{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T20:10:03Z","timestamp":1743365403334,"version":"3.40.3"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:p><jats:italic>Abstract<\/jats:italic>\u2014Sympathotonic orthostatic hypotension (SOH) is an idiopathic syndrome characterized by tachycardia, hypotension, elevated plasma norepinephrine, and symptoms of orthostatic intolerance provoked by assumption of an upright posture. We studied a woman with severe progressive SOH with blood pressure unresponsive to the pressor effects of \u03b1<jats:sub>1<\/jats:sub>-adrenergic receptor (AR) agonists. We tested the hypothesis that a circulating factor in this patient interferes with vascular adrenergic neurotransmission. Preincubation of porcine pulmonary artery vessel rings with patient plasma produced a dose-dependent inhibition of vasoconstriction to phenylephrine in vitro, abolished vasoconstriction to direct electrical stimulation, and had no effect on nonadrenergic vasoconstrictive stimuli (endothelin-1), PGF-2\u03b1 (or KCl). Preincubation of vessels with control plasma was devoid of these effects. SOH plasma inhibited the binding of an \u03b1<jats:sub>1<\/jats:sub>-selective antagonist radioligand ([<jats:sup>125<\/jats:sup>I]HEAT) to membrane fractions derived from porcine pulmonary artery vessel rings, rat liver, and cell lines selectively overexpressing human ARs of the \u03b1<jats:sub>1B<\/jats:sub>subtype but not other AR subtypes (\u03b1<jats:sub>1A<\/jats:sub>and \u03b1<jats:sub>1D<\/jats:sub>). We conclude that a factor in SOH plasma can selectively and irreversibly inhibit adrenergic ligand binding to \u03b1<jats:sub>1B<\/jats:sub>ARs. We propose that this factor contributes to a novel pathogenesis for SOH in this patient. This patient\u2019s syndrome represents a new disease entity, and her plasma may provide a unique tool for probing the selective functions of \u03b1<jats:sub>1<\/jats:sub>-ARs.<\/jats:p>","DOI":"10.1161\/01.hyp.36.4.553","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:25:31Z","timestamp":1339460731000},"page":"553-560","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Endogenous Circulating Sympatholytic Factor in Orthostatic Intolerance"],"prefix":"10.1161","volume":"36","author":[{"given":"Robert E.","family":"Shapiro","sequence":"first","affiliation":[{"name":"From the Department of Neurology (R.E.S.), College of Medicine, University of Vermont, Burlington; the Department Anesthesiology and Critical Care Medicine (B.W., D.E.B.) and Department of Pulmonary Medicine (M.H., T.B.), The Johns Hopkins Medical Institutions, Baltimore, Md; the Departments of Anesthesiology, Surgery, and Pharmacology (D.A.S.), Duke University Medical Center, Durham, North Carolina; and the Heart and Lung Institute (N.F.), The Ohio State University, Columbus, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradford","family":"Winters","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.E.S.), College of Medicine, University of Vermont, Burlington; the Department Anesthesiology and Critical Care Medicine (B.W., D.E.B.) and Department of Pulmonary Medicine (M.H., T.B.), The Johns Hopkins Medical Institutions, Baltimore, Md; the Departments of Anesthesiology, Surgery, and Pharmacology (D.A.S.), Duke University Medical Center, Durham, North Carolina; and the Heart and Lung Institute (N.F.), The Ohio State University, Columbus, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariesa","family":"Hales","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.E.S.), College of Medicine, University of Vermont, Burlington; the Department Anesthesiology and Critical Care Medicine (B.W., D.E.B.) and Department of Pulmonary Medicine (M.H., T.B.), The Johns Hopkins Medical Institutions, Baltimore, Md; the Departments of Anesthesiology, Surgery, and Pharmacology (D.A.S.), Duke University Medical Center, Durham, North Carolina; and the Heart and Lung Institute (N.F.), The Ohio State University, Columbus, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Townsend","family":"Barnett","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.E.S.), College of Medicine, University of Vermont, Burlington; the Department Anesthesiology and Critical Care Medicine (B.W., D.E.B.) and Department of Pulmonary Medicine (M.H., T.B.), The Johns Hopkins Medical Institutions, Baltimore, Md; the Departments of Anesthesiology, Surgery, and Pharmacology (D.A.S.), Duke University Medical Center, Durham, North Carolina; and the Heart and Lung Institute (N.F.), The Ohio State University, Columbus, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra A.","family":"Schwinn","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.E.S.), College of Medicine, University of Vermont, Burlington; the Department Anesthesiology and Critical Care Medicine (B.W., D.E.B.) and Department of Pulmonary Medicine (M.H., T.B.), The Johns Hopkins Medical Institutions, Baltimore, Md; the Departments of Anesthesiology, Surgery, and Pharmacology (D.A.S.), Duke University Medical Center, Durham, North Carolina; and the Heart and Lung Institute (N.F.), The Ohio State University, Columbus, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Flavahan","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.E.S.), College of Medicine, University of Vermont, Burlington; the Department Anesthesiology and Critical Care Medicine (B.W., D.E.B.) and Department of Pulmonary Medicine (M.H., T.B.), The Johns Hopkins Medical Institutions, Baltimore, Md; the Departments of Anesthesiology, Surgery, and Pharmacology (D.A.S.), Duke University Medical Center, Durham, North Carolina; and the Heart and Lung Institute (N.F.), The Ohio State University, Columbus, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan E.","family":"Berkowitz","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (R.E.S.), College of Medicine, University of Vermont, Burlington; 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