Changes in interstitial K+ and pH during exercise: implications for blood flow regulation.

The analysis of blood samples has clearly demonstrated that exercise is associated with the release of K+ and H+ from muscle. However, blood samples give only incomplete information about the ion changes in the muscle interstitium. Interstitial changes in ion composition may affect the transport properties of the sarcolemmal membrane, may affect fibre excitability and induce fatigue, and may affect sensory nerve endings. Therefore, to better understand muscle function, it is important to quantify the exercise-induced interstitial ion changes. Both interstitial K+ and H+ changes have been quantified with the microdialysis technique. Interstitial K+ accumulation is dependent on the intensity and duration of muscle activity and may reach 10 mmol/L during intense exercise, and the concentration in T-tubules may be even higher. Thus, interstitial K+ can reach a level that affects fibre excitability and the development of fatigue. It has also been demonstrated with microdialysis that the interstitial decrease in pH during muscle activity is larger than the reduction in blood pH. Ion changes in the interstitium may affect blood flow directly or indirectly. Infusion of K+ into the femoral artery in humans has demonstrated that blood flow is affected by changes in K+ as low as 0.1 mmol/L. The vasodilatory effect of K+ can be inhibited with simultaneous barium infusion, indicating that inward rectifier potassium (Kir)channels are involved. Acidosis has a direct effect on blood flow and an indirect effect, mediated by changes in other vasoactive compounds.