In the present study, the RBF increased by 37% during hypercapnia (5% carbon dioxide with 21% oxygen and 74% nitrogen) in the PBS group
(Fig. 1) . There have been reports about changes in RBF during hypercapnia.
6 7 8 9 28 Using fluorescein angiography, Tsacopoulos and David
6 reported that, in monkeys, a Pa
co 2 increase of 1 mm Hg induces a 3% increase in RBF and a 1% increase in vessel diameter during hypercapnia. In humans, Harris et al.,
7 using fluorescein angiography, reported that hypercapnia-induced increases in blood velocity averaged 1% per mm Hg Pa
co 2. In the present study, a Pa
co 2 increase of 1 mm Hg induced a 2.8% increase in RBF, a 0.7% increase in vessel diameter, and a 1.2% increase in blood velocity during hypercapnia in the PBS group
(Fig. 1) . Although there may be differences among species and with different measurement techniques, the degree of increase of RBF in our study seems to agree with previous findings.
Intravenous administration of
l-NAME, the NOS inhibitor, increases systemic blood pressure,
29 30 31 resulting in a change in the tissue perfusion pressure and blood flow. In the present study, the NOS inhibitor was administered using an intravitreal injection technique that resulted in topical application of NOS primarily in the retina. Our results (i.e., that MABP did not significantly change after injection of
l-NAME) indicate that this technique seems to minimize the systemic effects of the NOS inhibitor
(Table 1) . Furthermore, the fact that MABP did not significantly change during hypercapnia indicates that the changes in vessel diameter, blood velocity, and RBF were caused mainly by a retinal vascular response.
In the present study, we provided new evidence that intravitreal injection of
l-NAME markedly reduced the increase in RBF during hypercapnia
(Fig. 1) . Inhibition of NOS as a mechanism for the effects of
l-NAME is supported by the fact that
d-NAME had no effect
(Fig. 1) . These results indicate that NO production in the retina may contribute to the increased RBF in response to hypercapnia. However, Gidday and Zhu,
12 who measured the vessel diameter in newborn pigs, reported that the increase in the diameter of the retinal arterioles occurred in response to hypercapnia in animals pretreated with
l-NMMA, another nonselective NOS inhibitor. Those investigators concluded that NO does not contribute to hypercapnia-induced vasodilatation. Their findings do not agree with ours, possibly because of differences between their study and ours in species, methods of measurement, NOS inhibitors administered, and the age of the animals. Another possible explanation is the time course from the injection of the NOS inhibitor to the induction of hypercapnia.
l-NMMA was administered 20 minutes before the induction of hypercapnia in their study, but
l-NAME was administered 2 hours before the initiation of hypercapnia in our study.
Many hypotheses have been forwarded to explain increased NO production in response to hypercapnia in the brain.
32 33 Carbon dioxide or acidosis-associated hypercapnia may stimulate NOS enzyme activity
33 to produce NO, which activates guanylate cyclase to increase production of cyclic guanylic acid.
34 The nNOS activity increases as pH decrease,
33 whereas endothelial NOS (eNOS) activity appears to increase as the pH increases
34 in the brain. In mammalian retina, NOS has been found in photoreceptor cells, amacrine, horizontal and ganglion cells,
35 36 37 38 and Müller cells.
39 In the cerebral circulation, intracellular acidification produced by carbon dioxide may trigger NO production.
33 However,
l-NAME is a nonselective NOS inhibitor, and we could not determine whether these effects were caused by inhibition of endothelial or neuronal NOS, or both.
In the present study, we further examined the effect of the selective nNOS inhibitor 7-NI on the regulation of RBF during hypercapnia. Our result (i.e., that the 7-NI significantly attenuated the increase in RBF during hypercapnia, although it did not completely abolish the increase;
Fig. 3 ) suggests that nNOS in the retina is partially involved in the increase in RBF during hypercapnia. The fact that 7-NI significantly attenuated the increase in vessel diameter
(Fig. 3) raises the possibility that NO released from nNOS in the retina during hypercapnia may participate in the vasodilation of the retinal arterioles. In the present study, we did not perform any control experiments in which cats were injected only with the vehicle (10 mL peanut oil). Teppema et al.
40 reported that the infusion of the peanut oil vehicle of 7-NI did not result in measurable circulatory and respiratory changes in cats. That result suggested that peanut oil has little effect on the systemic parameters. Other reports have indicated that 7-NI had no effect on MABP, HR, and cardiac output.
41 42 Consistent with the findings of the previous studies, we did not observe any increase in MABP and HR after administration of 7-NI.
In the cerebral cortex, NO released from nNOS-containing neurons directly regulates cerebral blood flow.
43 The presence of nicotinamide adenine dinucleotide phosphate diaphorase–positive/NOS–immunoreactive cells and processes near the retinal capillaries and larger vessels was reported.
44 This may indicate that NO from a neuronal source plays a role in linking RBF with metabolism, as suggested in the brain.
45 This could be of particular importance in the retina, where arterioles and capillaries are not subject to autonomic innervation.
46 47
A flow-induced mechanism has been shown to be an adaptive response of the vessels to the change in blood flow that maintains a constant level of shear stress on the vessel wall.
5 The flow-induced mechanism exerts dominant effects on the upstream large arterioles (∼100–150 μm).
48 The diameters of the measured retinal arterioles in our study, which ranged from 65 to 95 μm, correspond approximately to those of the upstream large arterioles that have a dominant flow-induced mechanism. The flow-induced vasodilation, which probably results from the release of relaxing factors such as NO by the endothelium, can be evaluated by measuring the changes in WSR as an index of shear stress.
4 49 The flow-induced vasodilation is characterized by a delay between the increase in blood flow and the vasodilatory response. Thus, an increase in WSR preceding an increase in vessel diameter suggests that an increase in shear stress is the stimulus for the flow-induced vasodilator response. In the present study, however, no latency period was detected between blood velocity and vessel diameter increases
(Fig. 1) . Moreover, in the present study, the WSR did not increase significantly, even in the PBS groups
(Fig. 1) , although, during hypoxia in the previous study, flow-induced vasodilation was caused by increased WSR.
4 The flow-induced mechanism may have contributed little to the increase in RBF during hypercapnia. The response of the retinal circulation to hypercapnia may be different from the response to hypoxia, because there may be a difference of the degree of increase in blood flow. Although flow-induced vasodilation was caused by increased WSR during hypoxia in the previous study,
4 these responses were induced by a very large blood flow. The 13.7% dilation in response to a 39.5% increase in blood velocity was induced by hypoxia. The 39.5% increase in blood velocity during hypoxia was much greater than the 15.5% increase during hypercapnia in the present study. We speculate that the small increase in blood flow during hypercapnia did not cause the WSR to increase significantly and the flow-induced vasodilation to be activated.
In the PBS group, there was a significant negative correlation between the increase in vessel diameter and the increase in blood velocity
(Fig. 3) —namely, there was a tendency that the smaller the increase in vessel diameter, the larger the increase in blood velocity. This may reflect a well-coordinated vascular response to adapt blood flow to tissue demands so that the decrease of the RVR is adequate. However, in the
l-NAME group, this negative correlation disappeared
(Fig. 2) . These results suggest that NO plays a major role in the autoregulatory mechanism of the RBF during hypercapnia.
In summary, the present study demonstrated that NO contributes to the increase in RBF during hypercapnia and furthermore that nNOS in the retina is involved in the increase. We conclude that NO plays a major role in the autoregulatory mechanism of RBF during hypercapnia.
The authors thank Kazuya Saito and Hirofumi Harada for providing generous assistance.