(Stroke. 2000;31:751.)
© 2000 American Heart Association, Inc.
Original Contributions |
From the Division of Basic Medical Sciences, Memorial University, St Johns, Newfoundland, Canada.
| Abstract |
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MethodsConstriction to pressure, elevated [K+]o and/or [Ca2+]o, and SM membrane potentials (Em) were measured in isolated pressurized MCAs of SHRsp and stroke-resistant SHR.
ResultsMCAs of SHRsp exhibited an age-related decrease in PDC before hemorrhagic stroke and a loss of PDC after stroke. At 100 mm Hg, the MCAs of poststroke SHRsp maintained partial constriction that was not altered with pressure but was inhibited by nifedipine (1 µmol/L). The MCAs of poststroke SHRsp constricted to vasopressin (0.17 µmol/L) but not to elevated [K+]o. When pressure was reduced from 100 to 0 mm Hg, the MCAs from young prestroke SHRsp exhibited SM hyperpolarization (-38 to -46 mV), whereas those of poststroke SHRsp maintained a constant, depolarized Em (-34 mV). Alterations in Em with varying [K+]o suggested that there was a decrease in SM K+ conductance in the MCAs of poststroke SHRsp.
ConclusionsThe observation that the MCAs of poststroke SHRsp depolarize but do not constrict to elevated [K+]o suggests the presence of dysfunctional voltage-gated Ca2+ channels. The inability to alter Em with pressure or to constrict to depolarization could partially contribute to the loss of PDC in the MCAs of poststroke SHRsp.
Key Words: calcium channels membrane potentials myogenic regulatory factors nifedipine rats
| Introduction |
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The signal transduction mechanisms promoting PDC are not fully understood but probably involve both an intercellular influx of Ca2+ and the activation of protein kinase C.2 3 4 5 6 7 8 Electrophysiological studies of both cerebral and renal vessels have shown that PDC is associated with smooth muscle (SM) depolarization.4 7 8 In vitro and in vivo studies involving pressurized rat and cat MCAs or rat pial cerebral arteries, as well as dog renal interlobular and preglomerular arterioles, have indicated that PDC is dependent on the presence of external Ca2+ and is inhibited by L-type Ca2+ channel blockers.2 4 5 6 7 8 It is possible that constriction in response to elevated pressure could be partially produced by pressure-dependent depolarization and the subsequent opening of voltage-gated Ca2+ channels.9
The present study was undertaken to determine whether the electromechanical function of the MCAs was altered with stroke development in SHRsp in a manner that could contribute to the loss of PDC. In the study, the relative sensitivity and reactivity of PDC at 100 mm Hg to nifedipine and external Ca2+ were measured in the MCA. In addition, PDC was temperature-inactivated, and the contractile reactivity of the MCA to depolarization (produced by altering external [K+]o) was determined. Electrophysiological studies were performed to determine whether the SM resting membrane potential (Em) and pressure-dependent depolarization were altered in relation to stroke development. Through the experiments we have performed, we will attempt to demonstrate that stroke development in SHRsp is associated with a defect in the ability of the MCA to alter Em in relation to pressure and to constrict in response to depolarization. We believe that the inability to constrict in response to depolarization in the MCA of poststroke SHRsp may be partially promoted by the inability of SM depolarization to initiate Ca2+ entry into the SM through L-type Ca2+ channels.
| Materials and Methods |
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17 weeks of age. srSHR fed
the same diet do not develop stroke.10 In the present
study, SHRsp between the ages of 9 and 16 weeks that had not yet
developed stroke and poststroke SHRsp 12 to 18 weeks of age were
sampled and compared with each other and with srSHR between 10 and 18
weeks of age. In our colony of SHRsp, a 12.5-week-old SHRsp that has
not developed behavioral signs of stroke and (on sampling) shows no
evidence of cerebral hemorrhage has an
50% chance of
developing stroke in the next week. The probability of stroke
development in the near future increases dramatically in prestroke
SHRsp when they surpass 12.5 weeks of age. Hence,
physiological/pharmacological changes occurring in
SHRsp after 12.5 weeks of age best represent the changes that
occur just before stroke development. Such alterations may be important
in the development of stroke. Therefore, in some experiments, the
prestroke SHRsp were partitioned into animals older or younger than
12.5 weeks. The systolic blood pressure (BP) of the animals was
measured with a tail-cuff compression method (PE 300, Programmed
Electrosphygmomanometer, Narco Biosystems Inc).
Animals exhibiting and lacking symptoms of stroke were
anesthetized with sodium pentobarbital 60 mg/kg IP and
exsanguinated. The brain (including the brain stem) was removed and
placed in oxygenated ice-cooled (
3°C) Krebs
physiological salt solution (95%
O2, 5% CO2, pH 7.4). The
right or left MCA at a point at which it crosses the rhinalis
fissure was removed and mounted in a pressure
myograph.2 11 The rest of the brain was placed in fixative
(4% formaldehyde, 1% glutaraldehyde, 84 mmol/L
PO4, pH 7.4) and histologically
examined for lesions.10 In our colony of SHRsp, stroke
development is associated with the occurrence of
intracerebral hemorrhage, and the observation
of subarachnoid hemorrhage is rare.10 All
prestroke SHRsp and srSHR used in the study lacked behavioral symptoms
of stroke and had brains lacking cerebral hemorrhage. The
presence of cerebral hemorrhage was identified in all
poststroke SHRsp.
Pressure Myograph Studies
The experiments were performed at an end pressure of 100
mm Hg. There is a pressure drop of >50% between the BP measured in
the femoral or carotid arteries and distal segments of the middle
cerebral vasculature.12 13 Therefore, studies performed
at a pressure of 100 mm Hg represent a realistic mean BP
that the distal MCAs of srSHR and SHRsp (systolic BP averages
between 200 and 230 mm Hg) might experience in vivo.
The techniques and equipment used to measure PDC are described in detail elsewhere.2 The technique was developed to differentiate between the degree of constriction being maintained as a result of pressure activation (ie, PDC) versus pressure-independent tone (PIT) in a pressurized artery. Initially, the MCAs were excised from the brain of the SHRsp and mounted on the pipette submerged in oxygenated Krebs solution at 37°C in the pressure myograph. This aspect of the procedure usually takes 10 to 15 minutes. Subsequently, they were pressurized to 100 mm Hg for 45 minutes. Typically, under these conditions the MCAs of srSHR or SHRsp develop tone during the equilibration period. To distinguish between PIT and PDC, the MCAs were then subjected to a subsequent 6-minute equilibration period at 0 mm Hg followed by 4 minutes at 100 mm Hg. By definition, PDC should be abolished if the artery is maintained at a pressure of 0 mm Hg. To measure the degree of tone that maintains PDC at 100 mm Hg pressure, one cannot simply measure the differences in lumen diameter at 0 or some other low pressure versus that present at 100 mm Hg. At the low pressure, the decreased PDC (which would tend to dilate the artery) is counteracted by the presence of a smaller distending pressure that would tend to reduce the arterial lumen size. The latter problem was overcome by equilibrating the artery to 0 mm Hg for 6 minutes to deactivate PDC, then rapidly applying a 100-mm Hg pressure step. The lumen diameter present at 100 mm Hg shortly (1 second) after pressurization, before a significant degree of PDC developed, was measured. The degree of constriction that occurred between 1 second and 4 minutes after the application of the 100-mm Hg pressure step was recorded as a measure of PDC. Previous time-course analyses of the rate of constriction indicated that the predicted lumen diameter that would be present at time 0 differed by <5% of that measured 1 second after pressurization. Therefore, the latter lumen diameter represents an approximation of the lumen diameter that would exist at 100 mm Hg pressure if the artery lacked the ability to constrict to pressure. PDC was typically complete within 3 minutes after pressurization to 100 mm Hg.2 The difference in lumen diameter present between 1 second after pressurization and 100 mm Hg versus that present at 100 mm Hg under conditions in which the artery was maximally dilated represented the degree of constriction being maintained by PIT. PIT can be defined as the endogenous constriction present in the artery that cannot be increased by elevating arterial pressure or decreased by lowering pressure.
Nifedipine and Ca2+ and K+
Dose-Response Curves
The ability of nifedipine to relax the MCA was
tested at a pressure of 100 mm Hg under conditions in which the
MCAs were bathed with Krebs solution containing a normal
[Ca2+]o of 2.5
mmol/L in the presence of 4.6 or 100 mmol/L
[K+]o (Krebs solution was
kept isosmotic by the removal of Na+). The
maximal ability of nifedipine to relax the MCAs was
compared with that of 10-5 mmol/L
verapamil and Ca2+-free Krebs
solution containing 1 mmol/L EGTA.
In other experiments, MCAs were pressurized to 100 mm Hg under conditions in which the arteries were bathed with normal- (4.6 mmol/L) or high- (100 mmol/L) [K+]o Krebs solution. The arteries were initially suffused with Ca2+-free Krebs solution containing 200 µmol/L EGTA for 2 minutes to remove external Ca2+ bound to the artery and the perfusion chamber. Subsequently, the suffusate was replaced with Ca2+-free Krebs solution lacking EGTA. Ca2+ was then introduced in a dosewise fashion from 1-µmol/L to 9.0-mmol/L levels. The contractile reactivity (amplitude of constriction) in response to [Ca2+]o was measured.
The reactivity of the MCAs to varying levels of [K+]o ranging from 5 to 85 mmol/L was tested in the presence of a normal [Ca2+]o of 2.5 mmol/L. These experiments were performed at 23°C. At 37°C, pressurized MCAs from prestroke srSHR constrict to pressure, whereas those of poststroke SHRsp exhibit PIT. In view of this, we were concerned that the ability of the arteries to further constrict to elevations in [K+]o might be limited and differentially modified by the presence of differing levels of preexisting tone. To compare the MCAs under equivalent conditions, pressure-induced and pressure-independent constriction was inhibited in the MCAs of srSHR and prestroke SHRsp by lowering the bath temperature to 23°C. The notion of using this manipulation comes from an extrapolation of studies performed by Osol and Halpern,14 who observed that cooling (from 37°C to 35°C) pressurized posterior cerebral arteries sampled from SHRsp attenuates vasomotion and pressure-induced tone.
Em Measurements
Intercellular recording techniques were used to measure
the SM resting Em (Em) in
MCAs sampled from prestroke and poststroke SHRsp at a variety of ages.
Microelectrodes filled with 3 mol/L KCl having a tip resistance of
between 40 and 60 M
were used to impale the SM of the MCAs. The SM
Em was measured with a WPI 773 amplifier (World
Precision Instruments). The
electrophysiological signals were viewed
with a Hameg M205 oscilloscope (Hameg Inc) and recorded on a Vetter
420 FM recorder (A.R. Vetter Co). We maintained the electrode in
the cell to a point at which the Em remained
stable and did not further change with time (often for many minutes),
then withdrew the electrode. The Em value was
recorded only if the slightest withdrawal movement of the electrode
produced an abrupt shift in the Em to baseline
levels without an offset potential. We are confident in our technique
and in previous studies have used intercellular recording in
combination with current injections to measure electrical conduction
along the length of MCAs.15
In other experiments involving nonpressurized arteries, 10-6 mmol/L nifedipine was introduced into the bath to prevent constriction, and the change in Em with varying concentrations of [K+]o was assessed. The objective of these experiments was to determine whether (1) elevations in [K+]o promoted SM depolarization, (2) the intercellular concentration of K+ (in the SM) differed in prestroke versus poststroke SHRsp, and (3) there was evidence of a difference in K+ conductance in the SM between the 2 groups. Both alterations in K+ conductance in the SM and alterations in the intercellular concentrations of K+ could alter the Em at rest and alter the rate of depolarization (and contraction) in response to graded elevations in [K+]o. In plots of the Em change in response to altered [K+]o, the [K+]o values that produce an Em of 0 mV will approximate the intercellular K+ level, and changes in the slope of the plot of [K+]o versus Em would suggest altered K+ conductance. The most accurate assessment of the above parameters would be made under conditions in which alterations in [K+]o evoked minimal alterations in other ionic conductances that would exert secondary independent modifications in Em. In view of this, nifedipine was used to block the L-type voltage-gated channels. Such treatment prevented the (potential differential) influences of constriction and Ca2+ entry on Em when [K+]o was elevated. In different arteries, the SM Em was also measured in the absence of nifedipine in pressurized MCAs bathed in normal Krebs solution at 0 mm Hg and after a 40-minute equilibration to 100 mm Hg.
Statistical Analysis
Comparisons involving 2 groups of data were assessed with
Students t test. A 1-way ANOVA followed by Fishers post
hoc test was used in comparisons involving >2 groups. Dose-response
curves representing groups of animals were compared by a
general linear model of ANOVA (GLM) to determine whether they differed
significantly from each other. The curves were also assessed to
determine whether a differential interactive effect between dose and
response occurred between groups. A significant interactive effect with
dose is usually associated with a situation in which curve crossover
occurs or in which significant shifts in sensitivity are present.
In addition, an 1-way ANOVA followed by Fishers post hoc test was
used to assess differences between groups at each dose. Regression
analysis and the calculation of a Pearson product of
correlation (r value) was used to determine whether a
significant relationship existed between 2 parameters.
Results were considered significant at P<0.05 and were
expressed as the mean±SEM.
| Results |
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Pressure-Dependent and Pressure-Independent Tone in the MCAs
of SHR
Figure 1
, A and B, outlines the
characteristics of PDC in response to a 100-mm Hg pressure step in the
MCAs of srSHR and prestroke and poststroke SHRsp. The amplitude of PDC
measured between 1 second and 4 minutes after the application of the
100-mm Hg pressure step (Figure 1A
) was larger in the MCAs of
srSHR than prestroke SHRsp. Poststroke SHRsp maintained a nearly
constant lumen of diameter between 1 second and 4 minutes after the
application of a 100-mm Hg pressure step, indicating the absence of
PDC. After a 4-minute equilibration period to 100 mm Hg, lumen
diameters maintained by the MCAs of srSHR were smaller than those of
poststroke SHRsp. The loss of PDC in the MCAs of poststroke SHRsp
occurred in both the right and left MCAs and was not related to the
severity or location of the hemorrhagic lesions.
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The degree of PIT that maintained constriction (the difference in lumen
diameter under maximal dilation versus diameter 1 second after
pressurization to 100 mm Hg, ie, a, b, and c in Figure 1A
, plotted separately in Figure 1B
) was highest in the MCAs of
poststroke SHRsp. Prestroke SHRsp had larger levels of this tone than
MCAs from srSHR. The reduced lumen diameters observed 1 second after
pressurization to 100 mm Hg were not due to a structural
reduction in lumen diameter, because in the presence of
verapamil at maximal dilation, no differences in lumen
diameter were observed between the groups. The total amplitude of
constriction present in the MCAs of each animal group that is
maintained by PDC and PIT is shown in Figure 1B
. Under the
latter conditions, the vast majority of constriction present in the
MCAs of srSHR is pressure-dependent, whereas all the constriction
present in the MCAs of poststroke SHRsp is
pressure-independent.
Further studies were carried out to determine the mechanisms
maintaining PDC in the MCAs of srSHR and PIT in those of poststroke
SHRsp. Both types of constriction could be abolished by the removal of
[Ca2+]o (discussed
later). As shown in Figure 2A
, at
100 mm Hg, PDC in the MCAs of srSHR and PIT in the MCAs of
poststroke SHRsp could be inhibited by the L-type
Ca2+ channel antagonist
nifedipine. However, the dose-response curves
representing MCAs from poststroke SHRsp were shifted to the
left of the curves representing srSHR, indicating that the
sensitivity to nifedipine with respect to promoting the
relaxation of PIT was higher than that promoting the relaxation of
PDC.
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The ability of nifedipine to block the L-type
Ca2+ channel is affected by the SM
Em,16 which, as will be shown,
differs in relation to stroke development. Therefore,
nifedipine relaxation-response curves were also constructed
under conditions in which the SM of the arteries was depolarized with
100 mmol/L [K+]o.
The latter concentration of K+ depolarizes the SM
to levels at which the L-type Ca2+ channel is in
a state of maximal opening probability and minimizes the potential
effects that differing Em may have on the ability
of nifedipine to block the Ca2+
channels. Under the above-described conditions (Figure 2B
), the
dose-response curves of the MCAs of SHRsp with stroke still remained
shifted to the left of those representing srSHR, indicating
that an increased relaxation sensitivity to nifedipine
still existed in the MCAs of poststroke SHRsp.
Figure 3
demonstrates an age-related
decrease in the proportion of tone that was maintained by PDC
constriction in the MCAs of prestroke SHRsp. Regression
analysis also indicated an age-related increase in the lumen
diameter being maintained by the MCAs of prestroke SHRsp (n=13) after
equilibration to 100 mm Hg (lumen diameter [µm] at 100
mm Hg=8.09 x age + 22.4; r=0.556, P<0.05)
and a direct relationship between the loss of PDC and increased lumen
diameter size in the arteries (lumen diameter [µm] at 100
mm Hg = -0.753 x the amplitude of PDC in µm + 160;
r=0.761, P<0.01). The data indicate that the
loss of PDC precedes stroke in SHRsp and that in prestroke SHRsp, there
is an age-related decline in the ability of the MCA to constrict to
pressure between 10 and 16 weeks of age.
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Reactivity of the MCAs of srSHR, Prestroke SHRsp, and Poststroke
SHRsp to Alterations in [Ca2+]o and
[K+]o
Figure 4
, A and B, outlines the
contractile reactivity of the MCAs from srSHR and prestroke and
poststroke SHRsp to varying concentrations of
[Ca2+]o. Figure 4A
shows the development of tone under conditions in which
[Ca2+]o is replaced into
the bath medium in the presence of normal 4.6 mmol/L
[K+]o, whereas Figure 4B
outlines constriction under conditions in which the arteries
are depolarized with 100 mmol/L
[K+]o. Under conditions
of normal (4.6 mmol/L) K+, elevations in
[Ca2+]o produced greater
degrees of constriction and smaller lumen diameters in MCAs sampled
from srSHR versus those of prestroke or poststroke SHRsp. Compared with
poststroke SHRsp, the MCAs of srSHR and prestroke SHRsp altered their
lumen diameter differentially with varying
[Ca2+]o. The sensitivity
to [Ca2+]o was greatest
in MCAs of srSHR, followed by those of prestroke SHRsp. At higher
levels of [Ca2+]o, the
mean lumen diameter maintained by MCAs from prestroke SHRsp was greater
than those of srSHR but smaller than those of poststroke SHRsp.
Elevating the [K+]o from
4.6 to 100 mmol/L exaggerated the difference in lumen diameter
between prestroke and poststroke SHRsp (Figure 4B
). Under
conditions in which the SMs of the MCAs were depolarized with 100
mmol/L K+, the lumen diameter of the MCAs was not
significantly different between prestroke SHRsp and srSHR at any
external [Ca2+]o
level.
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A key observation made was that elevation of [K+]o from 4.6 to 100 mmol/L, a manipulation that should depolarize the SM of the MCAs, produced no change in the [Ca2+]o dose-response curves in MCAs sampled from poststroke SHRsp with PIT. The conclusion reached was that Ca2+ entry through L-type Ca2+ channels in the SM of MCAs from srSHR and prestroke SHRsp was sensitive to manipulations that should modify the Em of the cells. The latter L-type Ca2+ channel behaved in a voltage-gated manner, in that depolarization via 100 mmol/L [K+]o increased the contractile reactivity to [Ca2+]o. Conversely, the same manipulation did not alter the configuration or the contractile reactivity in response to varying [Ca2+]o observed in the MCAs of poststroke SHRsp. The pressure-independent constriction maintaining tone in the latter arteries appeared to be produced by an L-type Ca2+ channel that could not be further activated by depolarization. To test further for this possibility, the ability of the MCAs to constrict to varying levels of [K+]o was determined.
As demonstrated in Figure 1
, at 100 mm Hg, the levels of
tone in MCAs differed between srSHR, prestroke SHRsp, and poststroke
SHRsp. To overcome this, the temperature was decreased to 23°C. Such
manipulation inhibited PDC constriction. As shown in Figure 5
, the ability to constrict to
[K+]o was greatest in
MCAs from prestroke SHRsp <12.5 weeks of age. Prestroke SHRsp >12.5
weeks of age demonstrated an attenuated ability to constrict maximally
to [K+]o, and MCAs
sampled from SHRsp with stroke demonstrated a total inability to
constrict to elevated
[K+]o. The differences in
response to [K+]o could
not be accounted for by general differences in the ability of the MCAs
to constrict, because the latter MCAs constricted equally to
vasopressin (% constriction of lumen in 4.6 mmol/L
[K+]o to 0.17
µmol/L vasopressin at 23°C, srSHR 58.3±2.5%; young prestroke
SHRsp 49.4±3.1%; poststroke SHRsp 52.6±12.6%; no significant
[P>0.05] difference between the groups). In other
experiments, the ability of the MCAs of srSHR and poststroke SHRsp to
constrict to 100 mmol/L
[K+]o was determined at
37°C. MCAs from poststroke SHRsp still demonstrated an inability to
constrict to an elevation in
[K+]o (mean lumen
diameter change <1%, n=7 SHRsp), whereas those of srSHR reduced their
lumen size by 43.4±4.2% (n=4 srSHR). Hence, the latter phenomenon was
not a feature observed only at 23°C.
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Alterations in the SM Em in MCAs of Prestroke and
Poststroke SHRsp
This aspect of the study was carried out to gain more information
on why the MCAs of poststroke SHRsp lacked the ability to constrict to
elevations in [K+]o.
Initially, we attempted to determine the degree of SM depolarization
that occurred in response to variations to
[K+]o. In addition, the
Em of the SM cells of the MCAs of poststroke
SHRsp was assessed to determine whether it was of a magnitude that
could cause the voltage-gated Ca2+ channels to be
in a state of maximum opening probability. If such was the case, then
elevations in [K+]o might
not be expected to further increase the degree of constriction.
Finally, we assessed the ability of the MCAs to elicit
pressure-dependent SM depolarization in response to a 100-mm Hg
pressure step.
MCAs were mounted in a pressure myograph and equilibrated to a pressure
of 100 mm Hg for 40 minutes, after which time the SM cell
Em was measured. Subsequently, the pressure was
dropped to 0 mm Hg, and Em measurements
were made. Finally, the ability of the MCAs to elicit PDC in response
to a 100-mm Hg pressure step was measured. The
Em values obtained at both pressures are outlined
in the Table
. When the pressure
was reduced from 100 to 0 mm Hg, the SM Em
hyperpolarized in MCAs sampled from prestroke SHR and remained constant
in a depolarized state in MCAs sampled from poststroke SHRsp. MCAs
sampled from prestroke SHRsp and srSHR but not poststroke SHRsp were
capable of eliciting PDC.
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Nonpressurized MCAs from both groups were treated with 3 µmol/L
nifedipine to prevent contraction, and the SM
Em was measured at varying
[K+]o levels (Figure 6
). In the presence of
nifedipine at 4.6 mmol/L (normal)
[K+]o levels, MCAs
sampled from poststroke SHRsp still exhibited a more depolarized SM
Em than those of prestroke SHRsp. The presence of
a less steep decline in Em with respect to
increased [K+]o was
observed in MCAs sampled from poststroke versus prestroke SHRsp. The
predicted [K+]o level
that produced an Em value of 0 mV, which should
correspond to the SM
[K+]i, was similar in the
2 groups. The nature of the changes in the slope of the plot of
Em versus
[K+]o suggested that the
more depolarized Em observed in the MCAs of
poststroke SHRsp was not due to the presence of a smaller SM
intercellular concentration of K+ but rather was
consistent with a relative decrease in K+
to Na+ conductance in the SM cells.
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| Discussion |
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The MCAs of poststroke SHRsp could not elicit PDC and did not achieve the reductions in lumen diameter that could be achieved by the MCAs of prestroke SHRsp or srSHR. The decline in the ability of MCAs to elicit PDC preceded stroke development in SHRsp and occurred between 10 and 16 weeks of age in prestroke SHRsp. We believe that the development of the latter defect could play an important role in the initiation of cerebral hemorrhage in SHRsp. Under hypertensive conditions, a decline in the ability to elicit PDC could result in the overperfusion of the distal vasculature fed by the MCAs and promote the elevation of downstream intravascular pressures. Such changes would be conducive to the formation of cerebrovascular hemorrhage. The balance of the study attempted to investigate the potential vascular defects that could contribute to the loss of PDC in the MCAs of SHRsp.
Studies involving pressurized rat, cat, and rabbit MCAs or smaller dog renal arteries have indicated that PDC is inhibited by L-type Ca2+ channel antagonists.2 4 6 7 8 9 17 In these arteries, PDC was associated with SM membrane depolarization, perhaps produced by the direct activation of an SM arachidonic acid product, such as 20-hydroxyeicosatetraenoic acid,18 19 or a process involving the activation of select Cl- channels.20 In cat, rat, and rabbit MCAs, including MCAs of srSHR, the magnitude of depolarization observed in response to elevated pressure was sufficient to open voltage-gated L-type Ca2+ channels.4 7 8 17 K+ conductance blockers that modified SM Em in rabbit MCAs also modified the amplitude of PDC.17 Therefore, it was suggested that PDC could be produced by an influx of Ca2+ through voltage-gated L-type Ca2+ channels in response to pressure-induced depolarization.9
Experimental evidence presented in this paper suggests that
some of the above-described mechanisms are altered in relation to
stroke development in SHRsp. At 100 mm Hg pressure, the SM
Em of MCAs was comparable between prestroke and
poststroke SHRsp. However, when pressure was lowered to 0 mm Hg,
the SM Em of MCAs sampled from poststroke SHRsp
did not alter to more hyperpolarized levels but rather was maintained
at levels similar to those observed at 100 mm Hg pressures
(Table
). If the signal transduction mechanisms promoting
vasomotor responses to pressure involved the opening or closing of SM
voltage-gated L-type Ca2+ channels in response to
depolarization or hyperpolarization, respectively,
the maintenance of a constant SM Em in
the SM of MCAs at 0 and 100 mm Hg pressures could have prevented
the arteries from altering tone in response to pressure. However, we
believe that functional changes in the L-type
Ca2+ channel must also exist in the SM of the
MCAs of poststroke SHRsp to account for their unresponsiveness to
elevated [K+]o. Studies
of isolated SM from rat cerebral arteries have indicated that the
maximal opening probability of the voltage-gated L-type
Ca2+ channel occurs at Em
levels less negative than -20 mV.21 At 100 or 0
mm Hg pressures, the SM Em of MCAs from
poststroke SHRsp was near -35 mV. Depolarization with 100 mmol/L
[K+]o should have
produced an Em of -15 mV (Figure 6
) and
further constriction. However, elevations in
[K+]o only enhanced
constriction in MCAs sampled from prestroke SHRsp and srSHR (Figure 4
). The inability of the MCAs of poststroke SHRsp to constrict
to elevation in [K+]o
could occur if the maximum opening probability of the
Ca2+ channels was achieved at
Em levels already present in the SM of the
MCAs of SHRsp or if there was a defect in the voltage sensor in the
channel causing the channel not to respond to further depolarizing
changes in SM Em. Further confirmation of the
above hypothesis will require the use of patch-clamp studies of
isolated muscle cells to determine the voltage-dependence of L-type
Ca2+ channelmediated Ca2+
currents.
Studies have indicated that PDC in rat posterior cerebral arteries is inhibited not only by L-type Ca2+ antagonists but also by protein kinase C inhibitors.22 23 We have also observed that the inhibition of protein kinase C with staurosporine (40 nmol/L), chelerythrine (12 µmol/L), or bisindolylmaleimide (5 µmol/L) inhibits PDC in the MCAs of prestroke SHRsp.24 In addition, the MCAs of poststroke SHRsp exhibited an attenuated ability to constrict in response to protein kinase C activation by phorbol esters in the presence of nifedipine.24 SM Ca2+ influx and protein kinase C activation may act in a cooperative manner to promote PDC. In rabbit facial veins, an influx of Ca2+ has been suggested to promote protein kinase C activation, leading to increased constriction in response to stretch.25 Other studies have hypothesized that during pressure- or tension-related constriction, an influx of Ca2+, possibly through voltage-gated channels, and protein kinase C activation (through a separate signal transduction pathway possibly involving phospholipase C activation and diacylglycerol formation26 27 ) may combine to promote constriction.28 29 These studies implied that neither the influx of Ca2+ nor the activation of protein kinase C (promoted by an elevation in pressure) can independently promote constriction in response to elevated pressure and that the cooperative action of both mechanisms is necessary to contract the blood vessels. Hence, in the latter model, either protein kinase C or Ca2+ channel inhibitors would independently inhibit PDC, a finding that is consistent with our observations.24 In the context of the present study, elevations in pressure may induce SM depolarization, which could open voltage-gated L-type Ca2+ channels. The subsequent entry of Ca2+ into the SM may act as a trigger to activate PDC in the arteries via an activation of protein kinase C or facilitate constriction in conjunction with protein kinase C activation through an alternative activation pathway. Other sequences of activation are also possible. For example, in cultured vascular SM cell lines (A7r5) clamped at a constant Em, activation of protein kinase C by phorbol esters results in the initiation of an L-type Ca2+ current that can be blocked by dihydropyridine antagonists.30 It is possible that elevations in pressure, perhaps via activation of phospholipase C and production of diacylglycerol, might activate protein kinase C,26 27 which in turn could be involved in promoting PDC by opening L-type Ca2+ channels directly, in a voltage-independent manner.30 Regardless of the sequence of events, if PDC in the MCAs of SHR involved pressure-induced depolarization and Ca2+ entry through voltage-gated L-type Ca2+ channels, the maintenance of a constant SM Em at varying pressure and an inability to constrict in response to depolarization would act to inhibit PDC. Likewise, even if Ca2+ entry into the SM through L-type Ca2+ channels was initiated via other signal transduction mechanisms that did not involve SM depolarization (such as protein kinase C activation), a dysfunction in the Ca2+ channel, such as that observed in the present study, could also affect the ability of the latter signals to operate the channel and initiate PDC.
| Acknowledgments |
|---|
| Footnotes |
|---|
Received October 7, 1999; revision received December 13, 1999; accepted December 14, 1999.
| References |
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Department of Obstetrics/Gynecology, University of Vermont, College of Medicine, Burlington, Vermont
| Introduction |
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A pharmacological approach (modulation of extracellular calcium and
potassium concentrations; use of a calcium channel blocker) in
combination with electrophysiology (microelectrode impalement of smooth
muscle) was applied to isolated, pressurized segments of the middle
cerebral artery from 9- to 18-week-old SHRsp and
stroke-resistant rats (SHRsr). The results show that
arterial smooth muscle from SHRsp animals that have
recently undergone a stroke is unable to hyperpolarize when
pressure is decreased (Table 1
) and that
vessels lose their ability to change diameter in response to pressure
(Figures 1A
and 1B
). SHRsp arteries were also more found to be more
sensitive to nifedipine (Figure 2A
) and less sensitive to
extracellular calcium (Figure 4B
), even under depolarized conditions
(Figures 2B
and 4B
), and did not constrict to potassium depolarization
(Figures 5
and 6
). This loss of reactivity could not be attributed to a
defect in the contractile apparatus, because responsiveness
to vasopressin, a constrictor agonist, was preserved. Together, these
observations suggest that cerebral arteries from post-stroke SHRsp
possess dysfunctional voltage gated calcium channels, and that the
consequence of this defect is to uncouple the mechanosensory elements
within the vascular wall from the regulation of smooth muscle membrane
potential, cytosolic calcium, and arterial diameter.
Some of these functional alterations precede the onset of stroke; hence, severe and progressive hypertension, and not stroke per se, appears to be the most likely culprit. It deserves note that systolic pressures in SHRsp continued to increase from just over 200 mm Hg (statistically similar to SHRsp) to a significantly higher mean value of 233 mm Hg in the poststroke SHRsp group and that the severity of the defects increased accordingly over time.
I found the PIT versus PDC terminology somewhat confusing, since a
diminished but significant degree of tone (approximately 30%; see
Figure 1
) does develop in poststroke SHRsp vessels during equilibration
at 100 mm Hg, presumably in response to the stimulus of pressure.
If it is pressure induced, can it really be called pressure
independent? This is partly semantic and of secondary importance. The
key point, however, is that the combination of reduced pial
artery tone, and an inability to modulate that tone (via changes in
membrane potential and calcium) in response to considerable (100
mm Hg) fluctuations in pressure, would most likely affect both
cerebrovascular resistance and blood flow autoregulation, and
might therefore be important in the etiology of hemorrhagic stroke.
Both changes favor exposure of smaller, more fragile downstream vessels
to higher transmural pressures, thereby increasing wall tension and
potentially leading to rupture and intracerebral
hemorrhage.
The challenge ahead is to understand just how high intravascular pressures alter cellular function and to determine whether this defect persists in the intact, living animal. Although a number of studies have reported effects of pressure or stretch on gene activation in a variety of cells, the link between chronic hypertension and vascular smooth muscle calcium channel expression and function has yet to be described in any detail.
Received October 7, 1999; revision received December 13, 1999; accepted December 14, 1999.
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