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Propranolol inhibits cavernous vascular malformations by β1 adrenergic receptor antagonism in animal models.


ABSTRACT: Propranolol, a pleiotropic β-adrenergic blocker, has been anecdotally reported to reduce cerebral cavernous malformations (CCMs) in humans. However, propranolol has not been rigorously evaluated in animal models, nor has its mechanism of action in CCM been defined. We report that propranolol or its S(-) enantiomer dramatically reduced embryonic venous cavernomas in ccm2 mosaic zebrafish, whereas R-(+)-propranolol, lacking β antagonism, had no effect. Silencing of the β1, but not β2, adrenergic receptor mimicked the beneficial effects of propranolol in a zebrafish CCM model, as did the β1-selective antagonist metoprolol. Thus, propranolol ameliorated cavernous malformations by β1 adrenergic antagonism in zebrafish. Oral propranolol significantly reduced lesion burden in 2 chronic murine models of the exceptionally aggressive Pdcd10/Ccm3 form of CCM. Propranolol or other β1-selective antagonists may be beneficial in CCM disease.

SUBMITTER: Li W 

PROVIDER: S-EPMC7843213 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Propranolol inhibits cavernous vascular malformations by β1 adrenergic receptor antagonism in animal models.

Li Wenqing W   Shenkar Robert R   Detter Mathew R MR   Moore Thomas T   Benavides Christian C   Lightle Rhonda R   Girard Romuald R   Hobson Nicholas N   Cao Ying Y   Li Yan Y   Griffin Erin E   Gallione Carol C   Zabramski Joseph M JM   Ginsberg Mark H MH   Marchuk Douglas A DA   Awad Issam A IA  

The Journal of clinical investigation 20210201 3


Propranolol, a pleiotropic β-adrenergic blocker, has been anecdotally reported to reduce cerebral cavernous malformations (CCMs) in humans. However, propranolol has not been rigorously evaluated in animal models, nor has its mechanism of action in CCM been defined. We report that propranolol or its S(-) enantiomer dramatically reduced embryonic venous cavernomas in ccm2 mosaic zebrafish, whereas R-(+)-propranolol, lacking β antagonism, had no effect. Silencing of the β1, but not β2, adrenergic r  ...[more]

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