McGraw Dennis W, Almoosa Khalid F, Paul Richard J, Kobilka Brian K, Liggett Stephen B
University of Cincinnati College of Medicine, 231 Albert Sabin Way, Room G062, Cincinnati, Ohio 45267, USA.
J Clin Invest. 2003 Aug;112(4):619-26. doi: 10.1172/JCI18193.
beta-adrenergic receptors (betaARs) relax airway smooth muscle and bronchodilate, but chronic beta-agonist treatment in asthma causes increased sensitivity to airway constriction (hyperreactivity) and is associated with exacerbations. This paradox was explored using mice with ablated betaAR genes (betaAR-/-) and transgenic mice overexpressing airway smooth muscle beta2AR (beta2AR-OE) representing two extremes: absence and persistent activity of airway betaAR. Unexpectedly, betaAR-/- mice, lacking these bronchodilating receptors, had markedly decreased bronchoconstrictive responses to methacholine and other Gq-coupled receptor agonists. In contrast, beta2AR-OE mice had enhanced constrictive responses. Contraction to permeabilization with beta-escin was unaltered by gene ablation or overexpression. Inositol phosphate accumulation by Gq-coupled M3-muscarinic, thromboxane-A2, and 5-HT2 receptors was desensitized in airway smooth muscle cells from betaAR-/- mice and sensitized in cells from beta2AR-OE mice. Thus, betaAR antithetically regulates constrictive signals, affecting bronchomotor tone/reactivity by additional means other than direct dilatation. Studies of signaling elements in these pathways revealed the nodal point of this cross talk as phospholipase C-beta1, whose expression was altered by betaAR in a direction and magnitude consistent with the physiologic and cellular responses. These results establish a mechanism of the beta-agonist paradox and identify a potential asthma modifier gene (phospholipase C-beta1), which may also be a therapeutic target in asthma when chronic beta-agonists are required.
β-肾上腺素能受体(βARs)可舒张气道平滑肌并使支气管扩张,但哮喘患者长期使用β-激动剂治疗会导致气道对收缩的敏感性增加(高反应性),并与病情加重相关。利用βAR基因敲除小鼠(βAR-/-)和过表达气道平滑肌β2AR的转基因小鼠(β2AR-OE)探索了这一矛盾现象,这两种小鼠代表了两个极端情况:气道βAR的缺失和持续激活。出乎意料的是,缺乏这些支气管扩张受体的βAR-/-小鼠对乙酰甲胆碱和其他Gq偶联受体激动剂的支气管收缩反应明显降低。相反,β2AR-OE小鼠的收缩反应增强。用β-七叶皂苷通透细胞后的收缩不受基因敲除或过表达的影响。βAR-/-小鼠气道平滑肌细胞中Gq偶联的M3-毒蕈碱、血栓素A2和5-HT2受体引起的肌醇磷酸积累脱敏,而β2AR-OE小鼠细胞中则致敏。因此,βAR以相反的方式调节收缩信号,通过直接扩张以外其他方式影响支气管运动张力/反应性。对这些途径中信号元件的研究揭示了这种相互作用的节点为磷脂酶C-β1,其表达受βAR改变,改变的方向和幅度与生理和细胞反应一致。这些结果确立了β-激动剂矛盾现象的机制,并鉴定出一个潜在的哮喘修饰基因(磷脂酶C-β1),当需要长期使用β-激动剂时,该基因也可能是哮喘的治疗靶点。