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Am J Physiol Heart Circ Physiol 282: H2245-H2253, 2002. First published February 14, 2002; doi:10.1152/ajpheart.00972.2001
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Vol. 282, Issue 6, H2245-H2253, June 2002

Model of nitric oxide diffusion in an arteriole: impact of hemoglobin-based blood substitutes

Mahendra Kavdia, Nikolaos M. Tsoukias, and Aleksander S. Popel

Department of Biomedical Engineering and Center for Computational Medicine and Biology, School of Medicine, The Johns Hopkins University, Baltimore, Maryland 21205


    ABSTRACT
TOP
ABSTRACT
INTRODUCTION
MATHEMATICAL MODEL
RESULTS
DISCUSSION
REFERENCES

Administration of hemoglobin-based oxygen carriers (HBOCs) frequently results in vasoconstriction that is primarily attributed to the scavenging of endothelium-derived nitric oxide (NO) by cell-free hemoglobin. The ensuing pressor response could be caused by the high NO reactivity of HBOC in the vascular lumen and/or the extravasation of hemoglobin molecules. There is a need for quantitative understanding of the NO interaction with HBOC in the blood vessels. We developed a detailed mathematical model of NO diffusion and reaction in the presence of an HBOC for an arteriolar-size vessel. The HBOC reactivity with NO and degree of extravasation was studied in the range of 2-58 × 106 M-1 · s-1 and 0-100%, respectively. The model predictions showed that the addition of HBOC reduced the smooth muscle (SM) NO concentration in the activation range (12-28 nM) for soluble guanylate cyclase, a major determinant of SM contraction. The SM NO concentration was significantly reduced when the extravasation of HBOC molecules was considered. The myoglobin present in the parenchymal cells scavenges NO, which reduces the SM NO concentration.

mathematical model; microcirculation; extravasation; vasoconstriction; myoglobin


    INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
MATHEMATICAL MODEL
RESULTS
DISCUSSION
REFERENCES

NITRIC OXIDE (NO) is involved in many important physiological and pathophysiological processes, including regulation of vascular smooth muscle tone, inhibition of platelet aggregation, and neurotransmission (25). One of the pathways of regulation of vascular smooth muscle tone is the release of NO from the endothelial cell. The released NO diffuses into the lumen where it reacts with hemoglobin (oxy and/or deoxy Hb, ~2.3 mM concentration in blood) inside the red blood cells (RBCs), and into the nearby smooth muscle cells. In the smooth muscle cells, NO stimulates its target hemoprotein soluble guanylate cyclase (sGC) that catalyzes the conversion of guanosine triphosphate to cGMP thus relaxing smooth muscle cells (13). This endothelium-dependent vasorelaxation coupled with the known reactivity of hemoglobin toward NO has created widespread interest in the scientific community. Physiologically, hemoglobin is contained in RBCs and the effective reaction rate of NO with RBCs is several orders of magnitude smaller than with free hemoglobin (12, 18). The difference in reactivity of RBCs has been attributed to a very low membrane permeability for NO (12) and extracellular diffusion limitation (18). In any case, the NO bioactivity is preserved in the blood under normal physiological conditions.

Cell-free hemoglobins are being developed as hemoglobin-based oxygen carriers (HBOCs) that can temporarily replace RBCs (42). Several of these HBOCs, including cross-linked hemoglobin (Xl-Hb), polyethylene glycol (PEG)-conjugated hemoglobin (PEG-Hb), and recombinant hemoglobin (rHb), are currently in developmental stages or clinical trials as oxygen-carrying therapeutics. These HBOCs have been demonstrated to provide oxygen delivery and maintain circulating volume (35, 41). However, the transfusion of many of these HBOCs causes hypertension in various species, including humans (8, 30, 31). This hypertension resulting from vasoconstriction is often attributed to the scavenging of NO by the hemoglobin or oxyhemoglobin of HBOC, which causes a decrease in the steady-state level of biologically active endothelium-derived NO in the blood and surrounding smooth muscle (15, 26). The HBOC could be in the vascular lumen and/or in the vascular wall due to the extravasation. Using recombinant hemoglobins of varying NO reactivity, Doherty et al. (5) showed that the magnitude of pressor response depends directly on the NO reactivity with hemoglobin. In addition, Rohlfs et al. (31) showed correlation between NO binding affinities and blood pressure response.

There is a need for the knowledge about NO diffusion distance and concentration in the blood vessel in the presence of an HBOC. However, direct measurements of NO concentration in the microcirculation with high spatial resolution are not available. The fragile and unsteady nature of the porphyrinic-based microsensors renders direct measurement of NO concentrations in vivo very difficult (19). Thus it remains to be determined to what extent the plasma-based HBOC or the extravasation of HBOC affects the NO concentration, sufficient to impair endothelial-dependent dilation in vivo.

Mathematical models based on fundamental principles of mass balance, vessel geometry, and reaction kinetics can be used to predict NO concentration distribution in vivo. Buerk (1) reviewed mathematical models of NO biotransport, including the effects of NO on O2 transport and metabolism and hemoglobin scavenging of NO. In brief, Lancaster (16) published one of the first models of NO reaction-diffusion. His model used two endothelial cells 20 µm apart as point sources of NO production, and he concluded that the NO could diffuse a relatively long distance of ~160 µm from its source of production. Vaughn et al. (38) modeled the NO production and consumption in a blood vessel and parenchymal tissue. The model provides a general analysis of NO reaction and diffusion in the lumen, endothelium, and abluminal (including both adventitia and smooth muscle) regions. According to Vaughn et al.'s results, a reaction rate constant of NO with hemoglobin of the order 15 s-1 is required to obtain a NO concentration >250 nM at the abluminal side that is necessary to activate 50% sGC (34). However, there is disagreement on the amount of free NO required to stimulate the sGC; recently, NO concentration in the range of 5-100 nM has been reported for half-maximal activity of sGC (4).

Butler et al. (2) published another model describing the diffusion of NO in the vasculature. Their model considered a cell-free layer in the lumen (a layer of plasma free of RBCs) and the reaction of NO with sGC. The results were presented for 80-1,500 µm radius vessels. The results indicated that the effect of the cell-free layer is significant in allowing a substantial amount of NO to diffuse outward to the smooth muscle cells in spite of effective scavenging by RBC hemoglobin.

The largest part of vascular resistance resides in the microcirculation, specifically in arterioles of 25-200 µm diameter. Thus there is a need for prediction of NO levels for small blood vessels of this size. In this study, we developed a mathematical model for an arteriolar size blood vessel to analyze the issue of free NO availability to the smooth muscle cell in the presence of various HBOCs. The analysis uses experimental values of the reaction kinetics of NO with HBOCs and extravasation to determine the NO availability.


    MATHEMATICAL MODEL
TOP
ABSTRACT
INTRODUCTION
MATHEMATICAL MODEL
RESULTS
DISCUSSION
REFERENCES

Model geometry and governing equations. An arteriolar blood vessel of intermediate size is modeled. The model geometry shown in Fig. 1 includes cell-free and cell-rich luminal regions, endothelial glycocalyx (G) and its associated surface layer, endothelium (E), narrow interstitial space (IS) between the endothelial and smooth muscle cells, smooth muscle layer (SM) and parenchymal region. RBCs are considered in homogeneous phase in the cell-rich luminal region. The endothelial glycocalyx and its associated surface layer is a layer of plasma-membrane-bound macromolecules of glycoproteins and proteoglycans, and plasma proteins bound to these molecules (29). The endothelium is modeled as a cylinder with NO production concentrated on its surface in accordance with experimental evidence (6), and the NO production is incorporated in the boundary conditions. The NO released by endothelial cells diffuses to the smooth muscle cells and activates guanylate cyclase or diffuses into the lumen and reacts with hemoglobin. The hemoglobin may be in the RBC or in the plasma, i.e., HBOC.


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Fig. 1.   Arteriolar vessel geometry with subregions, including luminal region of cell-rich region (CR), cell-free region (CF), and glycocalyx (G). Nitric oxide (NO) produced by endothelial (E) cells can diffuse either to lumen or through interstitial space (IS) to smooth muscle (SM) and then to parenchyma. r = Rt, is the outer edge of parenchymal tissue region.

The reaction of NO with hemoglobin is very fast, and the velocity of blood in the lumen is low (<1 cm/s for arterioles). Therefore, the transport of NO by convection can be neglected (see Model parameters). The steady-state equation for NO for the cylindrical geometry is
<FR><NU>D<SUB>NO</SUB></NU><DE><IT>r</IT></DE></FR> <FR><NU><IT>∂</IT></NU><DE><IT>∂</IT></DE></FR> <FENCE><IT>r </IT><FR><NU><IT>∂</IT>C<SUB>NO</SUB></NU><DE><IT>∂r</IT></DE></FR></FENCE><IT>−</IT>R<SUB>NO</SUB><IT>=</IT>0 (1)
where r is the radial distance from the vessel axis, CNO is the NO concentration, and DNO is the diffusivity of NO within the region. The net rate of NO consumption by reaction, RNO, is the sum of the individual reaction rates for each reaction in which the NO is involved. The net rate of consumption for NO in all regions can be expressed as
R<SUB>NO</SUB><IT>=k</IT><SUB>i</SUB>C<SUP><IT>n</IT></SUP><SUB>NO</SUB>C<SUB>i</SUB> (2)
where ki is the reaction rate constant of NO, n is the order of the reaction with respect to NO in the region, and Ci is the concentration of the reactive species in the region. In the absence of cell-free hemoglobin, the main species for the cell-rich region and the smooth muscle region is hemoglobin (in RBCs) and sGC, respectively. Oxygen is the main species in the cell-free and glycocalyx regions and IS. For the parenchymal region, the main reactive species is the hemoglobin inside RBCs flowing in the capillaries. When HBOC is introduced in the lumen, cell-free hemoglobin in the cell-rich and cell-free regions becomes important. We assumed that the cell-free hemoglobin does not penetrate the glycocalyx region (29). When extravasation of HBOC is considered, hemoglobin becomes the main species in the IS. When myoglobin is present in the parenchymal region, its binding of NO becomes important.

The concentrations of all species are much greater than that of NO, thus these are assumed to remain constant and the RNO can be expressed as
R<SUB>NO</SUB><IT>=k</IT><SUB>o</SUB>C<SUP><IT>n</IT></SUP><SUB>NO</SUB> (3)
where ko is the overall reaction rate constant of NO. The NO reaction with hemoglobin and O2 is first and second order, respectively, for NO. Because the consumption of NO by sGC occurs only in the smooth muscle, the consumption rate of NO with sGC is assumed to be similar to the consumption of NO by smooth muscle cell and is assumed to be of second order (39). Thus the value of n = 1 for hemoglobin reaction and 2 for O2 and sGC reactions.

Boundary conditions. The boundary conditions of continuity of flux and concentration are applied at all of the interfaces and zero flux is imposed at the outer edge of the parenchymal region. The continuity of concentration assumes that the solubility of NO in all layers is the same. It is assumed that the endothelial cell NO synthase (eNOS), which is responsible for the NO production, is membrane bound (6). The eNOS is assumed to be distributed uniformly on the membrane, thus releasing equal amount of NO on both sides of endothelial cell region (38). The release rates of eNOS are incorporated in the boundary conditions at the glycocalyx-endothelium interface
C<SUB>NO<IT>,</IT>G</SUB><IT>=</IT>C<SUB>NO,E</SUB>

P<SUB>NO</SUB><IT>=D</IT><SUB>NO</SUB> <FR><NU><IT>∂</IT>C<SUB>NO,G</SUB></NU><DE><IT>∂r</IT></DE></FR><IT>−D</IT><SUB>NO</SUB> <FR><NU><IT>∂</IT>C<SUB>NO,E</SUB></NU><DE><IT>∂r</IT></DE></FR> (4)
and at the endothelium-IS interface
C<SUB>NO,E</SUB><IT>=</IT>C<SUB>NO,IS</SUB>

P<SUB>NO</SUB><IT>=D</IT><SUB>NO</SUB> <FR><NU><IT>∂</IT>C<SUB>NO,E</SUB></NU><DE><IT>∂r</IT></DE></FR><IT>−D</IT><SUB>NO</SUB> <FR><NU><IT>∂</IT>C<SUB>NO,IS</SUB></NU><DE><IT>∂r</IT></DE></FR> (5)
where PNO is one-half of the total NO release rate from endothelium.

Because of the symmetry, at the center of lumen
<FENCE><FR><NU>∂C<SUB>NO</SUB></NU><DE><IT>∂r</IT></DE></FR></FENCE><SUB><IT>r=</IT>0</SUB><IT>=</IT>0 (6)
and finally, the boundary condition at the outer edge of parenchymal tissue (r = Rt) region is
<FENCE><FR><NU>∂C<SUB>NO</SUB></NU><DE><IT>∂r</IT></DE></FR></FENCE><SUB><IT>r=</IT>R<SUB>t</SUB></SUB><IT>=</IT>0 (7)

Model parameters. The parameters of the model and their variation range are provided in the Table 1. The geometric parameters of the model include the thickness of various regions. The endothelial cell thickness is 0.5 µm, based on the electron microscopy studies of Walmsley et al. (40). Pries et al. (29) have reviewed the experimental evidence for the presence of the glycocalyx and its associated surface layer and reported that its thickness can vary between several tens of nanometers to 1 µm. A glycocalyx thickness of 0.5 µm is assumed. The smooth muscle cell thickness is 6 µm based on the measurements by Haas and Duling (9). In the calculations, we assume a single smooth muscle cell layer in the vascular wall. The IS thickness is assumed to be 0.5 µm. The cell-free layer thickness is a function of vessel diameter and hematocrit (33). The potential use of HBOC is for a clinical setting of low levels of systemic hematocrit. Therefore, as a reference case, the blood hematocrit level in the cell-rich region was assumed to be 22.5%, which corresponds to a systemic hematocrit of ~20% (33). The core hematocrit (cell-rich region hematocrit) is slightly higher than the systemic hematocrit. The calculations can be extended to lower hematocrits, down to zero, but the systematic variation of hematocrit is not the main goal of this study. For a 50-µm-diameter arteriolar vessel with 22.5% core hematocrit, the total cell-free layer thickness is estimated to be 6.7 µm (33). We assumed that the glycocalyx is a part of the total cell-free layer. Thus the actual cell-free region thickness (total cell-free layer - glycocalyx thickness) in our model is 6.2 µm for 22.5% core hematocrit. Because the tissue boundary condition (Eq. 7) assumes zero flux of NO far away from the vessel, we assumed the parenchymal region to extend to 2,000-µm radius. However, the numerical value for this distance is not important because we will show that the flux disappears at distances about 50 µm away from the wall.

                              
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Table 1.   Model parameters

The endothelial rate of NO release is affected by a variety of stimuli, including shear stress, oxidative stress, and hormonal exposure. The release rate of NO estimated from in vivo experimental measurements is 5.3 × 10-12 mol · cm-2 · s-1 (39), which is one of the highest reported. The diffusion coefficient of NO is assumed constant in all regions and is taken as 3.3 × 10-5 cm2/s (20).

The rate constant (ki in Eq. 2) for NO reaction with O2 is 9.6 × 106 M-2 · s-1 (17). The in vivo tissue O2 concentration is ~27 µM (or 15.5 mmHg) (28). Therefore, the overall rate constant (ko in Eq. 3) of NO reaction with O2 is 2.6 × 102 M-1 · s-1. The overall rate constant ko, estimated for vascular smooth muscle sGC, is 5 × 104 M-1 · s-1 (39).

The ko for NO and hemoglobin is the product of hemoglobin concentration with the reaction rate constant. Under normal physiological conditions, all of the hemoglobin is inside RBC. Therefore, the ko for NO reaction with hemoglobin in the lumen can be approximated to NO consumption by RBC. For cell-rich region, ko is assumed as 1,300 s-1 at 22.5% hematocrit, which is similar to the reaction rate of 1,280 s-1 with RBC used by Vaughn et al. (38). We also examined reaction rates of 770 and 250 s-1, based on the experimentally measured values at very low hematocrit (3, 18). The change in reaction rates had minimal effect on the NO profiles and concentrations when HBOCs were present.

For the parenchymal tissue region, the capillaries and muscle fibers were modeled as distributed homogeneous medium. The NO reaction rate RNO was calculated with the capillary endothelial cell NO production and NO consumption by the flowing RBCs and HBOC. For the set of parameters, we chose hamster retractor muscle, for which extensive experimental and theoretical studies of oxygen transport have been carried out (37). On the basis of the endothelial NO release rate of 5.3 × 10-12 mol · cm-2 · s-1, a capillary density of 1,435 per mm2 and a capillary radius of 1.8 µm, the capillary endothelial NO production rate is estimated at 8.6 × 10-7 M/s-1. The capillary consumption of NO is calculated by multiplying the fractional volume occupied by capillaries (=0.0146) with the hemoglobin concentration and the rate of reaction of NO with either RBC or HBOC. Because capillary hematocrit is normally lower than systemic hematocrit (14), 15% capillary hematocrit was chosen for a systemic hematocrit of 20%. The 15% hematocrit yielded an overall consumption rate of 5.2 s-1 for parenchymal tissue region. Thus the RNO for the parenchymal tissue region is
R<SUB>NO</SUB>(M · s<SUP><IT>−</IT>1</SUP>)<IT>=</IT>5.2C<SUB>NO</SUB><IT>−</IT>8.6<IT>×</IT>10<SUP><IT>−</IT>7</SUP> (8)
where negative sign represents the production. It was assumed that the capillary endothelial production of NO does not change with the administration of HBOC. However, the capillary NO consumption is a function of the HBOC and NO concentration and the HBOC reaction rate with NO.

The convection term in the model is not included because the Damkohler number for convection was very high. The Damkohler number for convection represents the ratio of rate of consumption by reaction to the rate of transport by convection. For the first-order reaction in the lumen for our NO model, the Damkohler number is equal to koL/Um, where L is the characteristic length and Um is the mean velocity of blood in the lumen. Assuming the L and Um of typical arteriolar length of 0.05-0.15 cm and blood velocity of 0.5-1 cm s-1, the Damkohler number ranges from 65-390 for the reference case of ko of 1,300 s-1. This conclusion was corroborated by direct numerical simulations, which considered the convection term in the axial direction in the mass balance equation.

Numerical solution. The NO diffusion-reaction problem (Eqs. 1-8) was solved numerically with the use of FlexPDE software (PDESolutions; Antioch, CA). The complete domain was divided into seven subregions: cell-rich, cell-free, glycocalyx, endothelial, interstitial, smooth muscle, and parenchymal tissue. The solution had a relative accuracy of 0.001.


    RESULTS
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ABSTRACT
INTRODUCTION
MATHEMATICAL MODEL
RESULTS
DISCUSSION
REFERENCES

Reference case. The model was solved to calculate NO concentration in all regions of the reference case of an arteriolar vessel of 25 µm radius with 22.5% hematocrit in the cell-rich region. Figure 2 shows the NO concentration in all regions (only the region up to 50 µm in the parenchyma is shown). The concentration of NO in most of the lumen is very small, except for the cell-free region and the edge of the cell-rich region. The NO released from the endothelial cells diffuses into the luminal cell-free region before reaching the cell-rich region where it reacts extremely fast with the hemoglobin present in the RBC. On the other side, after diffusing through IS, the released NO reaches the smooth muscle cells where its maximum concentration is 167 µM.


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Fig. 2.   Concentration profile of NO for the 22.5% hematocrit (Ht). The unmarked region at 25 µm includes E and IS region. The NO penetrates into the lumen because of the presence of CF layer.

Effect of HBOC presence in lumen. Because many of the experimental and clinical studies with HBOCs were performed with isovolemic exchange transfusion (31), we investigated the effect of a 50% isovolemic exchange transfusion with HBOC on the NO profile. We assumed HBOC solution concentration of 5 g/dl resulting in an in vivo blood concentration of 2.5 g/dl (i.e., 2.5 g Hb/dl of blood), equivalent of 0.39 mM of hemoglobin tetramer. For the purpose of understanding the effect of reaction rate of NO with hemoglobin on the NO profile, we have used three different reaction rate constants of 2, 24, and 58 × 106 M-1 · s-1 (per heme basis, 1 Hb = 4 heme groups), which we denote as Hb1, Hb2, and Hb3, respectively. These NO reaction rates are similar to the values for rHb4, rHb2, and rHb1.1, respectively, reported by Doherty et al. (5). The reaction rate for Hb3 is also similar to the wild-type human hemoglobin. Figure 3 shows the NO profile for Hb1, Hb2, and Hb3. The NO concentrations have been reduced compared with the reference case without cell-free hemoglobin. At the endothelial side of smooth muscle region, the NO concentrations are 27.6, 13.7, and 11.9 nM, respectively, for Hb1, Hb2, and Hb3. Thus the smooth muscle exposure to NO can be affected by changing the reaction rate of NO with hemoglobin. The average NO concentrations in smooth muscle in this and other cases are shown in Table 2.


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Fig. 3.   Concentration profile of NO for 50% isovolemic hemodilution with various hemoglobin Hb-based oxygen carriers (HBOCs) in the lumen. The HBOC Hb1 and Hb3 has the slowest and the fastest reaction with NO, respectively. The unmarked region at 25 µm includes E and IS regions.


                              
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Table 2.   Sensitivity of average NO concentration in smooth muscle for Hb3

Because of the uncertainty of the thickness of glycocalyx layer in the presence of HBOC, we also considered a glycocalyx thickness of 0.2 µm. However, we assumed that the total cell-free layer thickness remains the same at 6.7 µm (see Model parameters). As the glycocalyx thickness is reduced, the HBOC can come closer to the NO-producing endothelial cells. Thus the NO concentration at the endothelial side of smooth muscle region was reduced to 23.6, 10.3, and 8.7 nM, respectively, for Hb1, Hb2, and Hb3.

Effect of vessel size. To understand the effect of geometric parameters on the availability of NO to the smooth muscle cells, we considered additional arterioles with radii 12.5 and 50 µm containing Hb3 at 50% isovolemic exchange. We assumed the total cell-free layer thickness at 5.8 and 6.0 µm (including glycocalyx thickness of 0.5 µm) for 12.5 and 50 µm radius vessel, respectively (33). Other geometrical parameter values were as in the reference case. As shown in Fig. 4, the NO concentration in the smooth muscle remains similar irrespective of the arteriolar diameter.


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Fig. 4.   Effect of radius (R) of blood vessel, R = 12.5, 25 and 50 µm, on the NO profile for 50% isovolemic hemodilution with Hb3.

Effect of parenchymal tissue region reaction rate. In previous NO models, Butler et al. (2) assumed a vascular smooth muscle region of infinite thickness and Vaughn et al. (38) combined adventitia and smooth muscle in one abluminal region; capillary perfusion was not considered. In our reference case, we included the NO production by the capillary endothelium and the NO consumption by hemoglobin in the capillaries in the parenchymal region. In addition, we investigated the effect of several other parenchymal-tissue reaction rates on the NO profile for the 50% isovolemic exchange of Hb3. These reaction rates are from only O2, only myoglobin, and myoglobin and NO production and reaction from capillaries. For the only O2 case, we used ko = 2.6 × 102 M-1 · s-1 and n = 2 (see Model parameters) and ignored the capillary production and reaction of NO in the parenchymal-tissue region. The myoglobin is present in the cytoplasm of many skeletal and in cardiac muscle cells; it plays an important role in O2 transport (23), and its role in NO transport is being discussed (7). Myoglobin concentration was assumed in the tissue at 0.38 mM as measured in the hamster retractor muscle (22), and its reaction rate constant with NO is 4.3 × 107 M-1 · s-1 (11). Thus the ko is 1.6 × 104 s-1 and n = 1 in the parenchymal tissue region for only myoglobin case. In the case of combined myoglobin and capillaries in the parenchymal region, the overall reaction rate in Eq. 8 is modified to
R<SUB>NO</SUB>(M<IT>·</IT>s<SUP>−1</SUP>)<IT>=</IT>1.6<IT>×</IT>10<SUP>4</SUP>C<SUB>NO</SUB> (9)

<IT>+</IT>1.3<IT>×</IT>10<SUP>3</SUP>C<SUB>NO</SUB><IT>−</IT>8.6<IT>×</IT>10<SUP>−7</SUP>
where the first term on the right side represents the consumption by myoglobin, second term represents the consumption by Hb3 flowing in the capillary, and the last term represents the production by capillary endothelium. Figure 5 represents the effect of these parenchymal tissue reaction rates on the NO profile. The NO profile and the NO concentration changes significantly for the O2 only case compared with the capillary only case. When myoglobin is introduced in the parenchymal region, the NO concentration in the region beyond smooth muscle becomes almost zero and the NO profile remains unaffected by the capillary presence.


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Fig. 5.   NO profile for various parenchymal-reaction rates for 50% isovolemic hemodilution with Hb3. The unmarked region at 25 µm includes E and IS regions.

Effect of HBOC extravasation. Plasma-based hemoglobin can also affect the diffusion of NO to the smooth muscle cells by the extravasation of hemoglobin into the IS between endothelial cells and smooth muscle, where it could scavenge the NO before the NO can reach smooth muscle cells. The extravasation of cell-free hemoglobin has been observed experimentally (21). To investigate this possibility, we varied the amount of HBOC in the IS and show the resulting NO profiles in Fig. 6. In Fig. 6A, the NO profile for the extravasation of varying amount of Hb1, which has the slowest NO reaction rate, is shown. The NO concentration at the endothelial side of smooth muscle region is 27.5, 26.3, 25.3, 18.8, and 14.2 nM, respectively, for 1, 20, 39, 195, and 390 µM concentration of Hb1 in the IS, which corresponds to 0.3, 5, 10, 50, and 100% extravasation. As expected, the NO concentration decreases with increasing hemoglobin concentration in the IS. The NO concentration remains approximately one-half of the value in the absence of extravasation even at the complete extravasation of the Hb1. For Hb2, the NO profile (Fig. 6B) is different from that for Hb1 because of the higher reaction rate of Hb2 with NO and the NO concentration at the endothelial side of smooth muscle region is 13.4, 9.9, 7.8, 2.5, and 1.2 nM, respectively, for a 1, 20, 39, 195, and 390 µM concentration of Hb2. The NO profile (Fig. 6C) and the NO concentration are similar for Hb3 and Hb2. The NO concentration at the endothelial side of smooth muscle region is 11.4, 6.4, 4.3, 0.9, and 0.3 nM, respectively, for a 1, 20, 39, 195, and 390 µM concentration of Hb3. Figure 6D shows the average NO concentration in the smooth muscle for all three hemoglobins as a function of percent extravasation. The average NO concentration was calculated as the arithmetic average of smooth muscle NO concentration at the endothelial and the parenchymal side. Importantly, the NO concentrations are in the 5-100 nM range required for the half-maximal activity of sGC.


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Fig. 6.   Effect of extravasation of varying amount of HBOCs into the IS. A-C: extravasation of HBOC Hb1, Hb2, and Hb3, respectively. The amounts of HBOCs are 1, 20, 39, 195, and 390 µM, which represents 0.3, 5, 10, 20, 50, and 100% extravasation, respectively. Unmarked region at 25 µm includes E and IS region. D: average NO concentration in the smooth muscle region for varying amount of extravasation. The average NO concentration is calculated from the endothelial and parenchymal side NO concentrations in the smooth muscle.


    DISCUSSION
TOP
ABSTRACT
INTRODUCTION
MATHEMATICAL MODEL
RESULTS
DISCUSSION
REFERENCES

In this study, we have modeled the NO distribution for an arteriolar vessel to understand the effects of physicochemical properties related to NO binding to cell-free hemoglobin in the vascular lumen, in the IS between the endothelium and smooth muscle, and in the parenchyma on the NO concentration to which vascular smooth muscle is exposed.

Effective NO concentration for activating sGC in smooth muscle. Figure 2 shows that the NO concentration in the smooth muscle cells is ~167 nM at a core hematocrit of 22.5%, which corresponds to a systemic hematocrit of ~20%. Therefore, the NO concentration to which smooth muscle cells would be exposed is smaller than the value of 250 nM required for activation of sGC reported by Stone and Marletta (34). This high concentration of NO cannot be achieved when the NO reaction rate of 1,300 s-1 is used. Vaughn et al. (38) have used 250 nM NO concentration to conclude that the NO reaction rate should be 15 s-1. Recently, Condorelli and George (4) have reported a much lower NO concentration range of 5-100 nM for the activation of sGC with a half maximal activation concentration of 23 nM. Predictions of our model are consistent with the range of 5-100 nM for the NO concentration under in vivo physiological conditions.

NO scavenging by administration of HBOC. Although there are differences in physicochemical properties of various types of HBOCs and several mechanisms have been attributed to their vasoconstrictor activity, the reactivity of HBOCs with NO and extravasation of HBOCs are the main factors implicated for HBOC-induced vasoconstriction.

To examine the effect of NO scavenging, Doherty et al. (5) conducted experiments using rHb1.1, rHb2, and rHb4 of varying reactivity with NO, with rHb1.1 the most reactive and rHb4 the least reactive. The reactivity of these recombinant hemoglobins rHb1.1, rHb2, and rHb4 is similar to that for Hb3, Hb2, and Hb1, respectively, in our model. With the use of these recombinant hemoglobins in conscious rats, they found that the mean arterial pressure increases with higher reactivity with NO. With rHb4, the pressor response was similar to human serum albumin response with a very mild increase in mean arterial pressure. From our model predictions, the calculated NO concentration to which smooth muscle cells are exposed is between 12 and 28 nM (Fig. 3). However, this range of NO concentration is based on the assumption of no extravasation of HBOC into the abluminal side of endothelium.

The relative capacity of different molecules to extravasate is dependent on molecular size of hemoglobin molecule (27), with large molecules extravasating at a slower rate than smaller molecules. The extravasation of cell-free hemoglobin has been studied by Matheson et al. (21). When extravasation of hemoglobin into IS is taken into account in our model, the NO concentration changes based on the concentration of HBOC in the IS between the endothelium and smooth muscle (see Fig. 6D). The smooth muscle cell's exposure to NO is significantly affected for Hb2 and Hb3. For these HBOCs, the NO concentration becomes lower than the physiological range of 5-100 nM reported for 50% activation of sGC (average 23 nM) at <50% extravasation (50% extravasation is equal to 195 µM of hemoglobin in the IS). However, the NO concentration is not reduced <14 nM for 100% extravasation of Hb1. Such high NO concentration in the smooth muscle region cannot be achieved for Hb2 and Hb3 even without extravasation.

To further understand the effect of extravasation, we can consider the experimental study of Sakai et al. (32). They have used several cell-free hemoglobins to investigate the molecular dimension effects of HBOCs on vasoconstriction. Two of the studied HBOCs were XL-Hb and PEG-Hb with molecular diameters of 7 and 22 nm, respectively, and molecular mass of 66 and 189 kDa, respectively. The bolus infusion of 5 g/dl of XL-Hb caused an immediate hypertension in hamster. Infusion of PEG-Hb resulted in lesser vasoconstriction and hypertension. Measurements by the flash photolysis method showed that these modified hemoglobin molecules have similar hemoglobin-NO binding rates (~30 × 106 M-1 · s-1). Hence, the effect of HBOCs on NO concentration in the lumen should be similar and the vasoactivity cannot be explained solely on the basis of NO reactivity in the lumen. Thus the extravasation to the IS has to be considered. Because PEG-Hb is much larger than the XL-Hb, PEG-Hb would extravasate to a lesser extent than XL-Hb. As seen for Hb2 (see Fig. 6B) with similar NO reaction rate of 24 × 106 M-1 · s-1, a 50% extravasation could reduce the exposure of smooth muscle cells to NO from a high of 14 nM to 2 nM. Thus our model predictions are consistent with these experimental results. The results of experimental study by Migita et al. (24) of 50% isovolemic hemodilution in rat with alpha alpha -Hb and PEG-Hb having NO binding rates of ~30 × 106 M-1 · s-1 are also in qualitative agreement with the results of this model. The study showed that the rats administered with alpha alpha -Hb (64 kDa molecular mass) (10) had significant increase in mean arterial pressure compared with no increase in PEG-Hb administered rats.

Kinetics of vascular wall and beyond. In our model, we have included various layers of vascular wall and a parenchymal region beyond the vascular wall. The addition of capillaries in parenchymal tissue region has significant effect on the NO profile (see Fig. 5); therefore, the simplifications of NO-binding kinetics in the regions of vascular wall and beyond should be carefully examined. With the use of a diffusion-reaction model for NO, Thomas et al. (36) estimated that the NO half-life in the extravascular tissue would substantially increase from 0.09 to >2 s when the parenchymal cells rate of consumption of NO was a function of both NO and O2 concentration compared with a function of only NO concentration. The half-life range of 0.09-2 s results in a diffusion distance of 24-115 µm before the NO concentration reduces to one-half of its value at source. However, in vivo, the capillary consumption and production of NO will determine the lifetime of NO in the extravascular region. Our model predicts that the NO concentration is reduced to much less than one-half of its value at source (endothelium) within 10-15 µm distance (see Fig. 5) for the Hb3. In vivo, this distance may be affected by the particular anatomic arrangements of the capillaries in the vicinity of the arteriole. In addition, the effect of myoglobin on the NO concentration should be significant for skeletal muscle and cardiac muscle tissue. Experiments with hearts of myoglobin-deficient mice have shown that these hearts had more pronounced vasodilatory response to the endogenously produced and exogeneously applied NO compared with the wild-type hearts with myoglobin at physiological concentration (7). These results suggest that in vivo myoglobin reaction could be significant in NO uptake.

In conclusion, the model described in this study can be used to interpret vasopressor activity in experimental studies with administration of HBOC. Predictions of the present NO diffusion-reaction model indicate that the HBOCs of wide range of NO reactivity and molecular size would influence the NO exposure of smooth muscle cell in the range where sGC is known to be activated. This would result in varied vasoconstriction response to each HBOC whether chemically or genetically modified. From our model results, we can conclude that the extravasation of smaller hemoglobin molecules having reaction rates similar to human wild-type hemoglobin scavenge the NO before it can reach smooth muscle cell. We also demonstrated that the presence of myoglobin can significantly affect NO concentration in the parenchymal and smooth muscle regions.


    ACKNOWLEDGEMENTS

This work was supported in part by National Heart, Lung, and Blood Institute Grant HL-18292 and by a grant from the Eugene and Mary B. Meyer Center for Advanced Transfusion Practices and Blood Research at The Johns Hopkins University.


    FOOTNOTES

Address for reprint requests and other correspondence: M. Kavdia, Dept. of Biomedical Engineering, The Johns Hopkins School of Medicine, 720 Rutland Ave., 613 Traylor Bldg., Baltimore, MD 21205 (E-mail: kavdia{at}bme.jhu.edu).

The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

First published February 14, 2002;10.1152/ajpheart.00972.2001

Received 7 November 2001; accepted in final form 12 February 2002.


    REFERENCES
TOP
ABSTRACT
INTRODUCTION
MATHEMATICAL MODEL
RESULTS
DISCUSSION
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Am J Physiol Heart Circ Physiol 282(6):H2245-H2253
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