Stimulation of nonshivering thermogenesis in the Syrian hamster by norepinephrine and β-selective adrenergic agents: A phenomenon of refractoriness

The ability of different adrenergic agents to stimulate nonshivering thermogenesis in Syrian hamsters was investigated. The hamsters were cold-acclimated to 6 °C and their thermogenic response was investigated in an open-circuit system at 24 °C. Both norepinephrine and the β₃-specific adrenergic agonist CGP-12177 induced a high rate of nonshivering thermogenesis. However, neither CGP-12177 nor other β₃-selective agonists (BRL-37344, ICI-D7114) could induce nonshivering thermogenesis fully to the extent induced by norepinephrine. It was further observed that an apparent “thermogenic refractoriness” was induced by certain adrenergic agents (isoprenaline, CGP-12177) but not by others (norepinephrine, BRL-37344, ICI-D7114). It is discussed whether the refractoriness could be secondary to effects of these agents on the vascular system. It is pointed out that the thermogenic response to adrenergic stimulation observed in the intact animal does not always fully correspond to what would be predicted from corresponding studies with isolated brown-fat cells.     

Diminished respiratory responses of brown adipocytes isolated from BIO 14.6 dystrophic hamsters

Catecholamine-induced thermogenesis is significantly diminished in BIO 14.6 cardiomyopathic hamsters as demonstrated by a reduced increase in oxygen consumption of these hamsters in response to administered isoproterenol. This decreased responsiveness is accompanied by a reduction in the amount of brown adipose tissue, a major nonshivering thermogenic effector. The present study demonstrates that the metabolic responses of individual brown fat cells are also altered in the dystrophic hamster. That is, 1 microM norepinephrine, the physiological mediator of nonshivering thermogenesis, evoked rates of oxygen consumption that were significantly lower in brown adipocytes isolated from the BIO 14.6 hamsters than in those from normal controls. Additionally, the dystrophic adipocytes exhibited: decreased maximal activity (per cell as well as per milligram protein) of citrate synthase; decreased cell size; and decreased amounts of protein per cell. These data indicate that the nonshivering thermogenic capacity of the intact BIO 14.6 hamsters reflects altered characteristics of the individual brown adipocytes themselves, as well as decreased amounts of the tissue.     

Thermogenic response to insulin and glucose infusions in man: A model to evaluate the different components of the thermic effect of carbohydrate

The thermogenic response to an insulin and glucose infusion was determined in 10 healthy lean volunteers using a euglycemic clamp technique in conjunction with respiratory exchange measurements. The progressive rise in resting metabolic rate (RMR) from 4.295 ± 0.360 kJ/min during the baseline to 4.771 ± 0.410 kJ/min during the 90–120 min period of the euglycemic clamp (p < 0.01) correlated with the progressive increase in the glucose infusion rate (r = 0.836, p < 0.01), with the glucose storage rate (r = 0.812, p < 0.01), but not with the significant rise in insulin or norepinephrine concentrations. Storage of nutrients, as well as increased sympathetic nervous system (SNS) activity are known to increase RMR. Two thirds to three quarters of the observed increment in RMR following the insulin and glucose infusion in this study can be accounted for by the metabolic processing of the infused glucose for storage purposes. The rest of the thermogenic response (24–35%) must be explained by other mechanisms such as increased SNS activity.     

Characteristics of diet-induced brown adipose tissue growth and thermogenesis in rats

The characteristics of regional brown (BAT) and white adipose tissue (WAT) growth and of thermogenesis following experimental overfeeding were studied in groups of male Sprague-Dawley rats fed lab chow or cafeteria diets for 8 weeks postweaning. Regional BAT and WAT growth was determined by dissection and weighing, and thermogenesis was characterized by measurements of resting and norepinephrine (NE)-stimulated oxygen consumption, of serum thyroid hormone concentrations, and of 24-hour urinary NE excretion levels. Cafeteria feeding resulted in a 113% increase in total BAT, with the most prominent increases in the interscapular, thoracic, and perirenal regions. Retroperitoneal, epididymal, and omental WAT were significantly greater in cafeteria than in chow-fed rats. Resting oxygen consumption of cafeteria-fed rads increased by 10% and NE excretion by 64% compared to chow-fed controls, while serum T₃ concentrations were nearly doubled in the cafeteria-fed rats. The thermogenic response to NE injection in cafeteria-fed rats was 102% of their resting levels, compared to a 51% increase in the chow-fed controls. The results indicate that increased BAT growth occurs in all primary BAT depots following cafeteria-feeding in rats, and that the greater BAT mass is qualitatively proportional to their greater capacity for non-shivering thermogenesis. Also, the increased NE excretion and greater serum T₃ concentration are consistent with increased sympathetic and thyroidal activity and may in part explain the thermogenic response to diet in the rat.     

Thermogenic and hormonal responses to palatable protein and carbohydrate rich food.

Simultaneous variations of oxygen consumption, and plasma insulin and norepinephrine were measured during the postprandial cephalic and gastrointestinal phases of feeding in six human subjects following the ingestion of various nutrients. On alternative days the subjects were given foods (1280 kjoules) either rich in carbohydrates (sugar pie) or in proteins (fish). Both nutrients produced an initial (0-40 min) enhanced thermogenesis and an early (2 min) cephalic insulin release. During that period, elevations of plasma norepinephrine were also observed with pie feeding at 10 and 30 min and at 10 min with fish. Palatability ratings indicated that both food items were equally tasting. During the gastrointestinal phase (40 to 120 min) the variations of these same parameters including glucagon seem to be explained by the content in carbohydrates and proteins in the food rather than by its palatability. Indeed during that period the protein meal was more thermogenic and the carbohydrate meal induced the expected insulin secretion. These results suggest that the palatability of the food is responsible for the early cephalic increase in postprandial thermogenesis, and for the insulin and norepinephrine release. During the subsequent gastrointestinal phase the increased thermogenesis is related to the composition of the food which exerts its action by the biochemical processes involved in the disposal of the absorbed nutrients.     

Does food shortage delay development of homeothermy in European shag nestlings (<Emphasis Type="Italic">Phalacrocorax aristotelis</Emphasis>)?

Nestlings seem to face a trade-off between reducing the basal level of energy metabolism, as an energy-saving response, and maintaining thermogenic capacity during temporal food shortage. In the present study we examined developmental responses to short-term diet restriction of 12–16 day old nestling European shags kept under laboratory conditions and tested whether temporal food shortage delay the development of homeothermy. During food shortage the European shag nestlings substantially reduced basal level of energy metabolism, resulting in significant energy savings. The reduction in basal level of energy metabolism corresponded with a reduction in peak metabolic rate. At the same time, the low peak metabolic rate of diet-restricted nestlings was offset by a lower mass-specific minimal thermal conductance, and an increased mass-specific absolute scope. Consequently, the insulation and the portion of peak metabolic rate available for regulatory thermogenesis seemed to develop normally, as expected from age, during the period of food shortage. Further, the degree of homeothermy, measured as the index of homeothermy, was not significantly lower in diet-restricted nestlings compared to controls at the same age. We conclude that temporal food shortage did not significantly delay the development of homeothermy in the European shag nestlings despite substantial reductions in basal level of energy metabolism and peak metabolic rate.Communicated by: G. Heldmaier     

Supramaximal heat production induced by aminophylline in temperature-acclimated rats

Previous studies have shown that aminophylline, a phosphodiesterase inhibitor (thereby increasing intracellular cyclic AMP concentration) elicits supramaximal heat production and improves cold tolerance in rats acclimated to 22°C. To test whether aminophylline-stimulated supramaximal thermogenesis is independent of both the thermogenic capacity (i.e. aerobic fitness) and the mode of thermogenesis (shivering vs. non-shivering), rats (adult male Sprague-Dawley, approximately 400 g) of two different ages (4–11 month and 9–17 month, n=12 for each) were acclimated to 5, 15, and 25°C in succession and their thermogenic responses to aminophylline subsequently assessed. Aminophylline elicited supramaximal thermogenesis and improved cold tolerance regardless of age or acclimating temperatures. Further, the absolute net increase in heat production stimulated by aminophylline was also similar for all acclimating temperatures. After acclimating to 15°C, a single injection of aminophylline in the older rats elicited thermogenesis greater than that of the controls acclimated to 5°C; in the younger rats, aminophylline duplicated 46% of the increase in thermogenesis observed after acclimating to 5°C. These results indicated that the aminophylline-stimulated extra heat production is independent of both the thermogenic capacity and the mode of thermogenesis. It is possible that an enhanced substrate mobilization consequent to increased intracellular cyclic AMP concentration by aminophylline underlies the common mechanism via which supramaximal thermogenesis is elicited in temperature-acclimated rats.     

Thermogenic responses in brown fat cells are fully UCP1-dependent. UCP2 or UCP3 do not substitute for UCP1 in adrenergically or fatty scid-induced thermogenesis

To examine the thermogenic significance of the classical uncoupling protein-1 (UCP1), the thermogenic potential of brown adipocytes isolated from UCP1-ablated mice was investigated. Ucp1(-/-) cells had a basal metabolic rate identical to wild-type; the mitochondria within them were coupled to the same degree. The response to norepinephrine in wild-type cells was robust ( approximately 10-fold increase in thermogenesis); Ucp1(-/-) cells only responded approximately 3% of this. Ucp1(-/-) cells were as potent as wild-type in norepinephrine-induced cAMP accumulation and lipolysis and had a similar mitochondrial respiratory complement. In wild-type cells, fatty acids induced a thermogenic response similar to norepinephrine, but fatty acids (and retinoate) were practically without effect in Ucp1(-/-) cells. It is concluded that no other adrenergically induced thermogenic mechanism exists in brown adipocytes except that mediated by UCP1 and that entopic expression of UCP1 does not lead to overt innate uncoupling, and it is suggested that fatty acids are transformed to an intracellular physiological activator of UCP1. High expression of UCP2 and UCP3 in the tissue was not associated with an overt innate highly uncoupled state of mitochondria within the cells, nor with an ability of norepinephrine or endo- or exogenous fatty acids to induce uncoupled respiration in the cells. Thus, UCP1 remains the only physiologically potent thermogenic uncoupling protein in these cells.     

CH-19 Sweet,a Non-Pungent Cultivar of Red Pepper,Increased Body Temperature and Oxygen Consumption in Humans

We investigated the effect of CH-19 Sweet, a nonpungent cultivar of red pepper, on body temperature and oxygen consumption in humans. CH-19 Sweet was given to 11 healthy volunteers, and core body temperature, body surface temperature and oxygen consumption were measured. The control group ingested California-Wandar, which contained neither capsaicin nor capsiate. The core body temperature in the CH-19 Sweet group was significantly higher than that in the control group (P<0.01). The forehead temperature measured by infrared thermography in the CH-19 Sweet group was significantly higher than that in the control group. The body surface temperature was increased for about 20 min after consumption of CH-19 Sweet intake, and the neck temperature was significantly higher (P<0.001) than when the subjects consumed California-Wandar. We also measured respiratory gas by indirect calorimetry while subjects wore a face mask. A significant difference was detected in oxygen consumption between the two groups, and the value was significantly higher in the CH-19 Sweet group (P<0.03). These results suggest that CH-19 Sweet increased thermogenesis and energy consumption.     

Shivering modulation in humans: Effects of rapid changes in environmental temperature

During cold exposure, increase in heat production is produced via the activation of shivering thermogenesis and nonshivering thermogenesis, the former being the main contributor to compensatory heat production in non-acclimatized humans. In rats, it has been demonstrated that shivering thermogenesis is modulated solely by skin thermoreceptors but this modulation has yet to be investigated in humans. The aim of this study was to determine if cold-induced shivering in humans can be modulated by cutaneous thermoreceptors in conditions where increases in heat loss can be adequately compensated by increases in thermogenic rate. Using a liquid-conditioned suit, six non-acclimatized men were exposed to cold (6 °C) for four 30 min periods, each of them separated by 15 min of heat exposure (33 °C). Core temperature remained stable throughout exposures whereas skin temperatures significantly decreased by 12% in average during the sequential cold/heat exposures compared to baseline (p<0.0001). Shivering intensity and metabolic rate increased significantly during 6 °C exposures (3.3±0.7% MVC, 0.40±0.0 L O₂/min, respectively) and were significantly reduced during 33 °C exposure (0.5±0.1% MVC, 0.25±0.0 L O₂/min; p<0.005 for both). Most importantly, shivering could be quickly and strongly inhibited during 33 °C exposure although skin temperature often remained below baseline values. In conclusion, under compensatory conditions, cutaneous thermoreceptors appear to be a major modulator of the shivering response in humans and seem to react rapidly to changes in the microclimate right next to the skin and to skin temperature.     

Oxygenation and establishment of thermogenesis in the avian embryo

The production of heat (or thermogenesis) and its response to cold improve very quickly around birth in both mammals and birds. The mechanisms for such rapid perinatal development are not fully understood. Previous experiments with hyperoxia suggested that, during the last phases of incubation, eggshell and membranes might pose a limit to oxygen availability. Hence, it was hypothesized that an improvement in oxygenation by opening the eggshell may contribute to the establishment of thermogenesis. Thermogenesis and its response to cold were measured by indirect calorimetry, in warm (38 degrees C) conditions and during 1-h exposure to 30 degrees C. Both improved throughout the various phases of the hatching process. During the latest incubation phases (internal pipping, IP, and star fracture of external pipping, EP), the removal of the eggshell in the region above the air cell raised metabolic rate both in warm and cold conditions (in IP) or the thermogenic response to cold (in EP). Adding hyperoxia after opening the eggshell caused no further increase in the thermogenic response. In cold-incubated embryos thermogenesis during the EP phase was much less than normal; in these embryos, increasing the oxygen availability did not improve thermogenesis. We conclude that oxygenation contributes to the maturation of the thermogenic mechanisms in the perinatal period as long as these mechanisms have initiated their normal developmental process.     

Altered Brown Adipose Tissue and Na,K Pump Activities During Diet-Induced Obesity and Weight Loss in Rats

Brown adipose tissue (BAT) thermogenesis is an uncoupled ATPase-independent thermogenic mechanism. Ion transport by the Na,K pump is an ATPase- dependent thermogenic mechanism. Both have been proposed as mechanisms of altered energy expenditure during states of dietary energy surfeit and deficit. Our aim was to study these mechanisms during diet-induced obesity and weight loss. Over 36 weeks rats were fed lard- or tallow-based diets (63% energy as fat), or a control diet (12% energy as fat). During periods of restriction rats were fed 50% of the energy intake of controls in the form of a control diet. Several components of thermogenic response increased in rats eating high fat diets and decreased following dietary restriction. BAT activation occurred, particularly with a lard-based diet, as indicated by increased GDP binding and uncoupling protein (UCP) content. Na,K pump activity in thymocytes increased with the feeding of both high fat diets at some time points. Plasma T₃ level increased in rats eating the lard-based diet and decreased with dietary restriction regardless of previous diet. Resting metabolic rate (RMR) of the animals was unchanged despite increases in these thermogenic components and was decreased in all groups following dietary restriction. Our results indicate a lack of any major role for activated BAT thermogenesis in mitigating the extent of the obesity induced by the high fat diets. The reasons for the differences in response to the two different sources of saturated fat, lard, and tallow, are not clear.     

Activation of Toll-like Receptor 4 (TLR4) Attenuates Adaptive Thermogenesis via Endoplasmic Reticulum Stress

Adaptive thermogenesis is the cellular process transforming chemical energy into heat in response to cold. A decrease in adaptive thermogenesis is a contributing factor to obesity. However, the molecular mechanisms responsible for the compromised adaptive thermogenesis in obese subjects have not yet been elucidated. In this study we hypothesized that Toll-like receptor 4 (TLR4) activation and subsequent inflammatory responses are key regulators to suppress adaptive thermogenesis. To test this hypothesis, C57BL/6 mice were either fed a palmitate-enriched high fat diet or administered with chronic low-dose LPS before cold acclimation. TLR4 stimulation by a high fat diet or LPS were both associated with reduced core body temperature and heat release. Impairment of thermogenic activation was correlated with diminished expression of brown-specific markers and mitochondrial dysfunction in subcutaneous white adipose tissue (sWAT). Defective sWAT browning was concomitant with elevated levels of endoplasmic reticulum (ER) stress and autophagy. Consistently, TLR4 activation by LPS abolished cAMP-induced up-regulation of uncoupling protein 1 (UCP1) in primary human adipocytes, which was reversed by silencing of C/EBP homologous protein (CHOP). Moreover, the inactivation of ER stress by genetic deletion of CHOP or chemical chaperone conferred a resistance to the LPS-induced suppression of adaptive thermogenesis. Collectively, our data indicate the existence of a novel signaling network that links TLR4 activation, ER stress, and mitochondrial dysfunction, thereby antagonizing thermogenic activation of sWAT. Our results also suggest that TLR4/ER stress axis activation may be a responsible mechanism for obesity-mediated defective brown adipose tissue activation.     

Thermogenic capabilities of the opossum Monodelphis domestica when warm and cold acclimated: similarities between American and Australian marsupials

1. Monodelphis domestica is a small marsupial mammal from South America. Its thermogenic abilities in the cold were determined when the opossums were both warm (WA) and cold (CA) acclimated. Maximum heat production of M. domestica was obtained at low temperatures in helium-oxygen. 2. Basal metabolic rate (BMR) in the WA animals was 3.2 W/kg and mean body temperature was 32.6 degrees C at 30 degrees C. These values were lower than those generally reported for marsupials. Nevertheless, these M. domestica showed considerable metabolic expansibility in response to cold. Sustained (summit) metabolism was 8-9 times BMR, while peak metabolism was 11-13 times BMR. These maximum values were equal to, or above, those expected in small placentals. 3. Cold acclimation altered the thermal responses of M. domestica, particularly in warm TaS. However, summit metabolism was not significantly increased; nor did M. domestica show a significant thermogenic response to noradrenaline, which in many small placentals elicits non-shivering thermogenesis. The thermoregulatory responses of this American marsupial were, in most aspects, similar to those of Australian marsupials. This suggests that the considerable thermoregulatory abilities of marsupials are of some antiquity.     

The role of insulin in norepinephrine turnover and thermogenesis in brown adipose tissue after acute cold-exposure

The role of insulin in norepinephrine turnover (NE) and thermogenesis in brown adipose tissue (BAT) after acute cold-exposure was studied using streptozocin (STZ)-induced diabetic rats. NE turnover was estimated by the NE synthesis inhibition technique with alpha-methyl-p-tyrosine. BAT thermogenesis was estimated by measuring mitochondrial guanosine-5'-diphosphate (GDP), cytochrome oxidase activity and mitochondrial oxygen consumption in BAT at an ambient temperature of 22 degrees C and during a six-hour cold-exposure at 4 degrees C. In insulin-deficient diabetic rats, the NE turnover, mitochondrial GDP binding, cytochrome oxidase activity and mitochondrial oxygen consumption in BAT at 22 degrees C were significantly reduced, compared with those of control rats. Treatment of STZ-induced diabetic rats with insulin prevented a decrease in NE turnover and BAT thermogenesis. Acute cold-exposure increased the NE turnover of BAT in insulin-deficient diabetic rats. The BAT thermogenic response to acute cold-exposure, however, did not occur in insulin-deficient diabetic rats. These results suggest that insulin is not essential in potentiating NE turnover in BAT after acute cold-exposure, but is required for cold-induced thermogenesis.     

Attenuation of noradrenergic neurotransmission by the thromboxane synthetase inhibitor,UK 38,485

The purpose of this study was to determine the effects of chronic administration of the thromboxane synthetase inhibitor, UK 38,485, on noradrenergic neurotransmission. Male Sprague Dawley rats (n=14) were treated once daily with either UK 38,485 (100 mg/kg; n=7) or the vehicle of UK 38,485 (olive oil; n=7) by gavage. The dose of UK 38,485 chosen was sufficient to inhibit $\text{ex vivo}$ platelet TXB₂ production by >90% for 24 hours. One week into the treatment animals were prepared for $\text{in situ}$ perfusion of their mesenteric vascular beds. Vasoconstrictor responses to both exogenous norepinephrine and periarterial nerve stimulation were determined both before and during an infusion of angiotensin II (9ng/min) into the superior mesenteric artery. UK 38,485 significantly (P<0.02) attenuated the vascular response to periarterial nerve stimulation without altering the vascular response to either norepinephrine or angiotensin II. UK 38,485 did not influence the baseline perfusion pressure, the mean arterial blood pressure or the potentiation of neurotransmission by angiotensin II. These data indicate that in the $\text{in situ}$ rat mesentery UK 38,485 attenuates the release of neurotransmitter from sympathetic nerve terminals.     

Energy expenditure in children with type I diabetes: evidence for increased thermogenesis.

The aim of the study was to assess whether increased energy expenditure causes the negative energy balance (tissue catabolism) commonly seen in children with insulin dependent (type I) diabetes. Resting metabolic rate and thermogenesis induced by adrenaline were measured in five healthy children and 14 children with type I diabetes who were all free of clinical signs of late complications of diabetes mellitus but differed in their degree of glycaemic control (in eight glycated haemoglobin concentration was less than 10% and in the six others greater than or equal to 10%). When compared with the control subjects children with type I diabetes had normal resting metabolic rates but their urinary nitrogen excretion was significantly raised (11.5 (SD 5.4) mg/min in those with glycated haemoglobin concentration less than 10%, 11.6 (5.2) mg/min in those with concentration greater than or equal to 10% v 5.4 (3.0) mg/min in control subjects). During the infusion of adrenaline the diabetic children showed a threefold and sustained increase in thermogenesis and disproportionate increases in the work done by the heart, in lipid oxidation rate, and in plasma concentrations of glucose, free fatty acids, and ketone bodies. The increased thermogenic effect of adrenaline did not correlate with the degree of glycaemic control. Increased thermogenesis may explain the tissue wasting commonly seen in children with type I diabetes during intercurrent stress.     

Mutations in cytoplasmic dynein lead to a Huntington's disease-like defect in energy metabolism of brown and white adipose tissues

The molecular motor dynein is regulated by the huntingtin protein, and Huntington's disease (HD) mutations of huntingtin disrupt dynein motor activity. Besides abnormalities in the central nervous system, HD animal models develop prominent peripheral pathology, with defective brown tissue thermogenesis and dysfunctional white adipocytes, but whether this peripheral phenotype is recapitulated by dynein dysfunction is unknown. Here, we observed prominently increased adiposity in mice harboring the legs at odd angles (Loa/+) or the Cramping mutations (Cra/+) in the dynein heavy chain gene. In Cra/+ mice, hyperadiposity occurred in the absence of energy imbalance and was the result of impaired norepinephrine-stimulated lipolysis. A similar phenotype was observed in 3T3L1 adipocytes upon chemical inhibition of dynein showing that loss of functional dynein leads to impairment of lipolysis. Ex vivo, dynein mutant adipose tissue displayed increased reactive oxygen species production that was, at least partially, responsible for the decreased cellular responses to norepinephrine and subsequent defect in stimulated lipolysis. Dynein mutation also affected norepinephrine efficacy to elicit a thermogenic response and led to morphological abnormalities in brown adipose tissue and cold intolerance in dynein mutant mice. Interestingly, protein levels of huntingtin were decreased in dynein mutant adipose tissue. Collectively, our results provide genetic evidence that dynein plays a key role in lipid metabolism and thermogenesis through a modulation of oxidative stress elicited by norepinephrine. This peripheral phenotype of dynein mutant mice is similar to that observed in various animal models of HD, lending further support for a functional link between huntingtin and dynein.     

Effects of the capsaicin analogue resiniferatoxin on thermoregulation in anesthetized rats

(1) Administration of resiniferatoxin (RTX; 50 μg/kg, s.c.) induced triphasic metabolic responses with immediate facilitation followed by transitory inhibition and subsequent long-lasting facilitation in urethan-anesthetized rats. The temperature of skin increased immediately after the RTX injection, suggesting cutaneous vasodilation and heat loss. The colonic temperature decreased initially and then increased above the baseline level. (2) Pretreatment with ruthenium red, a putative vanilloid receptor (VN₂) antagonist, attenuated the RTX-induced heat loss and inhibition of heat production. (3) Adrenal demedullation selectively attenuated the RTX-induced immediate thermogenesis, and the β-blocker propranolol prevented both phases of thermogenesis. Thus, the sympathetic nervous system and adrenaline contributed to the thermogenic responses.     

Endothelium-dependent and -independent vasodilation of the superficial femoral artery in spinal cord-injured subjects

Extreme inactivity of the legs in spinal cord-injured (SCI) individuals does not result in an impairment of the superficial femoral artery flow-mediated dilation (FMD). To gain insight into the underlying mechanism, the present study examined nitric oxide (NO) responsiveness of vascular smooth muscles in controls and SCI subjects. In eight healthy men (34 +/- 13 yr) and six SCI subjects (37 +/- 10 yr), superficial femoral artery FMD response was assessed by echo Doppler. Subsequently, infusion of incremental dosages of sodium nitroprusside (SNP) was used to assess NO responsiveness. Peak diameter was examined on a second day after 13 min of arterial occlusion in combination with sublingual administration of nitroglycerine. Resting and peak superficial femoral artery diameter in SCI subjects were smaller than in controls (P < 0.001). The FMD response in controls (4.2 +/- 0.9%) was lower than in SCI subjects (8.2 +/- 0.9%, P < 0.001), but not after correcting for area under the curve for shear rate (P = 0.35). When expressed as relative change from baseline, SCI subjects demonstrate a significantly larger diameter increase compared with controls at each dose of SNP. However, when expressed as a relative increase within the range of diameter changes [baseline (0%) - peak diameter (100%)], both groups demonstrate similar changes in response to SNP. Changes in diameter during SNP infusion and FMD response are larger in SCI subjects compared with controls. When these results are corrected, superficial femoral artery FMD and NO sensitivity in SCI subjects are not different from those in controls. This illustrates the importance of appropriate data presentation and suggests that, subsequent to structural inward remodeling of conduit arteries as a consequence of extreme physical inactivity, arterial function is normalized.