Neuronal Source of Plasma Dopamine

BACKGROUND: Determinants of plasma norepinephrine (NE) and epinephrine concentrations are well known; those of the third endogenous catecholamine, dopamine (DA), remain poorly understood. We tested ill humans whether DA enters the plasma after corelease with NE during exocytosis from sympathetic noradrenergic nerves. METHODS: We reviewed plasma catecholamine data from patients referred for autonomic testing and control subjects under the following experimental conditions: during Supine rest and in response to orthostasis; intravenous yohimbine (YOH), isoproterenol (ISO), or glucagon (GLU), which augment exocytotic release of NE from sympathetic nerves; intravenous trimethaphan (TRI) or pentolinium (PEN), which decrease exocytotic NE release; or intravenous tyramine (TYR), which releases NE by nonexocytotic means. We included groups of patients with pure autonomic failure (PAF), bilateral thoracic sympathectomises (SNS-x) or multiple system atrophy (MSA), since PAF and SNS-x are associated with noradrenergic denervation and MSA is not. RESULTS: Orthostasis, YOH, ISO, and TYR increased and TR1/PEN decreased plasma DA concentrations. Individual Values for changes in plasma DA concentrations correlated positively with changes in NE in response to orthostasis (r = 0.72, P < 0.0001), YOH (r = 0.75, P < 0.0001), ISO (r = 0.71, P < 0.0001), GLU (r = 0.47, P = 0.01), and TYR (r = 0.67, P < 0.0001). PAF and SNS-x patients had low plasma DA concentrations. We estimated that DA constitutes 2%-4% of the catecholamine released by exocytosis from sympathetic nerves and that 50%-90% of plasma DA has a sympathoneural Source. CONCLUSIONS: Plasma DA is derived Substantially from sympathetic noradrenergic nerves. (C) 2008 American Association for Clinical Chemistry