Beta 1-selective Antagonist Metoprolol Research Articles

Nonselective beta blockade attenuates the recruitment of CD62L(-)T lymphocytes following exercise.

Exercise induces a selective redistribution of CD62L(-) T lymphocytes. This study examined the effects of beta adrenergic receptor blockade on this phenomenon. Twelve healthy men were exercised to exhaustion on a treadmill prior to and following 1 week of treatment with the nonselective beta antagonist propranolol or the beta1 selective antagonist metoprolol. Dynamic exercise resulted in a significant lymphocytosis (p < 0.001). CD8(+)CD62L(-) T cells showed a greater than 3-fold increase in response to exercise (p < 0.001) as compared to CD8(+)CD62L(+) T cells, which showed a more modest increase. Treatment with the nonselective beta antagonist propranolol significantly attenuated the preferential increase of circulating CD8(+)CD62L(-) lymphocytes (p = 0.01) but had no effect on CD8(+)CD62L(+) T cells. Treatment with the beta1 selective antagonist metoprolol did not affect the response of either subset. Our findings replicate a prior study indicating that CD62L expression influences T lymphocyte trafficking in response to exercise and extends those findings by showing that this phenomenon is mediated, in part, via the beta2-adrenergic receptor.

Sympathetic and immune interactions during dynamic exercise. Mediation via a beta 2-adrenergic-dependent mechanism.

The relation between the sympathetic nervous system and the immune system has not been fully defined. Recent investigations have suggested an adrenergically driven efflux of specific beta 2-receptor-rich lymphocyte subsets into the circulation with either exercise or infusion of exogenous catecholamines. To determine whether acute sympathetic stimulation mediates immunoregulatory cell traffic and function via a beta 2-receptor mechanism, we exercised 20 healthy volunteers before and after 1 week of treatment with either the nonselective beta-antagonist propranolol or the beta 1-selective antagonist metoprolol. Before treatment, exhaustive exercise according to the Bruce protocol led to a marked lymphocytosis. Tsuppressor/cytotoxic (Ts/c) and natural killer cells, subtypes with the largest density of beta-receptors, showed the most pronounced increases after exercise, with less impressive elevations in T(helper) and B cells. With respect to function, exhaustive exercise led to a decrease in concanavalin A-stimulated IL-2 receptor expression and [3H]thymidine incorporation while enhancing natural killer cell activity. One week of propranolol therapy blunted the exercise-induced increases in circulating Ts/c and natural killer subpopulations as well as the previously observed alterations in cellular immune function. Treatment with the beta 1-selective antagonist metoprolol, however, did not impair the influence of exercise on any of the above parameters. Acute sympathetic stimulation by exhaustive exercise leads to selective release of immunoregulatory cells into the circulation with subsequent alterations in cellular immune function, either secondary to subset changes or as a result of direct catecholamine effects on function. These changes are attenuated by propranolol but not metoprolol, suggesting a beta 2-mediated mechanism.

Hemodynamic Effects at Rest and During Exercise of Combined α/β-Receptor Blockade and of β-Receptor Blockade Alone in Patients with Ischemic Heart Disease

The acute hemodynamic responses to beta-adrenoceptor blockade with the beta 1-selective antagonist metoprolol, and to combined alpha/beta-receptor blockade with labetalol, were compared intraindividually in a randomized single-blind, cross-over study. Fourteen patients with proved ischemic heart disease, aged 52-64 years, were studied at rest (supine) and during ischemia-inducing exercise (in the seated posture) using invasive percutaneous techniques. Metoprolol reduced heart rates and cardiac output greatly (p less than 0.001) and systemic arterial pressures slightly (p less than 0.001) under all conditions. Left ventricular filling pressures increased. Labetalol induced a slight decrease in heart rates during exercise, while cardiac output was unchanged. Systemic arterial pressures and vascular resistances, pressures and resistances in the pulmonary circulation, and left ventricular filling pressures were distinctly lower. During ischemia-inducing exercise, the differences between the effects of labetalol and metoprolol on heart rate, cardiac output, systemic vascular resistance, and left ventricular filling pressures were highly significant. The effects on the rate X pressure product and on angina were similar. It is concluded that combined alpha/beta-blockade with labetalol offsets or attenuates the potential adverse hemodynamic effects of beta-receptor blockade alone without loss of symptomatic efficacy.

Agonist-induced regulation of adrenoceptor subtypes in cerebral cortical slices.

Cerebral cortical slices from rat brain were incubated at 37 degrees C for 2 h in the presence of isoproterenol, noradrenaline, or adrenaline, and binding affinities and densities of adrenoceptor subtypes were subsequently examined in homogenized tissue. The density of alpha 2- and total beta-adrenoceptors was estimated using the radioligands [3H]rauwolscine and [3H]dihydroalprenolol (DHA), respectively. The percentages of beta 1- and beta 2-adrenoceptors were defined by inhibiting the binding of [3H]DHA with the beta 1-selective antagonist metoprolol. Exposure of slices to noradrenaline and adrenaline significantly decreased the maximal number of binding sites (Bmax) of alpha 2-adrenoceptors (48 and 37% respectively) without significantly affecting affinity; isoproterenol had no effect. Exposure to isoproterenol, noradrenaline, and adrenaline significantly decreased the Bmax of beta-adrenoceptors (by 60, 34, and 24%, respectively) but did not affect the affinity. Isoproterenol and adrenaline significantly decreased the density of beta 1-adrenoceptors by 75 and 24% and beta 2-adrenoceptors by 23 and 28%, respectively. Noradrenaline significantly decreased the density of beta 1-adrenoceptors by 42% without affecting the number of beta 2-adrenoceptors. These findings indicate that subtypes of adrenoceptors in rat cerebral cortex are differentially regulated by adrenergic agonists.

Central beta-adrenoceptors can modulate 5-hydroxytryptamine-induced tremor in rats.

The effects of two beta 2-adrenoceptor agonists with different lipophilicities were studied on tremor induced by L-5-hydroxytryptophan (L-5-HTP) in pargyline- and carbidopa-pretreated rats. Tremor was recorded and analysed by an objective method based on accelerometry. Clenbuterol, a lipophilic beta 2-selective agonist, dose-dependently enhanced tremor intensity, whereas the hydrophilic beta 2-agonist terbutaline had no effect. The clenbuterol-induced enhancement of tremor was completely abolished by the beta 2-selective antagonist ICI 118,551 but unchanged by the beta 1-selective antagonist metoprolol. The results suggest that centrally located beta 2-adrenoceptors can mediate a modulation of 5-hydroxytryptamine-induced tremor in rats.

Beta 1- and beta 2-adrenoceptor-mediated secretion of amylase from incubated rat parotid gland.

The present in vitro investigation was undertaken in an attempt to obtain further information on beta-adrenoceptor specificity and action in the rat parotid gland, with regard to amylase secretion. The beta 1-selective agonist prenalterol was roughly 800 times more potent than the beta 2-agonist terbutaline, and about 5 times more effective than noradrenaline in evoking amylase release . Propranolol was the most effective inhibitor of amylase release in all experiments. The beta 1-selective antagonist metoprolol and H104 /08 were also effective blockers of maximal noradrenaline- and prenalterol-induced release. The inhibition curves displayed biphasic shapes when amylase secretion was induced by noradrenaline, but not when prenalterol was the secretagogue. The beta 2-antagonist H35 /25 was without effect on maximal noradrenaline- and prenalterol-stimulated secretion. The amylase release evoked by submaximal concentration of terbutaline was inhibited by the two antagonists H35/25 and IPS 339. In another series of experiments propranolol and metoprolol clearly shifted the noradrenaline concentration-response curve to the right, whereas H35/25 was without effect. The results further demonstrate the major importance of the beta 1-adrenoceptor (noradrenaline-activated) in eliciting amylase release from the rat parotid gland. However, it is also suggested that the beta 2-adrenoceptors (terbutaline-activated) may to some extent serve the same function.

Effects of beta-adrenoceptor antagonists on the firing rate of noradrenergic neurones in the locus coeruleus of the rat.

Acute i.v. administration of the non-selective beta-adrenoceptor antagonist dl-propranolol given in incremental doses (less than 40 mg/kg) did not affect the firing rate of locus coeruleus (LC) neurones in the rat, as revealed by single cell recording techniques. Furthermore, no effect was seen 4 h after a single i.p. dose of this beta-blocker (10 mg/kg). However, repeated treatment with dl-propranolol (1, 5, 10 or 20 mg/kg i.p., twice daily for 4 days) produced a significant, dose-dependent decrease of the average LC neuronal firing rate in comparison to controls. The dextro isomer of propranolol, which has negligible beta-blocking activity but the same local anaesthetic potency as the racemate, had no corresponding effect. The non-selective beta-adrenoceptor antagonist sotalol, which is one of the most hydrophilic beta-blockers, had much less inhibitory effect on LC neurones than dl-propranolol. The beta 1-selective antagonist metoprolol did not change the firing of noradrenergic neurones in the LC after similar treatment for 4 days. However, when the rats were subjected to oral treatment for 28 days, metoprolol was found to produce a slight inhibitory effect although much less than dl-propranolol. In view of these findings we propose a stimulatory and mainly beta 2-adrenoceptor-mediated control mechanism for the noradrenergic neurones in the LC. This mechanism seems to be characterized by a delayed responsiveness.