Animal studies suggest that ATP plays a role in evoking the muscle reflex via stimulating purinergic P2 receptors on sensory neurons. However, there are no human data regarding the role ATP and P2 receptors may play in evoking the exercise pressor reflex. We hypothesized that P2 receptor blockade in humans would attenuate the exercise pressor response. Blood pressure (Finometer), heart rate and muscle sympathetic nerve activity (MSNA; peroneal nerve) were assessed during fatiguing isometric handgrip, post-exercise circulatory occlusion (PECO), and passive muscle stretch during PECO in 10 young healthy volunteers. The protocol was performed before and after local infusion of pyridoxine hydrochloride (i.e. vitamin B6) in saline via Bier block. Pyridoxine is converted into pyridoxal-5-phosphate, a P2-purinoceptor antagonist. In the second experiment, the same amount of saline was infused via the same procedure. After pyridoxine, the MSNA responses to fatiguing handgrip (Δ349 ± 70 vs.Δ556 ± 92), PECO (Δ285 ± 37 vs.Δ532 ± 115) and PECO + passive stretch (Δ368 ± 66 vs.Δ641 ± 128 units min-1, all P < 0.05) were all significantly less than those before pyridoxine. The blood pressure responses were also significantly (all P < 0.05) less than those before pyridoxine. Infusion of saline (as opposed to pyridoxine) had no effect on the MSNA and blood pressure responses. These data are consistent with the concept that P2 receptors contribute to the exercise pressor reflex in humans.
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