Effects of dipyridamole and adenosine on vasoactive peptides calcitonin gene-related peptide and atrial natriuretic peptide in humans: role of sympathetic activation.
1. It has been observed that dipyridamole (DIP) administration produces equivalent cardiovascular effects at lower systemic adenosine (ADO) plasma concentrations than those obtained with exogenous ADO infusion. This observation led to the identification of DIP for additional 'ischaemia-inducing' mechanisms, possibly based on sympathetic activation. 2. In turn, exogenous ADO administration has proven to elicit a complex neurohumoral response, including an increase in the plasma concentration of catecholamines, associated with augmented levels of the vasoactive peptides calcitonin gene-related peptide (CGRP) and atrial natriuretic peptide (ANP). More particularly, increases in CGRP seem to be dependent on sympathetic activation, while changes in ANP do not. 3. In order to clarify some aspects of the activity of DIP on neurohumoral systems, the effects of administration of DIP and ADO on plasma levels of noradrenaline (NA), CGRP and ANP were studied in healthy volunteers. Haemodynamic parameters were also monitored. 4. Infusion of exogenous ADO produced plasma levels of ADO as high as 1893+/-386 nmol/L, together with a significant increase in plasma levels of CGRP, ANP and NA. Similarly, the infusion of DIP produced augmented plasma concentrations of the examined parameters, with a peak plasma ADO concentration of 470+/-49 nmol/L. 5. At a given ADO plasma concentration of 450+/-10 nmol/L, the increase in CGRP and NA levels with DIP infusion was significantly higher than that observed following the infusion of ADO, whereas the increase in the plasma concentration of ANP following DIP infusion was very similar to that seen following ADO infusion. 6. The physiological background of these findings is based on evidence that DIP displays a greater sympathoexcitatory activity than does exogenous ADO and only the increase in plasma CGRP seems to be mediated, although indirectly, by beta-adrenoceptor stimulation. The exact mechanism of DIP-dependent sympathetic activation remains to be elucidated.
Guideri
F
F
Department of Internal Medicine, University of Siena, Italy.
Capecchi
P L
PL
Lazzerini
P E
PE
Pasini
F L
FL
D000241:Adenosine / Q000097:blood / Q000494:pharmacology*; D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide / Q000097:blood*; D004176:Dipyridamole / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D009638:Norepinephrine / Q000097:blood; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology; D013564:Sympathetic Nervous System / Q000187:drug effects* / Q000502:physiology; D014665:Vasodilator Agents / Q000494:pharmacology*
D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents; D004176:Dipyridamole; D009320:Atrial Natriuretic Factor; D015740:Calcitonin Gene-Related Peptide; D000241:Adenosine; D009638:Norepinephrine