Norepinephrine infusion with and without alpha-adrenergic blockade by phentolamine increases salivary alpha amylase in healthy men

BACKGROUND: Mental stress reliably induces increases in salivary alpha amylase (sAA), a suggested surrogate marker for sympathetic nervous system (SNS) reactivity. While stress-induced sAA increases correlate with norepinephrine (NE) secretion, a potential mediating role of noradrenergic mechanisms remains unclear. In this study, we investigated for the first time in humans whether a NE-stress-reactivity mimicking NE-infusion with and without alpha-adrenergic blockade by phentolamine would induce changes in sAA. METHODS: In a single-blind placebo-controlled within-subjects design, 21 healthy men (29-66 years) took part in three different experimental trials varying in terms of substance infusion with a 1-min first infusion followed by a 15-min second infusion: saline-infusion (trial-1), NE-infusion (5 μg/min) without alpha-adrenergic blockade (trial-2), and with phentolamine-induced non-selective blockade of alpha1- and alpha2-adrenergic receptors (trial-3). Saliva samples were collected immediately before, during, and several times after substance infusion in addition to blood pressure and heart rate readings. RESULTS: Experimental trials significantly differed in sAA reactivity to substance-infusion (p=.001) with higher sAA reactivity following NE-infusion with (trial-3; p=.001) and without alpha-adrenergic-blockade (trial-2; p=.004) as compared to placebo-infusion (trial-1); sAA infusion reactivity did not differ between trial-2 and trial-3 (p=.29). Effective phentolamine application was verified by blood pressure and heart rate infusion reactivity. Salivary cortisol was not affected by NE, either with or without alpha-adrenergic-blockade. CONCLUSIONS: We found that NE-infusion stimulates sAA secretion, regardless of co-administered non-selective alpha-adrenergic blockade by phentolamine, suggesting that the mechanism underlying stress-induced sAA increases may involve NE.

Insulin resistance in mice lacking neuronal nitric oxide synthase is related to an alpha-adrenergic mechanism

BACKGROUND: nitric oxide (NO) plays an important role in the regulation of cardiovascular and glucose homeostasis. Mice lacking the gene encoding the neuronal isoform of nitric oxide synthase (nNOS) are insulin-resistant, but the underlying mechanism is unknown. nNOS is expressed in skeletal muscle tissue where it may regulate glucose uptake. Alternatively, nNOS driven NO synthesis may facilitate skeletal muscle perfusion and substrate delivery. Finally, nNOS dependent NO in the central nervous system may facilitate glucose disposal by decreasing sympathetic nerve activity. METHODS: in nNOS null and control mice, we studied whole body glucose uptake and skeletal muscle blood flow during hyperinsulinaemic clamp studies in vivo and glucose uptake in skeletal muscle preparations in vitro. We also examined the effects of alpha-adrenergic blockade (phentolamine) on glucose uptake during the clamp studies. RESULTS: as expected, the glucose infusion rate during clamping was roughly 15 percent lower in nNOS null than in control mice (89 (17) vs 101 (12) [-22 to -2]). Insulin stimulation of muscle blood flow in vivo, and intrinsic muscle glucose uptake in vitro, were comparable in the two groups. Phentolamine, which had no effect in the wild-type mice, normalised the insulin sensitivity in the mice lacking the nNOS gene. CONCLUSIONS: insulin resistance in nNOS null mice was not related to defective insulin stimulation of skeletal muscle perfusion and substrate delivery or insulin signaling in the skeletal muscle cell, but to a sympathetic alpha-adrenergic mechanism.

Beta-adrenergic blockade and intravenous nutrient-induced thermogenesis in lean and obese women.

Continuous respiratory exchange measurements were performed in nine obese and eight lean women for 1 h before, 3 h during, and 1 h after the intravenous administration of a nutrient mixture infused at twice the postabsorptive resting energy expenditure (REE). This experiment was conducted without or with beta-adrenergic blockade (iv propranolol). Propranolol administration did not change the postabsorptive REE [i.e., 1.03 +/- 0.07 before vs. 1.01 +/- 0.02 kcal/min after administration in lean women and 1.16 +/- 0.04 vs. 1.15 +/- 0.03 kcal/min (NS) in obese women]. The mean overall thermogenic response expressed as a percentage of the infused energy was similar in both groups and was not significantly blunted after propranolol infusion [6.9 +/- 0.4 vs. 5.9 +/- 0.6% in the lean women and 7.5 +/- 0.5 vs. 7.1 +/- 0.6% (NS) in the obese women]. During beta-adrenergic blockade the rate of lipid oxidation decreased in the lean group but was unchanged in the obese group and the glycemic response to nutrient administration was significantly higher in both groups than without propranolol. It is concluded that beta-adrenergic blockade has no effect on REE and on intravenous nutrient-induced thermogenesis in both lean and obese women.

Cardiovascular response to beta-adrenergic blockade or activation in 23 inbred mouse strains.

We report the characterisation of 27 cardiovascular-related traits in 23 inbred mouse strains. Mice were phenotyped either in response to chronic administration of a single dose of the beta-adrenergic receptor blocker atenolol or under a low and a high dose of the beta-agonist isoproterenol and compared to baseline condition. The robustness of our data is supported by high trait heritabilities (typically H(2)>0.7) and significant correlations of trait values measured in baseline condition with independent multistrain datasets of the Mouse Phenome Database. We then focused on the drug-, dose-, and strain-specific responses to beta-stimulation and beta-blockade of a selection of traits including heart rate, systolic blood pressure, cardiac weight indices, ECG parameters and body weight. Because of the wealth of data accumulated, we applied integrative analyses such as comprehensive bi-clustering to investigate the structure of the response across the different phenotypes, strains and experimental conditions. Information extracted from these analyses is discussed in terms of novelty and biological implications. For example, we observe that traits related to ventricular weight in most strains respond only to the high dose of isoproterenol, while heart rate and atrial weight are already affected by the low dose. Finally, we observe little concordance between strain similarity based on the phenotypes and genotypic relatedness computed from genomic SNP profiles. This indicates that cardiovascular phenotypes are unlikely to segregate according to global phylogeny, but rather be governed by smaller, local differences in the genetic architecture of the various strains.

Effects of adrenergic blockade on hepatic glucose production during ethanol administration.

Acute ethanol administration stimulates sympathetic nervous system activity. The present study was designed to determine whether this sympathetic activation affects glycogenolysis and total hepatic glucose production (HGP) during ethanol-induced inhibition of gluconeogenesis. Nineteen volunteers participated in four protocols. Two protocols aimed to study--using combined infusion of [6,6-2H2]glucose and [U-13C]glucose, VCO2 and 13CO2 measurements--the effects of ethanol infusion alone (n = 10) or with propranolol (n = 6) or phentolamine infusion (n = 4) on HGP, glucose disposal (Rd), glucose oxidation [13C]Glcox and non-oxidative glucose disposal (NOGD = Rd - [13C]Glcox). The fourth protocol assessed the effects of saline infusion alone on HGP. Using ethanol, HGP decreased by 23%, Rd by 20% and glycaemia by 9% (all P < 0.001); heart rate increased by 10%, whereas blood pressure remained unchanged. The effects were not observed with saline, except a slight (10%) decrease in HGP (P < 0.01 vs. ethanol). Ethanol did not affect [13C]Glcox but decreased NOGD by 73% (P < 0.001). Propranolol or phentolamine did not alter any of the effects of ethanol on glucose metabolism, but decreased mean arterial pressure. Propranolol prevented the ethanol-induced increase in heart rate. In conclusion, ethanol decreased blood glucose by decreasing HGP, presumably by inhibiting gluconeogenesis. Sympathetic activation prevented the decrease in blood pressure produced by ethanol but did not stimulate glycogenolysis.

Insulin resistance in mice lacking neuronal nitric oxide synthase is related to an alpha-adrenergic mechanism

Rapport de synthèse : Le monoxyde d'azote (NO) joue un rôle important dans la régulation de l'homéostasie du système cardiovasculaire et du glucose. Les souris déficientes pour le gène codant l'isoforme neuronale de la synthase de monoxyde d'azote (nNOS) sont résistantes à l'insuline, mais les mécanismes sous-jacents sont inconnus. Le manque de NO produit par la nNOS pourrait être à l'origine d'une diminution de la perfusion du muscle squelettique et ainsi d'une diminution de l'apport de substrat. Alternativement, le déficit de nNOS normalement hautement exprimé dans le tissu musculaire squelettique pourrait directement y perturber la consommation de glucose. Finalement l'absence de l'action sympatholytique du NO neuronal pourrait diminuer la sensibilité à l'insuline. Afin de tester ces hypothèses nous avons étudié, chez des souris déficientes en nNOS et des souris-contrôle, la consommation corporelle totale de glucose et le flux musculaire squelettique pendant des clamps hyperinsulinémiques euglycémiques in vivo, ainsi que la consommation de glucose dans le muscle squelettique in vitro. De plus nous avons analysé les effets d'une inhibition alpha-adrénergique sur la consommation de glucose pendant les clamps hyperinsulinémiques euglycémiques in vivo. Le taux de perfusion de glucose pendant les clamps était grossièrement 15 pourcent plus bas (P<0.001) chez les souris déficientes en nNOS que chez les souris-contrôle. Cette résistance à l'insuline chez les souris déficientes en nNOS n'était due ni à une stimulation déficiente du flux sanguin musculaire par l'insuline ni à un défaut intrinsèque de la consommation de glucose du muscle (qui étaient comparables dans les deux groupes), mais à un mécanisme alpha-adrénergique, car l'administration de phentolamine rétablissait la sensibilité à l'insuline chez les souris déficientes en nNOS. Ces résultats suggèrent qu'une hyperactivité sympathique, potentiellement due à la perte de l'inhibition neuronale centrale du flux sympathique par le NO provenant de nNOS, contribue à la résistance à l'insuline des souris déficientes en nNOS. Par ailleurs ces résultats tendent à prouver qu'un défaut de production de NO provoquerait une résistance à l'insuline par des mécanismes différents selon l'isoforme de NO synthase déficiente (par exemple chez les souris déficientes pour la forme endothéliale de NO synthase, il a été montré que la résistance à l'insuline est due à un défaut de stimulation de la perfusion musculaire par l'insuline et à un défaut du signalling de l'insuline dans la cellule musculaire squelettique). Chez l'être humain il est établi que les états de résistance à l'insuline sont associés à une synthèse défectueuse et/ou une mauvaise biodisponibilité du NO, ainsi qu'à une hyperactivité sympathique. Nous spéculons que la perte d'inhibition centrale du flux sympathique représente un mécanisme contribuant à la résistance à l'insuline et ses complications cardiovasculaires chez l'être humain.

Effects of central alpha-adrenergic agonists on hormone-induced 3% NaCl and water intake

Male rats received intracerebroventricular (ICV) renin (600 ng) or daily subcutaneous injections of deoxycorticosterone (5 mg) to induce 3% NaCl and water intake. Noradrenaline (NOR; 40-160 nmol) and clonidine (CLO; 5-20 nmol) injected ICV. induced 70 to 100% inhibition of the intakes. Phenylephrine (PHE; 40-160 nmol) injected ICV induced 60 to 95% inhibition of the intakes. NOR and PHE induced a stronger inhibition on the 3% NaCl intake induced by renin than on the intake induced by deoxycorticosterone (DOC), and CLO did the opposite. CLO was always more effective than PHE to induce inhibition of the intakes. The results suggest that NOR inhibits hormone (angiotensin II, aldosterone)-induced NaCl intake by acting mainly on alpha(2)-adrenergic receptors.

Central alpha-adrenergic agonists and need-induced 3% NaCl and water intake

In the present study, noradrenaline (NOR, alpha-non-specific adrenergic agonist), clonidine (CLO, alpha(2)), phenylephrine (PHE, alpha(1)) or isoproterenol (ISO, beta-agonist) was injected in the medial septal area (MSA) of water-deprived, sodium-deplete or food-deprived rats. NOR (80, 160 nmol) inhibited the intake of 3% NaCl, water deprivation-induced and meal-associated water intake. Food deprivation-induced food intake and 10% sucrose intake were not altered by NOR. CLO (10, 20, 30, 40 nmol) inhibited (80-100% inhibition compared to control during 60 min) the intake of 3% NaCl, water deprivation-induced and meal-associated water intake. CLO had a weaker inhibition on food and 10% sucrose intake (30-50% less than the control during 60 and 15 min, respectively). PHE (160 nmol) inhibited 3% NaCl intake and 10% sucrose intake (30% less than the control for 15-30 min). ISO (160 nmol) did not after water or 3% NaCl intake. NOR induced an increase, CLO and ISO induced a decrease, and PHE no alteration in mean arterial pressure. NOR did not alter water or 3% NaCl intake when injected unilaterally into the caudate nucleus. The results suggest that NOR injected in the MSA acts on alpha(2)-adrenergic receptors inducing a specific inhibition of 3% NaCl and water intake. (C) 1997 Elsevier B.V.

ALPHA-ADRENERGIC PATHWAYS IN THE LATERAL HYPOTHALAMUS ARE IMPORTANT FOR THE DIPSOGENIC EFFECT OF CARBACHOL INJECTED INTO THE MEDIAL SEPTAL AREA

We studied the effect of the alpha(1)- and alpha(2)-adrenergic receptors of the lateral hypothalamus (LH) on the control of water intake induced by injection of carbachol into the medial septal area (MSA) of adult male Holtzman rats (250-300 g) implanted with chronic stainless steel cannulae into the LH and MSA. The volume of injection was always 1 mu l and was injected over a period of 30-60 s. For control, 0.15 M NaCl was used. Clonidine (20 nmol) but not phenylephrine (160 nmol) injected into the LH inhibited water intake induced by injection of carbachol (2 nmol) into the MSA, from 5.4 +/- 1.2 ml/h to 0.3 +/- 0.1 and 3.0 +/- 0.9 ml/h, respectively (N = 26). When we injected yohimbine (80 nmol) + clonidine (20 nmol) and prazosin (40 nmol) + clonidine (20 nmol) into theLH, water intake induced by injection of carbachol into the MSA was inhibited from 5.4 +/- 1.2 ml/h to 0.8 +/- 0.5 and 0.3 +/- 0.2 ml/h, respectively (N = 19). Water intake induced by carbachol (2 nmol) injected into the MSA was decreased by previous injection of yohimbine (80 nmol) + phenylephrine (160 nmol) and prazosin (40 nmol) + phenylephrine (l60 nmol) from 5.4 +/- 1.2 ml/h to 1.0 +/- 0.7 and 1.8 +/- 0.8 ml/h, respectively (N = 16). The cannula reached both the medial septal area in its medial portion and the lateral hypothalamus. It has been suggested that the different pathways for induction of drinking converge on a final common pathway. Thus, adrenergic stimulation of alpha(2),-adrenoceptors ofLH can influence this final common pathway.

Effect of an acute β-adrenergic blockade on exercise intensity corresponding to the lactate minimum

β-Adrenoreceptor blockade is reported to impair endurance, power output and work capacity in healthy subjects and patients with hypertension. The purpose of this study was to investigate the effect in eighth athletic males of an acute β-adrenergic blockade with propranolol on their individual power output corresponding to a defined lactate minimum (LM). Eight fit males (cyclist or triathlete) performed a protocol to determine the power output corresponding to their individual LM (defined from an incremental exercise test after a rapidly induced exercise lactic acidosis). This protocol was performed twice in a double-blind randomized order by each athlete first ingesting propranolol (80mg) and in a second trial a placebo, 120 minutes respectively prior to the test sequence. The blood lactate concentration obtained 7 minutes after anaerobic exercise (a Wingate test) was significantly lower after acute β-adrenergic blockade (8.6 ± 1.6mM) than under the placebo condition (11.7 ± 1.6mM). The work rate at the LM was lowered from 215.0 ± 18.6 to 184.0 ± 18.6 watts and heart rate at the LM was reduced from 165 ± 1.5 to 132 ± 2.2 beats/minute as a result of the blockade. There was a non-significant correlation (r = 0.29) between the power output at the LM with and without acute β-adrenergic blockade. In conclusion, since the intensity corresponding to the LM is related to aerobic performance, the results of the present study, are able to explain in part, the reduction in aerobic power output produced during β-adrenergic blockade.

Effect of an acute β-adrenergic blockade on the blood glucose response during lactate minimum test

The aim of this study was to determine the relationship between blood lactate and glucose during an incremental test after exercise induced lactic acidosis, under normal and acute β-adrenergic blockade. Eight fit males (cyclists or triathletes) performed a protocol to determine the intensity corresponding to the individual equilibrium point between lactate entry and removal from the blood (incremental test after exercise induced lactic acidosis), determined from the blood lactate (Lacmin) and glucose (Glucmin) response. This protocol was performed twice in a double-blind randomized order by ingesting either propranolol (80 mg) or a placebo (dextrose), 120 min prior to the test. The blood lactate and glucose concentration obtained 7 minutes after anaerobic exercise (Wingate test) was significantly lower (p<0.01) with the acute β-adrenergic blockade (9.1±1.5 mM; 3.9±0.1 mM), respectively than in the placebo condition (12.4±1.8 mM; 5.0±0.1 mM). There was no difference (p>0.05) between the exercise intensity determined by Lacmin (212.1±17.4 W) and Glucmin (218.2±22.1 W) during exercise performed without acute β-adrenergic blockade. The exercise intensity at Lacmin was lowered (p<0.05) from 212.1±17.4 to 181.0±15.6 W and heart rate at Lacmin was reduced (p<0.01) from 161.2±8.4 to 129.3±6.2 beats min-1 as a result of the blockade. It was not possible to determine the exercise intensity corresponding to Glucmin with β-adrenergic blockade, since the blood glucose concentration presented a continuous decrease during the incremental test. We concluded that the similar pattern response of blood lactate and glucose during an incremental test after exercise induced lactic acidosis, is not present during β-adrenergic blockade suggesting that, at least in part, this behavior depends upon adrenergic stimulation.

Cardiovascular response to beta-adrenergic blockade or activation in 23 inbred mouse strains

We report the characterisation of 27 cardiovascular-related traits in 23 inbred mouse strains. Mice were phenotyped either in response to chronic administration of a single dose of the beta-adrenergic receptor blocker atenolol or under a low and a high dose of the beta-agonist isoproterenol and compared to baseline condition. The robustness of our data is supported by high trait heritabilities (typically H(2)>0.7) and significant correlations of trait values measured in baseline condition with independent multistrain datasets of the Mouse Phenome Database. We then focused on the drug-, dose-, and strain-specific responses to beta-stimulation and beta-blockade of a selection of traits including heart rate, systolic blood pressure, cardiac weight indices, ECG parameters and body weight. Because of the wealth of data accumulated, we applied integrative analyses such as comprehensive bi-clustering to investigate the structure of the response across the different phenotypes, strains and experimental conditions. Information extracted from these analyses is discussed in terms of novelty and biological implications. For example, we observe that traits related to ventricular weight in most strains respond only to the high dose of isoproterenol, while heart rate and atrial weight are already affected by the low dose. Finally, we observe little concordance between strain similarity based on the phenotypes and genotypic relatedness computed from genomic SNP profiles. This indicates that cardiovascular phenotypes are unlikely to segregate according to global phylogeny, but rather be governed by smaller, local differences in the genetic architecture of the various strains.

Doxazosin Treatment Alters Stromal Cell Behavior and Increases Elastic System Fibers Deposition in Rat Prostate

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)