Sulfonylureas Compromise Microvascular Flow in Mouse Skeletal Muscle

Sulfonylureas are among the most prescribed oral anti-hyperglycaemics, particularly in low- and middle-income countries. Sulfonylureas are insulin secretagogues through blocking ATP-sensitive potassium channels (KATP) in β-cells of the pancreas. Despite wide usage, sulfonylureas are associated with increased cardiovascular disease morbidity and all-cause mortality, with ill-defined mechanisms. We tested the hypothesis that glyburide could block KATP channels in the microvasculature, thereby disrupting tissue oxygen demand-supply balance. We further investigated the contribution of other potassium channels to capillary-to-arteriole signalling. Experiments were conducted using an in-vivo anesthetized mouse skeletal muscle preparation (extensor digitorum longus, EDL); exteriorized and situated at in-situ length, overtop an oxygen-permeable membrane covering a gas chamber, and bathed in PlasmaLyte. C57BL/6 mice were employed (n=6-8). Brightfield images were captured at two wavelengths: oxygen-dependent and oxygen-independent, enabling the simultaneous determination of capillary hemodynamics and RBC oxygen content. Low oxygen challenges were achieved by dropping oxygen levels in the gas chamber from 7% to 2% for 3 minutes. Challenges were conducted before (control) and after drugs were added to bathing solution. Parameters were obtained before the challenge (baseline), during the challenge (2 regions) and after the challenge (recovery). Statistical significance was determined using a paired Student’s t-test. Target channels localization was investigated using immunofluorescence in formalin-fixed EDL. Oxygen challenges augmented EDL surface capillary hematocrit and RBC velocity and supply rate, while reducing RBC oxygen saturation. Incubation of the EDL with 10 μM glyburide decreased the baseline RBC supply rate (p<0.05 vs control) and blunted the magnitude of capillary responses to the oxygen challenge (p<0.05 vs control). Immunofluorescence confirmed the localization of KATP channels in EDL capillaries. Normal capillary responses were obtained when small and intermediate conductance or inward rectifier potassium channels were neutralized. This implies minimal or no contribution of these channels in oxygen signaling in the microvasculature. This data begins to elucidate the acute and direct effects of systemic KATP blockers on capillary-to-arteriole conducted signaling, which is likely key to optimal tissue oxygen regulation. Further experiments are warranted to confirm this conclusion. This work was supported by the Natural Science and Engineering Research Council of Canada (NSERC, RGPIN/04659-2017), an Ontario Graduate Scholarship (M.A.E) and a CIHR doctoral award (M.A.E). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.