Whether or not neurally mediated vasodilation contributes to the rise in skeletal muscle blood flow during exercise in humans remains unknown. Such a mechanism might serve as an important 'feed-forward' regulatory signal causing blood flow to rise prior to the development of a metabolic demand. Research in animal species has identified three neurally mediated vasodilating mechanisms with the potential to increase skeletal muscle blood flow during exercise. These include sympathetic vasodilator nerves, the potential for substances released by motor nerves to evoke vasodilation and the possibility of an 'intrinsic' vasodilator nerve system within the walls of blood vessels. In humans, sympathetic vasodilator nerves are present in several vascular beds (e.g. cutaneous). However, more recent information suggests that the human skeletal muscle is not innervated by this class of nerves. Along these lines, the vasodilator response to exercise is unaffected by sympathectomy or by blockade of the traditional transmitters associated with neurally mediated vasodilation. The possibility that spillover of substances released from motor neurones evokes vasodilation is provocative. For example, acetylcholine could produce both skeletal muscle contraction via nicotinic receptors and vasodilation via endothelial muscarinic receptors. However, in many species including humans, atropine has no effect on exercise hyperaemia. While the concept of an 'intrinsic' vasodilator pathway within the walls of the skeletal muscle vascular bed is fascinating, limited information is available on this mechanism in animals and none is available in humans. Taken together, the current information suggests that neurally mediated vasodilating mechanisms may not exist in human skeletal muscle. Additionally, even if such mechanisms exist, they do not play an obligatory role in governing the rise in muscle blood flow during exercise in humans.
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