Acute regulation of lymphocyteβ-adrenoceptor activity in pheochromocytoma

Middeke, Martin; Lohmöller, G; Remien, J.; Kirzinger, S.; Holzgreve, Heinrich

doi:10.1007/bf01728195

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…This observation is not consistent with the report of Middeke et al (24), who found a transient increase in the density of the mononuclear leukocyte ß 2 -receptors in a patient with a phaeochromocytoma within 30 min of the beginning of an acute episode of symptoms caused by a tenfold increase in the concentrations of epinephrine in plasma. However, although the sampling scheme in our study could not provide a continuous coverage of the time profile of the density of the mononuclear leukocyte ß 2 -receptors, the intervals (ca.…”

Section: Discussioncontrasting

confidence: 99%

Magnitude and Kinetics of Alterations in Plasma Catecholamines and Leukocyte β-Adrenergic Receptors in Response to Anaesthesia and Surgery

Ratge

Wiedemann²,

Kohse³

et al. 1990

Clinical Chemistry and Laboratory Medicine

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Summary:We studied the response of the sympatho-adrenal system to varying intensities of different stimuli. Concentrations of norepinephrine and epinephrine in plasma as well as densities of ß 2 -adrenergic receptors on mononuclear leukocytes were determined in patients subjected to operations of varying complexity and different types of anaesthesia.In patients undergoing hysterectomy (n = 9), the maximal increases in plasma norepinephrine and epinephrine were 2.7-and 2.8-fold, respectively, corresponding to a post-operative decrease of the mononuclear leukocyte ß 2 -adrenergic receptors of 27% after 4 hours.Patients with coronary revascularization (n = 17) were randomly selected to receive either enflurane/N 2 O or neurolept anaesthesia. During intraoperative periods of stress, such as cardiopulmonary bypass and hypothermia, norepinephrine and epinephrine levels were 2 -3 times higher in the neurolept patients, compared with the enflurane patients. In the former group, the respective maximal norepinephrine and epinephrine concentrations were 9.7 and 28 times the vasal values of the non-anaesthetized patients. One day postoperatively, the mononuclear leukocyte ß 2 -receptor density decreased maximally by 45 ± 11 % in the enflurane patients, and by 53 ± 6% in the neurolept patients. As early as two to five days after cardiac surgery, ß 2 -receptor densities were no longer distinguishable from the preoperative values. Significant correlations between the increases in catecholamine concentrations and the decreases in ß 2 -receptor densities did not exist.It is concluded that enflurane blocks the sympatho-adrenal response to surgical stress more effectively than neurolept anaesthesia. In addition to the increases in catecholamine concentrations, other factors must contribute to the postoperative decrease in mononuclear leukocyte ß 2 -receptor densities. Such factors may include endotoxin production, or an alteration of the receptor in the membrane due to the action of the different narcotics on the lipid phase of the membrane.

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Section: Discussioncontrasting

confidence: 99%

Magnitude and Kinetics of Alterations in Plasma Catecholamines and Leukocyte β-Adrenergic Receptors in Response to Anaesthesia and Surgery

Ratge

Wiedemann²,

Kohse³

et al. 1990

Clinical Chemistry and Laboratory Medicine

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“…Two 24-hurinary collections demonstrated elevated noradrenaline (mean 315 lg/24 h, normal <80 lg/24 h) and adrenaline (mean 268 lg/24 h, normal <20 mg/24 h) levels. Blood samples, which were drawn during excessive blood pressure rise, revealed elevation of plasma catecholamines (6.793 pg/ml for adrenaline (normal 50-150 pg/ml) and 10.424 pg/ml for noradrenaline (normal 200-500 pg/ml), so that the diagnosis of pheochromocytoma was considered established. The tumor was successfully removed during laparascopic surgery.…”

Section: Sinus Node Dysfunction With Intermittent Sinus Arrest and Avmentioning

confidence: 99%

“…Hierzu zählt die Desensibilisierung von Beta-Rezeptoren, deren Empfindlichkeit erst durch eine exzessive Katecholaminausschüttung hochreguliert werden soll (10). Eine entsprechende Untersuchung der Beta-Rezeptorenaktivität ist mittels eines Lymphozytenassays möglich (10), wurde jedoch im vorliegenden Fall nicht durchgeführt.…”

Section: Diskussionunclassified

Sinusknotendysfunktion mit intermittierendem Sinusarrest und AV-junktionaler Ersatzrhythmus als Erstmanifestation eines Phäochromozytoms

Bruch¹,

Dagres²,

Wieneke³

et al. 2002

Z Kardiol

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A 25-year-old male student complained about episodic palpitations, dizziness, nausea and headache 5 years prior to presentation. No otorhinolaryngic, neurologic or gastrointestinal causes were identified. Several ECG recordings revealed sinus node dysfunction with intermittent sinus arrest and AV-nodal escape rhythm. The patient was given a permanent DDD-pacemaker. Six months later, the clinical symptoms were unchanged. During an attack, physical examination revealed paleness, diffuse sweating and an arterial blood pressure of 250/130 mmHg, which decreased to 120/80 mmHg within a few minutes. Abdominal ultrasound and abdominal computed tomographic scan demonstrated the presence of a large (6.4 x 5.5 cm) left-sided adrenal mass. Two 24-h-urinary collections demonstrated elevated noradrenaline (mean 315 micrograms/24 h, normal < 80 micrograms/24 h) and adrenaline (mean 268 micrograms/24 h, normal < 20 mg/24 h) levels. Blood samples, which were drawn during excessive blood pressure rise, revealed elevation of plasma catecholamines (6.793 pg/ml for adrenaline (normal 50-150 pg/ml) and 10.424 pg/ml for noradrenaline (normal 200-500 pg/ml), so that the diagnosis of pheochromocytoma was considered established. The tumor was successfully removed during laparascopic surgery. After surgery, the patient remained well and normotensive. Three months later, several long-term ECG recordings showed sinus arrhythmia with no evidence of sinus arrest or AV-nodal escape rhythm, so that the DDD pacemaker was turned off. This case underlines that sinus node dysfunction with intermittent sinus arrest and AV-nodal escape rhythm is a potential early manifestation of a pheochromocytoma. These changes seem to disappear after successful removal of the tumor.

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Beta-adrenergic blood pressure regulation in shy-drager syndrome and pheochromocytoma

Middeke¹,

Ittner

Mezger

et al. 1989

Klin Wochenschr

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Both Shy-Drager syndrome and pheochromocytoma are characterized by an abnormal catecholamine secretion, e.g. a reduced secretion in Shy-Drager syndrome, and an excessive stimulation in pheochromocytoma resulting in adrenergic dysfunction and in adrenergic hyperactivity, respectively. The relationship between extreme variations in circulating catecholamines and beta-adrenergic receptor activity was studied in two patients with severe orthostatic hypotension (Shy-Drager syndrome) and in a patient with pheochromocytoma with excessive spontaneous catecholamine increases using the lymphocyte beta 2-adrenoceptor assay. In both patients with Shy-Drager syndrome, basal plasma concentrations of epinephrine and dopamine were low under resting conditions and could not be stimulated in the upright position. Norepinephrine was low in the first patient, and could not be stimulated; whereas the second patient had a normal basal concentration of norepinephrine, which could be moderately stimulated. There was no beta-adrenoceptor abnormality in the first patient: however, in the second patient, there were no measurable beta-adrenoceptors on membrane fractions, whereas a population of receptors only in the low affinity state could be identified on intact cells. Alpha-adrenoceptor density on thrombocyte membranes was slightly increased in both patients with Shy-Drager syndrome and showed no substantial change during upright posture. Catecholamine increases in the pheochromocytoma patient were accompanied by a rise in blood pressure, bradycardia, and an acute up-regulation of beta-adrenoceptors. Plasma concentrations of cAMP paralleled the increase in receptor density and blood pressure. The findings in pheochromocytoma add support to the theory that an acute catecholamine stimulation gives rise to an acute beta-adrenergic sensitization leading to blood pressure elevation.(ABSTRACT TRUNCATED AT 250 WORDS)

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Acute regulation of lymphocyteβ-adrenoceptor activity in pheochromocytoma

Cited by 5 publications

References 9 publications

Magnitude and Kinetics of Alterations in Plasma Catecholamines and Leukocyte β-Adrenergic Receptors in Response to Anaesthesia and Surgery

Magnitude and Kinetics of Alterations in Plasma Catecholamines and Leukocyte β-Adrenergic Receptors in Response to Anaesthesia and Surgery

Sinusknotendysfunktion mit intermittierendem Sinusarrest und AV-junktionaler Ersatzrhythmus als Erstmanifestation eines Phäochromozytoms

Beta-adrenergic blood pressure regulation in shy-drager syndrome and pheochromocytoma

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