In this invited review, we explore the burgeoning possibility of capillary endothelial cells as coordinators of skeletal muscle blood flow in response to muscle contraction. The idea that the capillary is an active vascular unit in skeletal muscle microcirculation starkly diverges from the traditional dogma that seats arterioles as the central controllers of blood flow during exercise. This review aims to incite discussion as we revisit and rethink the role of capillary endothelial cells in skeletal muscle. We discuss the potential for a mismatch in the architectural relationships between the arteriolar microvasculature and contracting motor units that would negate consistent communication between them. We review the data from the past two decades demonstrating that capillaries are ideally located architecturally to communicate with skeletal muscle fibers and are mechanistically capable of signaling upstream arterioles that control their own perfusion. We show that the orchestration of a coordinated vascular response necessary to support active skeletal muscle fibers cannot be achieved by the arterioles, but rather it is the capillaries that drive the blood flow response to muscle contraction. Thus, capillaries need to be seriously considered as critical in the coordination of skeletal muscle blood flow during active hyperemia.

Redundancy, in active hyperaemia, where one vasodilator can compensate for another if the first is missing, would require that one vasodilator inhibits the effects of another; therefore, if the first vasodilator is inhibited, its inhibitory influence on the second vasodilator is removed and the second vasodilator exerts a greater vasodilatory effect. We aimed to determine whether vasodilators relevant to skeletal muscle contraction [potassium chloride (KCl), adenosine (ADO) and nitric oxide] inhibit one another and, in addition, to investigate the mechanisms for this interaction. We used the hamster cremaster muscle and intravital microscopy to directly visualize 2A arterioles when exposed to a range of concentrations of one vasodilator [10(-8) to 10(-5) M S-nitroso-N-acetyl penicillamine (SNAP), 10(-8) to 10(-5) M ADO, 10 and 20 mM KCl] in the absence and then in the presence of a second vasodilator (10(-7) M ADO, 10(-7) M SNAP, 10 mM KCl). We found that KCl significantly attenuated SNAP-induced vasodilatations by ∼65.8% and vasodilatations induced by 10(-8) to 10(-6) M ADO by ∼72.8%. Furthermore, we observed that inhibition of KCl vasodilatation, by antagonizing either Na(+)/K(+) ATPase using ouabain or inward rectifying potassium channels using barium chloride, could restore the SNAP-induced vasodilatation by up to ∼53.9% and 30.6%, respectively, and also restore the ADO-induced vasodilatations by up to ∼107% and 76.7%, respectively. Our data show that vasodilators relevant to muscle contraction can interact in a way that alters the effectiveness of other vasodilators. These data suggest that active hyperaemia may be the result of complex interactions between multiple vasodilators via a redundant control paradigm.

CO and H produce arteriolar vasodilation but, critically, cannot stimulate the spread of vasodilation throughout the network, thus limiting their ability to coordinating blood flow to contracting skeletal muscle fibers. Given their potential for interaction, the importance of CO and H may lie in their ability to modify the effects of other vasodilators.

We sought to determine if redundancy between vasodilators is physiologically relevant during active hyperaemia. As inhibitory interactions between vasodilators are indicative of redundancy, we tested whether vasodilators implicated in mediating active hyperaemia (potassium (K ), adenosine (ADO) and nitric oxide (NO)) inhibit one another's vasodilatory effects through direct application of pharmacological agents and during muscle contraction. Using the hamster cremaster muscle and intravital microscopy, we locally stimulated capillaries with one vasodilator in the absence and the presence of a second vasodilator (10 m S-nitroso-N-acetylpenicillamine (SNAP), 10 m ADO, 10 mm KCl) applied sequentially and simultaneously, and observed the response in the associated upstream 4A arteriole controlling the perfusion of the stimulated capillary. We found that KCl significantly attenuated SNAP- and ADO-induced vasodilatations by ∼49.7% and ∼128.0% respectively and ADO significantly attenuated KCl- and SNAP-induced vasodilatations by ∼94.7% and ∼59.6%, respectively. NO significantly attenuated KCl vasodilatation by 93.8%. Further, during muscle contraction we found that inhibition of NO production using l-N -nitroarginine methyl ester and inhibition of ADO receptors using xanthine amine congener was effective at inhibiting contraction-induced vasodilatation but only in the presence of K release channel inhibition. Thus, only when the inhibiting vasodilator K was blocked was the second vasodilator, NO or ADO, able to produce effective vasodilatation. Therefore, we show that there are inhibitory interactions between specific vasodilators at the level of the capillary. Further, these inhibitions can be observed during muscle contraction indicating that redundancies between vasodilators are physiologically relevant and influence vasodilatation during active hyperaemia.

AIMS: We sought to determine if a pannexin/purinergic-dependent intervascular communication pathway exists in skeletal muscle microvasculature that facilitates capillary communication with upstream arterioles that control their perfusion. METHODS: Using the hamster cremaster muscle and intravital microscopy we locally stimulated capillaries and observed the vasodilatory response in the associated upstream 4A arteriole. We stimulated capillaries with vasodilators relevant to muscle contraction (10-6M S-nitroso-N-acetyl-DL-penicillamine (SNAP; nitric oxide donor), 10-6M adenosine, 10mM potassium chloride, 10-5M pinacidil as well as a known initiator of gap-junction-dependent intervascular communication, acetylcholine (10-5M), in the absence and the presence of the purinergic membrane receptor blocker suramin (10-5M), pannexin blocker mefloquine (2x10-5M) or probenecid (5x10-6M) and gap-junction inhibitor halothane (0.07%) applied in the transmission pathway, between the capillary stimulation site and the upstream 4A observation site. RESULTS: Potassium chloride, SNAP and adenosine-induced upstream vasodilations were significantly inhibited by suramin, mefloquine and probenecid but not halothane, indicating the involvement of a pannexin/purinergic-dependent signaling pathway. Conversely, SNAP-induced upstream vasodilation was only inhibited by halothane indicating that communication was facilitated by gap junctions. Both pinacidil and acetylcholine were inhibited by suramin but only acetylcholine was inhibited by halothane. CONCLUSIONS: These data demonstrate the presence of a pannexin/purinergic-dependent communication pathway between capillaries and upstream arterioles controlling their perfusion. This pathway adds to the gap-junction-dependent pathway that exists at this level as well. Given that vasodilators relevant to muscle contraction can use both of these pathways, our data implicate the involvement of both pathways in the coordination of skeletal muscle blood flow.