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Departments of Anesthesiology and Critical Care Medicine and Pediatrics, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21205
Ammonia
intoxication, which results in astrocytic edema and glutamine
accumulation, blocks cerebral vasodilation during hypercapnia but not
during hypoxia. Ammonia's effect on blood flow during hypocapnia is
unclear, with some brain regions showing a paradoxical increase in
flow. Here, we studied the responses to hypocapnia of pial arterioles
not surrounded by astrocytic end feet to avoid mechanical compression
by local edema. Blood flow was measured by microspheres in
pentobarbital sodium-anesthetized rats equipped with closed cranial
windows that permitted intravital microscopy. The normal pial arterial
constriction in hypocapnia (12 ± 1%; mean ± SE) was
blocked (2 ± 1%) during a 6-h intravenous infusion of ammonium
acetate, with some regions (cerebrum, midbrain) showing increased flow
during hypocapnia. After pretreatment with methionine sulfoximine
(MSO), which inhibits glutamine synthesis, the normal hypocapnic
constrictor response was retained in pial arterioles (11 ± 2%) during hyperammonemia. The increase in the calculated cerebrovascular resistance also was retained. An analog of MSO that
does not block glutamine synthesis (buthionine sulfoximine) was
ineffective in maintaining hypocapnic reactivity. In a sodium acetate-treated control group, MSO did not alter the pial arteriolar response. Normal vasoconstrictive ability was shown during ammonium infusion in response to U-46619, a thromboxane analog. We conclude that
the inhibition of hypocapnic responsivity induced by ammonium is not
due to paralysis of the pial arteriolar smooth muscle or to vascular
compression by swollen astrocytes but is in some way due to glutamine
metabolically produced from the ammonium.
ammonia; carbon dioxide; cerebral circulation; glia; rat
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