β2-Adrenoceptor agonist activity of higenamine

Higenamine was included in the World Anti-Doping Agency (WADA) Prohibited Substances and Methods List as a beta(2)-adrenoceptor agonist in 2017, thereby resulting in its prohibition both in and out of competition. The present mini review describes the physiology and pharmacology of adrenoceptors, summarizes the literature addressing the mechanism of action of higenamine and extends these findings with previously unpublished in silico and in vitro work. Studies conducted in isolated in vitro systems, whole-animal preparations and a small number of clinical studies suggest that higenamine acts in part as a beta(2)-adrenoceptor agonist. In silico predictive tools indicated that higenamine and possibly a metabolite have a high probability of interacting with the beta(2)-receptor as an agonist. Stable expression of human beta(2)-receptors in Chinese hamster ovary (CHO) cells to measure agonist activity not only confirmed the activity of higenamine at beta(2) but also closely agreed with the in silico prediction of potency for this compound. These data confirm and extend literature findings supporting the inclusion of higenamine in the Prohibited List.