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New guidelines on asthma management.

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D Keeley, J Rees. 1997-02-01. New guidelines on asthma management.. https://doi.org/10.1136/bmj.314.7077.315

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Control of myocardial contractile function by the level of beta-adrenergic receptor kinase 1 in gene-targeted mice.

We studied the effect of alterations in the level of myocardial beta-adrenergic receptor kinase betaARK1) in two types of genetically altered mice. The first group is heterozygous for betaARK1 gene ablation, betaARK1(+/-), and the second is not only heterozygous for betaARK1 gene ablation but is also transgenic for cardiac-specific overexpression of a betaARK1 COOH-terminal inhibitor peptide, betaARK1(+/-)betaARKct. In contrast to the embryonic lethal phenotype of the homozygous betaARK1 knockout (Jaber, M., Koch, W. J., Rockman, H. A., Smith, B., Bond, R. A., Sulik, K., Ross, J., Jr., Lefkowitz, R. J., Caron, M. G., and Giros, B. (1996) Proc. Natl. Acad. Sci. U. S. A. 93, 12974-12979), betaARK1(+/-) mice develop normally. Cardiac catheterization was performed in mice and showed a stepwise increase in contractile function in the betaARK1(+/-) and betaARK1(+/-)betaARKct mice with the greatest level observed in the betaARK1(+/-)betaARKct animals. Contractile parameters were measured in adult myocytes isolated from both groups of gene-targeted animals. A significantly greater increase in percent cell shortening and rate of cell shortening following isoproterenol stimulation was observed in the betaARK1(+/-) and betaARK1(+/-)betaARKct myocytes compared with wild-type cells, indicating a progressive increase in intrinsic contractility. These data demonstrate that contractile function can be modulated by the level of betaARK1 activity. This has important implications in disease states such as heart failure (in which betaARK1 activity is increased) and suggests that betaARK1 should be considered as a therapeutic target in this situation. Even partial inhibition of betaARK1 activity enhances beta-adrenergic receptor signaling leading to improved functional catecholamine responsiveness.

Adrenergic beta-Agonists

Beta3-adrenergic relaxation of bovine iris sphincter.

Bovine iris sphincter in vitro responded to beta-adrenergic stimulation with pronounced relaxation (EC50 of isoproterenol = 0.3 nM), which was potentiated by the cAMP phosphodiesterase inhibitor, isobutylmethylxanthine, and mimicked by the adenylyl cyclase activator, forskolin. The beta1/beta2 antagonist, propranolol, exhibited low potency with calculated Ki of 200 nM. The beta3-selective antagonist, bupranolol, exhibited a biphasic inhibition profile, with calculated Kis of approximately 20-50 and 200-300 nM. The beta3-selective agonist, BRL 37344, elicited 70% of maximal relaxation (EC50 = 30 nM). When relaxation was induced by BRL 37344, bupranolol exhibited much higher potency (calculated Ki = 1 nM). Our data suggest that the beta-adrenergic relaxation response in bovine iris sphincter is mediated by a mixed population of beta-adrenergic receptors, with a predominant contribution of atypical, most likely beta3 subtype, receptors.

Adrenergic beta-Agonists

Myocyte recovery after mechanical circulatory support in humans with end-stage heart failure.

BACKGROUND: The failing myocardium is characterized by decreased force production, slowed relaxation, and depressed responses to beta-adrenergic stimulation. In some heart failure patients, heart function is so poor that a left ventricular assist device (LVAD) is inserted as a bridge to transplantation. In the present research, we investigated whether circulatory support with an LVAD influenced the functional properties of myocytes from the failing heart. METHODS AND RESULTS: Myocytes were isolated from human explanted failing hearts (HF-myocytes) and failing hearts with antecedent LVAD support (HF-LVAD-myocytes). Studies of myocyte function indicated that the magnitude of contraction was greater (9.6+/-0.7% versus 6.9+/-0.5% shortening), the time to peak contraction was significantly abbreviated (0.37+/-0.01 versus 0.75+/-0.04 seconds), and the time to 50% relaxation was reduced (0.55+/-0.02 versus 1.45+/-0.11 seconds) in the HF-LVAD-myocytes compared with the HF-myocytes (P<0.05). The HF-LVAD-myocytes had larger contractions than the HF-myocytes at all frequencies of stimulation tested. The negative force-frequency relationship of the HF-myocytes was improved in HF-LVAD-myocytes but was not reversed. Responses to beta-adrenergic stimulation (by isoproterenol) were greater in HF-LVAD-myocytes versus HF-myocytes. CONCLUSIONS: The results of the study strongly support the idea that circulatory support with an LVAD improves myocyte contractile properties and increases beta-adrenergic responsiveness.

Adrenergic beta-Agonists