-
Biology Open Apr 2022This study examines the role of autonomic control of maternal and fetal heart rate variability (MHRV and FHRV) and their heartbeats phase coupling prevalence...
This study examines the role of autonomic control of maternal and fetal heart rate variability (MHRV and FHRV) and their heartbeats phase coupling prevalence (CPheartbeat) in mice. The subjects are divided into three groups: control with saline, cholinergic blockade with atropine, and β-adrenergic blockade with propranolol. Electrocardiogram signals of 27 anesthetized pregnant mice and 48 fetuses were measured for 20 min (drugs were administered after 10 min). For the coupling analysis, different maternal heartbeats were considered for one fetal beat. Results show that saline infusion did not produce any significant changes in MHRV and FHRV, as well as CPheartbeat. Atropine increased maternal HR (MHR) and decreased MHRV significantly without any considerable effect on fetal HR (FHR) and FHRV. Propranolol infusion did not produce any significant changes in MHR and MHRV, but significantly decreased FHR and increased FHRV. Moreover, atropine had led to a decrease in CPheartbeat when considering two and three maternal beats, and an increase for four beats; while propranolol resulted in a decrease for two heartbeats, but an increase for four and five beats. The proposed approach is useful for assessing the impact of maternal autonomic modulation activity on fetal distress and obstetric complications prevalent in pregnant mothers.
Topics: Adrenergic Antagonists; Animals; Atropine; Cholinergic Agents; Female; Fetus; Heart Rate, Fetal; Humans; Mice; Pregnancy; Propranolol
PubMed: 35188546
DOI: 10.1242/bio.058999 -
Yakugaku Zasshi : Journal of the... Mar 2006Alpha(1)-adrenoceptors are widely distributed in the human body and play important physiologic roles. Three alpha(1)-adrenoceptor subtypes (alpha(1A), alpha(1B) and... (Review)
Review
Alpha(1)-adrenoceptors are widely distributed in the human body and play important physiologic roles. Three alpha(1)-adrenoceptor subtypes (alpha(1A), alpha(1B) and alpha(1D)) have been cloned and show different pharmacologic profiles. In addition, a putative alpha(1)-adrenoceptor (alpha(1L) subtype) has also been proposed. Recently, three drugs (tamsulosin, naftopidil, and silodosin) have been developed in Japan for the treatment of urinary obstruction in patients with benign prostatic hyperplasia. In this review, we describe recent alpha(1)-adrenoceptor subclassifications and the pharmacologic characteristics (subtype selectivity and clinical relevance) of alpha(1)-adrenoceptor antagonists.
Topics: Adrenergic alpha-1 Receptor Antagonists; Adrenergic alpha-Antagonists; Amino Acid Sequence; Animals; Cloning, Molecular; Drug Design; Drug Tolerance; Humans; Male; Molecular Sequence Data; Naphthalenes; Piperazines; Prostatic Hyperplasia; Receptors, Adrenergic, alpha-1; Sulfonamides; Tamsulosin; Urethral Obstruction
PubMed: 16518082
DOI: 10.1248/yakushi.126.187 -
British Journal of Pharmacology Jun 2012The MMPs and their inhibitors [tissue inhibitor of MMPs (TIMPs)] form the mainstay of extracellular matrix homeostasis. They are expressed in response to numerous... (Review)
Review
The MMPs and their inhibitors [tissue inhibitor of MMPs (TIMPs)] form the mainstay of extracellular matrix homeostasis. They are expressed in response to numerous stimuli including cytokines and GPCR activation. This review highlights the importance of adrenoceptors and phosphoprotein phosphatases (PPP) in regulating MMPs in the cardiovascular system, which may help explain some of the beneficial effects of targeting the adrenoceptor system in tissue remodelling and will establish emerging crosstalk between these three systems. Although α- and β-adrenoceptor activation increases MMP but decreases TIMP expression, MMPs are implicated in the growth stimulatory effects of adrenoceptor activation through transactivation of epidermal growth factor receptor. Furthermore, they have recently been found to catalyse the proteolysis of β-adrenoceptors and modulate vascular tone. While the mechanisms underpinning these effects are not well defined, reversible protein phosphorylation by kinases and phosphatases may be key. In particular, PPP (Ser/Thr phosphatases) are not only critical in resensitization and internalization of adrenoceptors but also modulate MMP expression. The interrelationship is complex as isoprenaline (ISO) inhibits okadaic acid [phosphoprotein phosphatase type 1/phosphoprotein phosphatase type 2A (PP2A) inhibitor]-mediated MMP expression. While this may be simply due to its ability to transiently increase PP2A activity, there is evidence for MMP-9 that ISO prevents okadaic acid-mediated expression of MMP-9 through a β-arrestin, NF-κB-dependent pathway, which is abolished by knock-down of PP2A. It is essential that crosstalk between MMPs, adrenoceptors and PPP are investigated further as it will provide important insight into how adrenoceptors modulate cardiovascular remodelling, and may identify new targets for pharmacological manipulation of the MMP system.
Topics: Adrenergic Agonists; Adrenergic Antagonists; Animals; Enzyme Activation; Enzyme Inhibitors; Gene Expression Regulation, Enzymologic; Humans; Matrix Metalloproteinase Inhibitors; Matrix Metalloproteinases; Molecular Targeted Therapy; Phosphoprotein Phosphatases; Phosphorylation; Protein Processing, Post-Translational; Protein Transport; Proteolysis; Receptors, Adrenergic; Signal Transduction
PubMed: 22364165
DOI: 10.1111/j.1476-5381.2012.01917.x -
European Annals of Otorhinolaryngology,... Nov 2011Infantile haemangioma (IH) is the most common tumour during early childhood. Although these benign lesions resolve spontaneously, up until recently laryngotracheal sites... (Review)
Review
Infantile haemangioma (IH) is the most common tumour during early childhood. Although these benign lesions resolve spontaneously, up until recently laryngotracheal sites of IH required invasive management. The dramatic efficacy of β-blockers on IH has radically changed the prognosis. Surgery is now no longer indicated as first-line therapy, but should only be performed for difficult, refractory cases, or in the presence of absolute contraindications to β-blockers. Long-term steroid therapy is also no longer indicated. Propranolol can be used as first-line, single-agent therapy.
Topics: Acebutolol; Adrenergic beta-Antagonists; Dose-Response Relationship, Drug; Hemangioma; Humans; Infant; Laryngeal Neoplasms; Laryngoscopy; Propranolol; Tracheal Neoplasms
PubMed: 21498145
DOI: 10.1016/j.anorl.2010.11.009 -
The Netherlands Journal of Medicine May 2014During surgical treatment of pheochromocytoma,`haemodynamic instability may occur. To prevent this, patients receive preoperative treatment with an alpha-blocker.... (Review)
Review
BACKGROUND
During surgical treatment of pheochromocytoma,`haemodynamic instability may occur. To prevent this, patients receive preoperative treatment with an alpha-blocker. Nowadays, some centres use phenoxybenzamine, while others use doxazosin. The purpose of this review is to analyse the current evidence of the benefits and risks of phenoxybenzamine and doxazosin in the preoperative treatment of pheochromocytoma.
METHODS
The literature was reviewed by searching PubMed using the following search terms: pheochromocytoma, phenoxybenzamine, doxazosin and alpha-blockade. The filter was set on English language.
RESULTS
No randomised controlled trials were found. Five follow-up studies comparing phenoxybenzamine and doxazosin in the treatment of pheochromocytoma were retrieved and analysed. There was a trend that systolic arterial pressure is slightly better controlled by phenoxybenzamine. However, this resulted in more pronounced postoperative hypotension as well. The use of an alpha-blocker was often accompanied by other vasoactive agents. phenoxybenzamine was often accompanied by a beta-blocker to control reflex tachycardia, while patients on doxazosin received significantly more additional antihypertensive medicines. Most of the studies showed that the use of vasoactive drugs and fluid infusion does not differ significantly between the two drugs. Phenoxybenzamine caused significantly more orthostatic hypotension, oedema and complaints of a stuffy nose.
CONCLUSION
On the basis of the current evidence, there is no evidently superior alpha-blocker for the pretreatment of patients with pheochromocytoma. Perioperative haemodynamics seem to be slightly better controlled with phenoxybenzamine, at the cost of more pronounced postoperative hypotension. Side effects occurred less often in the doxazosin group.
Topics: Adrenal Gland Neoplasms; Adrenergic alpha-1 Receptor Antagonists; Adrenergic alpha-Antagonists; Blood Pressure; Doxazosin; Humans; Phenoxybenzamine; Pheochromocytoma; Preoperative Care
PubMed: 24829175
DOI: No ID Found -
Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: a systematic review.Progress in Neuro-psychopharmacology &... Mar 2009The selective serotonin reuptake inhibitors (SSRIs) are considered the first-line pharmacological treatment for PTSD. However, even when treated with this class of... (Review)
Review
The selective serotonin reuptake inhibitors (SSRIs) are considered the first-line pharmacological treatment for PTSD. However, even when treated with this class of drugs, response rates rarely exceed 60% and less than 20-30% of the patients achieve full remission. The aim of this study was to address this limitation by systematically reviewing the options left for the treatment of PTSD when patients do not respond satisfactorily to or tolerate SSRIs. A systematic review covering all original articles, letters and brief reports published in any language until October 2008 was conducted through searches in the ISI/Web of Science, PubMed and PILOTS databases. The search terms included the pharmacological class of each agent or its generic name plus "PTSD" or "stress disorder" in the title, in the abstract or as a keyword. Sixty-three articles were selected, covering the following categories: antipsychotics, anticonvulsants, adrenergic-inhibiting agents, opioid antagonists, benzodiazepines and other agents. None of the identified agents reached the level A of scientific evidence, 5 reached level B, 7 level C and 13 level D. The non-antidepressant agent with the strongest scientific evidence supporting its use in PTSD is risperidone, which can be envisaged as an effective add-on therapy when patients did not fully benefit from previous treatment with SSRIs. Prazosin, an adrenergic-inhibiting agent, is a promising alternative for cases of PTSD where nightmares and insomnia are prominent symptoms. So far, there is no consistent empirical support for using benzodiazepines in the prevention or in the treatment of PTSD, although these drugs could alleviate some associated non-specific symptoms, such as insomnia or anxiety. Further controlled clinical trials and meta-analysis are needed to guide clinicians in their search of effective pharmacological alternatives to antidepressants in PTSD.
Topics: Adrenergic Antagonists; Animals; Anticonvulsants; Antidepressive Agents; Antipsychotic Agents; Benzodiazepines; Humans; Narcotic Antagonists; Stress Disorders, Post-Traumatic
PubMed: 19141307
DOI: 10.1016/j.pnpbp.2008.12.004 -
Japanese Journal of Pharmacology Jan 2002The presence of close apposition between the adrenergic and the non-adrenergic or nitrergic nerve terminals in large cerebral arteries in several species is well... (Review)
Review
The presence of close apposition between the adrenergic and the non-adrenergic or nitrergic nerve terminals in large cerebral arteries in several species is well documented. The axo-axonal distance between these different types of nerve terminals is substantially closer than the synaptic distance between the adventitial nerve terminals and the outermost layer of smooth muscle in the media. This feature suggests that a functional axo-axonal interaction between nerve terminals is more likely to occur than that between the nerve and muscle. Thus, transmitters released from one nerve terminal may modulate release of transmitters from the neighboring nerve terminals, resulting in a neurogenic response. We have reported that nicotine-induced nitric oxide (NO)-mediated neurogenic vasodilation is dependent on intact sympathetic innervation in porcine and cat cerebral arteries. Evidence also has been presented to indicate that nicotine acts on alpha7-nicotinic receptors located on sympathetic nerve terminals, resulting in release of norepinephrine which then diffuses to act on beta2-adrenoceptos located on the neighboring nitrergic nerve terminals to release NO and therefore vasodilation. The predominant facilitatory effect of beta2-adrenoceptors in releasing NO is compromised by presynaptic alpha2-adrenoceptors located on the same nerves. Activation of cerebral sympathetic nerves may cause NO-mediated dilation in large cerebral arteries at the base of the brain.
Topics: Adrenergic Antagonists; Animals; Brain; Cerebral Arteries; Cerebrovascular Circulation; Nicotine; Nitrergic Neurons; Vasodilation; Vasomotor System
PubMed: 11859855
DOI: 10.1254/jjp.88.26 -
Physiological Reports Sep 2018Preeclampsia (PE), a disorder of new-onset maternal hypertension and vascular dysfunction during pregnancy, is thought to be linked to placental ischemia-induced release...
Preeclampsia (PE), a disorder of new-onset maternal hypertension and vascular dysfunction during pregnancy, is thought to be linked to placental ischemia-induced release of prohypertensive factors and reductions of vasoprotective factors in the maternal circulation. Although markers of sympathetic nervous activity are elevated in experimental models of placental ischemia-induced hypertension and women with PE compared with their normal pregnant counterparts, the importance of adrenergic receptor signaling in the development of hypertension in PE is unknown. Therefore, we tested the hypothesis that adrenergic receptor blockade attenuates the development of placental ischemia-induced hypertension in rats. Wistar Hannover rats underwent reduced uterine perfusion pressure (RUPP) or Sham surgeries on gestational day 14. By day 19, mean arterial blood pressure (MAP) was increased in RUPP over Sham rats. Groups of RUPP and Sham pregnant rats received terazosin and propranolol (3 mg/kg per day of each via subcutaneous osmotic minipump) to block α- and β-adrenergic receptors, respectively, beginning on gestational day 14. Adrenergic blockade significantly attenuated the development of hypertension in the RUPP rats with a slight blood pressure-lowering response in the Sham, normal pregnant rats by day 19. In conclusion, these data implicate that placental ischemia-induced hypertension involves adrenergic receptor signaling to promote increases in blood pressure during PE.
Topics: Adrenergic alpha-1 Receptor Antagonists; Adrenergic beta-Antagonists; Animals; Blood Pressure; Female; Ischemia; Placenta; Prazosin; Pre-Eclampsia; Pregnancy; Propranolol; Rats; Rats, Wistar
PubMed: 30229567
DOI: 10.14814/phy2.13814 -
Indian Journal of Ophthalmology Jan 2011Congenital glaucoma is a global problem and poses a diagnostic and therapeutic challenge to the ophthalmologist. A detailed evaluation under general anesthesia is...
Congenital glaucoma is a global problem and poses a diagnostic and therapeutic challenge to the ophthalmologist. A detailed evaluation under general anesthesia is advisable to establish the diagnosis and plan for management. Medical therapy has a limited role and surgery remains the primary therapeutic modality. While goniotomy or trabeculotomy ab externo is valuable in the management of congenital glaucoma, primary combined trabeculotomy-trabeculectomy offers the best hope of success in advanced cases. Trabeculectomy with antifibrotic agent and glaucoma drainage devices has a role in the management of refractory cases, and cyclodestructive procedures should be reserved for patients where these procedures have failed. Early diagnosis, prompt therapeutic intervention and proper refractive correction are keys to success. Management of residual vision and visual rehabilitation should be an integral part of the management of children with low vision and lifelong follow-up is a must.
Topics: Adrenergic Agents; Adrenergic Antagonists; Carbonic Anhydrase Inhibitors; Cryotherapy; Glaucoma; Glaucoma Drainage Implants; Humans; Infant, Newborn; Light Coagulation; Mitomycin; Ophthalmologic Surgical Procedures; Prostaglandins; Trabeculectomy
PubMed: 21150027
DOI: 10.4103/0301-4738.73683 -
World Journal of Emergency Surgery :... 2017The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant outcomes in severely burned patients (TBSA >20%).
METHODS
Relevant articles from randomized controlled trials were identified by a literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving patients with a severe burn (>20% of total body surface area affected). Trials were eligible if they evaluated propranolol and compared to usual care or placebo. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for the final analysis. We conducted a meta-analysis using a random-effects model.
RESULTS
We included ten studies in our systematic review. These studies randomized a total of 1236 participants. There were no significant differences between propranolol and placebo with respect to mortality (RD -0.02 [95% CI -0.06 to 0.02]), sepsis (RD -0.03 [95% CI -0.09 to 0.04]), and the overall hospital stay (MD -0.37 [-4.52 to 3.78]). Propranolol-treated adults had a decrease in requirements of blood transfusions (MD -185.64 [95% CI -331.06 to -40.43]) and a decreased heart rate (MD -26.85 [95% CI -39.95 to -13.75]).
CONCLUSIONS
Our analysis indicates that there were no differences in mortality or sepsis in severely burned patients treated with propranolol compared with those who had usual care or placebo. However, the use of propranolol in these patients resulted in lower requirements of blood transfusion and lower values of heart rate. The evidence synthesized in this systematic review is limited to conclude that propranolol reduces the length of hospital stay among severely burned patients. Future trials should assess the impact of propranolol on clinically relevant outcomes such as mortality and adverse events.
Topics: Adrenergic beta-Antagonists; Burns; Humans; Patient Safety; Propranolol
PubMed: 28265298
DOI: 10.1186/s13017-017-0124-7