Adrenaline activation of prejunctional beta-adrenoceptors in guinea-pig atria

Presynaptic beta-adrenoceptors

The existence of facilitatory presynaptic beta-adrenoceptors has been shown in approximately 30 tissues of 6 different species including human. A positive feed back loop for further release of the transmitter appears to be activated by an endogenous agonist, epinephrine, taken up and released as a cotransmitter with norepinephrine rather than norepinephrine itself released from peripheral noradrenergic nerve terminals. Presynaptic beta-adrenoceptors are mainly of a beta 2-subtype. Some beta 1-subtype receptors are also suggested. There coexist presynaptic beta 1- and beta 2-adrenoceptors in cat and rat hypothalamus. Higher sensitivity of peripheral presynaptic beta-adrenoceptors to isoproterenol may be implicated in the early development of hypertension in SHR. Epinephrine taken up and released initiates the development of hypertension in rats via activation of these receptors. Increased activation of these receptors by epinephrine may play a role in the development of essential hypertension. The antihypertensive action of beta-antagonists may be in part due to blockade of these facilitatory presynaptic beta-adrenoceptors.

Adrenaline and stress-induced increases in blood pressure in rats

Stress was induced by immobilizing the hind limbs of rats for 12 days and housing the rats in individual cages. Control rats were housed in groups without immobilization. Blood pressure and heart rate were measured through an indwelling carotid cannula. After 10 and 12 days of immobilization and isolation, the stressed rats had significantly higher blood pressures (ca. 10 mmHg) and higher cardiac adrenaline levels (ca. 90%). After adrenal medullectomy cardiac adrenaline levels were markedly reduced in both stressed and control rats. Furthermore, the stressing procedure did not cause a rise in blood pressure in adrenal-medullectomized rats. Desipramine HCl (2 mg/kg per day), administered orally to block the neuronal uptake of adrenaline, prevented the elevation in blood pressures and cardiac adrenaline levels. Propranolol HCl (2.8 mg/kg per day), orally, also prevented the rise in blood pressure. The results are consistent with the hypothesis that activation of facilitatory prejunctional beta-adrenoceptors on sympathetic nerves by neuronally-released adrenaline may be responsible for the raised blood pressure.

The physiological and pharmacological role of presynaptic alpha- and beta-adrenoceptors in man

Two studies were performed each in six normal volunteers in order to find evidence of either a physiological or pharmacological role of presynaptic alpha- and presynaptic beta-adrenoceptors in man. In Study 1 subjects received a 60 min infusion of guanfacine 3 mg (alpha 2-adrenoceptor agonist) preceded by either idazoxan (alpha 2-adrenoceptor antagonist) or vehicle. Guanfacine reduced plasma noradrenaline concentration by approximately 30% and this fall was not antagonised by the alpha 2-receptor antagonist. The 30-fold increase in plasma growth hormone, measured as a marker of the central action of guanfacine, was almost completely blocked by idazoxan. A comparison of the drug concentrations of idazoxan and guanfacine, together with their relative affinities for alpha 2-adrenoceptors, suggested that the idazoxan could not block the peripheral actions of guanfacine and that these were responsible for the fall in plasma noradrenaline concentration. In Study 2 adrenaline 0.05 micrograms kg-1 min-1 was infused for 80 min preceded by either idazoxan or vehicle. After vehicle, adrenaline caused no change in plasma noradrenaline concentration whereas it rose approximately 25% after administration of idazoxan. This was probably due to unmasking of presynaptic beta-adrenoceptor stimulation by adrenaline when the opposing inhibitory autoreceptor was blocked.

Identification of presynaptic beta 2-adrenoceptors on the sympathetic nerve fibres of the human pulmonary artery

Strips of human pulmonary arteries from patients undergoing surgery for lung tumour were incubated with [3H]-noradrenaline. Subsequently, they were superfused with physiological salt solution containing cocaine and corticosterone. Tritium overflow from the strips was stimulated by transmural electrical impulses (2 Hz). The electrically evoked overflow of tritium consisted of 91% unmetabolized [3H]-noradrenaline, and this percentage was not altered by isoprenaline. Adrenaline (in the presence of rauwolscine), isoprenaline and the preferential beta 2-adrenoceptor agonist, procaterol, concentration-dependently increased the electrically evoked tritium overflow. Prenalterol, a beta-adrenoceptor agonist with moderate preference for beta 1-adrenoceptors, was considerably less active than the previously mentioned agonists; noradrenaline (in the presence of rauwolscine) was ineffective. The concentration-response curve of procaterol was shifted to the right by the preferential beta 2-adrenoceptor antagonist ICI 118-551 but was not affected by the beta 1-selective antagonist, atenolol. Propranolol, but not atenolol, produced a shift to the right of the concentration-response curve of isoprenaline. It is concluded that the sympathetic nerve fibres of the human pulmonary artery are endowed with facilitatory presynaptic beta 2-adrenoceptors.

Interaction between the inhibitory action of acetylcholine and the alpha-adrenoceptor autoinhibitory feedback system on release of [3H]-noradrenaline from rat atria and rabbit ear artery

Stimulation-induced increases in the efflux of radioactivity (S-I efflux) were measured in the bathing medium following labelling of the noradrenergic transmitter pools of rat atria and rabbit artery preparations with [3H]-noradrenaline. In atria stimulated with trains of 16 or 60 pulses at 2 Hz, phentolamine enhanced, whereas acetylcholine inhibited S-I efflux. With trains of 16 pulses phentolamine had a smaller enhancing effect than with trains of 60 pulses, whereas the inhibitory effect of acetylcholine was more pronounced with 16 pulses of stimulation. The inhibitory effect of acetylcholine was markedly enhanced by phentolamine when stimulation was with 60 pulses. With 16 pulses of stimulation the effect of acetylcholine was unaltered by phentolamine and abolished by the alpha 2-adrenoceptor agonist 3,4-dihydroxyphenylimino-2-imidazolidine (DPI). Phentolamine had no effect on the negative inotropic effect of acetylcholine on driven left atrial preparations. In arterial preparations stimulated with trains of 30 pulses at 1 Hz, both acetylcholine and clonidine inhibited S-I efflux, whereas yohimbine and idazoxan enhanced S-I efflux. Combining acetylcholine with clonidine did not alter the inhibitory effect of clonidine but the combination of acetylcholine with yohimbine or idazoxan abolished the marked enhancing effects of yohimbine or idazoxan on S-I efflux. These findings indicate that there may be a reciprocal interaction between prejunctional alpha-adrenoceptors and prejunctional muscarinic cholinoceptors.

Adrenergic receptors of isolated snake atria

Cardiac adrenergic receptors in snakes were examined using an isolated atria preparation of Naja naja and Ptyas korros. Treatments included an examination of the atrial responses to selective alpha- and beta-adrenergic agonists and antagonists. In both species, both phenylephrine and isoproterenol produced dose-dependent increases in the atrial beating rate and tension. Phenylephrine-induced increases were characterized with a high affinity and low affinity components. These positive chronotropic and inotropic effects produced by phenylephrine and isoproterenol were abolished with propranolol and in the phenylephrine-induced response phentolamine also attenuated the low affinity response and blocked the high affinity response. With catecholamines depletion via 6-OH dopamine or reserpine, the high affinity component in the phenylephrine-induced response was no longer observed. It is concluded that beta-adrenoceptors are the predominant post-synaptic adrenoceptors in snake atria. Stimulatory presynaptic alpha-adrenoceptors for modulating noradrenaline release may also be present.

Differential effects of D600, nifedipine and dantrolene sodium on excitation-secretion coupling and presynaptic beta-adrenoceptor responses in rat atria

The stimulation-evoked release of tritium was measured from rat atria labelled with [3H]-noradrenaline. The calcium dependence of evoked release and the facilitation of this release via activation of presynaptic beta-adrenoceptors were examined using D600 (methoxyverapamil), nifedipine and dantrolene sodium. Both D600 and nifedipine at dose levels of 20 and 100 microM inhibited evoked release. Dantrolene (20, 100 microM) reduced release by 25%, the effect being maximal at 20 microM. In the presence of 20 nM isoprenaline, a facilitation of evoked release occurred, which was blocked by 0.1 microM (-)-propranolol. The facilitatory action of isoprenaline was abolished by omission of calcium from the buffer, or by D600 or nifedipine, (100 microM). In contrast, the response to isoprenaline was not modified by dantrolene (20, 100 microM). It is concluded that the evoked release of noradrenaline (NA) utilizes Ca from both intra- and extracellular sources and that isoprenaline increases NA secretion by promoting the depolarization-induced influx of Ca.

Adrenaline mediates a positive feedback loop in noradrenergic transmission: its possible role in development of hypertension

Adrenaline activates prejunctional beta-adrenoceptors of the beta 2-subtype on sympathetic nerve terminals and enhances noradrenergic transmission. Adrenaline can be incorporated in transmitter stores of noradrenergic nerves and, when released as a cotransmitter, activates the prejunctional beta 2-adrenoceptors, thereby mediating autofacilitation of noradrenergic transmission. Adrenaline released from the adrenal medulla in stress may be incorporated in noradrenergic transmitter stores and reach a sufficient concentration as a cotransmitter to activate the autofacilitatory feedback loop involving prejunctional beta 2-adrenoceptors, resulting in prolongation of the increases in vasomotor tone and cardiac activity that occur acutely: with frequent repetition of stress, there may be progression into a hypertensive state. In accord with this hypothesis, adrenaline administration produces persistent increases in blood pressure in rats, and plasma levels of adrenaline are elevated in a proportion of hypertensive patients; furthermore, repeated stress produces prolonged increases in blood pressure in animals and man.

Minireview. Presynaptic receptors and alterations in norepinephrine release in spontaneously hypertensive rats

The ability of blood vessels to constrict to a given stimulus is significantly increased in spontaneously hypertensive rats (SHR). Such an increase in the vasoconstrictor responsiveness contributes to the elevated peripheral vascular resistance noted in SHR. The present review discusses evidence in support of the concept that an increased release of norepinephrine during sympathetic nerve stimulation may contribute to the increase in vasoconstrictor responsiveness and, subsequently, to an increase in vascular resistance in the SHR. Several studies suggest that the exocytotic release of norepinephrine from sympathetic nerves may be altered by endogenously occurring neurohumoral substances which produce their effects by interacting with presynaptic receptors located on postganglionic sympathetic nerves. Therefore, it is postulated that alterations in presynaptic regulation of norepinephrine release, resulting from changes in the functioning of one or more of these presynaptic receptors, may lead to a greater release of norepinephrine in the SHR. This review summarizes the results of studies evaluating presynaptic receptor mechanisms and norepinephrine release in the SHR. These studies suggest that norepinephrine release during sympathetic nerve stimulation is greater in the SHR and that alterations in some of the presynaptic receptor mechanisms may be responsible for this phenomenon.

Effect of epinephrine on norepinephrine release from rat kidney during sympathetic nerve stimulation

Experiments were performed to study presynaptic beta-adrenoceptor facilitation of sympathetic neurotransmitter release in the isolated perfused rat kidney and evaluate the effect of epinephrine on norepinephrine release during sympathetic nerve stimulation. The right kidney was isolated and perfused with Krebs-Ringer solution. Norepinephrine storage sites were labelled with [3H]norepinephrine. Increasing concentrations of isoproterenol and salbutamol when perfused through the kidney, caused an enhancement of the stimulus-induced release of [3H]norepinephrine at 0.5 and 2 Hz, with the maximum facilitatory effect being observed at 0.5 Hz. The effect of salbutamol on [3H]norepinephrine release was concentration-dependent and more pronounced than that of isoproterenol. While propranolol (10(-9)-10(-5)M) by itself did not cause any significant changes in the stimulus-induced release of [3H]norepinephrine, it antagonized the facilitatory action of salbutamol on [3H]norepinephrine release during periarterial nerve stimulation. When epinephrine (10(-10)-10(-7)M), was perfused through the kidney in the presence of cocaine, it caused a concentration-dependent inhibition of the stimulus-induced release of [3H]norepinephrine release elicited during periarterial nerve stimulation. However, when epinephrine was perfused in the presence of cocaine, phentolamine and corticosterone it caused a slight but significant increase in the stimulus-induced release of [3H]norepinephrine; the highest concentration (10(-7)M) still caused a decrease in the [3H]norepinephrine release. These results, while providing evidence for the existence of presynaptic facilitatory beta-adrenoceptors on renal sympathetic nerves, fail to support the hypothesis that these receptors have a physiological role in the regulation of sympathetic neurotransmitter release.

Age and cardiovascular response adaptation. Determinants of an antihypertensive treatment concept primarily based on beta-blockers and calcium entry blockers

The patient's age has great impact on the development of hypertension, its duration, and severity. In patients with essential hypertension, sympathetic cardiovascular control changes from an early phase with increased beta-adrenoceptor-mediated responses, e.g., cardiac output and renin, into a later phase where these responses are blunted and alpha-adrenoceptor-mediated vasoconstriction prevails, associated with higher intracellular free sodium and calcium concentration. This pathophysiological view of essential hypertension has its corollary in the pharmacotherapeutic approach. Younger patients, who often have high renin levels, respond better to monotherapy with a beta-blocker or with a converting-enzyme inhibitor. Older patients, who often have low renin levels, respond less well to beta-blockers but particularly well to calcium entry blockers as an alternative to diuretics. Therefore, beta-blockers and calcium entry blockers form new cornerstones for antihypertensive treatment and strategy, with the potential of cardioprotection.

Modulation of noradrenaline release through activation of presynaptic beta-adrenoreceptors

On peripheral noradrenergic nerve endings there exist beta-adrenoreceptors activation of which results in an enhanced release of noradrenaline in response to nerve stimulation. These presynapatic beta-adrenoreceptors do not appear to be activated by neuronally-released noradrenaline. However, adrenaline may be a physiological activator during enhanced adrenomedullary secretion. Adrenaline can also be incorporated into the noradrenergic transmitter stores and be released as a co-transmitter. Under these conditions presynaptic beta-adrenoreceptors may be activated by neuronally-released adrenaline, thus forming a 'positive feedback loop'. The release of adrenaline from the adrenal medullae may also be modulated through facilitatory beta-adrenoreceptors, but the release of noradrenaline from noradrenergic nerves in the central nervous system is not. The facilitatory presynaptic beta-adrenoreceptors appear to be in the main of the beta 2-subtype although precise receptor characterization has not been carried out. Increased activation of presynaptic beta-adrenoreceptors by adrenaline may be implicated in the development of essential hypertension. Part of the antihypertensive action of beta-adrenoreceptor blocking drugs may be due to blockade of these facilitatory presynaptic beta-adrenoreceptors.

Alpha-adrenoceptors, adrenaline, and exaggerated vasoconstrictor response to stress in essential hypertension

Stressful sympathetic stimulation by cold pressor test in patients with essential hypertension results in an exaggerated response of the already elevated plasma adrenaline, heart rate, blood pressure, and alpha-adrenoceptor-mediated vasoconstriction when compared with normotensive subjects. The stress-induced increase in adrenaline was correlated with the attendant increase in blood pressure. The stress-induced reduction in forearm flow was reversed during infusion of the postjunctional alpha 1-adrenoceptor blocker prazosin. Therefore, enhanced responses to sympathetic stress, as reflected and perhaps caused by an exaggerated rise in plasma adrenaline, may contribute to an increased alpha 1-adrenoceptor-mediated vasoconstriction in essential hypertension.

Aspects of the pharmacology of beta-adrenoceptor agonists and antagonists

A short review is given of the distribution of and effects mediated through beta-receptors. The pharmacodynamic profiles of some beta-receptor agonists and antagonists are briefly outlined and the clinical advantages and disadvantages of different pharmacodynamic properties are discussed.

The noradrenaline rate in the anaesthetized rabbit: facilitation by adrenaline

1. 3H-Noradrenaline was infused intravenously into pentobarbitone anaesthetized rabbits to reach a steady-state plasma 3H-noradrenaline level, from which the noradrenaline plasma clearance was calculated. The plasma level of endogenous noradrenaline was determined simultaneously and the rate of noradrenaline release was then derived. 2. Pargyline, amezinium, desipramine and guanethidine all reduced the noradrenaline plasma clearance. The noradrenaline release rate was decreased by desipramine, guanethidine and clonidine. 3. Adrenaline (6 nmol/kg i.v. twice) enhanced the noradrenaline release rate by 53%. This effect was apparent after the plasma adrenaline has returned to basal levels. The adrenaline levels in sympathetically innervated tissues were elevated at this time. 4. When the rabbits were pretreated with either propranolol HCl (1 mg/kg i.p.) to block beta-adrenoceptors, or desipramine HCl (1 mg/kg i.v.) to block neuronal uptake, the facilitatory effect of adrenaline was abolished. Noradrenaline (6 nmol/kg i.v. twice) had no effect on the noradrenaline release rate. 5. These findings suggest that if the sympathetic transmitter stores contain sufficient adrenaline neuronally released adrenaline may modulate noradrenaline release in vivo by activating facilitatory presynaptic beta-adrenoceptors.

Effects of impromidine, a specific H2-receptor agonist and 2(2-pyridyl)-ethylamine, an H1-receptor agonist, on stimulation-induced release of [3H]-noradrenaline in guinea-pig isolated atria

1 The specific histamine H2-receptor agonist, impromidine (3-100 nmol/l), increased the rate and force of beating of guinea-pig isolated atria. These effects were blocked by the H2-receptor antagonist, cimetidine (30 mumol/l), but not by the H1-receptor antagonist, mepyramine (0.1 mumol/l). 2 In atria that had previously been incubated in [3H]-noradrenaline, impromidine (3-100 nmol/l) had no effect on the resting efflux of radioactivity, but concentrations of 50 and 100 nmol/l significantly increased the efflux induced by electrical stimulation (2 Hz for 10 s) of the intramural sympathetic nerves by approximately 38%; lower concentrations (3, 10 and 25 nmol/l) had no effect. 3 The effect of impromidine in enhancing stimulation-induced efflux of radioactivity was abolished by cimetidine (30 mumol/l) and by mepyramine (0.1 mumol/l). It was unaffected by the alpha-adrenoceptor antagonist, phentolamine (30 mumol/l). 4 Impromidine produced some inhibition of the uptake of [3H]-noradrenaline, but this did not account for the enhancement of the stimulation-induced efflux of radioactivity, since impromidine (50 mumol/l) still increased release in the presence of cocaine (30 mumol/l). 5 The specific H1-receptor agonist, 2-(2-pyridyl)-ethylamine (10-100 mumol/l), increased both the resting and stimulation-induced efflux of radioactivity. These effects were not blocked by mepyramine (0.1 mumol/l) or the beta-adrenoceptor antagonist, metoprolol (0.1 mumol/l). 6 The prejunctional inhibitory histamine receptors in guniea-pig atria are not classifiable into H1- or H2-type by the use of relatively specific postjunctional histamine H1- or H2-receptor agonists and antagonists.

Elevated plasma noradrenaline in response to beta-adrenoceptor stimulation in man

1 Dose-dependent increments of plasma noradrenaline were observed during graded infusions of (±)isoprenaline (3.5-35 ng kg^-1 min^-1 i.v.) in seven normal subjects and in ten subjects with borderline hypertension. At the highest dose of isoprenaline, noradrenaline rose by 166 ± 16 pg/ml in normals and by 169 ± 34 pg/ml in hypertensives (mean ± s.e. mean).

2 In the subjects with borderline hypertension isoprenaline infusions were repeated after 7 days of treatment with (±)propranolol (320 mg/day, divided into 4 doses) and subsequently after 7 days of treatment with (±)atenolol (100 mg/day) 2-3 h after the morning dose of β-adrenoceptor blocker. The dose-response curve for plasma noradrenaline was shifted to higher doses of isoprenaline by a factor of 4 by atenolol and the heart rate response was similarly shifted. The heart rate response was shifted by a factor of 16 by propranolol, but plasma noradrenaline did not change after isoprenaline under propranolol treatment, even when isoprenaline was given at doses high enough to induce increments of heart rate similar to those without β-adrenoceptor blocker treatment.

3 In the subjects with borderline hypertension mean and diastolic intra-arterial pressures fell at the highest dose of isoprenaline by 9 ± 2 and 13 ± 2 mm Hg respectively. These effects were antagonized by propranolol and not by atenolol.

4 The observed rise in plasma noradrenaline after isoprenaline might have been caused by baro-reflex-stimulation of central sympathetic outflow. The isoprenaline-induced decrease in mean arterial pressure, however, was small. Moreover pulse pressure rose and this tends to suppress rather than stimulate baroreflex-mediated sympathetic activity. Activation of presynaptic β-adrenoceptors, allegedly of the β₂-subtype, is known to facilitate noradrenaline release upon nerve stimulation of isolated tissues. Our results lend support to the hypothesis that such a facilitatory mechanism is also operative in intact man.

How intrinsic sympathomimetic activity modulates the haemodynamic responses to beta-adrenoceptor antagonists. A clue to the nature of their antihypertensive mechanism

1 A survey has been made of the literature on acute and long-term haemodynamic effects of ten different β-adrenoceptor antagonists.

The β-adrenoceptor blockers are: pindolol, practolol, alprenolol, oxprenolol, acebutolol, penbutolol, metoprolol, atenolol, propranolol and timolol. The total numbers of patients included in this review are 396 patients in 41 acute studies and 410 patients in 36 long-term studies.

2 The effects of β-adrenoceptor blockers on the concentrations of plasma noradrenaline have also been reviewed. Ten studies including 110 patients on non-ISA-β-adrenoceptor blockers and eight studies including 116 patients on pindolol are presented.

3 In the acute studies (i.e. 15-90 min) arterial pressure was lowered by 1-7% and in the long-term studies (i.e. 3 days-5 years) by 6-17%.

4 The degree of cardio-depression induced by the various β-adrenoceptor blockers was inversely correlated with their pharmacologically defined quantity of intrinsic sympathomimetic activity (ISA) both in acute and in long-term studies.

5 In the acute studies the increments in peripheral vascular resistance were directly correlated with the degree of cardio-depression. This suggests that a fall in arterial pressure immediately after administration of a β-adrenoceptor blocker is prevented by increased vasoconstrictor nerve activity mediated through the arterial baroreflex.

6 The compensatory response of vascular resistance to cardio-depression was similar for β₁-selective and non-selective blockers, thereby indicating that extra-junctional vascular β-receptors are relatively unimportant for maintaining basal vascular tone.

7 In the long-term studies the correlation between changes in cardiac output and changes in vascular resistance was shifted to a lower level of vascular resistance. This means that the onset of blood pressure reduction during β-adrenoceptor blockade was associated with a fall in vascular resistance at any level of cardiac output. Thus vascular resistance was higher during treatment with a non-ISA-β-adrenoceptor blocker than during treatment with an ISA-β-adrenoceptor blocker.

8 The level of vascular resistance ultimately attained during treatment with the various β-adrenoceptor blockers appears to be inversely related to their effects on plasma renin activity.

9 The concentration of noradrenaline in plasma rose by approximately 30% during treatment with non-ISA-β-adrenoceptor blockers and fell by more than 30% after pindolol.

10 There is evidence that under propranolol, which reduces cardiac output and hepatic blood flow, the plasma noradrenaline clearance is diminished. Since noradrenaline is mainly cleared from the circulation by the lungs and by the liver, and since pindolol has no effect on cardiac output and hepatic blood flow, one may expect the plasma noradrenaline clearance not to be diminished by pindolol.

11 The reported effects of β-adrenoceptor blockers on plasma noradrenaline may indicate that the release of neurotransmitter is diminished, but in the case of non-ISA-β-adrenoceptor blockers this effect is not reflected by a decreased concentration of noradrenaline in plasma, because its clearance is also reduced.

12 The hypotensive effect of β-adrenoceptor blockers appears to be independent of blockade of postjunctional cardiac-β-receptors, juxtaglomerular-β-receptors and extrajunctional vascular β-receptors. This indicates that blockade of β-receptors at other sites (i.e. centrally and/or prejunctionally) is more important.

Beta-adrenoceptor blockade and psychic stress in man. A comparison of the acute effects of labetalol, metoprolol, pindolol and propranolol on plasma levels of adrenaline and noradrenaline

1 A random double-blind study was performed in healthy volunteers. The immediate effects of three different beta-adrenoceptor blocking agents, metoprolol, pindolol and propranolol, on the plasma concentrations of adrenaline and noradrenaline were compared in a situation of pleasant psychic stimulation during a television-game of tennis. The immediate effects of labetalol in a group of patients with arterial hypertension were studied in a similar experimental situation. 2 During psychic stress the plasma concentration of noradrenaline rose significantly by 85% after placebo, by 95% after labetalol, by 63% after metoprolol and by 55% after propranolol. After pindolol the noradrenaline concentration remained unchanged. 3 During psychic stress the plasma concentration of adrenaline rose significantly by 135% after labetalol, by 110% after metoprolol and by 83% after propranolol. After pindolol and placebo the adrenaline concentration remained unchanged. 4 The present results are taken to indicate that the intrinsic sympathomimetic activity possessed by pindolol prevents the rise in plasma noradrenaline normally seen during psychic stress. It is suggested that beta-adrenoceptor blockers with strong intrinsic sympathomimetic effect reduce the release of catecholamines during psychic stress.

Hypertension through adrenaline activation of prejunctional beta-adrenoceptors

1. Adrenaline can enhance the stimulation-induced release of transmitter noradrenaline in sympathetically innervated tissues by activating prejunctional beta-adrenoceptors. 2. Adrenaline incorporated into sympathetic transmitter stores by neuronal uptake can be subsequently released as a co-transmitter and can then activate prejunctional beta-adrenoceptors, thus completing a facilitatory feedback loop. 3. Rats chronically treated with adrenaline develop elevated blood pressures compared to control rats. beta-Adrenoceptor blockade prevents the rise in blood pressure. 4. Activation by adrenaline of facilitatory prejunctional beta-adrenoceptors of sympathetic nerves innervating cardiovascular effector tissues may explain adrenaline-induced rises in blood pressure.

Activation of prejunctional beta-adrenoceptors in rat atria by adrenaline applied exogenously or released as a co-transmitter

1 Adrenaline (10 nM) significantly enhanced the stimulation-induced efflux of radioactivity from rat atria previously incubated with [3H]-noradrenaline ([3H]-NA). This effect was abolished by metoprolol (.01 muM). 2 Adrenaline in a higher concentration (1 muM) and NA (1 muM) significantly reduced the stimulation-induced efflux of radioactivity. However, in the presence of phenoxybenzamine (10 muM), adrenaline (1 muM) enhanced the efflux, whereas NA (1 muM) had no effect. 3 In rat isolated atria pre-incubated with adrenaline and then incubated with NA, both catecholamines were taken up and were released by field stimulation. When pre-incubation was with adrenaline and incubation was with [3H]-NA, metoprolol decreased the stimulation-induced efflux of radioactivity. This effect did not occur if the atria were pre-incubated with NA instead of adrenaline, suggesting tht neuronally released adrenaline activates prejunctional beta-adrenoceptors. 4 In conscious rats, intravenously administered adrenaline (6.0 and 0.6 nmol/kg) was taken up and retained in the atria and could be released by field stimulation. The release was calcium-dependent from these rats up to 24 h after administration.

An interaction between prejunctional alpha-adrenoceptors and prejunctional beta-adrenoceptors

The ability os isoprenaline to enhance transmitter release from sympathetic nerves in rat atria incubated with [3H]noradrenaline was assessed under three conditions of prejunctional alpha-adrenoceptor activation: in the presence of phentolamine, in the presence of noradrenaline, and in the absence of either drug. Isoprenaline-induced enhancement of transmitter release was inversely related to the degree of activation of prejunctional alpha-adrenoceptors. Thus there appears to be an interaction between the prejunctional alpha-adrenoceptor inhibitory mechanism and the prejunctional beta-adrenoceptor facilitatory mechanism. In rabbit ear arteries incubated with [3H]noradrenaline, isoprenaline facilitated transmitter release in the presence but not in the absence of phentolamine. Therefore in some tissues it may be necessary to block prejunctional alpha-adrenoceptors before prejunctional beta-adrenoceptors can be demonstrated.