The importance of presynaptic beta receptors in Raynaud's disease.
The purpose of the present study was to investigate the effect of atenolol, a beta 1-selective blocker, along with flunarizine, a calcium antagonist, in the management of Raynaud's disease. Forty patients with Raynaud's disease were randomized into a trial in which atenolol (50 mg daily) was given with flunarizine (10 mg daily). During the trial all patients were subjected to finger photoplethysmography and were given a diary to note daily the number and duration of the crises and presence or absence of pain and paresthesia. The association of atenolol with flunarizine caused an 80% reduction in the number of vasospastic crises, a significant increase (p less than 0.001) in the photoplethysmographic wave amplitude, and complete disappearance of pain and paresthesia. These results were not observed in patients treated with a placebo. Flunarizine reinforces the action of atenolol in causing a decrease in vasoconstriction in patients with Raynaud's disease, as observed previously by us, in that it acts directly on the beta-presynaptic receptors or on the calcium slow channels connected to the beta-receptors. The present study confirms that the principal role in the physiopathologic progression of Raynaud's disease seems to be played by a modification of the beta-presynaptic receptors in the nerve endings of the peripheral vessels.
Brotzu
G
G
Instituto di Patologia e Chirurgia, Università di Cagliari, Italy.
Falchi
S
S
Mannu
B
B
Montisci
R
R
Petruzzo
P
P
Staico
R
R
D000293:Adolescent; D000328:Adult; D001262:Atenolol / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005260:Female; D005444:Flunarizine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D011897:Random Allocation; D011928:Raynaud Disease / Q000188:drug therapy* / Q000503:physiopathology; D011943:Receptors, Adrenergic, beta / Q000187:drug effects* / Q000502:physiology
D011943:Receptors, Adrenergic, beta; D001262:Atenolol; D005444:Flunarizine