Abstract

The objective of this study was to clarify the effects of disease on neurally mediated syncope (NMS) during an acute stress reaction. We analyzed the mechanism of the molecular interaction and the polymorphisms of the alpha-2 adrenoreceptor (α2B-AR) gene as the potential psychiatric cause of incentive stress. We focused on the following three genotypes of the repeat polymorphism site at Glu 301–303 in the α2B-AR gene: Glu12/12, Glu12/9, and Glu9/9. On the basis of our clinical research, NMS is likely to occur in people with the Glu12/9 heterotype. To verify this, we assessed this relationship with the interaction of Gi protein and adenylate cyclase by in silico analysis of the Glu12/9 heterotype. By measuring the difference in the dissociation time of the Gi-α subunit twice, we found that the Glu12/9 heterotype suppressed the action of adenylate cyclase longer than the Glu homotypes. As this difference in the Glu repeat number effect is thought to be one of the causes of NMS, we investigated the evolutionary significance of the Glu repeat number. Glu8 was originally repeated in simians, while the Glu12 repeats occurred over time during the evolution of bipedalism in humans. Taken with the Glu12 numbers, NMS would likely become a defensive measure to prevent significant blood flow to the human brain.

Highlights

  • The long-term goal of our research is to clarify the effects of disease on neurally mediated syncope (NMS) during an acute stress reaction

  • We examined the concentrations of adrenaline (Ad) and noradrenaline (NA) during blood fluctuations in the head-up tilt (HUT) test (S2 Fig)

  • We recruited 9 subjects (5 men and 4 women) with NMS who were referred to our outpatient department and 11 healthy subjects (7 men and 4 women) who had never experienced syncope to investigate the epidemiology of the disease at the time of an acute stress reaction

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Summary

Introduction

The long-term goal of our research is to clarify the effects of disease on neurally mediated syncope (NMS) during an acute stress reaction. Syncope is a relatively frequent disease, with approximately 30% of individuals experiencing it at least once in their lifetime. The resultant decrease in blood pressure leads to an increase in sympathetic tone. This increase is thought to trigger a reflex loss of sympathetic tone and associated vagotonia, which lead to hypotension and/or bradycardia [3]. Our findings from previous clinical research did not support this hypothesis [4]

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