Dynamics of Local Pressure-Induced Cutaneous Vasodilation in the Human Hand

Ábrahám, Pierre; Fromy, Bérengère; Merzeau, Sandra; Jardel, A.; Saumet, J. L.

doi:10.1006/mvre.2000.2290

Cited by 51 publications

(58 citation statements)

References 21 publications

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“…Although much attention has been focused on the role of thermal receptors in the control of skin blood flow, the role of cutaneous mechanical receptors has not been as extensively studied. We recently reported a significant transient increase of skin blood flow during local pressure application in the skin of humans (5,6). Because a skin temperature close to 34°C was considered the optimal temperature for the evaluation of skin vasomotor reflexes in the lower limb (13), the absence of PIV in healthy subjects may be attributable to a low skin temperature.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, sensory diabetic neuropathy mainly affects unmyelinated primary afferent fibers (2) and impairs the vasodilation related to normally functioning unmyelinated C fibers (3,4). We recently reported on cutaneous pressure-induced vasodilation (PIV) in humans (5,6) and rats (7) as a physiological response to an increase in nonnoxious progressive local pressure. This mechanism allows skin blood flow to increase in response to locally applied pressure, whereas in its absence, skin blood flow is progressively decreased with application of increased local pressure.…”

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Early Decrease of Skin Blood Flow in Response to Locally Applied Pressure in Diabetic Subjects

et al. 2002

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Pressure ulcers are common debilitating complications of diabetes that are caused by tissue ischemia. Skin blood flow in response to locally applied pressure might be impaired in diabetic patients because of the combined effects of a typically low skin temperature and alterations in microcirculatory function, and could be worsened by neuropathy. We measured skin blood flow by laser Doppler flowmetry over the internal anklebone in response to local pressure applied at 5.0 mmHg/min in three groups of diabetic patients (with clinical and subclinical neuropathy and without neuropathy) and in healthy matched control subjects at usual room temperature. Compared with in matched control subjects with comparable skin temperatures (29.3 ؎ 0.4 vs. 28.7 ؎ 0.4°C), in diabetic patients the skin blood flow response to locally applied pressure was further impeded, even in those without neuropathy. Indeed, skin blood flow decreased significantly from baseline at much lower applied pressure (7.5 mmHg) in diabetic subjects, again even in those without neuropathy, than in control subjects (48.8 mmHg). The large difference between these pressures could partially explain diabetic patients' high risk of developing decubitus and plantar ulcers. Diabetes 51:1214 -1217, 2002 P ressure ulcers are common debilitating complications of diabetes (1). Diabetes disturbs the autonomic regulation of skin microcirculation, even in the absence of neuropathy. Moreover, sensory diabetic neuropathy mainly affects unmyelinated primary afferent fibers (2) and impairs the vasodilation related to normally functioning unmyelinated C fibers (3,4). We recently reported on cutaneous pressure-induced vasodilation (PIV) in humans (5,6) and rats (7) as a physiological response to an increase in nonnoxious progressive local pressure. This mechanism allows skin blood flow to increase in response to locally applied pressure, whereas in its absence, skin blood flow is progressively decreased with application of increased local pressure. Although it results from nonpainful stimulation, this mechanism has been shown to disappear after chronic treatment with capsaicin in animals and humans (5,7), suggesting that it is dependent on the normal function of capsaicin-sensitive primary nervous afferents. Because temperature and blood flow in cutaneous microcirculation are highly correlated (8), skin temperature may have a major effect on skin blood flow response to applied pressure. Therefore, we hypothesized that the skin blood flow response to locally applied pressure would be impaired in diabetic patients because of the combined effects of their typically low skin temperature and diabetes-induced alterations of the vascular and nervous systems. To verify this hypothesis, we measured the effects of locally applied pressure on skin blood flow over the internal anklebone in diabetic patients with clinically apparent or subclinical neuropathy and without neuropathy and in healthy matched control subjects at usual ambient temperature. RESEARCH DESIGN AND METHODSSubjects. Subj...

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Section: Discussionmentioning

confidence: 99%

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Early Decrease of Skin Blood Flow in Response to Locally Applied Pressure in Diabetic Subjects

et al. 2002

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“…This transient pressure-induced vasodilation (PIV) appears to be a protective cutaneous response. This response was observed both on the hand in humans (5,6) and on the skin of the head in rats (7). This mechanism disappears after desensitization of primary afferents by capsaicin in animals and humans (6,7).…”

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Impaired Pressure-Induced Vasodilation at the Foot in Young Adults With Type 1 Diabetes

et al. 2004

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Vascular and neurological mechanisms are both likely to be involved in foot ulcer. We recently reported a pressure-induced vasodilation (PIV), relying on unmyelinated afferent excitation. We previously found that cutaneous blood flow in response to locally applied pressure might be impaired in diabetic patients because of the combined effects of low cutaneous temperature and alterations in microcirculatory function. Therefore, we aimed to analyze whether, at a relatively high cutaneous temperature, PIV is present in type 1 diabetes and to assess endothelial-dependent vasodilation and endothelium-independent vasodilation. We measured cutaneous blood flow using laser Doppler flowmetry on the head of the first metatarsus in response to applied pressure at 5.0 mmHg/min in warm conditions (29.5 ؎ 0.2°C). Responses to iontophoresis of acetylcholine (endothelium dependent) and sodium nitroprusside (endothelium independent) were measured using laser Doppler flowmetry in the forearm. The data indicate that PIV exists at the foot level in normal subjects, whereas it was not found in diabetic patients. In diabetic patients, the nonendothelial-mediated response to sodium nitroprusside was preserved, whereas the endothelial-mediated response to acetylcholine was impaired. These findings might be relevant to the high prevalence of foot ulcer that occurs in diabetic patients. Diabetes 53: [721][722][723][724][725] 2004

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“…These results are in accordance with previous research, which reported that StO2 increased with calf compression sleeves before and after running or cycling exercises (13,19). The higher StO 2 was attributed to the increased muscle flow rate (9, 10) and changes in skin blood flow with calf compression sleeves (26,27). Indeed, wearing compression on the lower limbs is known to increase venous return (2), causing venous pressure to decrease (1).…”

Section: Changes In Sto2 At Restmentioning

confidence: 99%

“…The pressure applied by sleeves is transmitted into the tissue, thus reducing the transmural pressure gradient of the arterial vessels (29). Finally, changes in skin blood flow must also be considered (26,27). Indeed, StO 2 was recorded at a maximum depth of 15 mm including cutaneous and muscular vessels.…”

Section: Changes In Sto2 At Restmentioning

confidence: 99%

Changes in Tissue Oxygen Saturation with Well- and Tight-Fitted Compression Sleeves During an Incremental Exercise on Treadmill

et al. 2017

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Dynamics of Local Pressure-Induced Cutaneous Vasodilation in the Human Hand

Cited by 51 publications

References 21 publications

Early Decrease of Skin Blood Flow in Response to Locally Applied Pressure in Diabetic Subjects

Early Decrease of Skin Blood Flow in Response to Locally Applied Pressure in Diabetic Subjects

Impaired Pressure-Induced Vasodilation at the Foot in Young Adults With Type 1 Diabetes

Changes in Tissue Oxygen Saturation with Well- and Tight-Fitted Compression Sleeves During an Incremental Exercise on Treadmill

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