Bruck Heike, Leineweber Kirsten, Temme Thomas, Weber Melanie, Heusch Gerd, Philipp Thomas, Brodde Otto-Erich
Department of Nephrology, University of Essen Medical School, Essen, Germany.
J Am Coll Cardiol. 2005 Dec 6;46(11):2111-5. doi: 10.1016/j.jacc.2005.08.041. Epub 2005 Nov 4.
The purpose of this research was to find out whether, in humans, dobutamine-induced hemodynamic effects and increase in plasma-renin activity (PRA) might be beta1-adrenoceptor (beta1AR) genotype-dependent.
In vitro Arg389Gly-beta1AR polymorphism exhibits decreased receptor signaling.
We studied 10 male homozygous Arg389-beta1AR subjects and 8 male homozygous Gly389beta1AR subjects; to avoid influences of codon 49 polymorphism, all were homozygous Ser49-beta1AR. Subjects were infused with dobutamine (1 to 6 microg/kg/min) with or without bisoprolol (10 mg orally) pretreatment, and PRA, heart rate, contractility, and blood pressure were assessed.
With regard to PRA, dobutamine increased PRA more potently in Arg389-beta1AR versus Gly389-beta1AR subjects. Bisoprolol markedly suppressed the dobutamine-induced PRA increase in Arg389- but only marginally in Gly389-beta1AR subjects. With regard to hemodynamics, dobutamine caused larger heart rate and contractility increases and diastolic blood pressure decreases in Arg389- versus Gly389-beta1AR subjects. Bisoprolol reduced dobutamine-induced heart rate and contractility increases and diastolic blood pressure decreases more potently in Arg389- versus Gly389-beta1AR subjects.
Codon 389 beta1AR polymorphism is a determinant not only of hemodynamic effects but also of PRA. Thus, beta1AR polymorphisms may be useful for predicting therapeutic responses to betaAR-blocker treatment.
本研究旨在探讨在人类中,多巴酚丁胺诱导的血流动力学效应及血浆肾素活性(PRA)升高是否可能依赖于β1-肾上腺素能受体(β1AR)基因型。
体外研究显示,精氨酸389 - 甘氨酸β1AR多态性会导致受体信号传导减弱。
我们研究了10名男性纯合精氨酸389 - β1AR受试者和8名男性纯合甘氨酸389 - β1AR受试者;为避免密码子49多态性的影响,所有受试者均为纯合丝氨酸49 - β1AR。受试者接受多巴酚丁胺(1至6微克/千克/分钟)输注,部分受试者在输注前口服比索洛尔(10毫克)进行预处理,然后评估PRA、心率、心肌收缩力和血压。
关于PRA,与甘氨酸389 - β1AR受试者相比,多巴酚丁胺使精氨酸389 - β1AR受试者的PRA升高更为显著。比索洛尔显著抑制了多巴酚丁胺诱导的精氨酸389 - β1AR受试者PRA升高,但对甘氨酸389 - β1AR受试者的抑制作用较弱。关于血流动力学,与甘氨酸389 - β1AR受试者相比,多巴酚丁胺使精氨酸389 - β1AR受试者的心率和心肌收缩力增加幅度更大,舒张压降低幅度更大。比索洛尔对多巴酚丁胺诱导的精氨酸389 - β1AR受试者心率和心肌收缩力增加及舒张压降低的抑制作用比对甘氨酸389 - β1AR受试者更强。
密码子389 β1AR多态性不仅是血流动力学效应的决定因素也是PRA的决定因素。因此,β1AR多态性可能有助于预测β受体阻滞剂治疗的疗效。