Nitric oxide and cutaneous active vasodilation during heat stress in humans

Whether nitric oxide (NO) is involved incutaneous active vasodilation during hyperthermia in humans is unclear.We tested for a role of NO in this process during heat stress(water-perfused suits) in seven healthy subjects. Two forearm siteswere instrumented with intradermal microdialysis probes. One site wasperfused with the NO synthase inhibitorN^G-nitro-L-argininemethyl ester (L-NAME)dissolved in Ringer solution to abolish NO production. The other sitewas perfused with Ringer solution only. At those sites, skin blood flow(laser-Doppler flowmetry) and sweat rate were simultaneously andcontinuously monitored. Cutaneous vascular conductance, calculated fromlaser-Doppler flowmetry and mean arterial pressure, was normalized tomaximal levels as achieved by perfusion with the NO donor nitroprusside through the microdialysis probes. Under normothermic conditions, L-NAME did not significantlyreduce cutaneous vascular conductance. During hyperthermia, with skintemperature held at 38-38.5°C, internal temperature rose from36.66 ± 0.10 to 37.34 ± 0.06°C (P < 0.01). Cutaneous vascularconductance at untreated sites increased from 12 ± 2 to 44 ± 5% of maximum, but only rose from 13 ± 2 to 30 ± 5% ofmaximum at L-NAME-treated sites(P < 0.05 between sites) during heatstress. L-NAME had no effect onsweat rate (P > 0.05). Thuscutaneous active vasodilation requires functional NO synthase toachieve full expression.