The plateau seems to depend on the local, non-neurally mediated release of nitric oxide (NO), because it is suppressed by inhibitors of NO synthase [11,12,16] and insensitive to local anesthesia [16]. In contrast, the early peak shows little dependence on NO, and is largely mediated by the stimulation of nociceptive C-fibers that trigger vasodilation through an axon reflex [13]. Accordingly, it is diminished by local anesthesia [7,16,21]. In short, the prevailing view [15] is that the early part of thermal hyperemia is due to the transient

activation of an axon reflex, which progressively gives way, as heating is pursued, to a non-neural, NO-dependent mechanism. Thermal hyperemia can easily be selleck products recorded in the skin in a non-invasive fashion, using laser-Doppler flowmetry to evaluate SkBF. Indeed, thermal hyperemia has been proposed as a test of microvascular function. This test has been used to document microvascular BGJ398 dysfunction in diabetes [1,22,23] and other conditions [14,19]. In a previous study, we found that the repeat application of a local thermal stimulus on the same skin patch was associated with a reduction in the elicited vasodilatory response,

a phenomenon hereafter termed desensitization [3]. This result is of some practical importance, for example, if thermal hyperemia is to be used as an end point in acute interventional trials. However, other groups [4,20] found no evidence for desensitization, when recording two thermal hyperemia either one or two hours apart on the same skin site, as we had done. The aim of this study was to understand the reasons for

this apparent discrepancy and, more specifically, to test whether it was related to differences in instrumentation. We had measured SkBF with laser-Doppler imaging (LDI) at a wavelength of 633 nm [3], whereas the cited studies used single-point laser-Doppler flowmetry (LDF) at 780 nm [4,20]. In comparison with 633 nm, the latter wavelength has greater skin penetration, and thus the potential to explore different vessels. In addition, the heating chambers used in our study were custom-made, as opposed to the commercial equipment employed by these other authors. We therefore set out to establish Methocarbamol whether desensitization to thermal hyperemia occurred under four sets of conditions, i.e., measuring SkBF with LDI or LDF, and heating the skin with our custom-made or with commercially available chambers. Twenty-eight healthy male subjects, aged from 18 to 32 years, were included. They were all non-smokers, had no personal history of hypertension, diabetes, or hypercholesterolemia, and no dermographism. None took any drugs or reported being sick in the last 15 days before the start of the study. The volunteers were fully informed about the protocol, and gave their written informed consent.