AimsAutoantibodies against second extracellular loops of β1-adrenergic receptors frequent in dilated cardiomyopathy confer myocardial dysfunction presumably via cAMP stimulation. Here, we investigate the autoantibody impact on receptor conformation and function.Methods and resultsIgG was prepared from patients with dilated cardiomyopathy, matched healthy donors (10 each) or commercial IgG preparations (2). IgG binding to β1-adrenergic receptor peptides was detected in 5 of 10 patients and 2 of 10 controls. IgG colocalization with the native receptor was detected in 8 of 10 patients and 1 of 10 controls (10 of 10 patients and 7 of 10 controls at >30 mg IgG/L). All IgGs exhibiting receptor colocalization triggered changes in receptor conformation (determined with fluorescent sensors) not stringently correlated to cAMP stimulation, suggesting the induction of more or less active receptor conformations. Receptor-activating IgG was detected in 8 of 10 patients but only 1 of 10 controls. In addition, IgG from 8 of 10 patients and 3 of 10 controls attenuated receptor internalization (measured by total internal reflection fluorescence microscopy). IgG-inducing inactive receptor conformations had no effect on subsequent cAMP stimulation by isoproterenol. IgG-inducing active receptor conformations dampened or augmented subsequent cAMP stimulation by isoproterenol, depending on whether receptor internalization was attenuated or not. Corresponding IgG effects on the basal beating rate and chronotropic isoproterenol response of embryonic human cardiomyocytes were observed.Conclusions(i) Autoantibodies trigger conformation changes in the β1-adrenergic receptor molecule. (ii) Some also attenuate receptor internalization. (iii) Combinations thereof increase the basal beating rate of cardiomyocytes and optionally entail dampening of their chronotropic catecholamine responses. (iv) The latter effects seem specific for patient autoantibodies, which also have higher levels.
The blocking and stimulant potencies of (-)-pindolol and (+)-pindolol were estimated on right atria and tracheae of guinea pig. Blocking affinities were estimated for beta-adrenoceptor subtypes by using several agonists. Binding affinities of (-)-pindolol and (+)-pindolol were also estimated for beta-adrenoceptors labelled with 3H-(-)-bupranolol in membranes of ventricular myocardium and lung of guinea pig. Both (-)-pindolol and (+)-pindolol caused tracheal relaxation with intrinsic activities of 0.3. The concentration-effect curve for (-)-pindolol exhibits a high-sensitivity and a low-sensitivity relaxant component; the curve for (+)-pindolol was nearly monophasic. The EC50's were (-log mol/l) 9.2 and 6.1 for (-)-pindolol and 7.6 for (+)-pindolol. Using subtype-selective blockers it was found that the relaxant effects of (+)-pindolol and those of the high-sensitivity component of (-)-pindolol are mediated through beta 2-adrenoceptors. The low-sensitivity component of relaxation of (-)-pindolol was antagonized by beta-blockers less than expected from their affinities for beta-adrenoceptors. Both (-)-pindolol and (+)-pindolol caused an increase of atrial beating rate with an intrinsic activity of 0.2. The concentration-effect curve of (-)-pindolol was biphasic; the curve of (+)-pindolol was monophasic. The EC50's were (-log mol/l) 9.1 and 7.0 for (-)-pindolol and 7.5 for (+)-pindolol. From the use of subtype-selective antagonists we conclude that the positive chronotropic effects of (+)-pindolol are mediated predominantly by beta 2-adrenoceptors. On the other hand, the high-sensitivity component of the positive chronotropic effects of (-)-pindolol appears to be mediated predominantly through beta 1-adrenoceptors, although beta 2-adrenoceptors may also participate. The low-sensitivity component of the positive chronotropic effects of (-)-pindolol is resistant to blockade by subtype-selective antagonists at concentrations causing at least 98% beta-adrenoceptor occupancy. Only high but non-depressant concentrations of non-selective (-)-bupranolol antagonized the low-sensitivity component of (-)-pindolol. (-)-Pindolol antagonized the effects of several agonists to similar extent in both trachea and right atrium. (+)-Pindolol was less potent as antagonist of the relaxant effects of (-)-noradrenaline on trachea than against those of (-)-adrenaline, (-)-isoprenaline and (+/-)-salbutamol.(ABSTRACT TRUNCATED AT 400 WORDS)
Experiments were designed to unravel the relative contribution of beta 1- and beta 2-adrenoceptors to the positive inotropic effects of adrenaline and noradrenaline in isolated tissues of left ventricular myocardium of man. We also analyzed relationships between the fractions of human left ventricular beta 1- and beta 2-adrenoceptors, estimated from binding assays, and stimulation of adenylate cyclase and contractile force by adrenaline and noradrenaline. Selective blockade of beta 2-adrenoceptors by erythro-(+/-)-(alpha-methyl-indan-4-yloxy)-3-isopropylaminobuta n-2-ol (ICI 118,551) attenuated the increase of contractile force caused by adrenaline but not by noradrenaline, suggesting some involvement of beta 2-adrenoceptors. Selective blockade of beta 2-adrenoceptors without affecting beta 1-adrenoceptors still enabled both adrenaline and noradrenaline to cause maximum possible increases of contractile force through beta 1-adrenoceptors. A direct involvement of beta 2-adrenoceptors became manifest by selectively antagonizing beta 1-adrenoceptors by 1-[2[3-carbamoyl-4-hydroxy)phenoxy)ethylamino]- 3-[4(1-methyl-4-trifluoromethyl-2-imidazolyl)phenoxy]-2-propanol (CGP 20712 A) without affecting beta 2-adrenoceptor. beta 2-adrenoceptors can mediate half of the maximum increase of contractile force elicited by low concentrations of adrenaline and also contribute to the increase of contractile force caused by high concentrations of noradrenaline. beta-adrenoceptors were labelled in membrane particles with 3H-(-)-bupranolol in the absence (beta 1 & beta 2) and presence of 500 nmol/l CGP 20712 A (beta 2). 71% of the beta-adrenoceptors were beta 1 and 29% beta 2. Binding inhibition experiments with CGP 20712 A and ICI 118,551 yielded 74% beta 1 and 26% beta 2.(ABSTRACT TRUNCATED AT 250 WORDS)
An appraisal of the affinity of (-)-propranolol was made for beta-adrenoceptors of isolated heart preparations and myocardial membrane particles from patients undergoing open heart surgery. In order to eliminate possible distorting influences of neuronal and extraneuronal uptakes of catecholamines on the affinity estimates for (-)-propranolol, isolated tissues were pretreated once with 5 or 10 mumol/l phenoxybenzamine for 2 h. Phenoxybenzamine caused potentiation of the positive inotropic effects of (-)-noradrenaline and (-)-adrenaline but not of (-)-isoprenaline; potentiation was more pronounced in atrial than in ventricular preparations. Potentiation was greater for (-)-noradrenaline than for (-)-adrenaline. It is concluded that the concentration of physiological catecholamines at the human heart beta-adrenoceptors is limited by neuronal capture but not by extraneuronal uptake. The antagonism of the positive inotropic effects of (-)-adrenaline and (-)-noradrenaline by (-)-propranolol was simple competitive in left ventricular myocardium of patients with mitral lesion. The effects of (-)-adrenaline and (-)-noradrenaline were antagonized to similar extent by (-)-propranolol. An equilibrium dissociation constant KB (-log mol/l) of 8.6 was estimated for (-)-propranolol. In atrial preparations the inotropic effects of (-)-adrenaline were antagonized significantly more by (-)-propranolol than those of (-)-noradrenaline. KB-Values (-log mol/l) of 8.9 [against (-)-adrenaline] and 8.5 [against (-)-noradrenaline] were estimated for (-)-propranolol. Concentration-effect curves for the stimulation of adenylate cyclase of both atrium and ventricle were biphasic for (-)-noradrenaline and monophasic for (-)-adrenaline. The high-sensitivity and low-sensitivity components of (-)-noradrenaline comprised 1/3 and 2/3, respectively, of maximum cyclase stimulation. As expected from beta 1-adrenoceptors, the high-sensitivity component of the curve for (-)-noradrenaline was selectively antagonized by (-)-bisoprolol; as expected from beta 2-adrenoceptors, the low-sensitivity component was selectively antagonized by ICI 118,551. (-)-Propranolol antagonized the effects of (-)-noradrenaline mediated by beta 2-adrenoceptors 2 to 3 times more potently than the effects mediated by beta 1-adrenoceptors. (-)-Propranolol competed with 3H-(-)-bupranolol for binding to left ventricular beta-adrenoceptors. An equilibrium dissociation constant (-log mol/l) of 8.6 was estimated for (-)-propranolol.(ABSTRACT TRUNCATED AT 400 WORDS)
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