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Microcirculation Laboratory, Department of Bioengineering and The Whitaker Institute of Biomedical Engineering, University of California San Diego, La Jolla, California
Submitted 14 July 2004 ; accepted in final form 28 September 2004
| ABSTRACT |
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mesentery; arteriole; capillary; venule; superoxide; nitroblue tetrazolium; dexamethasone; Wistar-Kyoto; adrenalectomy; hydralazine
Free radicals in hypertension may be derived from a variety of cells in vivo (35, 38, 44) and even from plasma (22). It is important to determine the cellular sources at the level of the microcirculation. For this purpose, we utilize here the microcirculation of the spontaneously hypertensive rat (SHR) model of hypertension with an approach that serves to display the degree of free radical formation in all cells in the microcirculation.
Hypertension in SHRs strongly depends on adrenal glucocorticoids. Adrenalectomy serves to normalize blood pressure in SHRs to the level of their normotensive Wistar-Kyoto (WKY) controls, whereas supplementation of adrenalectomized SHRs leads to significantly elevated blood pressure compared with WKY rats (1, 24, 30, 45). There are still few studies that serve to explore to what degree glucocorticoids influence free radical formation in SHRs (44). We hypothesize that oxygen free radical production in SHRs may be enhanced by glucocorticoids.
Thus the objective of this study was to examine in the microcirculation of SHRs and their normotensive WKY controls the level and localization of oxygen free radical production by means of tetranitroblue tetrazolium (TNBT) reduction to formazan. To explore the role of glucocorticoids, the two rat strains were studied before and after adrenalectomy and supplementation with a synthetic glucocorticoid. Because glucocorticoids directly affect blood pressure, we also examined TNBT reduction in a set of SHRs treated with an alternative technique, hydralazine treatment, to reduce blood pressure. The study was carried out on the mesentery to facilitate detailed delineation of the reaction with digital microscopy in multiple segments of the microcirculation at different blood pressures. We also examined TNBT reduction in lymphatic endothelium with substantially lower fluid pressures.
| METHODS |
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Animal groups and blood pressure. Age (1416 wk)- and weight (300350 g)-matched SHRs and normotensive WKY rats (n = 5 male rats/group; Charles River Laboratory; Wilmington, MA) and a cohort of bilaterally adrenalectomized SHRs and WKY rats (n = 4 rats/group) were enrolled in the study. One group of adrenalectomized WKY rats and SHRs was administered replacement therapy with dexamethasone (Sigma; St. Louis, MO) at a rate of 0.5 mg·kg1·day1 sc for 5 days (n = 4 rats/group). The adrenalectomized rats were fed standard rat diet and 0.9% (wt/vol) NaCl in their drinking water ad libitum and were maintained in a light-controlled holding facility for 1 wk. Completeness of the adrenalectomy was confirmed by postmortem examination of the suprarenal region.
To examine the role of blood pressure in oxygen free radical formation, groups of male WKY rats and SHRs (n = 3 rats/group) were treated at the age of 14 wk for 1014 days as well as at 26 wk with hydralazine hydrochloride (200 mg/l of drinking water ad libitum; average consumption, 2.73 mg·kg1·day1). Control rats were age and gender matched on regular drinking water without hydralazine.
The rats were given local anesthesia (4% xylocaine im; Astra; Westborough, MA) for placement of a polyethylene-50 femoral artery catheter (Clay Adams; Parsippany, NJ) and measurement of systemic blood pressures. After rats recovered from the surgical procedure, blood pressure values were continuously monitored in conscious, free-roaming animals via a transducer (Statham; Madison, WI) for 30 min (52, 56). Thereafter, 50 mg/kg iv pentobarbital sodium (Abbot Laboratories; North Chicago, IL) was given as general anesthesia.
Mesentery preparation. The animals were placed on a water-heated (37°C) stage. The mesentery was gently exposed through a short abdominal midline incision and was continuously superfused with Krebs-Henseleit bicarbonate-buffered solution saturated with a 95% nitrogen-5% carbon dioxide gas mixture. For this purpose, only selected segments of the small intestine were manipulated with cotton wicks soaked in saline, and no contact was made with the mesentery tissue per se. The mesentery sectors were immediately treated to minimize formation of oxygen free radicals due to tissue exposure.
Free radical detection. TNBT (Vector Laboratories; Burlingame, CA) reduction to formazan crystals in the presence of superoxide was used to detect superoxide radicals in vivo as previously described (48). No glucose, however, was used as a substrate, because it yielded a labeling pattern that was too intense for quantitative image analysis. Fresh TNBT (prepared approximately every 10 min from a fresh solution) was topically applied by constant drip for 1 h on selected mesenteric sectors. At the end of this period, Krebs-Henseleit (36.5°C; pH 7.4) was used to wash TNBT from the specimen for 15 min. The mesentery tissue was fixed a topical application of 10% formalin (Sigma) for 15 min, excised, and then stored in 10% formalin. The formazan deposits are stable for several weeks under these conditions, so a detailed analysis of the staining pattern in all segments of the microcirculation can be carried out after completion of the experiment. This approach avoids the need to record the labeling pattern in a living tissue under a time constraint as is the case during use of other free radical detection techniques (44), and it also permits analysis in all segments of the microvascular network. Special care was taken to standardize the anesthesia, tissue handling, and TNBT labeling among groups.
Measurement techniques.
The mesentery microcirculation is located at the distal segments of the blood supply from the superior mesenteric artery. In this study, only those regions of the mesentery without adipose tissue were examined, because the presence of adipose cells surrounding individual microvessels may limit the penetration of the TNBT solution and thereby reduce formazan crystal formation. Larger mesenteric arterioles are generally embedded in adipose tissue, which cannot be readily penetrated by the TNBT solution. Therefore, the largest arterioles included in the analysis were
25 to 30 µm in lumen diameter in the younger animals and
60 µm in the older group. Venules had diameters
60 µm. Lymphatics were mostly of the contractile type with spontaneous peristalsis and lymphatic intraluminal valves.
The TNBT reaction could be blocked in large part on single leukocytes in suspension by superoxide dismutase (3) and was abolished in the presence of the hydroxyl radical scavenger dimethylthiourea (2 mM; Aldrich Chemical; Milwaukee, WI; results not shown). The reaction could also be blocked in the plasma by intravenously administered superoxide dismutase conjugated with polyethylene glycol (2 mg/kg; Sigma). But the formation of formazan crystals was not completely blocked in endothelial cells in vivo, because superoxide dismutase after intravascular administration does not readily penetrate the endothelial cell, pericytes, or smooth muscle cells where most of the reaction product may be located even if conjugated with heparin.
Image analysis. To detect formazan crystal density in the microvasculature, bright-field images of individual microvessels were recorded through a Leica intravital microscope. Our analysis was limited to microvessels located outside adipose tissue. Tissue overviews were recorded with x10 and x20 objectives and, for the purpose of optical density measurements, with a x60 objective (numerical aperture, 0.9). The images were captured with a color charge-couple device camera (DEI-470; Optronics Engineering; Goleta, CA), digitized (512 x 512, 8-bit gray-level resolution) on a Power Mac laboratory computer (Apple Computer; Cupertino, CA), and analyzed in digital format (NIH Image 1.61 public domain software).
Average light intensities over the microvessel (Iv) and over the adjacent tissue (It), which contained no significant formazan deposits (Fig. 1, top), were recorded, and the light absorption (A) was computed as A = ln(Iv/It).
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Statistics. Measurements are presented as means ± SD. Comparisons of mean values among groups were carried out by unpaired Student's t-test. P < 0.05 was considered significant.
| RESULTS |
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Tissue pattern of TNBT reduction. In all groups, formazan deposits in the mesentery were largely limited to locations close to microvessels with some deposits in mast cells but with almost undetectable deposits in many regions of the interstitial space (see Fig. 1). There was no preferred localization of labeled mast cells regarding adjacency to arterioles, capillaries, or venules.
Formazan deposits could be detected in every hierarchy of microvessels but with a markedly nonuniform distribution along the microvascular network. Capillaries and smaller arterioles and venules in general had on average lower levels of formazan crystals than larger arterioles and venules (see Fig. 1, insets). These deposits were detectable in nonuniform formazan clusters located in close proximity to or within the endothelium. The deposition of formazan crystals was without a particular preference for vascular branch points or other locations along individual microvessels. Frequently, we saw arterioles or venules with high levels of formazan deposits giving rise to smaller side branches with low levels of deposits. The major change in formazan density occurred at branch points. Between branch points, we found a more uniform density of formazan deposits (see Fig. 1). Although mast cells in WKY rat mesentery had undetectable deposits, SHR mesentery showed evidence for localized formazan in the immediate vicinity of some but not all mast cells.
In addition to the formazan deposition in vascular endothelium, we also found significant TNBT reduction in the contractile lymphatics of the mesentery (Fig. 2) with enhancement at the (secondary) intralymphatic valves (Fig. 3) (34). The formazan deposits were uniform over the lymphatics (see Fig. 2) despite the highly attenuated endothelial morphology and were positioned frequently in immediate proximity to the strong formazan deposits in venules. Free radical production was also prominent on the leaflets of the lymphatic valves (see Fig. 3).
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Microvascular TNBT reduction after chronic hydralazine treatment. In the 40-wk-old WKY rats and SHRs (controls without treatment), average TNBT reduction was significantly elevated compared with the younger, untreated counterparts (1416 wk old) listed above. This increase with age was observed in all microvessels (P < 0.05). In addition, the formazan deposits in older SHRs were elevated in all groups of microvessels compared with WKY rats at the same ages (Fig. 5, top). Even capillaries, which in the younger group exhibited few formazan deposits and no difference between strains, had higher levels of light absorption in the older SHRs compared with the age-matched WKY rats.
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Free radical production in interstitium and microlymphatics. The average level of formazan deposits in interstitial cells was elevated in SHRs (40 wk of age; Fig. 6). Hydralazine treatment served to reduce the formazan levels in both WKY rats and SHRs but failed to reduce the difference between SHRs and WKY rats. A similar elevation of the light absorption in SHRs was detected in lymphatics on both the wall and the intraluminal leaflets (Fig. 7).
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| DISCUSSION |
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A key feature brought to light by display of the microvascular formazan distribution is that the production of reactive oxygen species is not limited to the arteriolar side. Formazan is equally distributed on the arterial and on the venous side but appears at lower levels in capillaries. This pattern of reactive oxygen production has been encountered in all forms of hypertension investigated to date with a variety of experimental approaches (23, 44, 47, 48). Enhanced oxygen free radical production in SHRs or hypertensive Dahl rats can be documented in circulating leukocytes and in plasma that passes through both high- and low-pressure regions (38, 39). Enhancement of free radical production is also prominent in SHR lymphatics, which are vessels that serve to drain the interstitium with only connective-tissue connections to the microvessels in the mesentery.
These observations suggest that the mechanisms that mediate free radical production in hypertension may not be limited to the arterial and/or arteriolar side of the circulation (17), but instead may represent a more general vascular condition that affects both high- and low-pressure regions of the circulation. One such mechanism may be due to glucocorticoids. Glucocorticoids have the ability to directly influence the formation of oxygen free radicals and blood pressure (28, 52). Depletion of glucocorticoids by adrenalectomy and supplementation with dexamethasone affect the blood pressure and TNBT reduction. The blood pressure of SHRs is more affected by supplementation with glucocorticoids than the blood pressure of WKY rats. In the mesentery microvessels, glucocorticoids affect free radical formation mostly on the venous side without pressure elevation (56), and they directly influence enzymes that are involved in oxygen free radical formation (see below). The present observations of free radical formation in endothelium of arterioles and venules are in agreement with previous measurements using hydroethidine as an alternative technique for detecting superoxide (44).
The fact that free radical production in SHRs is not limited to microvascular regions with elevated blood pressure is further highlighted by the present observations of elevated TNBT reduction in mesentery lymphatics. In a variety of species under normal conditions, these vessels typically operate at pressures
10 mmHg (33). There are presently, however, no measurements of lymphatic pressures in SHRs.
The question then arises, is blood pressure elevation the cause for free radical production, or vice versa, is it possible that free radical production may cause pressure elevation? Perhaps both events occur more or less simultaneously. Acute elevation of blood pressure per se in vitro serves to raise oxygen free radical production (14). But to date, no chronic in vivo experimental model is available that serves to examine the role of blood pressure elevation on free radical production. Most models either have an effect on fluid shear stress or rely on administration of an agent such as glucocorticoid or angiotensin that has its own effect on oxygen radical formation, be it at high or low pressures. We examined here the effect of an alternative method of blood pressure reduction with chronic hydralazine treatment (for 26 wk). We found that blood pressure and oxygen free radical production reduction go hand in hand, albeit on both the arteriolar and venular sides of the microcirculation, and in some microvessels in both WKY rats and SHRs (see Fig. 5). In our pilot study with a shorter period of hydralazine treatment, we saw no blood pressure reduction as well as no reduction in formazan deposits in any segment of the microcirculation of either strain (results not shown). The hydralazine treatment per se may be inconsequential for free radical production unless it is accompanied by a blood pressure reduction. In addition, we found that the level of TNBT reduction increased with age in all microvessels, a reaction that was not accompanied by significant elevation of the mean arterial blood pressure or venular pressure.
Furthermore, in the past, we were able to obtain evidence in human hypertensive subjects to indicate that there may already be elevated hydrogen peroxide production in normotensive individuals at genetic risk for hypertension years before their blood pressure is elevated (22). Thus there is a lack of a spatial correlation between blood pressure and free radical production in the microcirculation, while at the same time, several treatments to reduce blood pressure are closely correlated with reduction of free radical production in both high and low fluid-pressure regions. This evidence, combined with the fact that prehypertensive individuals may already be producing enhanced free radical production before blood pressure elevation, suggests that there may be systemic mechanisms that control free radical production in addition to just pressure elevation. The fact that SHRs have an enhanced level of glucocorticoid and mineralocorticoid receptors (7) and after adrenalectomy their blood pressure responds significantly more strongly to glucocorticoids (46) is in line with this hypothesis. Comparing adrenalectomy and hydralazine treatment in SHRs, it is noteworthy that both serve to reduce TNBT reduction and blood pressure, but hydralazine is not specific to SHRs and instead affects free radical production in the normotensive WKY rats as well on both the arteriolar and venular sides.
Increased sensitivity to adrenal glucocorticoids has also been observed in human essential hypertensive subjects in the form of a skin-blanching test (50). This sensitivity may be one of the underlying processes in hypertension. Blood pressures of SHRs may also be hyperresponsive to mineralocorticoid and its metabolites (10, 13), a trend that is not uniformly confirmed (46). Blood pressure is significantly elevated by aldosterone supplementation in adrenalectomized SHRs (10, 37). However, the effect of mineralocorticoids on oxygen free radical formation in microvessels as players in blood pressure regulation and organ injury remains to be examined.
The plasma of essential hypertensive individuals has the ability to produce oxygen free radicals at a level that correlates with their blood pressure (22). Individuals with a family history of hypertension but still without elevated blood pressure already have levels of free radical production above those of normotensive controls. This evidence suggests that the free radical production may precede the blood pressure elevation. The level of free radical production is a heritable trait in humans and may be attributed to genetic factors (21).
Among a number of different enzymes that may be involved in free radical production in SHRs are NAD(P)H oxidase (55) and xanthine oxidase (41). The gender dimorphism with male SHRs presenting higher superoxide anion concentration under basal conditions than female SHRs may act via a mechanism that depends on NAD(P)H oxidase components (6). There could also be depletion of antioxidant enzymes (16, 26, 32, 40, 54). These enzyme systems can be modulated by renal and adrenal hormones, a situation that may be closely linked to the specific complications encountered in SHRs. The level of xanthine oxidase may be influenced by adrenal hormones (20, 52) and in SHRs can be inhibited by a glucocorticoid receptor inhibitor (44). The enzyme is involved in the production of oxygen free radicals of SHRs, Dahl hypertensive model rats, and dexamethasone-induced hypertensive model animals (41, 47, 52). Renal transplantation with kidneys from normotensive donor rats (4) as well as adrenalectomy serve to reduce blood pressure in SHRs (30, 42, 44). Furthermore, the evidence points to the fact that oxygen free radical production is controlled by the renin-angiotensin system (40, 55) as well as by an adrenal pathway (28). Scavenging of superoxide by nitric oxide may be attenuated by reduced NO activity (5, 18, 27) possibly via glucocorticoids (42, 51).
In postcapillary venules of the younger group (see Fig. 4), we saw no difference in formazan deposits between WKY rats and SHRs. The formazan deposits in postcapillary venules (<30 µm) may have even been on average higher in WKY rats than in SHRs (not significant). The trend was observed in the control WKY rat and SHR groups before and after adrenalectomy and in the adrenalectomized groups after supplementation with dexamethasone, and it may be influenced by leukocyte-endothelial interaction. The postcapillary venules are subject to regular interaction with circulating leukocytes. The rolling is especially prominent in smaller postcapillary venules and may serve as a signal-transduction mechanism that stimulates endothelial cells and their free radical production. Leukocyte rolling on or adhesion to endothelium in postcapillaries is greatly inhibited in SHRs (2). Adrenalectomy serves to increase the leukocyte-endothelium interaction in SHRs, whereas dexamethasone is well recognized as inhibiting the interaction (43). Thus an increased leukocyte-endothelial interaction in WKY rat postcapillary venules may, in part, account for the trend in oxygen free radical formation observed in this particular class of microvessels.
What may be the consequences of enhanced free radical formation in SHRs? In addition to a role in signaling arteriolar tone due to NO annihilation (11, 18, 23) they may also cause frank cell death (15). It is interesting to note that the pattern of formazan deposits with preference for microvascular endothelium is closely mirrored by markers for endothelial apoptosis in the mesentery microcirculation of SHRs (24). Adrenalectomy serves to reduce endothelial apoptosis to levels that are indistinguishable between WKY rats and SHRs. Glucocorticoids also enhance apoptosis in SHR microcirculation (24).
| GRANTS |
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| FOOTNOTES |
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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.
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