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Pharmacological regulation of the circulation of bone

The Journal of Bone & Joint Surgery.  1990; 72:964-975 
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Abstract

A study was undertaken to investigate the reactivity of the circulation of bone and to pharmacologically characterize the receptor populations that may be present in this poorly described vascular bed. The nutrient artery of the tibia in skeletally mature mongrel dogs was cannulated, under direct vision, through a posterolateral operative approach. An extracorporeal circuit was established so that the nutrient artery of the tibia could be perfused in vivo under conditions of constant blood flow. Diverse vasoactive substances were injected into the perfusion circuit in small volumes as a bolus close to the nutrient artery of the tibia. A range of doses of nitroglycerin, acetylcholine, isoproterenol, methoxamine, U46619 (a thromboxane A2 mimic), dibutyryl cyclic AMP, 8-bromo-cyclic GMP, and endothelin-1 were injected in a randomized sequence for each experiment. The antagonists that were used were atropine (a non-selective muscarinic receptor antagonist), ICI 118551 (a selective beta 2-adrenoceptor antagonist), ONO 3708 (a prostaglandin H2/thromboxane A2 receptor antagonist), and prazosin (an alpha 1-adrenoceptor antagonist). The results of changes in bone-perfusion pressure under conditions of constant blood flow indicated that the vascular bed of bone actively responds to various vasoconstrictor mechanisms, whereas vasodilator mechanisms appear to be considerably less active. Intra-arterial injections of nitroglycerin, acetylcholine, and 8-bromo-cyclic GMP resulted in dose-related decreases in bone-perfusion pressure that were weak relative to concomitant changes in systemic arterial pressure. Intra-arterial administration of methoxamine, U46619, and endothelin-1 resulted in a potent dose-related increase in bone-perfusion pressure. The results of intra-arterial injections of isoproterenol and dibutyryl cyclic AMP were surprising; both substances caused a substantial rise in bone-perfusion pressure. The responses to acetylcholine, methoxamine, and U46619 were blocked in a competitive manner after administration of atropine, prazosin, and ONO 3708, respectively.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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