Journal
JOURNAL OF APPLIED PHYSIOLOGY
Volume 123, Issue 5, Pages 1024-1038Publisher
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/japplphysiol.00589.2017
Keywords
cutaneous vasodilation; skin sympathetic nerve activity; vascular function; endothelial dysfunction; nitric oxide
Categories
Funding
- National Institutes of Health [R23 AG-05653, R03 AG-14159, R01 HL-089302, R01 AG-07004, R21 HL-098645, R01 HL-093238, F32 HL-120471, T32 AG-049676, M01 RR-10732]
- American College of Sports Medicine Foundation
- American Heart Association [0515392U]
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The skin is an accessible model circulation for studying vascular function and dysfunction across the lifespan. Age-related changes, as well as those associated with disease progression, often appear first in the cutaneous circulation. Furthermore, impaired vascular signaling and attendant endothelial dysfunction, the earliest indicators of cardiovascular pathogenesis, occur in a similar fashion across multiple tissue beds throughout the body, including the skin. Because microvascular dysfunction is a better predictor of long-term outcomes and adverse cardiovascular events than is large vessel disease, an understanding of age-associated changes in the control of the human cutaneous microcirculation is important. This review focuses on 1) the merits of using skin-specific methods and techniques to study vascular function, 2) microvascular changes in aged skin (in particular, the role of the endothelial-derived dilator nitric oxide), and 3) the impact of aging on heat-induced changes in skin vasodilation. While skin blood flow is controlled by multiple, often redundant, mechanisms, our laboratory has used a variety of distinct thermal provocations of this model circulation to isolate specific age-associated changes in vascular function. Skin-pecific approaches and techniques, such as intradermal microdialysis coupled with laser-Doppler flowmetry (in vivo) and biochemical analyses of skin biopsy samples (in vitro), have allowed for the targeted pharmacodissection of the mechanistic pathways controlling skin vasoreactivity and study of the impact of aging and disease states. Aged skin has an attenuated ability to vasodilate in response to warm stimuli and to vasoconstrict in response to cold stimuli.
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