Changes in the beta-adrenergic system due to beta-adrenergic therapy: clinical consequences.
Continued exposure to a hormonal agonist often leads to a blunted response to that agonist. This process has been termed desensitization, refractoriness, tolerance or tachyphylaxis. Continued exposure to beta-adrenergic therapy has been shown to reduce the beta-adrenergic response of white blood cells as well as the number of beta-adrenergic binding places on those cells. Since white blood cells possess a great number of beta 2-adrenergic receptors, these findings seem to argue against the continuous use of beta-agonists as prophylactic and therapeutic therapy in asthmatic patients. However, lung function measurements in these asthmatic patients have not provided hard evidence for desensitization. In this paper, a review of the discrepancy between the findings on white blood cells and lung function measurements during continuous beta-adrenergic therapy is given and the possible clinical consequences are considered.
D000227:Adenine Nucleotides / Q000097:blood; D001249:Asthma / Q000188:drug therapy; D003888:Desensitization, Immunologic; D005541:Forced Expiratory Volume; D006801:Humans; D066298:In Vitro Techniques; D007545:Isoproterenol / Q000494:pharmacology; D007962:Leukocytes / Q000276:immunology; D009130:Muscle, Smooth / Q000187:drug effects / Q000276:immunology; D009132:Muscles / Q000187:drug effects; D011943:Receptors, Adrenergic, beta / Q000378:metabolism / Q000627:therapeutic use*; D013726:Terbutaline / Q000627:therapeutic use; D014202:Tremor / Q000139:chemically induced
D000227:Adenine Nucleotides; D011943:Receptors, Adrenergic, beta; D007545:Isoproterenol; D013726:Terbutaline