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Can intellectualism stifle scientific discovery?

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Figure 1: Acute versus chronic effects of metoprolol in heart failure.
Figure 2: Temporal differences in the actions of β-adrenoceptor ligands in heart failure.

References

  1. Gilman, A. G. Please check EGO at door. Mol. Intervention 1, 14–21 (2001).

    CAS  Google Scholar 

  2. Rajan, T. V. A Faustian bargain? The Scientist 14, 35 (2000).

    Google Scholar 

  3. Bond, R. A. Is paradoxical pharmacology a strategy worth pursuing? Trends Pharmacol. Sci. 22, 273–276 (2001).

    Article  CAS  PubMed  Google Scholar 

  4. Tarazi, R. C. & Dustan, H. P. β-Adrenergic blockade in hypertension. Practical and theoretical implications of long-term hemodynamic variations. Am. J. Cardiol. 29, 633–640 (1972).

    Article  CAS  PubMed  Google Scholar 

  5. Goodman, L., Gilman, A. & Gilman, A. G. The Pharmacological Basis of Therapeutics (Pergamon, New York, 1990).

    Google Scholar 

  6. Andrews, R. & Cowley, A. J. Phosphodiesterase inhibitors. Do the risks outweight the benefits? Drug Safety 9, 404–409 (1993).

    Article  CAS  PubMed  Google Scholar 

  7. Shipley, J. B. & Hess, M. L. Inotropic therapy for the failing myocardium. Clin. Cardiol. 18, 615–619 (1995).

    Article  CAS  PubMed  Google Scholar 

  8. Hall, S. A. et al. Time course of improvement in left ventricular function, mass and geometry in patients with congestive heart failure treated with β-adrenergic blockade. J. Am. Coll. Cardiol. 25, 1154–1161 (1995).

    Article  CAS  PubMed  Google Scholar 

  9. Packer, M. et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U. S. Carvedilol Heart Failure Study Group. N. Engl. J. Med. 334, 1349–1355 (1996).

    Article  CAS  PubMed  Google Scholar 

  10. MERIT-HF. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 353, 2001–2007 (1999).

  11. Hjalmarson, A. et al. Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). MERIT-HF study group. JAMA 283, 1295–1302 (2000).

    Article  CAS  PubMed  Google Scholar 

  12. Randomised, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease. Australia/New Zealand Heart Failure Research Collaborative Group. Lancet 349, 375–380 (1997).

  13. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet 353, 9–13 (1999).

  14. Eichhorn, E. J. & Bristow, M. R. The Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial. Curr. Control Trials Cardiovasc. Med. 2, 20–23 (2001).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Persson, C. G., Erjefalt, J. S., Uller, L., Andersson, M. & Greiff, L. Unbalanced research. Trends Pharmacol. Sci. 22, 538–541 (2001).

    Article  CAS  PubMed  Google Scholar 

  16. Bohm, M. & Maack, C. Treatment of heart failure with beta-blockers. Mechanisms and results. Basic Res. Cardiol. 95 (Suppl. 1), I15–I24 (2000).

    PubMed  Google Scholar 

  17. Kuhn, T. S. The Structure of Scientific Revolution (Univ. Chicago Press, Chicago and London, 1996).

    Book  Google Scholar 

  18. Bond, R. A. et al. Physiological effects of inverse agonists in transgenic mice with myocardial overexpression of the β2-adrenoceptor. Nature 374, 272–276 (1995).

    Article  CAS  PubMed  Google Scholar 

  19. Milano, C. A. et al. Enhanced myocardial function in transgenic mice overexpressing the β2-adrenergic receptor. Science 264, 582–586 (1994).

    Article  CAS  PubMed  Google Scholar 

  20. Costa, T. & Herz, A. Antagonists with negative intrinsic activity at δ-opioid receptors coupled to GTP-binding proteins. Proc. Natl Acad. Sci. USA 86, 7321–7325 (1989).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Chidiac, P., Hebert, T. E., Valiquette, M., Dennis, M. & Bouvier, M. Inverse agonist activity of β-adrenergic antagonists. Mol. Pharmacol. 45, 490–499 (1994).

    CAS  PubMed  Google Scholar 

  22. Samama, P., Cotecchia, S., Costa, T. & Lefkowitz, R. J. A mutation-induced activated state of the β2-adrenergic receptor. Extending the ternary complex model. J. Biol. Chem. 268, 4625–4636 (1993).

    CAS  PubMed  Google Scholar 

  23. Waagstein, F., Hjalmarson, A., Varnauskas, E. & Wallentin, I. Effect of chronic β-adrenergic receptor blockade in congestive cardiomyopathy. Br. Heart J. 37, 1022–1036 (1975).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Roethlisberger, F. J. & Dickson, W. J. Management and the Worker (Harvard Univ. Press, Boston, 1939).

    Google Scholar 

  25. Levine, J. D., Gordon, N. C. & Fields, H. L. Naloxone dose dependently produces analgesia and hyperalgesia in postoperative pain. Nature 278, 740–741 (1979).

    Article  CAS  PubMed  Google Scholar 

  26. Schmidt, J. F., Chraemmer-Jorgensen, B., Pedersen, J. E. & Risbo, A. Postoperative pain relief with naloxone. Severe respiratory depression and pain after high dose buprenorphine. Anaesthesia 40, 583–586 (1985).

    Article  CAS  PubMed  Google Scholar 

  27. Taiwo, Y. O., Basbaum, A. I., Perry, F. & Levine, J. D. Paradoxical analgesia produced by low doses of the opiate-antagonist naloxone is mediated by interaction at a site with characteristics of the δ-opioid receptor. J. Pharmacol. Exp. Ther. 249, 97–100 (1989).

    CAS  PubMed  Google Scholar 

  28. Shen, K. F. & Crain, S. M. Antagonists at excitatory opioid receptors on sensory neurons in culture increase potency and specificity of opiate analgesics and attenuate development of tolerance/dependence. Brain Res. 636, 286–297 (1994).

    Article  CAS  PubMed  Google Scholar 

  29. Shen, K. F. & Crain, S. M. Ultra-low doses of naltrexone or etorphine increase morphine's antinociceptive potency and attenuate tolerance/dependence in mice. Brain Res. 757, 176–190 (1997).

    Article  CAS  PubMed  Google Scholar 

  30. Crain, S. M. & Shen, K. F. Antagonists of excitatory opioid receptor functions enhance morphine's analgesic potency and attenuate opioid tolerance/dependence liability. Pain 84, 121–131 (2000).

    Article  CAS  PubMed  Google Scholar 

  31. Crain, S. M. & Shen, K. F. Modulation of opioid analgesia, tolerance and dependence by Gs-coupled, GM1 ganglioside-regulated opioid receptor functions. Trends Pharmacol. Sci. 19, 358–365 (1998).

    Article  CAS  PubMed  Google Scholar 

  32. He, L., Fong, J., von Zastrow, M. & Whistler, J. L. Regulation of opioid receptor trafficking and morphine tolerance by receptor oligomerization. Cell 108, 271–282 (2002).

    Article  CAS  PubMed  Google Scholar 

  33. Morello, J. P. et al. Pharmacological chaperones rescue cell-surface expression and function of misfolded V2 vasopressin receptor mutants. J. Clin. Invest. 105, 887–895 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Petaja-Repo, U. E. et al. Ligands act as pharmacological chaperones and increase the efficiency of δ-opioid receptor maturation. EMBO J. 21, 1628–1637 (2002).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Horrobin, D. F. Why is speculation so awful? BMJ 321, 571–572 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Kurtz, E. & Ketcham, K. The Spirituality of Imperfection (Bantam Books, New York, 1992).

    Google Scholar 

  37. Le Fanu, J. The Rise & Fall of Modern Medicine (Little, Brown and Co., London, 1999).

    Book  Google Scholar 

  38. Wurtman, R. J. & Bettiker, R. L. The slowing of treatment discovery, 1965–1995. Nature Med. 1, 1122–1125 (1995).

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The author wishes to thank J. Black, H. Giles and S. Shepley for their extremely helpful discussions. The National Institutes of Health, the American Heart Association and GlaxoSmithKline (UK) funded the experiments that contributed to the expressed ideas.

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DATABASES

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β2-adrenoceptor

insulin receptor

μ-opioid receptor

V2 receptor

Medscape DrugInfo

metoprolol

naltrexone

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nephrogenic diabetes insipidus

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Bond, R. Can intellectualism stifle scientific discovery?. Nat Rev Drug Discov 1, 825–829 (2002). https://doi.org/10.1038/nrd918

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