Nitric oxide and vasodilation in human limbs

Joyner, Michael J., and Niki M. Dietz.Nitric oxide and vasodilation in human limbs. J. Appl. Physiol. 83(6): 1785-1796, 1997.Both theskeletal muscle and skin of humans possess remarkable abilities tovasodilate. Marked vasodilation can be seen in these vascular beds inresponse to a variety of common physiological stimuli. These stimuliinclude reactive hyperemia (skin and muscle), exercise hyperemia(muscle), mental stress (muscle), and whole body heating (skin). Thephysiological mechanisms that cause vasodilation in response to thesestimuli are poorly understood, and the substance(s) responsible for itremain unclear. In this context, recent attention has been focused onthe possible contribution of nitric oxide (NO) to the regulation ofhyperemic responses in human skin and skeletal muscle. The emergingpicture is that NO is not an essential component of the dilatorresponse seen during reactive hyperemia. However, it does appear thatNO may play a modest role in exercise hyperemia. NO appears to play amajor role in the skeletal muscle vasodilation seen in response tomental stress in humans. Preliminary evidence also indicates that NO isnot essential for the normal dilator responses observed in thecutaneous circulation during body heating in humans, but this issueneeds further study. There are a number of possible mechanisms thatmight mediate NO release in humans, and the role of these mechanisms inthe various hyperemic responses is also poorly understood. The role ofaltered NO-mediated vasodilation in some disease states is alsodiscussed. Whereas NO is a potent vasodilating substance, the actionsof NO alone do not explain a variety of poorly understood vasodilatormechanisms in conscious humans. Much work remains for those interestedin the role of NO in the regulation of blood flow to the skin and skeletal muscle of humans.