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. 1985 Sep;76(3):1096–1101. doi: 10.1172/JCI112063

Terbutaline-induced desensitization of human lymphocyte beta 2-adrenoceptors. Accelerated restoration of beta-adrenoceptor responsiveness by prednisone and ketotifen.

O E Brodde, M Brinkmann, R Schemuth, N O'Hara, A Daul
PMCID: PMC423996  PMID: 2995446

Abstract

We investigated, in 36 healthy volunteers, the effects of prednisone and ketotifen on recovery of lymphocyte beta 2-adrenoceptor density (determined by (-)-125iodocyanopindolol binding) and responsiveness (assessed by lymphocyte cyclic AMP [cAMP] responses to 10 microM (-)-isoprenaline) after desensitization by the beta 2-agonist terbutaline. Terbutaline (3 X 5 mg/d) decreased lymphocyte beta 2-adrenoceptor density by approximately 40-50%; concomitantly, lymphocyte cAMP responses to 10 microM (-)-isoprenaline were significantly reduced. After withdrawal of terbutaline beta 2-adrenoceptor, density and responsiveness gradually increased, reaching predrug levels after 4 d. Prednisone (1 X 100 mg orally) accelerated beta 2-adrenoceptor recovery; only 8-10 h after administration of the steroid beta 2-adrenoceptor density and cAMP responses to (-)-isoprenaline had reached values not significantly different from pretreatment levels. Similar effects were obtained with ketotifen (2 mg; thereafter 2 X 1 mg/d for 4 d): 24 h after application of the drug beta 2-adrenoceptor density and cAMP responses to (-)-isoprenaline had reached pretreatment levels. Furthermore, ketotifen simultaneously applied with terbutaline completely prevented terbutaline-induced decrease in lymphocyte beta 2-adrenoceptor density and responsiveness. Prednisone (1 X 100 mg orally) or ketotifen (2 mg; thereafter 2 X 1 mg/d for 2 d) had no significant influence on lymphocyte beta 2-adrenoceptor density in healthy volunteers not pretreated with terbutaline, but shifted the ratio high-to-low affinity state of the lymphocyte beta 2-adrenoceptor toward high affinity state. We conclude that glucocorticoids as well as ketotifen can accelerate recovery of density and responsiveness of lymphocyte beta 2-adrenoceptors desensitized by long-term treatment with beta 2-agonists. Such an effect may have clinical implications for preventing tachyphylaxis of asthmatic patients against therapy with beta 2-agonists.

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Selected References

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  1. Aarons R. D., Nies A. S., Gerber J. G., Molinoff P. B. Decreased beta adrenergic receptor density on human lymphocytes after chronic treatment with agonists. J Pharmacol Exp Ther. 1983 Jan;224(1):1–6. [PubMed] [Google Scholar]
  2. Besse J. C., Bass A. D. Potentiation by hydrocortisone of responses to catecholamines in vascular smooth muscle. J Pharmacol Exp Ther. 1966 Nov;154(2):224–238. [PubMed] [Google Scholar]
  3. Bretz U., Martin U., Mazzoni L., Ney U. M. beta-Adrenergic tachyphylaxis in the rat and its reversal and prevention by ketotifen. Eur J Pharmacol. 1983 Jan 21;86(3-4):321–328. doi: 10.1016/0014-2999(83)90180-2. [DOI] [PubMed] [Google Scholar]
  4. Brodde O. E., Daul A., O'Hara N. Beta-adrenoceptor changes in human lymphocytes, induced by dynamic exercise. Naunyn Schmiedebergs Arch Pharmacol. 1984 Feb;325(2):190–192. doi: 10.1007/BF00506201. [DOI] [PubMed] [Google Scholar]
  5. Brodde O. E., Engel G., Hoyer D., Bock K. D., Weber F. The beta-adrenergic receptor in human lymphocytes: subclassification by the use of a new radio-ligand, (+/-)-125 Iodocyanopindolol. Life Sci. 1981 Nov 23;29(21):2189–2198. doi: 10.1016/0024-3205(81)90490-2. [DOI] [PubMed] [Google Scholar]
  6. Chuang D. M., Costa E. Evidence for internalization of the recognition site of beta-adrenergic receptors during receptor subsensitivity induced by (-)-isoproterenol. Proc Natl Acad Sci U S A. 1979 Jun;76(6):3024–3028. doi: 10.1073/pnas.76.6.3024. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Conolly M. E., Davies D. S., Dollery C. T., George C. F. Resistance to -adrenoceptor stimulants (a possible explanation for the rise in ashtma deaths). Br J Pharmacol. 1971 Oct;43(2):389–402. [PMC free article] [PubMed] [Google Scholar]
  8. Conolly M. E., Greenacre J. K. The lymphocyte beta-adrenoceptor in normal subjects and patients with bronchial asthma: the effect of different forms of treatment on receptor function. J Clin Invest. 1976 Dec;58(6):1307–1316. doi: 10.1172/JCI108586. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Davies A. O., Lefkowitz R. J. Agonist-promoted high affinity state of the beta-adrenergic receptor in human neutrophils: modulation by corticosteroids. J Clin Endocrinol Metab. 1981 Oct;53(4):703–708. doi: 10.1210/jcem-53-4-703. [DOI] [PubMed] [Google Scholar]
  10. Davies A. O., Lefkowitz R. J. Corticosteroid-induced differential regulation of beta-adrenergic receptors in circulating human polymorphonuclear leukocytes and mononuclear leukocytes. J Clin Endocrinol Metab. 1980 Sep;51(3):599–605. doi: 10.1210/jcem-51-3-599. [DOI] [PubMed] [Google Scholar]
  11. Davies A. O., Lefkowitz R. J. In vitro desensitization of beta adrenergic receptors in human neutrophils. Attenuation by corticosteroids. J Clin Invest. 1983 Mar;71(3):565–571. doi: 10.1172/JCI110801. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Davies A. O., Lefkowitz R. J. Regulation of beta-adrenergic receptors by steroid hormones. Annu Rev Physiol. 1984;46:119–130. doi: 10.1146/annurev.ph.46.030184.001003. [DOI] [PubMed] [Google Scholar]
  13. Davis C., Conolly M. E. Tachyphylaxis to beta-adrenoceptor agonists in human bronchial smooth muscle: studies in vitro. Br J Clin Pharmacol. 1980 Nov;10(5):417–423. doi: 10.1111/j.1365-2125.1980.tb01782.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Ellul-Micallef R., Fenech F. F. Effect of intravenous prednisolone in asthmatics with diminished adrenergic responsiveness. Lancet. 1975 Dec 27;2(7948):1269–1271. doi: 10.1016/s0140-6736(75)90608-x. [DOI] [PubMed] [Google Scholar]
  15. Engel G., Hoyer D., Berthold R., Wagner H. (+/-)[125Iodo] cyanopindolol, a new ligand for beta-adrenoceptors: identification and quantitation of subclasses of beta-adrenoceptors in guinea pig. Naunyn Schmiedebergs Arch Pharmacol. 1981;317(4):277–285. doi: 10.1007/BF00501307. [DOI] [PubMed] [Google Scholar]
  16. Exton J. H., Friedmann N., Wong E. H., Brineaux J. P., Corbin J. D., Park C. R. Interaction of glucocorticoids with glucagon and epinephrine in the control of gluconeogenesis and glycogenolysis in liver and of lipolysis in adipose tissue. J Biol Chem. 1972 Jun 10;247(11):3579–3588. [PubMed] [Google Scholar]
  17. Galant S. P., Duriseti L., Underwood S., Allred S., Insel P. A. Beta adrenergic receptors of polymorphonuclear particulates in bronchial asthma. J Clin Invest. 1980 Mar;65(3):577–585. doi: 10.1172/JCI109702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Galant S. P., Duriseti L., Underwood S., Insel P. A. Decreased beta-adrenergic receptors on polymorphonuclear leukocytes after adrenergic therapy. N Engl J Med. 1978 Oct 26;299(17):933–936. doi: 10.1056/NEJM197810262991707. [DOI] [PubMed] [Google Scholar]
  19. Gilman A. G. A protein binding assay for adenosine 3':5'-cyclic monophosphate. Proc Natl Acad Sci U S A. 1970 Sep;67(1):305–312. doi: 10.1073/pnas.67.1.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Greenacre J. K., Schofield P., Conolly M. E. Desensitization of the beta-adrenoceptor of lymphocytes from normal subjects and asthmatic patients in vitro. Br J Clin Pharmacol. 1978 Mar;5(3):199–206. doi: 10.1111/j.1365-2125.1978.tb01624.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Harden T. K. Agonist-induced desensitization of the beta-adrenergic receptor-linked adenylate cyclase. Pharmacol Rev. 1983 Mar;35(1):5–32. [PubMed] [Google Scholar]
  22. Holgate S. T., Baldwin C. J., Tattersfield A. E. beta-adrenergic agonist resistance in normal human airways. Lancet. 1977 Aug 20;2(8034):375–377. doi: 10.1016/s0140-6736(77)90304-x. [DOI] [PubMed] [Google Scholar]
  23. Hui K. K., Conolly M. E., Tashkin D. P. Reversal of human lymphocyte beta-adrenoceptor desensitization by glucocorticoids. Clin Pharmacol Ther. 1982 Nov;32(5):566–571. doi: 10.1038/clpt.1982.204. [DOI] [PubMed] [Google Scholar]
  24. Jenne J. W., Chick T. W., Strickland R. D., Wall F. J. Subsensitivity of beta responses during therapy with a long-acting beta-2 preparation. J Allergy Clin Immunol. 1977 May;59(5):383–390. doi: 10.1016/0091-6749(77)90023-9. [DOI] [PubMed] [Google Scholar]
  25. Kalsner S. Steroid potentiation of responses to sympathomimetic amines in aortic strips. Br J Pharmacol. 1969 Jul;36(3):582–593. doi: 10.1111/j.1476-5381.1969.tb08013.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Kaumann A. J. Potentiation of the effects of isoprenaline and noradrenaline by hydrocortisone in cat heart muscle. Naunyn Schmiedebergs Arch Pharmacol. 1972;273(1):134–153. doi: 10.1007/BF00508086. [DOI] [PubMed] [Google Scholar]
  27. Kumagai A., Tomioka H., Shida T., Takahashi T., Muranaka M. Clinical evaluation of a new orally active anti-anaphylactic compound: ketotifen (HC 20-511) in Japanese adult asthmatics. Schweiz Med Wochenschr. 1980 Feb 9;110(6):197–203. [PubMed] [Google Scholar]
  28. Landmann R. M., Bürgisser E., Wesp M., Bühler F. R. Beta-adrenergic receptors are different in subpopulations of human circulating lymphocytes. J Recept Res. 1984;4(1-6):37–50. doi: 10.3109/10799898409042538. [DOI] [PubMed] [Google Scholar]
  29. Lane D. J. A steroid sparing effect of ketotifen in steroid-dependent asthmatics. Clin Allergy. 1980 Sep;10(5):519–525. doi: 10.1111/j.1365-2222.1980.tb02132.x. [DOI] [PubMed] [Google Scholar]
  30. Lebeau B., Gence B., Bourdain M., Loria Y. Le kétotifène dans le traitement préventif de l'asthme. Analyse synthétique de 1 791 observations de médecine praticienne. Poumon Coeur. 1982 Mar-Apr;38(2):125–129. [PubMed] [Google Scholar]
  31. Lee T. P. Regulation of beta-adrenergic response in human lymphocytes: agonist induced subsensitivity. Res Commun Chem Pathol Pharmacol. 1978 Nov;22(2):233–242. [PubMed] [Google Scholar]
  32. Lefkowitz R. J., Caron M. G., Michel T., Stadel J. M. Mechanisms of hormone receptor-effector coupling: the beta-adrenergic receptor and adenylate cyclase. Fed Proc. 1982 Aug;41(10):2664–2670. [PubMed] [Google Scholar]
  33. Morris H. G., Rusnak S. A., Selner J. C., Barzens K., Barnes J. Adrenergic desensitization in leukocytes of normal and asthmatic subjects. J Cyclic Nucleotide Res. 1977 Dec;3(6):439–446. [PubMed] [Google Scholar]
  34. Motulsky H. J., Insel P. A. Adrenergic receptors in man: direct identification, physiologic regulation, and clinical alterations. N Engl J Med. 1982 Jul 1;307(1):18–29. doi: 10.1056/NEJM198207013070104. [DOI] [PubMed] [Google Scholar]
  35. Nelson H. S., Raine D., Jr, Doner H. C., Posey W. C. Subsensitivity to the bronchodilator action of albuterol produced by chronic administration. Am Rev Respir Dis. 1977 Nov;116(5):871–878. doi: 10.1164/arrd.1977.116.5.871. [DOI] [PubMed] [Google Scholar]
  36. Paietta E., Schwarzmeier J. D. Differences in beta-adrenergic receptor density and adenylate cyclase activity between normal and leukaemic leukocytes. Eur J Clin Invest. 1983 Aug;13(4):339–346. doi: 10.1111/j.1365-2362.1983.tb00110.x. [DOI] [PubMed] [Google Scholar]
  37. Samuelson W. M., Davies A. O. Hydrocortisone-induced reversal of beta-adrenergic receptor uncoupling. Am Rev Respir Dis. 1984 Dec;130(6):1023–1026. doi: 10.1164/arrd.1984.130.6.1023. [DOI] [PubMed] [Google Scholar]
  38. Sano Y., Watt G., Townley R. G. Decreased mononuclear cell beta-adrenergic receptors in bronchial asthma: parallel studies of lymphocyte and granulocyte desensitization. J Allergy Clin Immunol. 1983 Nov;72(5 Pt 1):495–503. doi: 10.1016/0091-6749(83)90587-0. [DOI] [PubMed] [Google Scholar]
  39. Scarpace P. J., Littner M. R., Tashkin D. P., Abrass I. B. Lymphocyte beta-adrenergic refractoriness induced by theophylline or metaproterenol in healthy and asthmatic subjects. Life Sci. 1982 Oct 11;31(15):1567–1573. doi: 10.1016/0024-3205(82)90048-0. [DOI] [PubMed] [Google Scholar]
  40. Schwabe U., Ebert R. Different effects of lipolytic hormones and phosphodiesterase inhibitors on cyclic 3',5'-AMP levels in isolated fat cells. Naunyn Schmiedebergs Arch Pharmacol. 1972;274(3):287–298. doi: 10.1007/BF00501938. [DOI] [PubMed] [Google Scholar]
  41. Stadel J. M., Strulovici B., Nambi P., Lavin T. N., Briggs M. M., Caron M. G., Lefkowitz R. J. Desensitization of the beta-adrenergic receptor of frog erythrocytes. Recovery and characterization of the down-regulated receptors in sequestered vesicles. J Biol Chem. 1983 Mar 10;258(5):3032–3038. [PubMed] [Google Scholar]
  42. Stephan W. C., Chick T. W., Avner B. P., Jenne J. W. Tachyphylaxis to inhaled isoproterenol and the effect of methylprednisolone in dogs. J Allergy Clin Immunol. 1980 Feb;65(2):105–109. doi: 10.1016/0091-6749(80)90193-1. [DOI] [PubMed] [Google Scholar]
  43. Stiles G. L., Caron M. G., Lefkowitz R. J. Beta-adrenergic receptors: biochemical mechanisms of physiological regulation. Physiol Rev. 1984 Apr;64(2):661–743. doi: 10.1152/physrev.1984.64.2.661. [DOI] [PubMed] [Google Scholar]
  44. Su Y. F., Harden T. K., Perkins J. P. Catecholamine-specific desensitization of adenylate cyclase. Evidence for a multistep process. J Biol Chem. 1980 Aug 10;255(15):7410–7419. [PubMed] [Google Scholar]
  45. Tashkin D. P., Conolly M. E., Deutsch R. I., Hui K. K., Littner M., Scarpace P., Abrass I. Subsensitization of beta-adrenoceptors in airways and lymphocytes of healthy and asthmatic subjects. Am Rev Respir Dis. 1982 Feb;125(2):185–193. doi: 10.1164/arrd.1982.125.2.185. [DOI] [PubMed] [Google Scholar]
  46. Weber R. W., Smith J. A., Nelson H. S. Aerosolized terbutaline in asthmatics: development of subsensitivity with long-term administration. J Allergy Clin Immunol. 1982 Dec;70(6):417–422. doi: 10.1016/0091-6749(82)90003-3. [DOI] [PubMed] [Google Scholar]
  47. van den Berg W., Leferink J. G., Fokkens J. K., Kreukniet J., Maes R. A., Bruynzeel P. L. Clinical implications of drug-induced desensitization of the beta receptor after continuous oral use of terbutaline. J Allergy Clin Immunol. 1982 May;69(5):410–417. doi: 10.1016/0091-6749(82)90115-4. [DOI] [PubMed] [Google Scholar]

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