Dynamic exercise increases the number of j-adrenergic receptors in mixed lymphocytes by a mechanism that is incompletely understood. In a set of in vivo studies, we have investigated the effects of dynamic exercise on the subset distribution of circulating lymphocytes and on the number of fJ-adrenergic receptors in each of these subsets in two groups of patients. In healthy subjects, exercise increased plasma norepinephrine and epinephrine and caused lymphocytosis. Whereas the number of The,lper cells increased only modestly, the number of Tsuppressoricytotoxic and natural killer cells more than tripled. The number of f-adrenergic receptors varied among subsets but was not significantly altered by dynamic exercise in any subset except natural killer cells (35% increase, p=0.0302). In a group of patients with congestive heart failure, dynamic exercise increased plasma norepinephrine but did not alter plasma epinephrine and did not cause significant lymphocytosis. We did not detect any significant alterations of circulating leukocyte subsets or /3-adrenergic receptors in any of these subsets after exercise. A combined analysis of healthy patients and heart failure patients revealed a significant correlation between increases in plasma epinephrine and increases in circulating lymphocytes. We conclude that the exercise-induced increase in /8-adrenergic receptors of mixed lymphocytes is predominantly caused by a redistribution of circulating cell subsets that differ in their 3-adrenergic receptor number. This appears to be mediated by epinephrine rather than norepinephrine. (Circulation 1990;82:2003-2010 It is well documented that prolonged exposure to agonists decreases the number of /3-adrenergic receptors in cultured cells and solid tissues of animals and humans in vitro and in ViVO.1-3 Such downregulation also occurs in human lymphocytes after prolonged treatment with 13-adrenergic agonists.