The review article “Cardiac and neuroprotection regulated by α1-adrenergic subtypes” by Diane Perez and Van Doz gives an excellent update on the extremely active area of catecholamine pharmacology and signaling and its relation to physiology and pathophysiology. Adrenergic receptors were the first test system used to develop the receptor subtype concept (beginning with the delineation of α and β subtypes by Ahlquist). The idea that the utility of a hormone could be extended through the expression of different but related receptors (so-called subtypes) was born in adrenergic pharmacology and quickly spread throughout pharmacology to now be recognized as a prominent physiological paradigm. The first attempts at receptor subtype taxonomy utilized tissue phenotypic response; Perez and Doz clarify early misclassifications in the adrenergic area and delineate where the field is today. But much more than this, they discuss and organize the enormous number of studies done on the role of α1-adrenoceptor subtypes in a range of pathophysiological conditions including cardiac failure, hypertrophy and ischemia, central neural function, neurogenesis and neurodegeneration and a range of centrally mediated diseases (depression, anxiety, cognitive problems and others). The authors’ clear mastery of this extremely complex area of pharmacology is evident in the concise ideas that emerge in the paper. The conclusions clearly move the field forward and suggest new therapeutic approaches to some very difficult pharmacological problems.
Terry Kenakin
Research Triangle Park, North Carolina, USA