The effect of acetylcholine on finger capillary pressure and capillary flow in healthy volunteers.

1. Constitutive nitric oxide (NO) synthase has been demonstrated in human skin microvascular endothelial cells; however, the physiological significance of this finding is not known. The aim of this study was to investigate the effects of acetylcholine (ACh), which stimulates the release of NO from endothelial cells, on skin capillary pressure, capillary pulse pressure amplitude (CPPA) and capillary red blood cell velocity (CBV) in healthy volunteers. 2. Finger nailfold capillary pressure was measured in five healthy volunteers. CBV was measured in capillaries of the dorsal middle phalangeal area of the finger in six subjects using a recently developed capillary anemometer. In each case the responses to ionophoretically applied ACh and vehicle were measured on two separate fingers on the left hand. 3. Application of vehicle did not significantly change either capillary pressure, CPPA or CBV. ACh significantly increased capillary pressure (from 15.8 +/- 2.2 mmHg under basal conditions to 27.7 +/- 3.8 mmHg at the plateau of the ACh response; P < 0.008), CPPA (from 2.4 +/- 2.4 mmHg at baseline to 8.4 +/- 2.4 mmHg at the plateau of the drug response; P < 0.013) and CBV (from 0.54 +/- 0.22 mm s-1 at baseline to 2.46 +/- 1.12 mm s-1 after ACh; P < 0.008). 4. The increases in capillary pressure, CPPA and CBV following the application of ACh suggest that the overall effect of ACh was to induce a reduction in the pre- to postcapillary resistance ratio.