title: Cerebral metabolic response to low blood flow: possible role of cytochrome oxidase inhibition.
abstract: The reactions of cerebral metabolism to imposed changes of cerebral blood flow (CBF) are poorly understood. A common explanation of the mismatched CBF and oxygen consumption (CMR(O(2))) during neuronal excitation holds that blood flow rises more than oxygen consumption to compensate for an absent oxygen reserve in brain mitochondria. The claim conversely implies that oxygen consumption must decline when blood flow declines. As the prevailing rate of reaction of oxygen with cytochrome c oxidase is linked to the tension of oxygen, the claim fails to explain how oxygen consumption is maintained during moderate reductions of CBF imposed by hyperventilation (hypocapnia) or cyclooxygenase (COX) inhibition. To resolve this contradiction, we extended the previously published oxygen delivery model with a term allowing for the adjustment of the affinity of cytochrome c oxidase to a prevailing oxygen tension. The extended model predicted constant oxygen consumption at moderately reduced blood flow. We determined the change of affinity of cytochrome c oxidase in the extended model by measuring CBF in seven, and CMR(O(2)) in five, young healthy volunteers before and during COX inhibition with indomethacin. The average CBF declined 35%, while neither regional nor average CMR(O(2)) changed significantly. The adjustment of cytochrome c oxidase affinity to the declining oxygen delivery could be ascribed to a hypothetical factor with several properties in common with nitric oxide.
authors.affiliation: Pathophysiology and Experimental Tomography Center, Aarhus University Hospital in Aarhus, Aarhus, Denmark. albert@pet.auh.dk
authors.forename: Albert
authors.initials: A
authors.lastname: Gjedde
authors.forename: Peter
authors.initials: P
authors.lastname: Johannsen
authors.forename: Georg E
authors.initials: GE
authors.lastname: Cold
authors.forename: Leif
authors.initials: L
authors.lastname: Ostergaard
mesh_terms: D000328:Adult; D000465:Algorithms; D001784:Blood Gas Analysis; D001923:Brain Chemistry / Q000502:physiology*; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000201:enzymology / Q000378:metabolism*; D002196:Capillaries / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000502:physiology*; D016861:Cyclooxygenase Inhibitors / Q000494:pharmacology; D004058:Diffusion; D003576:Electron Transport Complex IV / Q000037:antagonists & inhibitors / Q000502:physiology*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007213:Indomethacin / Q000494:pharmacology; D007700:Kinetics; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D049268:Positron-Emission Tomography
chemical_list: D016861:Cyclooxygenase Inhibitors; D006454:Hemoglobins; D003576:Electron Transport Complex IV; D007213:Indomethacin