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Changes in the beta-adrenergic system due to beta-adrenergic therapy: clinical consequences.

Continued exposure to a hormonal agonist often leads to a blunted response to that agonist. This process has been termed desensitization, refractoriness, tolerance or tachyphylaxis. Continued exposure to beta-adrenergic therapy has been shown to reduce the beta-adrenergic response of white blood cells as well as the number of beta-adrenergic binding places on those cells. Since white blood cells possess a great number of beta 2-adrenergic receptors, these findings seem to argue against the continuous use of beta-agonists as prophylactic and therapeutic therapy in asthmatic patients. However, lung function measurements in these asthmatic patients have not provided hard evidence for desensitization. In this paper, a review of the discrepancy between the findings on white blood cells and lung function measurements during continuous beta-adrenergic therapy is given and the possible clinical consequences are considered.