Single-exhalation profiles of NO and CO2 in humans: effect of dynamically changing flow rate

Endogenousproduction of nitric oxide (NO) in the human lungs has many importantpathophysiological roles and can be detected in the exhaled breath. Anunderstanding of the factors that dictate the shape of the NOexhalation profile is fundamental to our understanding of normal anddiseased lung function. We collected single-exhalation profiles of NOand CO₂ from normal human subjectsafter inhalation of ambient air (~15 parts/billion) and examined theeffect of a 15-s breath hold and exhalation flow rate(_E) on thefollowing features of the NO profile:1) series dead space,2) average concentration in phaseIII with respect to time and volume,3) normalized slope of phase IIIwith respect to time and volume, and4) elimination rate at endexhalation. The dead space is ~50% smaller for NO than forCO₂ and is substantially reducedafter a breath hold. The concentration of exhaled NO is inverselyrelated to _E,but the average NO concentration with respect to time has a stronger inverse relationship than that with respect to volume. The normalized slope of phase III NO with respect to time and that with respect tovolume are negative at a constant_E but can bemade to change signs if the flow rate continuously decreases during theexhalation. In addition, NO elimination at end exhalation vs._E produces anonzero intercept and slope that are subject dependent and can be usedto quantitate the relative contribution of the airways and the alveolito exhaled NO. We conclude that exhaled NO has an airway and analveolar source.

     

Endothelial Ca2+ wavelets and the induction of myoendothelial feedback

When arteries constrict to agonists, the endothelium inversely responds, attenuating the initial vasomotor response. The basis of this feedback mechanism remains uncertain, although past studies suggest a key role for myoendothelial communication in the signaling process. The present study examined whether second messenger flux through myoendothelial gap junctions initiates a negative-feedback response in hamster retractor muscle feed arteries. We specifically hypothesized that when agonists elicit depolarization and a rise in second messenger concentration, inositol trisphosphate (IP(3)) flux activates a discrete pool of IP(3) receptors (IP(3)Rs), elicits localized endothelial Ca(2+) transients, and activates downstream effectors to moderate constriction. With use of integrated experimental techniques, this study provided three sets of supporting observations. Beginning at the functional level, we showed that blocking intermediate-conductance Ca(2+)-activated K(+) channels (IK) and Ca(2+) mobilization from the endoplasmic reticulum (ER) enhanced the contractile/electrical responsiveness of feed arteries to phenylephrine. Next, structural analysis confirmed that endothelial projections make contact with the overlying smooth muscle. These projections retained membranous ER networks, and IP(3)Rs and IK channels localized in or near this structure. Finally, Ca(2+) imaging revealed that phenylephrine induced discrete endothelial Ca(2+) events through IP(3)R activation. These events were termed recruitable Ca(2+) wavelets on the basis of their spatiotemporal characteristics. From these findings, we conclude that IP(3) flux across myoendothelial gap junctions is sufficient to induce focal Ca(2+) release from IP(3)Rs and activate a discrete pool of IK channels within or near endothelial projections. The resulting hyperpolarization feeds back on smooth muscle to moderate agonist-induced depolarization and constriction.     

Multiple factors influence calcium synchronization in arterial vasomotion

The intercellular synchronization of spontaneous calcium (Ca(2+)) oscillations in individual smooth muscle cells is a prerequisite for vasomotion. A detailed mathematical model of Ca(2+) dynamics in rat mesenteric arteries shows that a number of synchronizing and desynchronizing pathways may be involved. In particular, Ca(2+)-dependent phospholipase C, the intercellular diffusion of inositol trisphosphate (IP(3), and to a lesser extent Ca(2+)), IP(3) receptors, diacylglycerol-activated nonselective cation channels, and Ca(2+)-activated chloride channels can contribute to synchronization, whereas large-conductance Ca(2+)-activated potassium channels have a desynchronizing effect. Depending on the contractile state and agonist concentrations, different pathways become predominant, and can be revealed by carefully inhibiting the oscillatory component of their total activity. The phase shift between the Ca(2+) and membrane potential oscillations can change, and thus electrical coupling through gap junctions can mediate either synchronization or desynchronization. The effect of the endothelium is highly variable because it can simultaneously enhance the intercellular coupling and affect multiple smooth muscle cell components. Here, we outline a system of increased complexity and propose potential synchronization mechanisms that need to be experimentally tested.     

A two-compartment model of pulmonary nitric oxide exchange dynamics

The relativelyrecent detection of nitric oxide (NO) in the exhaled breath hasprompted a great deal of experimentation in an effort to understand thepulmonary exchange dynamics. There has been very little progress intheoretical studies to assist in the interpretation of the experimentalresults. We have developed a two-compartment model of the lungs in aneffort to explain several fundamental experimental observations. Themodel consists of a nonexpansile compartment representing theconducting airways and an expansile compartment representing thealveolar region of the lungs. Each compartment is surrounded by a layerof tissue that is capable of producing and consuming NO. Beyond thetissue barrier in each compartment is a layer of blood representing thebronchial circulation or the pulmonary circulation, which are bothconsidered an infinite sink for NO. All parameters were estimated fromdata in the literature, including the production rates of NO in the tissue layers, which were estimated from experimental plots of theelimination rate of NO at end exhalation (E_NO) vs. theexhalation flow rate (_E). The modelis able to simulate the shape of the NO exhalation profile and tosuccessfully simulate the following experimental features of endogenousNO exchange: 1) an inverse relationship between exhaled NOconcentration and _E, 2) the dynamic relationship between the phase III slope and_E, and 3) the positiverelationship between E_NO and_E. The model predicts that theserelationships can be explained by significant contributions of NO inthe exhaled breath from the nonexpansile airways and the expansilealveoli. In addition, the model predicts that the relationship betweenE_NO and _E can be used as anindex of the relative contributions of the airways and the alveoli toexhaled NO.

     

A single-breath technique with variable flow rate to characterize nitric oxide exchange dynamics in the lungs.

Current techniques to estimate nitric oxide (NO) production and elimination in the lungs are inherently nonspecific or are cumbersome to perform (multiple-breathing maneuvers). We present a new technique capable of estimating key flow-independent parameters characteristic of NO exchange in the lungs: 1) the steady-state alveolar concentration (C(alv,ss)), 2) the maximum flux of NO from the airways (J(NO,max)), and 3) the diffusing capacity of NO in the airways (D(NO,air)). Importantly, the parameters were estimated from a single experimental single-exhalation maneuver that consisted of a preexpiratory breath hold, followed by an exhalation in which the flow rate progressively decreased. The mean values for J(NO,max), D(NO,air), and C(alv,ss) do not depend on breath-hold time and range from 280-600 pl/s, 3.7-7.1 pl. s(-1). parts per billion (ppb)(-1), and 0.73-2.2 ppb, respectively, in two healthy human subjects. A priori estimates of the parameter confidence intervals demonstrate that a breath hold no longer than 20 s may be adequate and that J(NO,max) can be estimated with the smallest uncertainty and D(NO,air) with the largest, which is consistent with theoretical predictions. We conclude that our new technique can be used to characterize flow-independent NO exchange parameters from a single experimental single-exhalation breathing maneuver.     

A computational model of oxygen transport in skeletal muscle for sprouting and splitting modes of angiogenesis

Oxygen transport from capillary networks in muscle at a high oxygen consumption rate was simulated using a computational model to assess the relative efficacies of sprouting and splitting modes of angiogenesis. Efficacy was characterized by the volumetric fraction of hypoxic tissue and overall heterogeneity of oxygen distribution at steady state. Oxygen transport was simulated for a three-dimensional vascular network using parameters for rat extensor digitorum longus (EDL) muscle when oxygen consumption by tissue reached 6, 12, and 18 times basal consumption. First, a control network was generated by using straight non-anastomosed capillaries to establish baseline capillarity. Two networks were then constructed simulating either abluminal lateral sprouting or intraluminal splitting angiogenesis such that capillary surface area was equal in both networks. The sprouting network was constructed by placing anastomosed capillaries between straight capillaries of the control network with a higher probability of placement near hypoxic tissue. The splitting network was constructed by splitting capillaries from the control network into two branches at randomly chosen branching points. Under conditions of moderate oxygen consumption (6 times basal), only minor differences in oxygen delivery resulted between the sprouting and splitting networks. At higher consumption levels (12 and 18 times basal), the splitting network had the lowest volume of hypoxic tissue of the three networks. However, when total blood flow in all three networks was made equal, the sprouting network had the lowest volume of hypoxic tissue. This study also shows that under the steady-state conditions the effect of myoglobin (Mb) on oxygen transport was small.     

A mathematical model of Ca2+ dynamics in rat mesenteric smooth muscle cell: agonist and NO stimulation

A mathematical model of calcium dynamics in vascular smooth muscle cell (SMC) was developed based on data mostly from rat mesenteric arterioles. The model focuses on (a) the plasma membrane electrophysiology; (b) Ca²⁺ uptake and release from the sarcoplasmic reticulum (SR); (c) cytosolic balance of Ca²⁺, Na⁺, K⁺, and Cl⁻ ions; and (d) IP₃ and cGMP formation in response to norepinephrine (NE) and nitric oxide (NO) stimulation. Stimulation with NE induced membrane depolarization and an intracellular Ca²⁺ ([Ca²⁺]_i) transient followed by a plateau. The plateau concentrations were mostly determined by the activation of voltage-operated Ca²⁺ channels. NE causes a greater increase in [Ca²⁺]_i than stimulation with KCl to equivalent depolarization. Model simulations suggest that the effect of [Na⁺]_i accumulation on the Na⁺/Ca²⁺ exchanger (NCX) can potentially account for this difference. Elevation of [Ca²⁺]_i within a concentration window (150-300 nM) by NE or KCl initiated [Ca²⁺]_i oscillations with a concentration-dependent period. The oscillations were generated by the nonlinear dynamics of Ca²⁺ release and refilling in the SR. NO repolarized the NE-stimulated SMC and restored low [Ca²⁺]_i mainly through its effect on Ca²⁺-activated K⁺ channels. Under certain conditions, Na⁺-K⁺-ATPase inhibition can result in the elevation of [Na⁺]_i and the reversal of NCX, increasing resting cytosolic and SR Ca²⁺ content, as well as reactivity to NE. Blockade of the NCX's reverse mode could eliminate these effects. We conclude that the integration of the selected cellular components yields a mathematical model that reproduces, satisfactorily, some of the established features of SMC physiology. Simulations suggest a potential role of intracellular Na⁺ in modulating Ca²⁺ dynamics and provide insights into the mechanisms of SMC constriction, relaxation, and the phenomenon of vasomotion. The model will provide the basis for the development of multi-cellular mathematical models that will investigate microcirculatory function in health and disease.