Lang JA, Holowatz LA, Kenney WL. Tetrahydrobiopterin does not affect end-organ responsiveness to norepinephrine-mediated vasoconstriction in aged skin. Am J Physiol Regul Integr Comp Physiol 299: R1651-R1655, 2010. First published October 6, 2010; doi:10.1152/ajpregu.00138.2010.-We have recently demonstrated that tetrahydrobiopterin (BH 4) augments reflex vasoconstriction (VC) in aged skin. Although this appears to occur through its role in norepinephrine (NE) biosynthesis, the extent with which vascular mechanisms are affected are unknown. We hypothesized that localized BH 4 supplementation would not affect the VC response to exogenous NE when sympathetic nerves were blocked. Two microdialysis fibers were placed in bretylium tosylate pretreated (presynaptically blocks neurotransmitter release from sympathetic adrenergic nerve terminals; iontophoresis, 200 A for 20 min) 3-cm 2 forearm skin of 10 young (Y) and 10 older (O) subjects for perfusion of 1) Ringer (control) and 2) 5 mM BH 4. While local skin temperature was clamped at 34°C, six concentrations of NE (10 Ϫ12 , 10 Ϫ10 , 10 Ϫ8 , 10 Ϫ6 , 10 Ϫ4 , 10 Ϫ2 M) were infused at each drug-treated site. Cutaneous vascular conductance (CVC) was calculated (CVC ϭ laser Doppler flux/mean arterial pressure) and normalized to baseline (%⌬CVC base). Despite prejunctional adrenergic blockade, NE-mediated VC was blunted in aged skin at each NE dose (10 Ϫ12 : Ϫ12 Ϯ 2 vs. Ϫ21 Ϯ 2; 10 Ϫ10 : Ϫ15 Ϯ 2 vs. Ϫ27 Ϯ 1; 10 Ϫ8 : Ϫ22 Ϯ 2 vs. Ϫ32 Ϯ 2; 10 Ϫ6 : Ϫ27 Ϯ 2 vs. Ϫ38 Ϯ 1; 10 Ϫ4 : Ϫ52 Ϯ 3 vs. Ϫ66 Ϯ 5; 10 Ϫ2 : Ϫ62 Ϯ 3 vs. Ϫ75 Ϯ 4%⌬CVC base; P Ͻ 0.01), and this response was not affected by pretreatment with BH 4 (P Ͼ 0.05). Localized BH4 did not affect end-organ responsiveness to exogenous NE, suggesting that the effects of BH 4 on cutaneous VC are primarily isolated to the NE biosynthetic pathway. skin blood flow; aging; temperature regulation; adrenergic REFLEX-MEDIATED CUTANEOUS vasoconstriction (VC) is an immediate and sustained thermoregulatory response to cold exposure that effectively minimizes convective heat loss to the environment. In older subjects this response is impaired, thereby rendering them more susceptible to excessive heat loss and possibly hypothermia (3, 21). Even when matched for body composition and aerobic fitness, older adults exhibit reduced peripheral VC and a relative inability to defend against decreases in core temperature even during mild (22°C) cold exposure (5, 21).We have recently demonstrated that intradermal administration of tetrahydrobiopterin (BH 4 ) and/or L-tyrosine offsets the attenuated VC response to gradual whole body cooling (Tsk ϭ 30.5°C) in aged skin (24,25). BH 4 is synthesized naturally within adrenergic nerve terminals, whereas exogenous BH 4 can enter presynaptic nerve terminals through a facilitated transport mechanism. Once inside the axon terminal, BH 4 functions as an essential cofactor for tyrosine hydroxylase (TH), the rate-limiting step in catecholamine biosynthesis (9,20,22,29,38). However, because BH 4 is a powerful reduci...