Selective depression of endothelium-dependent dilations during cerebral ischemia

Background and Purpose: Pial arterioles have diverse mechanisms for endothelium-dependent dilations. In mice, different mechanisms or endothelium-derived mediators exist for each of the following dilators: acetylcholine, bradykinin, and calcium ionophore A-23187. This study tests the response to each of these dilators during profound ischemia. The response to sodium nitroprusside, an endothelium-independent dilator, was also tested. Methods: In each mouse, ischemia was produced by bilateral carotid artery ligation that reduced cortical blood flow by approximately 90% as determined by laser-Doppler flowmetry. In separate studies of 10 mice each, dilations of pial arterioles to two doses of each dilator were compared before and after 10 minutes of occlusion, with the occlusion continuing during the second set of measurements. The dilator was applied in the suffusate bathing the pial surface exposed at a craniotomy site. Diameters were monitored by in vivo television microscopy and image splitting. Results: The dose-dependent dilations to acetylcholine, bradykinin, and calcium ionophore A-23187 were each profoundly depressed during ischemia. The response to sodium nitroprusside was not depressed. In all cases, the ischemia was accompanied by arteriolar narrowing of approximately 25% and by obvious slowing of blood flow observed by intravital microscopy. Superoxide dismutase plus catalase failed to prevent the depressed response to acetylcholine. Conclusions: Endothelium-dependent dilations, mediated by diverse endothelium-derived relaxing factors, are depressed during ischemia of 10 to 15 minutes' duration. This cannot be a nonselective effect on vessel responsivity caused by constriction, reduced flow, or reduced intraluminal pressure during ischemia because under the same conditions dilation to endothelium- independent sodium nitroprusside is preserved. The selective endothelial dysfunction may play a role in exacerbating ischemia by precluding the ability of some dilators, released during ischemia, to dilate the resistance vessels.