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Circulation. 1998;98:1783-1789

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*Heart Failure

(Circulation. 1998;98:1783-1789.)
© 1998 American Heart Association, Inc.


Basic Science Reports

Reciprocal In Vivo Regulation of Myocardial G Protein–Coupled Receptor Kinase Expression by ß-Adrenergic Receptor Stimulation and Blockade

Guido Iaccarino, MD; Eric D. Tomhave, BS; Robert J. Lefkowitz, MD; ; Walter J. Koch, PhD

From the Departments of Medicine (G.I., R.J.L.), Surgery (E.D.T, W.J.K.), and Biochemistry (R.J.L.) and Howard Hughes Medical Institute, Duke University Medical Center (R.J.L.), Durham, NC.

Correspondence to Walter J. Koch, PhD, Department of Surgery, Duke University Medical Center, Room 472, MSRB, Research Drive, Durham, NC 27710. E-mail koch0002{at}mc.duke.edu

Background—Impaired myocardial ß-adrenergic receptor (ßAR) signaling, including desensitization and functional uncoupling, is a characteristic of congestive heart failure. A contributing mechanism for this impairment may involve enhanced myocardial ß-adrenergic receptor kinase (ßARK1) activity because levels of this ßAR-desensitizing G protein–coupled receptor kinase (GRK) are increased in heart failure. An hypothesis has emerged that increased sympathetic nervous system activity associated with heart failure might be the initial stimulus for ßAR signaling alterations, including desensitization. We have chronically treated mice with drugs that either activate or antagonize ßARs to study the dynamic relationship between ßAR activation and myocardial levels of ßARK1.

Methods and Results—Long-term in vivo stimulation of ßARs results in the impairment of cardiac ßAR signaling and increases the level of expression (mRNA and protein) and activity of ßARK1 but not that of GRK5, a second GRK abundantly expressed in the myocardium. Long-term ß-blocker treatment, including the use of carvedilol, improves myocardial ßAR signaling and reduces ßARK1 levels in a specific and dose-dependent manner. Identical results were obtained in vitro in cultured cells, demonstrating that the regulation of GRK expression is directly linked to ßAR signaling.

Conclusions—This report demonstrates, for the first time, that ßAR stimulation can significantly increase the expression of ßARK1, whereas ß-blockade decreases expression. This reciprocal regulation of ßARK1 documents a novel mechanism of ligand-induced ßAR regulation and provides important insights into the potential mechanisms responsible for the effectiveness of ß-blockers, such as carvedilol, in the treatment of heart failure.


Key Words: heart failure • receptors, adrenergic, beta • myocardium • catecholamines




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