The alpha- and beta-adrenoceptor blocking activities of labetalol and its RR-SR (50:50) stereoisomers

Metabolic Activation and Cytotoxicity of Labetalol Hydrochloride Mediated by Sulfotransferases

Labetalol hydrochloride (LHCl), an α- and β-adrenoreceptor blocker, is widely used for the treatment of hypertension as well as angina pectoris. Previous reports have demonstrated the adverse events during clinical application of LHCl, such as liver injury and acute renal failure. The present study aimed to investigate metabolic activation of LHCl to initiate the elucidation of the mechanisms of its liver toxicity. One glutathione (GSH) conjugate was detected in rat and human primary hepatocytes as well as bile of rats after exposure to LHCl. The GSH conjugate was chemically synthesized and characterized by Q-TOF and ¹H NMR. Pretreatment of 2,6-dichloro-4-nitrophenol (DCNP), a broad-spectrum sulfotransferase (SULT) inhibitor, significantly attenuated the formation of the GSH conjugate in LHCl-treated hepatocytes and animals, indicating the participation of SULTs in metabolic activation of LHCl. Moreover, pretreatment with DCNP displayed significant protection against the observed cytotoxicity in rat primary hepatocytes, which suggests a correlation of the bioactivation of LHCl mediated by SULTs with LHCl-induced hepatotoxicity.

Retrospective evaluation of labetalol as antihypertensive agent in dogs

Background

To evaluate the effect on arterial blood pressure (ABP) of labetalol infusion as treatment for perioperative non nociceptive acute hypertension in dogs. The clinical records of dogs receiving intra or postoperative labetalol infusion were retrospectively reviewed. Invasive systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressure and heart rate (HR) before labetalol infusion (T0) and 15, 30, 45 and 60 min (T1, T2, T3 and T4 respectively) after infusion were retrieved. The dose rate of labetalol infusion and use of concurrently administered drugs that could have potentially affected ABP and/or HR were also recorded. ANOVA for repeated measures and Dunnett’s multiple comparison test were used to determine the effect of labetalol on ABP and HR. Differences were considered significant when p < 0.05.

Results

A total of 20 dogs met the inclusion criteria, and hypertension was documented after craniotomy (12/20), adrenalectomy (4/20) and other procedures (4/20). Five dogs received labetalol intraoperatively, 14 postoperatively, and 1 during the surgical procedure and recovery. Median infusion duration and rate were 463 (60-2120) minutes and 1.1 (0.2–3.4) mg/kg/h respectively. Median loading dose was 0.2 (0.2–0.4) mg/kg. Labetalol produced a significant decrease in SAP and DAP at all time points compared to T0 (p < 0.05), while the effect was not significant at T1 for MAP (p = 0.0519). Median maximum MAP decrease was 31 (20–90) mmHg. Heart rate did not increase significantly during treatment (p = 0.2454). Acepromazine given before or during labetalol treatment did not reduce significantly ABP (p = 0.735).

Conclusions

Labetalol produced a reliable and titratable decrease in ABP with non significant increase in HR.

Beta-Blockers and Cancer: Where Are We?

Cancer is one of the leading causes of death worldwide. After diagnosis, cancer treatment may involve radiotherapy, chemotherapy, and surgery. Several of the approaches used to treat cancer also attack normal cells and, thus, there is the need for more effective treatments that decrease the toxicity to normal cells and increase the success rates of treatment. The use of beta-blockers in cancer has been studied for their antagonist action on the adrenergic system through inhibition of beta-adrenergic receptors. Besides regulating processes such as blood pressure, heart rate, and airway strength or reactivity, beta-blockers block mechanisms that trigger tumorigenesis, angiogenesis, and tumor metastasis. This study presents a literature review of the available studies addressing cancer treatments and beta-blockers. Overall, data suggest that propranolol may be used as a complement for the treatment of several types of cancer due to its ability to improve cancer outcomes by decreasing cancer cell proliferation rates. Nonetheless, additional in vitro studies should be performed to fully understand the protective role of BBs in cancer patients.

Beta-blockers: Historical Perspective and Mechanisms of Action

Beta-blockers are widely used molecules that are able to antagonize β-adrenergic receptors (ARs), which belong to the G protein-coupled receptor family and receive their stimulus from endogenous catecholamines. Upon β-AR stimulation, numerous intracellular cascades are activated, ultimately leading to cardiac contraction or vascular dilation, depending on the relevant subtype and their location. Three subtypes have been described that are differentially expressed in the body (β₁-, β₂- and β₃-ARs), β₁ being the most abundant subtype in the heart. Since their discovery, β-ARs have become an important target to fight cardiovascular disease. In fact, since their discovery by James Black in the late 1950s, β-blockers have revolutionized the field of cardiovascular therapies. To date, 3 generations of drugs have been released: nonselective β-blockers, cardioselective β-blockers (selective β₁-antagonists), and a third generation of these drugs able to block β₁ together with extra vasodilation activity (also called vasodilating β-blockers) either by blocking α₁- or by activating β₃-AR. More than 50 years after propranolol was introduced to the market due to its ability to reduce heart rate and consequently myocardial oxygen demand in the event of an angina attack, β-blockers are still widely used in clinics.

Survey of Pharmacological Activity and Pharmacokinetics of Selected β-Adrenergic Blockers in Regard to Their Stereochemistry

The present survey concentrates on pharmacodynamics and pharmacokinetics of selected β-adrenergic blockers from the point of view of their stereochemistry. It could be shown that the activity in the arylaminoethanol and aryloxyaminopropanol group of β-blockers is higher in their (–)-enantiomers as compared with the (+)-enantiomers. The stereoisomers differ also in other types of bioactivity as well as in toxicity. The particular pharmacokinetic stages such as resorption, distribution, and metabolism are discussed in regard to their stereochemistry.

Screening for Biologically Annotated Drugs That Trigger Triacylglycerol Accumulation in the Diatom Phaeodactylum

Microalgae are a promising feedstock for the production of triacylglycerol (TAG) for a variety of potential applications, ranging from food and human health to biofuels and green chemistry. However, obtaining high TAG yields is challenging. A phenotypic assay for the accumulation of oil droplets was developed to screen a library of 1,200 drugs, annotated with pharmacology information, to select compounds that trigger TAG accumulation in the diatom Phaeodactylum tricornutum Using this screen, we identified 34 molecules acting in a dose-dependent manner. Previously characterized targets of these compounds include cell division and cell signaling effectors, membrane receptors and transporters, and sterol metabolism. Among the five compounds possibly acting on sterol metabolism, we focused our study on ethynylestradiol, a synthetic form of estrogen that is used in contraceptive pills and known for its ecological impact as an endocrine disruptor. Ethynylestradiol impaired the production of very-long-chain polyunsaturated fatty acids, destabilized the galactolipid versus phospholipid balance, and triggered the recycling of fatty acids from membrane lipids to TAG. The P. tricornutum transcriptomic response to treatment with ethynylestradiol was consistent with the reallocation of carbon from sterols to acetyl-coenzyme A and TAG. The mode of action and catabolism of ethynylestradiol are unknown but might involve several up-regulated cytochrome P450 proteins. A fatty acid elongase, Δ6-ELO-B1, might be involved in the impairment of very-long-chain polyunsaturated fatty acids and fatty acid turnover. This phenotypic screen opens new perspectives for the exploration of novel bioactive molecules, potential target genes, and pathways controlling TAG biosynthesis. It also unraveled the sensitivity of diatoms to endocrine disruptors, highlighting an impact of anthropogenic pollution on phytoplankton.

The sympathetic nervous system is controlled by transient receptor potential vanilloid 1 in the regulation of body temperature

Transient receptor potential vanilloid 1 (TRPV1) is involved in sensory nerve nociceptive signaling. Recently, it has been discovered that TRPV1 receptors also regulate basal body temperature in multiple species from mice to humans. In the present study, we investigated whether TRPV1 modulates basal sympathetic nervous system (SNS) activity. C57BL6/J wild-type (WT) mice and TRPV1 knockout (KO) mice were implanted with radiotelemetry probes for measurement of core body temperature. AMG9810 (50 mg/kg) or vehicle (2% DMSO/5% Tween 80/10 ml/kg saline) was injected intraperitoneally. Adrenoceptor antagonists or vehicle (5 ml/kg saline) was injected subcutaneously. In WT mice, the TRPV1 antagonist, AMG9810, caused significant hyperthermia, associated with increased noradrenaline concentrations in brown adipose tissue. The hyperthermia was significantly attenuated by the β-adrenoceptor antagonist propranolol, the mixed α-/β-adrenoceptor antagonist labetalol, and the α1-adrenoceptor antagonist prazosin. TRPV1 KO mice have a normal basal body temperature, indicative of developmental compensation. d-Amphetamine (potent sympathomimetic) caused hyperthermia in WT mice, which was reduced in TRPV1 KO mice, suggesting a decreased sympathetic drive in KOs. This study provides new evidence that TRPV1 controls thermoregulation upstream of the SNS, providing a potential therapeutic target for sympathetic hyperactivity thermoregulatory disorders.

Visual and quantitative screening of α1-adrenoceptor antagonists in living cells using quantum dots

The performance of α1-adrenoceptor antagonists in living cells was assessed using quantum dots conjugated to a derivative of the α1-adrenoceptor antagonist prazosin. The optimum receptor binding condition and apparent Kd of prazosin-conjugated quantum dots was first determined, followed by application of these structures to drug screening. Total internal reflection fluorescence microscopy and flow cytometry were used to visually and quantitatively measure the affinity of five candidate drugs. The observed affinity order and the affinity coefficient Ki were consistent with previously reported values. These results suggest that this method is suitable for specific drug screening in living cells and is able to realize the displacement assay over the large ranges of dissociation constants.

Isoproterenol-induced myocardial infarction in rabbits. Protection by propranolol or labetalol: a proposed non-invasive procedure

Myocardial infarction is usually induced in small animals by means of invasive techniques based on mechanical coronary obstruction. As it has been reported that isoproterenol can cause ischemic myocardial alterations, lipid peroxide generation and procoagulant activity, we administered it to rabbits in order to induce a non-invasive myocardial infarction associated with above mentioned cardiovascular risk factors. Considerable ischemic alterations were observed in the animals treated with isoproterenol, including areas of myocardial necrosis, contraction band necrosis, increased plasma levels of cardiac necrosis markers (c-troponin I and myoglobin), and electrocardiographic modifications (ST segment changes and T wave inversion). The myocardial infarction was attributed to the inotropic activity of isoproterenol leading to intracellular calcium overload. The cardiac necrosis phenomena appear to be associated with isoproterenol-induced lipid peroxide generation (as shown by the decrease in plasma Vitamin E levels) and increased procoagulant activity (a shortened PTT). As this model of myocardial damage is based on the use of beta-stimulatory isoproterenol, the beta-blockers propranolol and labetalol were administered to isoproterenol-treated animals. Pretreatment with propranolol or labetalol counteracted the appearance of the myocardial histological alterations and the associated ECG and biochemical lesions. This protective activity was attributed to the beta-blockade. The results of this study demonstrate that myocardial infarction can be induced chemically and non-invasively in small laboratory animals. The procedure is proposed for the study of early ischemic myocardial lesions and the screening of drugs (such as beta-blockers) that can prevent myocardial necrosis damage and the associated risk factors.

Effects of optical isomers of clenbuterol on the relaxant response in rat uterus

Previous works have shown that the administration of the racemic beta -adrenoceptor agent clenbuterol produces a desensitization of the relaxant response in rat uterus. The aim of this work was to study the effects of the optical isomers of clenbuterol on the relaxant response in rat uterus. The administration of (L)-clenbuterol (0.25 mg per kg per day) over 1 or 10 consecutive days, produced a reduction of the relaxant response to isoproterenol in uterine rings precontracted with 50 m m KCl from oestrogenic rats. The administration of (D)-clenbuterol (0.25 mg per kg per day) over 1 or 10 days did not affect the relaxant response of isoproterenol. (L)-clenbuterol also produced a concentration-dependent relaxant effect that was not observed with (D)-clenbuterol. These results show that the beta-adrenergic relaxant response and the desensitization of the relaxant effect to isoproterenol is due to the (L)-isomer and that the (D)-isomer is not involved in these effects.

Investigations on the stereoselective action of isoxsuprine on alpha- and beta-adrenoceptors in equine common digital artery

The affinity and functional effects of isoxsuprine enantiomers were investigated to determine the enantiospecificity of the beta-agonistic and alpha-blocking effects. Functional assays on isolated smooth muscle preparations from equine common digital artery were performed to determine the apparent affinity (pD(2)) and intrinsic activity (alpha(E)) of (-)erythro-isoxsuprine (alphaS, betaR, gammaR) and (+)erythro-isoxsuprine (alphaR, betaS, gammaS). The affinity of two enantiomers for the different adrenoceptor types was studied by radioligand binding assays on membrane preparations from the same tissue, using (-)[(3)H]CGP12177 and [(3)H]prazosin. On noradrenaline-precontracted artery preparations (-)isoxsuprine was markedly more potent than (+)isoxsuprine in dilating preparations, indicating that the laevorotatory enantiomer has a very high apparent affinity for alpha-adrenoceptors. Binding studies confirmed that (-)isoxsuprine has a higher affinity than (+)isoxsuprine for alpha-adrenoceptors, while the (+) isomer competes for beta-adrenoceptors with an affinity similar to that of propranolol. As described for other beta-phenylethylamines, the two isoxsuprine enantiomers studied have different efficacies for alpha- and beta-adrenoceptors and the effects of the commercially available mixture of stereoisomers therefore depend on the density and functional importance of the adrenoceptor types present in the tissue studied. 1999 Academic Press.

Influence of Vasodilator Drugs on Perioperative Blood Pressure

Survey results are given of the incidence and the etiology of perioperative hypertension in patients sub jected to coronary artery surgery. Over the years, numer ous types of antihypertensives have been used for intravenous administration with the aim of preventing or treating perioperative hypertension. Nitrovasodilator compounds such as sodium nitroprusside and nitroglyc erin (NTG), a few calcium antagonists (nifedipine, nicar dipine and isradipine), the short-acting β-blocker esmo lol, clonidine, and the multifactorial compounds labetalol and ketanserin are discussed in detail. Perioperatively, there is an increasing level of plasma catecholamines, causing α-adrenoceptor stimulation. This indicates that α-adrenoceptor blockade with appropriate antagonists is a logical approach for the treatment of perioperative hypertension. For this reason, the multifactorial agent urapidil, which is an α-adrenoceptor blocker and a 5-HT1A agonist, is discussed extensively.

Influence of corticotropin-releasing hormone on electrophysiological activity of locus coeruleus neurons

These experiments examined the effects of corticotropin-releasing hormone (CRH) on single-unit electrophysiological activity of locus coeruleus (LC) neurons. As has been reported previously, infusion of CRH into the ventricular system of the brain (i.c.v.) of halothane-anesthetized adult male rats increased spontaneous discharge rate of LC neurons while producing no increase, and possibly a decrease, in sensory-evoked activity. However, when i.c.v. CRH was given to female rats or immature male rats, which had not been studied previously, LC activity was not altered. To attempt to understand this sex and age difference, potential mechanisms by which i.c.v. CRH elevates LC spontaneous activity in adult male rats were examined; in that i.c.v. CRH activates the pituitary-adrenal axis and autonomic nervous system, these response systems were manipulated. Adrenalectomy (with or without corticosterone replacement by pellet) did not affect the ability of i.c.v. CRH to increase LC spontaneous activity in adult male animals, but blockade of sympathetically-mediated autonomic responses, either by chlorisondamine or the beta adrenergic receptor blocker timolol, blocked this increase, indicating that afferent feedback from peripheral autonomic responses was critical for activating LC neurons following i.c.v. CRH. To determine whether CRH neurotransmission might play a role in this feedback pathway, the CRH antagonist alpha-helical CRH (alpha-hCRH) was microinjected into several brain regions including LC prior to i.c.v. CRH. alpha-hCRH microinjected into LC reduced the increase in LC activity caused by i.c.v. CRH; however, blockade of this increase was total when alpha-hCRH was microinjected into the lateral parabrachial nucleus ipsilateral to the LC recording site, suggesting that increased LC activity following i.c.v. CRH is mediated by CRH acting in the parabrachial region. During these studies, it was also observed that microinjection of alpha-hCRH into LC increased LC spontaneous discharge rate; consequently, CRH was microinjected into LC, and produced a dose-dependent decrease in LC spontaneous activity in both male and female rats, which could be blocked by microinjection of alpha-hCRH - these data indicated that the direct influence of CRH on LC neurons is to decrease their spontaneous activity. To reconcile this with the original report that CRH applied to LC neurons increases their activity, one possibility suggested is that the CRH microinjection procedure used in the present study stimulated inhibitory receptors on LC dendrites whereas the original study stimulated excitatory receptors on LC cell bodies. It is concluded that an inhibitory influence of CRH on LC activity is consistent with recent data indicating that decreased LC activity increases anxiety and stress-related responses, but that direct influences of CRH appear rather minor in determining LC neuronal activity in comparison to other inputs to LC such as are seen after i.c.v. CRH infusion.

Sensitive high-performance liquid chromatographic method for the determination of labetalol diastereoisomers in plasma samples without derivatization

A direct high-performance liquid chromatographic assay for the determination of labetalol diastereoisomers in plasma without derivatization was developed. Baseline resolution of diastereoisomers was accomplished on a C18 bonded reversed-phase polymeric column with a basic (pH 11.5) mobile phase and isocratic elution. Sample treatment was optimized in order to achieve a complete extraction of labetalol diastereoisomers and to avoid racemization during extraction. Fluorimetric detection improved the selectivity and afforded a detection limit of 3 ng/ml for each diastereoisomer. This method is suitable for routine quantification of labetalol diastereoisomers and has been applied to a pharmacokinetic study in small laboratory animals.

An overview of the pharmacodynamic properties and therapeutic potential of combined alpha- and beta-adrenoceptor antagonists

Haemodynamically, the combination of alpha 1- and beta-adrenoceptor antagonists is a logical one. alpha 1-Adrenoceptor blockade causes vasodilatation and hence counteracts elevated peripheral vascular resistance, the most consistent haemodynamic derangement in established essential hypertension. beta-Blockers, which lower elevated blood pressure by a different (not yet clearly understood) mechanism, suppress the reflex tachycardia triggered by vasodilatation. Combined alpha/beta-adrenoceptor blockade can be obtained by the simultaneous administration of both types of adrenoceptor antagonists, but also by giving drugs that possess alpha- and beta-adrenoceptor antagonistic activity in the same molecule. Carvedilol and labetalol are the best known examples of such combined alpha/beta-adrenoceptor antagonists, although their pharmacodynamic profile is a result of different receptor selectivity of their component stereoisomers, rather than combined alpha/beta-blocking activity in a single chemical entity. Both compounds have been investigated clinically in the treatment of essential hypertension in moderate-to-large scale trials. A few newer combined alpha/beta-adrenoceptor antagonists, such as amosulalol, arotinolol and medroxalol have been developed, but clinical data on these compounds are relatively scarce.

Reversed-phase high-performance liquid chromatographic separation of the stereoisomers of labetalol via derivatization with chiral and non-chiral isothiocyanate reagents

The antihypertensive agent labetalol is a mixture of two racemates. We report reversed-phase high-performance liquid chromatographic (HPLC) methodology for the separation of the four stereoisomers of labetalol via derivatization with the chiral reagent (4S-cis)-2,2-dimethyl-5-isothiocyanato-4-phenyl-1,3-dioxane. The derivatives were separated on octadecylsilane columns with a methanol-ammonium phosphate buffer mixture as mobile phase. Separations of the diastereomeric forms of labetalol were achieved with the non-chiral derivatizing reagents benzyl isothiocyanate and 1-naphthalenemethyl isothiocyanate. In all cases the derivatives of the R,S/S,R forms eluted before those of the R,R/S,S forms. Isothiocyanates may have general utility in stereoisomer separations of amines by HPLC.