Associate editor: P. Molenaar
Emerging concepts and therapeutic implications of β-adrenergic receptor subtype signaling

https://doi.org/10.1016/j.pharmthera.2005.04.006Get rights and content

Abstract

The stimulation of β-adrenergic receptor (βAR) plays a pivotal role in regulating myocardial function and morphology in the normal and failing heart. Three genetically and pharmacologically distinct βAR subtypes, β1AR, β2AR, and β3AR, are identified in various types of cells. While both β1AR and β2AR, the predominant βAR subtypes expressed in the heart of many mammalian species including human, are coupled to the Gs–adenylyl cyclase–cAMP–PKA pathway, β2AR dually activates pertussis toxin-sensitive Gi proteins. During acute stimulation, β2AR–Gi coupling partially inhibits the Gs-mediated positive contractile and relaxant effects via a Gi–Gβγ–phosphoinositide 3-kinase (PI3K)-dependent mechanism in adult rodent cardiomyocytes. More importantly, persistent β1AR stimulation evokes a multitude of cardiac toxic effects, including myocyte apoptosis and hypertrophy, via a calmodulin-dependent protein kinase II (CaMKII)-, rather than cAMP–PKA-, dependent mechanism in rodent heart in vivo and cultured cardiomyocytes. In contrast, persistent β2AR activation protects myocardium by a cell survival pathway involving Gi, PI3K, and Akt. In this review, we attempt to highlight the distinct functionalities and signaling mechanisms of these βAR subtypes and discuss how these subtype-specific properties of βARs might affect the pathogenesis of congestive heart failure (CHF) and the therapeutic effectiveness of certain β-blockers in the treatment of congestive heart failure.

Introduction

β-adrenergic receptor (βAR) stimulation by the sympathetic nervous system or circulating catecholamines regulates a wide range of biological processes, from heart pacemaker activity, myocardial contractility, and relaxation to vascular and bronchia smooth muscle tone, to glucose and lipid metabolism. βARs belong to G protein-coupled receptors (GPCRs) characterized by a conserved structural topology of 7-transmembrane domains (7TM) with an extracellular N-terminus and an intracellular C-terminus. In 1967, Lands et al. (1967) classified βARs into β1AR and β2AR as cardiac/lipolytic and vascular/bronchial subtypes, respectively, based on the rank order of potency of a series of structurally related catecholamines, including epinephrine and norepinephrine in different tissues. Over the past 4 decades, the accumulation of a wealth of knowledge of βAR subtype entities and their signaling mechanisms has rendered the βAR as a model system of the GPCR superfamily. Beginning in the early 1980s, Lefkowitz and colleagues developed a series of techniques to purify and reconstitute adrenergic receptors. In 1986, they successfully cloned the gene and cDNA encoding the hamster β2AR (Dixon et al., 1986). This important breakthrough paved the road for the field of GPCR biology. In the next several years, many GPCRs were cloned, including human β1AR (Frielle et al., 1987) and human β3AR (Emorine et al., 1989). The human β1AR and β2AR share 54% homology in their amino acid sequences, while β3AR shares 51% and 46% homology with β1AR and β2AR amino acid sequences, respectively.

Although cardiac βAR was initially thought to be β1AR, radioligand binding or pharmacological assays revealed the existence of cardiac β2AR and β3AR. There is now compelling evidence indicating that the predominant βAR subtypes expressed in the heart are β1AR and β2AR in many mammalian species, including human (Brodde, 1988, Brodde, 1991). These βAR subtypes fulfill different, even opposite, physiological and pathophysiological roles via activating subtype-specific signaling pathways in the heart. These characteristics of cardiac βAR subtypes bear important etiological and therapeutic implications for congestive heart failure (CHF).

Section snippets

Distinct signaling properties of cardiac β1AR and β2AR revealed from pharmacological and genetic approaches

Cardiac βAR signaling and functional properties were traditionally studied using pharmacological assays with selective agonists and antagonists. In particular, using highly selective β1AR and β2AR antagonists, CGP 20712A (Dooley et al., 1986, Baker, 2005) and ICI 118,551 (O'Donnell & Wanstall, 1980, Baker, 2005), respectively, in conjunction with radioligand binding with [125I]-Cyanopindolol, the densities of these βAR subtypes have been characterized in normal and failing hearts of human and

Possible causal relation between β-adrenergic receptor subtype signaling and the pathogenesis of heart failure

A possible causal relation between βAR stimulation and the pathogenesis of CHF have evolved progressively during the past 3 decades. Because a hallmark of CHF is the diminished cardiac contractile performance, the early prevalent view was that the reduced βAR contractile support is a causal factor for the progression of heart failure (Braunwald & Bristow, 2000). However, clinical administration of βAR agonists unexpectedly increased the mortality of patients with CHF, despite the short-term

Concluding remarks

Recent progress in cardiac βAR signaling is marked by discoveries on subtype-specific and time-dependent signaling mechanisms, receptor heterodimerization, dual G protein coupling, and several new intracellular signaling pathways. These advances have greatly deepened our understanding of the causal relation between βAR stimulation and the pathogenesis of CHF. The distinct β1AR and β2AR biology and signaling properties also shed new light on the clinical variation in the effectiveness of

Acknowledgments

The authors would like to thank Dr. H. Cheng for critical comments and discussions. This work is supported by the Chinese National Natural Science Foundation (30100215), Peking University 985 Project, Chinese National Key Project 973 (G2000056906), and Chinese Young Investigator Award (30225036), and, in part, by NIH intramural research grant (WZW and RPX).

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