Circulation Research. 2005;97:507-509
doi: 10.1161/01.RES.0000184615.56822.bd
(Circulation Research. 2005;97:507.)
© 2005 American Heart Association, Inc.
The Enigma of ß2-Adrenergic Receptor Gi Signaling in the Heart
The Good, the Bad, and the Ugly
Weizhong Zhu,
Xiaokun Zeng,
Ming Zheng,
Rui-Ping Xiao
From the Laboratory of Cardiovascular Science (W.Z., X.Z., R.-P.X.), National Institute of Aging, National Institutes of Health, Baltimore, Md; and The Institute of Molecular Medicine (M.Z., R.-P.X.), Peking University, Beijing, China.
Correspondence to Rui-Ping Xiao, MD, PhD, Laboratory of Cardiovascular Science, Gerontology Research Center, NIA, NIH, 5600 Nathan Shock Drive, Baltimore, MD 21224. E-mail xiaor{at}grc.nia.nih.gov
See related article, pages 566573
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Introduction
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Four decades ago, it was thought that the cardiac ß-adrenergic
receptor (AR) was ß
1AR, the vascular/bronchial counterpart
was ß
2AR, and that ß
2AR was either nonexistent
or nonfunctional in myocardium.
1 In the heart, stimulation of
ß
1AR leads to PKA-dependent phosphorylation of a set
of Ca
2+ regulatory proteins, including sarcolemmal L-type Ca
2+ channels, sarcoplasmic reticulum (SR) Ca
2+-release channels
(ryanodine receptors), SR Ca
2+-ATPase (SERCA) and its regulator
phospholamban (PLB), and some myofilament proteins, resulting
in positive inotropic, lusitropic, and chronotropic effects.
However, over the past decade, compelling evidence has shown
that the ß
2AR subtype is expressed in the heart and
its signaling and functionalities markedly differ from those
evoked by the closely related ßAR subtype, the ß
1AR.
Unlike ß
1AR, ß
2AR couples dually to G
s and
G
i proteins; the ß
2AR-G
i signaling pathway plays a
crucial role in cardioprotection against apoptotic death of
myocytes in culture and in vivo (the "good"), while attenuating
the ß
2AR-G
s-mediated inotropic response (the "bad")
(
Figure).
2 Now, in the current issue of
Circulation Research,
He et al revealed one "ugly" facet of the ß
2AR-G
i signaling in a canine heart failure model.
3 They demonstrated
that in the failing heart, activation of ß
2AR dampens
the ability of ß
1AR, the primary cardiac subtype,
to stimulate I
Ca,L, thus resulting in an overall dysfunction
of ßAR inotropic response in the failing heart (
Figure).
3 Specifically, the effect of ßAR stimulation with a
nonselective agonist, isoproterenol (ISO), on I
Ca,L is strikingly
diminished in cardiomyocytes from canine failing heart, but
can be revived by disruption of G
i function with pertussis toxin
(PTX) or ß
2AR blockade with ICI 118 551.
3 These findings
highlight that an alteration in the status of the ß
2AR-G
i coupling can dictate the overall outcome of cardiac ßAR
signaling under some pathological circumstances. Thus, this
enigmatic, multifaceted ß
2AR-G
i signaling pathway
might bear important pathogenic and therapeutic implications.

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Cross Inhibition of ß1AR-mediated activation of L-type Ca2+ currents (ICa,L) and positive inotropic effect by enhanced ß2AR-Gi signaling in the failing heart. The ß2AR-Gi signaling also protects cardiomyocytes against ß1AR-mediated apoptosis and maladaptive remodeling via suppressing PKA-independent stimulation of ICa,L and CaMKII (PTX indicates pertussis toxin; PKA, protein kinase A; CaMKII, Ca2+/calmodulin-dependent protein kinase II). In addition, in the normal heart but not the failing heart, heterodimerization of ß1AR and ß2AR optimizes ß-adrenergic modulation of cardiac contractility likely via reducing ß2AR-Gi coupling.
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The "Good": Cardioprotection Induced by Sustained ß2AR Stimulation
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A large body of evidence gleaned from pharmacological and mouse
genetic studies has revealed opposing contributions of sustained
ß
1AR and ß
2AR stimulation in regulating
the fate of cardiomyocytes. Whereas sustained ß
1AR
stimulation promotes apoptotic death of cardiomyocytes, sustained
stimulation of ß
2AR protects myocytes against a wide
range of apoptotic insults. For instance, agonist-induced ß
2AR
stimulation prevents catecholamine-, hypoxia-, or reactive oxygen
species (ROS)-induced apoptotic death in both neonatal and adult
rat cardiomyocytes.
46 Moreover, in adult mice lacking
the native ß
2AR, stimulation of the native ß
1AR
by catecholamine causes overtly exaggerated cardiomyopathy,
myocyte apoptosis, and more severe heart failure relative to
wild-type control animals.
7 In contrast, selective activation
of ß
2AR by fenoterol for 8 weeks exerts a clear antiapoptotic
effect and improves cardiac performance in a myocardial infarctioninduced
rat heart failure model.
8 These in vivo studies have provided
evidence that ß
2AR stimulation exerts a cardiac protective
effect in response to elevated circulating catecholamine levels
or myocardial infarction.
The cardiac protective effect of persistent ß2AR signaling is largely mediated by ß2AR-Gi coupling, which, in turn, activates a cell survival pathway sequentially involving Giß
, PI3K, and Akt. First, ß2AR blockade enhances ß1AR-induced apoptosis in cultured adult rat myocytes in a PTX-sensitive manner, suggesting the ß2AR protective effect is Gi-dependent.4 Second, ß2AR, but not ß1AR, activates a Gi-Gß
-PI3K-Akt cell survival signaling pathway6,9, and inhibition of this pathway abolishes the ability of ß2AR to block hypoxia- and ROS-induced myocyte apoptosis.6 Thus, the ß2AR-Gi- Gß
-PI3K-Akt signaling cascade not only counteracts ßAR-induced apoptosis and but also protects cardiomyocytes against other apoptotic stimuli.
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The " Bad" or "Ugly": ß2AR-coupled Gi Negates ß1AR- and ß2AR-Mediated Contractile Support in the Failing Heart
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Although beneficial in terms of cardiac protection, the ß
2AR
protective effect comes at the cost of compromised contractile
support. Previous studies have demonstrated that the ß
2AR-G
i functionally restricts the ß
2AR-G
smediated
cAMP/PKA signaling to subsarcolemmal microdomain in the vicinity
of L-type Ca
2+ channels, thus preventing the G
s-PKA mediated
phosphorylation of some key target proteins in SR membrane and
intracellular contractile myofilaments, blunting the positive
inotropic and lusitropic effects.
1013 Activation of PI3K,
an important downstream event of the ß
2AR-G
i signaling,
confines and minimizes the concurrent ß
2AR-G
sevoked
cAMP/PKA signaling.
14 In the failing heart, an upregulation
of G
i15 and a selective downregulation of ß
1AR
16 are
often associated with enhanced ß
2AR-G
i signaling and
reduced myocardial contractile response to both ß
1AR
and ß
2AR stimulation. Importantly, inhibition of the
G
i signaling pathway with PTX restores the diminished ßAR
inotropic response in a variety of heart failure models, including
a spontaneous hypertensive rat heart failure model,
17 a myocardial
infarction rat heart failure model,
18 and myocytes from failing
human hearts.
19 Furthermore, in failing porcine and mouse hearts
or cardiomyocytes, inhibition of ßAR-targeted PI3K,
the major downstream mediator the G
i signaling, improves the
contractile function of the failing myocardium.
20,21 Now, He
and colleagues demonstrate a cross-inhibition of ß
1AR-mediated
stimulation of I
Ca,L by the ß
2AR-G
i signaling.
3 Similarly,
the ß
2AR-G
i signaling largely inhibits ß
1AR-induced
positive inotropic effect in adult rat cardiomyocytes moderately
overexpressing Na
+/Ca
2+ exchanger proteins.
22 Collectively,
these studies suggest that reinforcement of ß
2AR-G
i signaling is a hallmark of the failing heart and is critically
involved in heart failureassociated dysfunction or desensitization
of both ßAR subtypes.
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The Cell Logic of Multifaceted ß2AR-Gi Signaling
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At the first glance, inhibition of the ß
1AR-mediated
stimulation of I
Ca,L and, consequentially, the contractile response
by ß
2AR-coupled G
i might paint ß
2AR stimulation
as the "bad guy" in the context of heart failure. It is, however,
noteworthy that sustained ß
1AR stimulation induces
myocyte apoptosis and positive inotropic effect mainly via PKA-independent
stimulation of L-type Ca
2+ channels and resultant activation
of CaMKII in adult mouse and rat cardiomyocytes (
Figure).
23,24 Inhibition of I
Ca,L or CaMKII can effectively protect the cultured
cardiomyocytes from ß
1AR-induced apoptotic death.
23 In contrast, overexpression of the L-type channel (

1C) causes
severe cardiac hypertrophy and apoptosis.
25 Recent in vivo studies
have further confirmed that inhibition of CaMKII substantially
prevents cardiac maladaptive remodeling from excessive ßAR
stimulation and myocardial infarction and markedly improves
cardiac function (
Figure).
26 In light of these observations,
we envision that the inhibitory effect of the ß
2AR-G
i signaling on ß
1AR-mediated activation of I
Ca,L and
resultant CaMKII may represent an intrinsic cardiac protective
mechanism, acting as a "friend" rather than a "foe," to protect
the heart against apoptosis and maladaptive remodeling in response
to chronic catecholamine stimulation. Thus, the apparent "bad"
or "ugly" behavior might be an overreaction of the defense mechanism;
appropriately tipping the balance might be able to bring out
the "good" nature of ß
2AR-G
i signaling to benefit
the struggling heart.
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Potential Mechanisms Underlying the Gi-Dependent Crosstalk of ßAR Subtypes
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The exact mechanism underlying the cross-inhibition of ß
1AR
function by the ß
2AR-G
i signaling remains elusive.
There are several candidate mechanisms, including the ß
2AR-G
i signalingmediated direct suppression of adenylyl cyclase
activity or activation of PI3K. With respect to the latter,
it has been shown that activation of PI3K inhibits I
Ca,L in
normal adult rat cardiomyocytes.
27 More importantly, inhibition
of membrane-targeted PI3K activity ameliorates cardiac dysfunction
and improves survival in multiple heart failure models.
20,21
Alternatively, we have recently demonstrated that ß1AR and ß2AR are able to form heterodimers in adult mouse cardiomyocytes and HEK 293 cells.28,29 Specifically, in cardiomyocytes, the heterodimeric receptors exhibit altered ligand binding profiles, enhanced signaling efficiency in regulating myocyte cAMP production and contractility, and suppressed ß2AR spontaneous activity in the absence of agonist stimulation, thus optimizing ß-adrenergic regulation of cardiac contractility (Figure).28 Interestingly, heterodimerization between ß1AR and ß2AR inhibits the agonist-promoted internalization of ß2AR and its ability to activate the Gi-ERK1/2 MAPK signaling pathway in HEK 293 cells.29 Similarly, whereas either ß2AR or ß3AR alone couples to both Gs and Gi proteins, the ß2AR-ß3AR heterodimer is unable to activate Gi signaling.30 Thus, alterations in the status of oligomerization of GPCRs from the same or different families may lead to changes in the selectivity and specificity of G protein coupling of those receptors, thereby altering their signaling and functional features, perhaps also raising important therapeutic considerations.
The heart failureassociated decrease in the ratio of ß1AR to ß2AR,3,16 in conjunction with changes in cardiomyocyte morphology and membrane integrity, might interfere with the heterodimerization of the remaining ßARs, thus allowing the ß2AR to better couple to Gi proteins. The enhanced Gi signaling inhibits ß1AR-mediated increases in ICa,L and contractility, perhaps most importantly, ameliorates ß1AR-evoked maladaptive remodeling and loss of cardiomyocytes (Figure). These hypotheses merit future investigation.
In summary, it is reasonable to speculate that the selective downregulation of ß1AR and the upregulation of ß2AR-coupled Gi signaling in the functionally compensated hypertrophied heart may represent salutary cardiac adaptation, which may protect myocytes against apoptosis and maladaptive remodeling and consequently slow the progression of cardiomyopathy and contractile dysfunction. However, exaggerated ß2AR-Gi signaling blunts the Gs-mediated stimulation of ICa,L and contractile support, thus contributing to the contractile defect of the failing heart despite of its antiapoptotic effect. Thus, restoration of the Yin and Yang balance of ß2AR-coupled Gi and Gs signaling cascades may open a novel therapeutic avenue for the treatment of heart failure.
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Acknowledgments
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This work is supported by National Institutes of Health intramural
research grant (to Z.W.Z., X.Z., and R.P.X.), and in part by
Chinese National Key Project 973 (G2000056906) and Chinese Young
Investigator Award (30225036). The authors thank Dr H. Cheng
for critical comments and discussions.
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Footnotes
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The opinions expressed in this editorial are not necessarily
those of the editors or of the American Heart Association.
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References
|
|---|
- Lands AM, Arnold A, Mcauliff JP, Luduena FP, Brown TG. Differentiation of receptor systems activated by sympathomimetic amines. Nature. 1967; 214: 596598.
- Xiao RP, Zhu W, Zheng M, Bond R, Lakatta EG, Cheng H. Subtype-specific ß-adrenergic signaling pathways and their clinical implications. Trends Pharmacol Sci. 2004; 25: 358365.[CrossRef][Medline]
[Order article via Infotrieve]
- He JQ, Balijepalli RC, Haworth RA, Kamp TJ. Crosstalk of ß-adrenergic receptor subtypes through Gi blunts ß-adrenergic stimulation of L-type Ca2+ channels in canine heart failure. Circ Res. 2005; 97: 566573.[Abstract/Free Full Text]
- Communal C, Singh K, Sawyer DB, Colucci WS. Opposing effects of ß1- and ß2-adrenergic receptors on cardiac myocyte apoptosis: role of a pertussis toxin-sensitive G protein. Circulation. 1999; 100: 22102212.[Abstract/Free Full Text]
- Zaugg M, Xu W, Lucchinetti E, Shafiq SA, Jamali NZ, Siddiqui MA. ß-adrenergic receptor subtypes differentially affect apoptosis in adult rat ventricular myocytes. Circulation. 2000; 102: 344350.[Abstract/Free Full Text]
- Chesley A, Ohtani S, Asai T, Xiao RP, Lunberg MS, Lakatta EG, Crow MT. The ß2-adrenergic receptor delivers an antiapoptotic signal to cardiac myocytes through Gi-dependent coupling to phosphatidylinositol 3'-kinase. Circ Res. 2000; 87: 11721179.[Abstract/Free Full Text]
- Patterson AJ, Zhu W, Chow A, Agrawal R, Kosek J, Xiao RP, Kobilka B. Protecting the myocardium: a role for the ß2-adrenergic receptor in the heart. Crit Care Med. 2004; 32: 10411048.[CrossRef][Medline]
[Order article via Infotrieve]
- Ahmet I, Krawczyk M, Heller P, Moon C, Lakatta EG, Talan MI. Beneficial effects of chronic pharmacological manipulation of ß-adrenoreceptor subtype signaling in rodent dilated ischemic cardiomyopathy. Circulation. 2004; 110: 10831090.[Abstract/Free Full Text]
- Zhu WZ, Zheng M, Lefkowitz RJ, Koch WJ, Kobilka B, Xiao RP. Dual modulation of cell survival and cell death by ß2-adrenergic signaling in adult mouse cardiac myocytes. Proc Natl Acad Sci U S A. 2001; 98: 16071612.[Abstract/Free Full Text]
- Kuschel M, Zhou YY, Cheng H, Zhang SJ, Chen-Izu Y, Lakatta EG, Xiao RP. Gi protein-mediated functional compartmentalization of cardiac ß2-adrenergic signaling. J Biol Chem. 1999; 274: 2204822052.[Abstract/Free Full Text]
- Chen-Izu Y, Xiao RP, Izu LT, Cheng H, Kuschel M, Spurgeon H, Lakatta EG. Gi-dependent localization of ß2-adrenergic receptor signaling to L-type Ca2+ channels. Biophys J. 2000; 79: 25472556.[Abstract/Free Full Text]
- Xiao RP, Ji X, Lakatta EG. Functional coupling of the ß2-adrenoceptor to a pertussis toxin-sensitive G protein in cardiac myocytes. Mol Pharmacol. 1995; 47: 322329.[Abstract]
- Xiao RP, Avdonin P, Zhou YY, Cheng H, Akhter SA, Eschenhagen T, Lefkowitz RJ, Koch WJ, Lakatta EG. Coupling of ß2-adrenoceptor to Gi proteins and its physiological relevance in murine cardiac myocytes. Circ Res. 1999; 84: 4352.[Abstract/Free Full Text]
- Jo SH, Leblais V, Wang PH, Crow MT, Xiao RP. Phosphatidylinositol 3-kinase functionally compartmentalizes the concurrent Gs signaling during ß2-adrenergic stimulation. Circ Res. 2002; 91: 4653.[Abstract/Free Full Text]
- Eschenhagen T, Mende U, Nose M, Schmitz W, Scholz H, Haverich A, Hirt S, Doring V, Kalmar P, Hoppner W. Increased messenger RNA level of the inhibitory G protein alpha subunit Gia1 in human end-stage heart failure. Circ Res. 1992; 70: 688696.[Abstract/Free Full Text]
- Bristow MR, Ginsburg R, Umans V, Fowler M, Minobe W, Rasmussen R, Zera P, Menlove R, Shah P, Jamieson S. ß1- and ß2-adrenergic receptor subpopulations in nonfailing and failing human ventricular myocardium: coupling of both receptor subtypes to muscle contraction and selective ß1-receptor down-regulation in heart failure. Circ Res. 1986; 59: 297309.[Abstract/Free Full Text]
- Xiao RP, Zhang SJ, Chakir K, Avdonin P, Zhu W, Bond RA, Balke CW, Lakatta EG, Cheng H. Enhanced Gi signaling mediates the diminution of ß2-adrenergic contractile response in failing spontaneous hypertensive rat heart. Circulation. 2003; 108: 16331639.[Abstract/Free Full Text]
- Kompa AR, Gu XH, Evans BA, Summers RJ. Desensitization of cardiac ß-adrenoceptor signaling with heart failure produced by myocardial infarction in the rat. Evidence for the role of Gi but not Gs or phosphorylating proteins. J Mol Cell Cardiol. 1999; 31: 11851201.[CrossRef][Medline]
[Order article via Infotrieve]
- Brown LA, Harding SE. The effect of pertussis toxin on ß-adrenoceptor responses in isolated cardiac myocytes from noradrenaline-treated guinea-pigs and patients with cardiac failure. Br J Pharmacol. 1992; 106: 115122.[Medline]
[Order article via Infotrieve]
- Perrino C, Naga Prasad SV, Schroder JN, Hata JA, Milano C, Rockman HA. Restoration of ß-adrenergic receptor signaling and contractile function in heart failure by disruption of the ßARK1/phosphoinositide 3-kinase complex. Circulation. 2005; 111: 25792587.[Abstract/Free Full Text]
- Perrino C, Naga Prasad SV, Patel M, Wolf MJ, Rockman HA. Targeted inhibition of ß-adrenergic receptor kinase-1-associated phosphoinositide-3 kinase activity preserves ß-adrenergic receptor signaling and prolongs survival in heart failure induced by calsequestrin overexpression. J Am Coll Cardiol. 2005; 45: 18621870.[Abstract/Free Full Text]
- Sato M, Gong H, Terracciano CMN, Ranu H, Harding SE. Loss of ß-adrenoceptor response in myocytes overexpressing the Na+/Ca2+-exchanger. J Mol Cell Cardiol. 2004; 36: 4348.[CrossRef][Medline]
[Order article via Infotrieve]
- Zhu WZ, Wang SQ, Chakir K, Kolbilka BK, Cheng H, Xiao RP. Linkage of ß1-adrenergic stimulation to apoptotic heart cell death through protein kinase A-independent activation of Ca2+/Calmodulin Kinase II. J Clin Invest. 2003; 111: 617625.[CrossRef][Medline]
[Order article via Infotrieve]
- Wang W, Zhu W, Wang S, Yang D, Crow MT, Xiao RP, Cheng H. Sustained ß1-adrenergic stimulation modulates cardiac contractility by Ca2+/calmodulin kinase signaling pathway. Circ Res. 2004; 95: 798806.[Abstract/Free Full Text]
- Muth JN, Bodi I, Lewis W, Varadi G, Schwartz A. A Ca2+-dependent transgenic model of cardiac hypertrophy: A role for protein kinase Calpha. Circulation. 2001; 103: 140147.[Abstract/Free Full Text]
- Zhang R, Khoo MSC, Wu Y, Yang Y, Grueter CE, Ni G, Price EE Jr, Thiel W, Guatimosim S, Song LS, Madu EC, Shah AN, Vishnivetskaya TA, Atkinson JB, Gurevich VV, Salama G, Lederer WJ, Colbran RJ, Anderson ME. Calmodulin kinase II inhibition protects against structural heart disease. Nature Medicine. 2005; 11: 409417.[CrossRef][Medline]
[Order article via Infotrieve]
- Leblais V, Jo SH, Chakir K, Maltsev V, Zheng M, Crow MT, Wang W, Lakatta EG, Xiao RP. Phosphatidylinositol 3-kinase offsets cAMP-mediated positive inotropic effect via inhibiting Ca2+ influx in cardiomyocytes. Circ Res. 2004; 95: 11831190.[Abstract/Free Full Text]
- Zhu WZ, Chakir K, Zhang S, Yang D, Lavoie C, Bouvier M, Hébert TE, Lakatta EG, Cheng H, Xiao RP. Heterodimerization of ß1- and ß2-adrenergic receptor subtypes optimizes ß-adrenergic modulation of cardiac contractility. Circ Res. 2005; 97: 244251.[Abstract/Free Full Text]
- Lavoie C, Mercier JF, Salahpour A, Umapathy D, Breit A, Villeneuve LR, Zhu WZ, Xiao RP, Lakatta EG, Bouvier M, Hebert TE. ß1/ß2-adrenergic receptor heterodimerization regulates ß2-adrenergic receptor internalization and ERK signaling efficacy. J Biol Chem. 2002; 277: 3540235410.[Abstract/Free Full Text]
- Breit A, Lagace M, Bouvier M. Hetero-oligomerization between ß2- and ß3-adrenergic receptors generates a ß-adrenergic signaling unit with distinct functional properties. J Biol Chem. 2004; 279: 2875628765.[Abstract/Free Full Text]
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