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  lüll Ligand-directed signalling at beta-adrenoceptors Evans BA; Sato M; Sarwar M; Hutchinson DS; Summers RJBr J Pharmacol  2010[Mar]; 159 (5): 1022-38beta-Adrenoceptors (ARs) classically mediate responses to the endogenous ligands  adrenaline and noradrenaline by coupling to Gsalpha and stimulating cAMP  production; however, drugs designed as beta-AR agonists or antagonists can  activate alternative cell signalling pathways, with the potential to influence  clinical efficacy. Furthermore, drugs acting at beta-ARs have differential  capacity for pathway activation, described as stimulus trafficking, biased  agonism, functional selectivity or ligand-directed signalling. These terms refer  to responses where drug A has higher efficacy than drug B for one signalling  pathway, but a lower efficacy than drug B for a second pathway. The accepted  explanation for such responses is that drugs A and B have the capacity to induce  or stabilize distinct active conformations of the receptor that in turn display  altered coupling efficiency to different effectors. This is consistent with  biophysical studies showing that drugs can indeed promote distinct conformational  states. Agonists acting at beta-ARs display ligand-directed signalling, but many  drugs acting as cAMP antagonists are also able to activate signalling pathways  central to cell survival and proliferation or cell death. The observed complexity  of drug activity at beta-ARs, prototypical G protein-coupled receptors,  necessitates rethinking of the approaches used for screening and characterization  of novel therapeutic agents. Most studies of ligand-directed signalling employ  recombinant cell systems with high receptor abundance. While such systems are  valid for examining upstream signalling events, such as receptor conformational  changes and G protein activation, they are less robust when comparing downstream  signalling outputs as these are likely to be affected by complex pathway  interactions.|*Drug Delivery Systems[MESH]|*Drug Design[MESH]|Animals[MESH]|Cell Death/drug effects[MESH]|Cell Proliferation/drug effects[MESH]|Cell Survival/drug effects[MESH]|Epinephrine/metabolism[MESH]|Humans[MESH]|Ligands[MESH]|Norepinephrine/metabolism[MESH]|Receptors, Adrenergic, beta/*drug effects/metabolism[MESH]|Signal Transduction/drug effects[MESH] |