Document Detail


Beta-adrenergic receptor-dependent and -independent stimulation of adenylate cyclase is impaired during severe sepsis in humans.
MedLine Citation:
PMID:  9885886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: a) To investigate the functional consequences of sepsis on the beta-adrenergic signal transduction in human circulating lymphocytes; b) to appreciate sepsis-associated catecholamine and cytokine release. DESIGN: Experimental, comparative study. SETTING: Research laboratory in a university hospital. SUBJECTS: Healthy controls (n = 10); critically ill patients who were not septic (n = 7); septic patients with severe sepsis or septic shock (n = 11). MEASUREMENTS AND MAIN RESULTS: Experiments were carried out using freshly isolated peripheral blood mononuclear cells (PBMC). We measured beta-adrenergic receptor (betaAR) number and affinity, and intracellular cAMP content at baseline and after the pharmacological stimulation of each component of the beta-adrenergic complex: betaAR with isoproterenol, Gs-protein with sodium fluoride (NaF), adenylate cyclase with forskolin. Catecholamine (adrenaline, noradrenaline) and cytokine (TNFalpha, IL-1alpha, IL-1beta, IL-6) serum levels were measured. In both septic and non-septic patients we observed a similar 40 % down-regulation of betaARs compared to controls, and a reduced basal and isoproterenol-stimulated cAMP accumulation (p < 0.05). The cAMP production elicited by NaF or forskolin was lower in septic patients than in the controls (p < 0.01). Forskolin-stimulated cAMP accumulation was significantly lower in septic patients than it was in non-septic ones (p < 0.001). Catecholamine serum concentrations were increased in the two patient groups without any significant difference. Elevated cytokine serum levels were detected in 45% of the septic patients (versus 14% of non-septic patients p < 0.05). CONCLUSIONS: Patients presenting with severe sepsis or septic shock have extended postreceptor defects of the beta-adrenergic signal transduction. This finding suggests a heterologous desensitization of adenylate cyclase stimulation.
Authors:
G Bernardin; A D Strosberg; A Bernard; M Mattei; S Marullo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Intensive care medicine     Volume:  24     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-03-29     Completed Date:  1999-03-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1315-22     Citation Subset:  IM    
Affiliation:
Service de Réanimation Médicale, Hôpital de l'Archet, Nice, France. gbernard@unice.fr
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MeSH Terms
Descriptor/Qualifier:
Adenylate Cyclase / metabolism*
Adult
Aged
Case-Control Studies
Catecholamines / blood*
Cyclic AMP / metabolism
Cytokines / blood*
Female
Humans
Lymphocytes / metabolism
Male
Middle Aged
Receptors, Adrenergic, beta / metabolism*
Shock, Septic / blood,  metabolism*
Signal Transduction
Chemical
Reg. No./Substance:
0/Catecholamines; 0/Cytokines; 0/Receptors, Adrenergic, beta; 60-92-4/Cyclic AMP; EC 4.6.1.1/Adenylate Cyclase

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