Neural crest neuroblasts can colonise aganglionic and ganglionic gut in vivo.

INTRODUCTION: Neural crest (NC) cells differentiate IN VITRO into neuroblasts, precursors of the enteric nervous system (ENS), when stimulated by specific agents. We developed a study aimed at establishing whether NC-derived neuroblasts can survive and colonise IN VIVO when injected into a recipient mouse gut. MATERIALS AND METHODS: The neuroblast precursors of the ENS were obtained from the vagal portion of the neural tubes of 296 CD-1 and GTROSA26 mouse embryos. The embryonic cells of GTROSA26 mice are identifiable through beta-galactosidase activity which allows recognition by blue staining. The host used in this study was the DOM/+ mouse, an animal model for Hirschsprung's disease (aganglionic megacolon). DOM/+ mouse pups (n = 43) received NC-derived cells inoculated into the seromuscular layer of the gut (33/43) or directly into the peritoneal abdominal cavity (10/43). RESULTS: All DOM/+ mice survived the procedure and were sacrificed after 7 or 14 days. Histochemical staining detected implanted cells in all mice. These showed specific myenteric colonisation into the aganglionic and ganglionic gut. CONCLUSION: The striking result of this study was the specific tropism of the injected NC-derived cells to target sites under the action of unknown chemotactic agents. This experimental procedure might represent a possible treatment option for specific forms of human ENS anomaly such as total intestinal aganglionosis.

Histologic study of peritoneal adhesions in children and in a rat model.

Peritoneal adhesions (PA) represent a major cause of morbidity in pediatric surgical patients. The pathogenesis is still largely unknown. A possible role could be played by foreign bodies (FB) accidentally contaminating the operative field during surgery. We report a histologic study of PA in a rat model and in children, investigating the role of FB in their formation. Abdominal adhesions were studied in 18 rats. In 6 (group A) we performed a laparotomy and rubbed the visceral and parietal peritoneum with a cotton bud. In 6 (group B) we performed a minimal laparotomy and injected powdered autologous and heterologous material into the peritoneal cavity, avoiding any peritoneal abrasions. In 6 (group C) we performed a laparotomy and applied both treatment methods, i.e., rubbing and injection of FB. After 1 month, at autopsy rats were classified according to the presence and grade of surgical adhesions. Twenty-two PA were also collected from seven children undergoing abdominal surgery in whom one or more procedures had been previously performed. The adhesions were stained with hematoxylin-eosin and Giemsa stains for histologic examination. Adhesions were found in 4 rats of group A and all 6 rats of group C. None were identified in group B. Group C rats showed a higher grade of adhesions with respect to group A. In both humans and animals PA were always found to coexist with microscopic particles of solid substances, which were incorporated inside the connective tissue. However, after simple injection of FB into the abdominal cavity we did not observe any PA. These data suggest that two different stimuli are necessary for adhesion formation: a direct lesion of the mesothelial layers and a solid substrate (FB). We underline the importance of reducing contamination with FB during surgery. On the basis of these considerations, the laparoscopic approach seems to be particularly pertinent.

Mouse-isolated plexus differentiates neural crest precursors into enteric neuroblasts.

Aim of this study was to investigate, for the first time, whether isolated newborn mouse enteric plexus could induce in vitro differentiation of the vagal neural crest-derived cells into enteric neuroblasts. Fragments of the myenteric plexus were isolated from the small intestine of 6-day-old Swiss mice and were collected and stored in DMEM-F12 medium, then cultured on polymerized human fibronectin layer. The vagal portion of the neural tube, isolated from a 9.5-day-old Swiss mouse embryo, was put in the same chamber slides where the isolated myenteric plexus had been cultured for 3 days. The vagal neural crest-derived cells migrated onto the polymerized human fibronectin layer and formed a crown of cells around the neural tube. After 6 days, the cultures were stopped and studied immunohistochemically for anti-NF160 KD, anti-TH, and RetR5 antibodies to analyse the differentiation stage of the cultured cells. Analysis of results included the comparison of two culture groups: Group 1, used as control, in which vagal neural crest-derived cells were put in DMEM-F12, supplemented only with 10 % of FCS; Group 2, in which vagal neural crest-derived cells were put in the same medium as Group 1, with the addition of myenteric plexus fragments isolated from newborn mice to form the co-culture. The following results were obtained: in Group 1 the neural tubes originated a cell population strongly positive for anti-NF160 and anti-TH Ab, but negative for RetR5 Ab. This positivity was found both in the cells adjacent to the neural tube and in those migrating from it distally. The Group 2 originated cells, which after migration were positive for anti-NF160 and for anti-TH antibodies. In addition, in this culture group, the cells which migrated from the neural tube were positive for anti-RetR5 antibody. The co-culture used in this study induces the differentiation of vagal stem cells into enteric neuroblasts, cells TH+ and RetR5+. These cells, after reaching the embryonic intestine, migrate to colonize the hindgut and form the ENS. Therefore this biotechnology seems a good method to obtain in vitro enteric precursors of ENS.

Anorectal malformations associated with enteric dysganglionosis in Danforth's short tail (Sd) mice.

BACKGROUND: The spontaneous mutant Danforth's short tail (Sd) mouse has been studied over the last 60 years from the morphological, embryological, and genetic point of view. The Sd mutation affects a gene essential to notochordal development, and the Sd mouse phenotype represents an analogue of human caudal regression syndrome. The Sd/Sd mouse presents different types of anorectal malformations (ARM) and was suggested as a simple and cheap model of investigation of ARM morphology and embryology. In the current study, the Sd mouse enteric nervous system (ENS) was thoroughly investigated with specific immunohistochemical markers. METHODS: Macroscopic analysis, normal histology, and immunohistochemical techniques for detecting neurofilaments (NF) and NOS1 were used to study ENS of 138 Sd mice and 25 controls. RESULTS: The surprising results of this study showed that Sd mutation is associated with different degrees of hypoganglionosis and aganglionosis. In 41% of Sd/SD-affected mice, the rectal pouch was aganglionic and in the remaining 58% was severely hypoganglionic. In addition, 4.1% of heterozygous mice presented a distal aganglionosis and 8.3% hypoganglionosis. CONCLUSIONS: These results suggest that Sd mutation independently affects distinct cell lines during early organogenesis, as notochord cells, ventral hingut endoderm, and neuroblasts migrating from neural crest cells. Comparing the Sd murine model with human pathology, this study confirms that the association between ARM and intestinal dysganglionosis is not rare and underlines the importance of detecting in every ARM patient the innervation abnormalities of rectal pouch and fistulas.

GDNF deficit in Hirschsprung's disease.

BACKGROUND/PURPOSE: In 1996, the glial cell line-derived neurotrophic factor (GDNF) was identified as one of the ligands of the RET transmembrane receptor. In the same year, GDNF mutations were found in association with RET protooncogene mutations in Hirschsprung patients. Mutations in GDNF per se are thought neither necessary nor sufficient to cause Hirschsprung's disease (HD). To date, our study group has identified GDNF mutations only in 2 of 98 cases of intestinal dysganglionosis. The aim of our study was to investigate a possible expression deficit of GDNF in the enteric nervous system of Hirschsprung patients not mutated for the GDNF gene. METHODS: We used rabbit polyclonal antibodies raised against a peptide corresponding to amino acids 186-205 mapping within the carboxy-terminal domain of human GDNF. GDNF expression was studied immunohistochemically in surgical specimens from 30 HD cases (27 classic forms and 3 ultralong forms) and from 10 age-matched controls. Serial sections from the same full-thickness specimens were investigated with the following histochemical and immunohistochemical techniques: acetylcholinesterase, lactate dehydrogenase, succinic dehydrogenase, alpha-naphthyl-esterase, glial fibrillary acid protein, S-100 protein, and neuron-specific enolase. RESULTS: A high level of GDNF expression was found in normal intestine and in Hirschsprung ganglionic segment. Satellite elements of myenteric ganglia presented a strong immunoreactivity to GDNF. Conversely, the aganglionic segment showed cholinergic hyperinnervation and hypertrophic trunks of nerve fibers in the muscular interstitium with complete absence of GDNF expression. The small ganglia of the hypoganglionic segment showed a reduced GDNF immunoreactivity. CONCLUSIONS: GDNF, a distantly related member of the transforming growth factor-beta superfamily, is a potent neurotrophic and survival factor for neurons and enteric ganglion cells. Mutations of the GDNF gene or GDNF expression deficit interrupt the faithful GDNF signaling via Ret, contributing to HD pathogenesis.

[Constipation and chronic intestinal pseudoobstruction as a clinical expression of intestinal neuronal dysplasia (IND)]. / Stipsi e pseudo-ostruzione intestinale cronica come espressione clinica di displasia neuronale intestinale (IND).

BACKGROUND: Intestinal neuronal dysplasia (IND) belongs to the group of dysganglionosis. It may occur as part of a syndrome of early chronic constipation, neonatal intestinal occlusion, chronic intestinal pseudo obstruction. The aim of this study was to report the cases examined by the Istituto G. Gaslini in Genoa and to discuss the numerous aspects of this disease which are still unclear. METHODS: 787 children were included in the study and underwent biopsy between 1984 and 1997. Rectal biopsies were obtained by suction or in some cases during surgery and were treated using enzymohistochemical techniques, such as acetylcholinesterase, rapid acetylcholinesterase and alpha-naphthylesterase. RESULTS: 574 children were found to be suffering from innervative alterations: 348 (60.6%) presented isolated Hirschsprung's disease, IND was found in 83 (14.5%), in 8 of the latter in association with other dysganglionosis. IND was accompanied by other diseases in 40 cases (48.2%). Over the past three years (since October 1994) a total of 164 dysganglionosis have been diagnosed, including 55 cases of aganglia. During this period IND was the most frequently observed alteration and affected 61 children. CONCLUSIONS: Rectal biopsy is the essential diagnostic test for the diagnosis of intestinal dysganglionosis. Biopsies are performed in outpatient clinics without sedation, and do not represent an invasive procedure for the young patients. Radiological and manometric examinations cannot provide reliable data for the diagnosis of IND. In our experience, the incidence of IND over the past few years has increased and its diagnosis is essential for correct treatment which is not surgical in the majority of cases. The real incidence of IND and its pathogenesis still need to be clarified.

Rat tibial osteoblasts III: propagation in vitro is accompanied by enhancement of osteoblast phenotype.

Postproliferative confluent cultures of primary rat tibial osteoblasts (ROB), cultured in medium supplemented with ascorbic acid and beta-glycerophosphate (AS-bGP, differentiation medium) express, in sequence, specific bone markers which identify a succession of maturation stages, and eventually form mineralized noduli. We report an investigation on the effect of extensive proliferation in vitro in unsupplemented medium on the osteogenic potential of mass cultures of ROB. The growth rates of the populations, derived from two independent primary cultures, was constant throughout 110 cumulative population doublings (CPD) in culture. Propagated cells maintained features similar to osteoblasts in primary cultures with respect to serum and anchorage dependence for growth and to the chemokinetic effect on endothelial cells exerted by their conditioned media (CM). Propagated populations, set at confluence in differentiation medium, were tested for the expression of early [alkaline phosphatase (AP)] and late [osteocalcin (OC); bone sialoprotein (BSP); 45Ca incorporation and mineralization] osteogenic markers. We observed an increase, parallel to the increase in CPD, in both the level of maximal expression of AP (enzyme/microgram cellular DNA) and in the frequency of nodules, reaching five- to sixfold (at 78 CPD) and eightfold (at 60 CPD), respectively, the levels of primary cultures. AP expression (enzyme and mRNA) persisted during mineralization and 45Ca incorporation. The time required by propagated cultures for the formation of nodules decreased with increase of CPD, and was reduced to less than one third at 87 CDP. Nodules became mineralized over a similar lapse of time as in primary cultures and were positive by histochemistry for BSP and OC. We also obtained osteogenic clones from two independent cultures after 72 CPD. 90% of these showed an osteoblast phenotype, expressing AP and forming nodules positive for OC and BSP, which mineralized. Timing of formation and frequency of nodules/plated cells in clones was similar to that found in propagated cultures of equivalent CPD. In summary, propagated ROB populations and derived clones showed enhanced osteoblast phenotype, possibly due to an increase in osteogenic cells and enrichment of proliferating mature osteoblasts, consequent to extended propagation in culture.

Water distribution in insulin-dependent diabetes mellitus in various states of metabolic control.

Alterations in water compartments have been described in insulin-dependent diabetes mellitus (IDDM). Both insulin and lack of natriuretic counteracting response lead to water expansion, while hyperglycemica-induced osmotic diuresis leads to water depletion. Both total body water and water distribution in the extra-intracellular space, as well as their relationships to metabolic control, were investigated in 15 controls (30.1 +/- 1.4 years) and in 26 IDDM patients (31.3 +/- 1.6, diabetes duration 11.3 +/- 1.4 years) who were neither hypertensive nor proteinuric. The amounts of total body water (TBW) and extracellular water (ECW) were predicted by impedance measurements at 100 KHz and at 1 KHz. The amount of intracellular water (ICW) was computed as the difference between the two. Water distribution was estimated by measuring the ratio between low- and high-frequency impedance and by computing the ratio between ECW and ICW. The IDDM patients were divided into four groups on the basis of reference HbA(lc) mean and SD: A < or = mean + 2 SD < B < or = mean + 4 SD < C < or = mean +6SD < D. The groups were comparable with sodium intake, insulin dosage, fasting glycemia and laboratory hydration markers. As compared to controls, impedance values at 1, 5, 10, 50 and 100KHz were significantly lower in diabetic patients and the difference within group D increased as the frequency increased: -3.9% at 1 KHz, -10.1% at 100 KHz. As compared to controls, groups A, B and C showed higher TBW, ECW and ICW while water distribution was normal, and group D showed higher TBW and ICW but normal ECW and a different water distribution. In all IDDM patients, HbA(lc) correlated with ECW (r = -0.49) and distribution ratios (r = 0.42, impedance; r = 0.40, ECW/ICW ratio). These observations suggest that good or moderate long-term control IDDM patients have proportionately normal distributions of ECW and ICW excess. However, water excess in poor control IDDM patients was only found in the ICW space.

Chronic ethanol consumption affects cholinoceptor- and purinoceptor-mediated contractions of the isolated rat bladder.

Isolated bladder strips from 12-week ethanol-fed, pair-fed and control adult male rats were investigated. Contractile responses to carbachol (CCh; 0.1-300 microM) were statistically significantly potentiated in the ethanol-fed group compared to pair-fed and control. Contractions to beta,gamma-methylene ATP (beta,gamma-MeATP; 1-300 microM) were statistically significantly potentiated in the ethanol-fed group at the highest concentration tested (300 microM). Neurogenic contractions (0.5-32 pps) from the ethanol-fed group in the absence of atropine and after desensitisation by alpha,beta-methylene ATP (alpha,beta-MeATP; 3 microM), were significantly potentiated compared to the pair-fed and control groups; in the presence of atropine (1 microM), neurogenic contractions were significantly augmented at the higher frequencies. It is concluded that chronic ethanol treatment affects both cholinoceptor- and purinoceptor-mediated contractions of the rat bladder.

Responses of rabbit basilar arteries to vasoconstrictor and vasodilator agents: the effects of atherosclerosis, age and sex.

We have studied the influences of atherosclerosis, age and sex on arterial responsiveness to vasoactive agents using male and female Watanabe heritable hyperlipidaemic (WHHL) rabbits (4-12 months, n = 36) as a model for atherosclerosis and sex- and age-matched New Zealand White (NZW) rabbits (n = 36) as controls. The responses of isolated rings of basilar arteries mounted in organ baths to vasoactive substances were studied. KCl-induced contractions in female atherosclerotic rabbits were greater than controls but those of male atherosclerotic rabbits were equivalent to the respective controls. Age did not influence KCl-induced contractions of rabbits of either strain or sex. Histamine-induced contractions increased with age in female atherosclerotic rabbits only. Acetylcholine (ACh)-induced relaxations of 6-month-old male and female atherosclerotic rabbits were greater than their respective controls. ACh-induced relaxations of female but not male NZW rabbits decreased with age. Calcitonin gene-related peptide- and vasoactive intestinal polypeptide-induced relaxations in atherosclerotic male and female rabbits were not affected by age. However, relaxations of female but not male control rabbits decreased with age. These findings suggest that there are subtle changes in the control of vascular tone which develop with the onset and progression of atherosclerosis. Of particular significance is the increase in endothelium-dependent relaxation in WHHL rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

Ethanol affects sympathetic cotransmission and endothelium-dependent relaxation in the rat.

The influence of ethanol on sympathetic nerve-mediated contractions of rat tail arteries and on endothelium-dependent relaxation of rat mesenteric arteries by acetylcholine was examined using the method of in vitro pharmacology. Ethanol potentiated sympathetic nerve-mediated contractions. Ethanol had no effect on the neurogenic contractions that remained after alpha-adrenoceptor blockade by prazosin. However, after P2x-purinoceptor desensitisation, the residual nerve-mediated contractions were significantly enhanced by ethanol. Contractions to exogenous noradrenaline and alpha,beta-methylene ATP were unaffected by ethanol. It is concluded that ethanol selectively potentiates the noradrenergic component of sympathetic neurotransmission. Ethanol depressed the relaxation by acetylcholine but not that induced by sodium nitroprusside. These results indicate that ethanol can affect both the neural and endothelial control of vascular tone. The potentiated noradrenergic vasoconstrictor response to sympathetic nerve stimulation and the compromised capacity of the endothelium to cause relaxation after ethanol treatment may contribute to the development of vascular diseases associated with alcohol consumption.

Identification of potent, selective P2Y-purinoceptor agonists: structure-activity relationships for 2-thioether derivatives of adenosine 5'-triphosphate.

Study of P2-purinoceptor subtypes has been difficult due to the lack of potent and selective ligands. With the goal of developing high affinity P2-purinoceptor-selective agonist, we have synthesized a series of analogues of adenine nucleotides modified on the purine ring as chain-extended 2-thioethers or as N6-methyl-substituted compounds. Chemical functionality incorporated in the thioether moiety included cyanoalkyl, nitroaromatic, amino, thiol, cycloalkyl, n-alkyl, and olefinic groups. Apparent affinity of the compounds for P2Y-purinoceptors was established by measurement of P2Y-purinoceptor-promoted phospholipase C activity in turkey erythrocyte membranes and relaxation of carbachol-contracted smooth muscle in three different preparations (guinea pig taenia coli, rabbit aorta, and rabbit mesenteric artery). Activity at P2X-purinoceptors was established by measurement of contraction of rabbit saphenous artery and of the guinea pig vas deferens and urinary bladder. All 11 of the 2-thioethers of ATP stimulated the production of inositol phosphates with K0.5 values of 1.5-770 nM, with an (aminophenyl)ethyl derivative being most potent. Two adenosine diphosphate analogues were equipotent to the corresponding ATP analogues. Adenosine monophosphate analogues were full agonists, although generally 4 orders of magnitude less potent. ATP 2-thioethers displayed pD2 values in the range of 6-8 in smooth muscle assay systems for activity at P2Y-receptors. There was a significant correlation for the 2-thioether compounds between the pK0.5 values for inositol phosphate production and the pD2 values for relaxation mediated via the P2Y-purinoceptors in the guinea pig taenia coli, but not for the vascular P2Y-receptors or for the P2X-receptors. At P2X-receptors, no activity was observed in the rabbit saphenous artery, but variable degrees of activity were observed in the guinea pig vas deferens and bladder depending on distal substituents of the thioether moiety. N6-Methyl-ATP was inactive at P2X-receptors, and approximately equipotent to ATP at taenia coil P2Y-receptors. This suggested that hybrid N6-methyl and 2-thioether ATP derivatives might be potent and selective for certain P2Y-receptors, as was shown for one such derivative, N6-methyl-2-(5-hexenylthio)-ATP.

Evidence for the involvement of both ATP and nitric oxide in non-adrenergic, non-cholinergic inhibitory neurotransmission in the rabbit portal vein.

The NANC inhibitory innervation of the longitudinal muscle of the rabbit portal vein has been examined. Neurogenic relaxations were partially inhibited by the P2-purinoceptor antagonist, suramin. Addition of the NO-synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME) also significantly reduced responses to electrical stimulation and the addition of L-arginine reversed this effect. A combination of both suramin and L-NAME abolished the neurogenic relaxation. A maximum relaxation of the vein was evoked by sodium nitroprusside which was not affected by L-NAME or suramin. Histochemical staining demonstrated the presence of NADPH-diaphorase containing nerves between the longitudinal and circular muscle coats of the media and also in the adventitia. It is concluded that both ATP and NO are inhibitory neurotransmitters in the NANC nerves of the rabbit portal vein.

Sex and age as factors influencing the vascular reactivity in Watanabe heritable hyperlipidaemic (WHHL) rabbits: a pharmacological and morphological study of the hepatic artery.

The responses to vasoactive agents and the fine structure of hepatic arterial ring segments from male and female Watanabe heritable hyperlipidaemic (WHHL) rabbits (4, 6, and 12 months) were compared with those of age- and sex-matched New Zealand White (NZW) rabbits. In males only, KCl-induced contractions were reduced in WHHL rabbits compared with NZW rabbits. In male and female WHHL rabbits, maximum noradrenaline-induced contractions and sensitivity to noradrenaline were greater than those of male and female NZW rabbits. In female WHHL and NZW rabbits only, maximum noradrenaline-induced contractions and the EC50 values were reduced at 6 months. Endothelium-dependent relaxation: In females only, maximum relaxant responses and the sensitivity of WHHL rabbits to acetylcholine increased with age, while there was a decrease in NZW rabbits. Similarly, relaxation to substance P increased with age in WHHL rabbits and decreased in NZW rabbits, but this occurred in both male and female animals. In addition, substance P-induced relaxation in female WHHL rabbits was greater than in male WHHL rabbits. Endothelium-independent relaxation: In both male and female WHHL rabbits, calcitonin gene-related peptide-induced and vasoactive intestinal polypeptide-induced relaxation did not change with age. However, there was an age-related decrease in the response of NZW rabbits to these peptides. Electron microscopic evaluation of hepatic arteries from WHHL rabbits showed occasional ruptures in the internal elastic lamina at 4 months. At 6 months, widespread intimal thickening associated with smooth muscle cell migration was apparent, but this became less obvious at 12 months. No obvious differences in structure between male and female hepatic arteries were observed. It is suggested that a "compensatory vasodilatation" develops in atherosclerosis, initially at the level of the endothelium, and then with the progression of the disease extends to changes in the smooth muscle. This may occur in order to offset the thickening of the arterial wall. Sexual dimorphism in vascular reactivity has been demonstrated.

Endothelium-dependent and endothelium-independent vasodilatation of the hepatic artery of the rabbit.

1. The isolated hepatic artery of the rabbit contracted to exogenously applied noradrenaline (NA). There was no significant difference in the maximal contraction or the EC50 value in vessels where the endothelium was present and in endothelium-denuded preparations. 2. Acetylcholine (ACh) induced a vasodilatation of vessels preconstricted with NA which was entirely dependent on the endothelium. 3. Adenosine 5'-triphosphate (ATP), 2-methylthio ATP, adenosine and sodium nitroprusside induced concentration-dependent, sustained relaxations of vessels in which tone had been induced with NA. The relaxation responses were not reduced after removal of the endothelium. 8-Phenyltheophylline antagonized the relaxation response produced by adenosine, but not that due to ATP at lower concentrations. The maximum response to ATP was reduced in the presence of 8-phenyltheophylline. 4. alpha,beta-Methylene ATP produced further contraction of vessels preconstricted with NA in both endothelium-denuded preparations and in vessels where the endothelium remained intact. 5. Immunohistochemical analysis was used to show the presence of nerve fibres containing substance P (SP), calcitonin gene-related peptide (CGRP) and vasoactive intestinal polypeptide (VIP) in the hepatic artery. Application of SP induced a concentration-dependent relaxation which was entirely dependent on the presence of an intact endothelium. CGRP and VIP, however, elicited concentration-dependent relaxations which were independent of the endothelium. 7. It is concluded that in the rabbit hepatic artery, responses to ACh are dependent on the presence of intact endothelium. P1-, P2x- and P2y-purinoceptors, mediating relaxation to adenosine, vasoconstriction to ATP and vasodilatation to ATP respectively, are located on vascular smooth muscle. Furthermore, CGRP and VIP mediate a direct vasodilatation of smooth muscle both in the absence and the presence of the endothelium, whereas SP produces a relaxation via receptors located on the endothelium.

[Evaluation in experimental animals of a mathematical model of foreseeing variations in values of stable glycosylated hemoglobin]. / Valutazione sull'animale da esperimento di un modello matematico per la previsione delle variazioni dei valori di emoglobina glicosilata stabile.

Assay of glycosylated hemoglobin provides reliable information on metabolic control in diabetes mellitus over a period of about 90 days. This is why it is currently used as a parameter of blood glucose control in diabetic patients. However, at present little is known about the kinetics of stable glycosylated hemoglobin variations as a result of circadian changes in blood glucose level. The authors describe a mathematical model which allows to foresee glycosylated hemoglobin variability as a result of alterations of blood glucose equilibrium.

Evidence for noradrenergic-purinergic cotransmission in the hepatic artery of the rabbit.

1. Transmural electrical field stimulation produced a transient contraction of the isolated hepatic artery of the rabbit that was frequency-dependent up to 64 Hz. A contraction was rarely evoked at a stimulation frequency of less than 8 Hz and never at 4 Hz or less. All contractions were abolished in the presence of tetrodotoxin. 2. Neurogenic contractions were partially inhibited by prazosin. After desensitization of the P2X-purinoceptor with alpha, beta-methylene ATP, contractions in response to electrical stimulation were significantly reduced at all frequencies tested (4-64 Hz). In most cases, contractions were abolished by a combination of both drugs. 3. In vessels treated with 6-hydroxydopamine, no nerve-mediated contractile responses were observed. 4. In arteries from reserpine-treated rabbits, nerve stimulation evoked contractions that were resistant to prazosin. After desentization of the P2X-purinoceptor with alpha,beta-methylene ATP, no neurogenic contractile response remained. 5. The tissue contracted to exogenously applied noradrenaline and alpha,beta-methylene ATP. There was an increase in sensitivity to noradrenaline in 6-hydroxydopamine-treated vessels compared with control vessels, but no difference in potency to alpha,beta-methylene ATP was detected. The potency of noradrenaline and alpha,beta-methylene ATP was not significantly affected by reserpine treatment. 6. In control tissues, fluorescence histochemistry demonstrated the presence of noradrenergic nerve fibres. Noradrenaline-containing nerves were not observed in 6-hydroxydopamine-treated or reserpine-treated vessels. 7. It is concluded that noradrenaline and ATP are cotransmitters in the sympathetic nerves supplying the hepatic artery of the rabbit. In contrast to other vessels, the hepatic artery requires a relatively high frequency of stimulation to evoke contractions and the purinergic component is not frequency-dependent. The significance of this finding in terms of the physiological demands of blood flow to the liver are discussed.