breceptor) Iasa estbishe vthat that te suppression of lactate production and transport, prdc o1,adrcpin(C-O-Aa n (2gdoxysgflucoase as a glycolysis inhibitor), transport (phloretin as a sukr of lacaroduto transport , aswellasastimultionof3lactate receptors in astroglial cells, lead to aberrant development of endothelial layer, ther by u g g e tin t h efor atio o f anti ngi gencmi roen ircm ent for cerebral endothelium due to inappropriate lactate-m ediated effects. KeYw.ords:-n-eur-ovascular unit; metabolism; glYcolysis; lactate.

Characterization of Perivascular Nerve Distribution in Rat Mesenteric Small Arteries.

The distribution pattern of perivascular nerves in some branches of rat mesenteric arteries was studied. Mesenteric arteries isolated from 8-week-old Wistar rats were divided into the 1st-, 2nd-, and 3rd-order branches. The distribution of perivascular nerves in each branch was immunohistochemically evaluated using antibodies against neuropeptide Y (NPY), tyrosine hydroxylase (TH), calcitonin gene-related peptide (CGRP), substance P (SP), and neuronal nitric oxide synthase (nNOS). The density of NPY-, TH-, CGRP-, and SP-like immunoreactive (LI) nerves in the 2nd and 3rd branches was significantly greater than that in the 1st branch, and a negative relationship was found between nerve density and arterial diameter, except for TH-LI nerves. The density of NPY- and TH-LI nerves in all branches, which was similar, was greater than that of CGRP- (except for NPY-LI nerves in the 1st branch), SP-, or nNOS-LI nerves. Double immunostaining revealed that TH-LI nerves made contact with nNOS-LI, CGRP-LI, and SP-LI nerves and that CGRP-LI nerves made contact with TH-, NPY-, or nNOS-LI nerves, while TH-LI and CGRP-LI nerves nearly merged with NPY-LI and SP-LI nerves, respectively. These results suggest that the each branch of mesenteric arteries is densely innervated by vasoconstrictor nerves containing NPY, TH, and vasodilator CGRP nerves. They also suggest that the intense density of perivascular nerves in the 2nd and 3rd branches may contribute to maintaining vascular tone.

Ischemia and diabetic neuropathy.

In addition to hyperglycemia and ensuing metabolic changes, vascular abnormalities and ischemia driven by hyperglycemia and metabolic change plays a paramount role for the development of diabetic polyneuropathy. Endothelial dysfunction plays a key role in the initiation of cellular events evolving into the development of vascular complications of diabetes, and is the common denominator between the metabolic and vascular abnormalities detected in diabetes. Diminished production and function of endothelium-derived vasodilators, and the exaggerated production of vasoconstrictors, lead to endothelial dysfunction, resulting in elevated vascular tone, culminating in macro- and microvascular damage. There is microvascular pathology in human diabetic polyneuropathy: basement membrane thickening, pericyte degeneration, and endothelial cell hyperplasia in endoneurial microvessels. These vascular changes strongly correlate with clinical defects and nerve pathology. Studies in human and animal models have shown endoneurial hypoxia caused by a reduction in nerve blood flow and increased endoneurial vascular resistance. There is strong evidence that the nerve fiber degeneration and a loss of nerve fibers are ischemic in diabetic polyneuropathy. Diabetic nerves reveal a paradoxical contrast between their physiological resistance to ischemia and increased morphological susceptibility to ischemia. Diabetic nerves are particularly vulnerable to reperfusion injury. This chapter will review the response of diabetic nerves to ischemia and reperfusion injury, and the evidence of ischemia and hypoxia in diabetic neuropathies.

Imaging of the islet neural network.

The islets of Langerhans receive signals from the circulation and nerves to modulate hormone secretion in response to physiological cues. Although the rich islet innervation has been documented in the literature dating as far back as Paul Langerhans' discovery of islets in the pancreas, it remains a challenging task for researchers to acquire detailed islet innervation patterns in health and disease due to the dispersed nature of the islet neurovascular network. In this article, we discuss the recent development of 3-dimensional (3D) islet neurohistology, in which transparent pancreatic specimens were prepared by optical clearing to visualize the islet microstructure, vasculature and innervation with deep-tissue microscopy. Mouse islets were used as an example to illustrate how to apply this 3D imaging approach to characterize (i) the islet parasympathetic innervation, (ii) the islet sympathetic innervation and its reinnervation after transplantation under the kidney capsule and (iii) the reactive cellular response of the Schwann cell network in islet injury. While presenting and characterizing the innervation patterns, we also discuss how to apply the signals derived from transmitted light microscopy, vessel painting and immunostaining of neural markers to verify the location and source of tissue information. In summary, the systematic development of tissue labelling, clearing and imaging methods to reveal the islet neuroanatomy offers insights to help study the neural-islet regulatory mechanisms and the role of neural tissue remodelling in the development of diabetes.

Noninvasive examination of endothelial, sympathetic, and myogenic contributions to regional differences in the human cutaneous microcirculation.

The aim of this study was to examine whether there are regional differences in the cutaneous microvascular responses of the forearm and the leg. Utilizing a non-invasive measure (spectral analysis),we looked at the influence of the endothelial, sympathetic, and myogenic function between regions at thermoneutral conditions (33 °C) and in response to local skin warming (42 °C) using laser-Doppler flowmetry (LDF). We recruited 18 young, healthy participants, who visited the lab on 2 separate occasions. Participants were instrumented with LDF probes and local skin heater probe-holders, placed on the forearm or the leg. Blood pressure was recorded by oscillometry. At both 33 °C and during local skin warming to 42 °C, skin vasomotion for the forearm and leg were evaluated using spectral analysis of the LDF recordings. There were significant differences among all frequencies of interest between the forearm and the leg. At 33 °C the leg presented with higher (P=0.003) activity for endothelial (0.009-0.021 Hz), sympathetic (P=0.002) (0.021-0.052 Hz), and myogenic (P=0.004) (0.052-0.145 Hz) activity when compared to the forearm. In contrast, following 35 min of local skin warming, the forearm had greater endothelial (P=0.019), sympathetic (P=0.006), and myogenic (P=0.005) vasomotion than the leg. These outcomes indicate regional differences in the cutaneous microcirculation. The current results are similar to our previous work using invasive methods and pharmacological agents, indicating that non-invasive analyses may be useful in the diagnoses and understanding of the mechanisms that control the microvascular function of pathological conditions.

Distribution of substance P and the calcitonin gene-related peptide in the human tensor tympani muscle.

Substance P-immunoreactive nerve fiber (SP-IR NF) and calcitonin gene-related peptide-immunoreactive nerve fiber (CGRP-IR NF) are important mediators of neurogenic inflammation and blood supply. SP-IR and CGRP-IR NFs in the tensor tympani muscle (TTM) of the human middle ear have yet to be described. In this study, the TTM, tympanic membrane, malleus in the middle ear and tensor veli palatini muscle (TVPM) were examined by whole-mount immunohistochemistry in tissue from Japanese subjects. Thirteen human cadavers (ranging in age from 46 to 90 years) were used in this study. SP-IR and CGRP-IR NFs were primarily found on vessels at the origin, insertion and belly of the surface of the TTM and on the internal surface of the tympanic membrane. These neural factors were also detected on the surface of the malleus and the insertion of the TVPM. Therefore, our results indicate that existence of the SP-IR and CGRP-IR NFs of the TTM and the TVPM may reflect muscle properties involved in pain or inflammation of the middle ear.