Purpose of Review: The present paper will review the results of experimental and clinical studies aimed at defining the functional behavior of the central and peripheral nervous system in adrenal pheochromocytoma. Recent Findings: The contribution of sympathetic neural influences to the development of high blood pressure values in pheochromocytoma is complex. Studies performed in experimental animal models have shown that hypertension and the concomitant high circulating levels of catecholamines can lead to inhibition of central sympathetic neural outflow by reflex mechanisms and direct stimulation of central adrenergic receptors, respectively. However, these studies have also shown that high circulating levels of catecholamines favor a downregulation of alpha- and beta-adrenergic receptors, lessening their response to endogenous and exogenous adrenergic stimulation. The present paper reviews results of human studies performed by our group and others on the behavior of the central and peripheral nervous system in human pheochromocytoma. We discuss data collected in patients with different levels of peripheral sympathetic drive, i.e., before and after surgical removal of the adrenal pheochromocytoma. Summary: In the presence of elevated plasma catecholamine level, such as that characterizing adrenal pheochromocytoma, microneurography shows that central sympathetic neural activity is normal or even inhibited. At the peripheral vascular level, pheochromocytoma is characterized by a reduced vascular reactivity to exogenous sympathetic stimulation but a normal response by the vessels to endogenous adrenergic stimulation.

Grassi, G., Trevano, F., Dell'Oro, R., Seravalle, G., Mancia, G. (2019). Pheochromocytoma as a Clinical Model of Peripheral Sympathetic Overdrive: Old and New Findings. CURRENT HYPERTENSION REPORTS, 21(11) [10.1007/s11906-019-0989-9].

Pheochromocytoma as a Clinical Model of Peripheral Sympathetic Overdrive: Old and New Findings

Grassi, Guido
Primo
;
Trevano, Fosca Quarti
Secondo
;
Dell'Oro, Raffaella;Mancia, Giuseppe
Ultimo
2019

Abstract

Purpose of Review: The present paper will review the results of experimental and clinical studies aimed at defining the functional behavior of the central and peripheral nervous system in adrenal pheochromocytoma. Recent Findings: The contribution of sympathetic neural influences to the development of high blood pressure values in pheochromocytoma is complex. Studies performed in experimental animal models have shown that hypertension and the concomitant high circulating levels of catecholamines can lead to inhibition of central sympathetic neural outflow by reflex mechanisms and direct stimulation of central adrenergic receptors, respectively. However, these studies have also shown that high circulating levels of catecholamines favor a downregulation of alpha- and beta-adrenergic receptors, lessening their response to endogenous and exogenous adrenergic stimulation. The present paper reviews results of human studies performed by our group and others on the behavior of the central and peripheral nervous system in human pheochromocytoma. We discuss data collected in patients with different levels of peripheral sympathetic drive, i.e., before and after surgical removal of the adrenal pheochromocytoma. Summary: In the presence of elevated plasma catecholamine level, such as that characterizing adrenal pheochromocytoma, microneurography shows that central sympathetic neural activity is normal or even inhibited. At the peripheral vascular level, pheochromocytoma is characterized by a reduced vascular reactivity to exogenous sympathetic stimulation but a normal response by the vessels to endogenous adrenergic stimulation.
Articolo in rivista - Articolo scientifico
Adrenergic receptors; Pheochromocytoma; Reflex control of the cardiovascular system; Secondary hypertension; Sympathetic activity
English
2019
21
11
90
none
Grassi, G., Trevano, F., Dell'Oro, R., Seravalle, G., Mancia, G. (2019). Pheochromocytoma as a Clinical Model of Peripheral Sympathetic Overdrive: Old and New Findings. CURRENT HYPERTENSION REPORTS, 21(11) [10.1007/s11906-019-0989-9].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/245264
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