Epinephrine suppresses stress-induced increases in plasma immunoreactive beta-endorphin in humans

The present study evaluated the hypothesis that increased plasma levels of epinephrine (EPI) stimulate immunoreactive beta-endorphin (i beta END) secretion in humans experiencing a mild stress. The stressor consisted of intraoral injections of a local anesthetic solution (with or without EPI) just before the surgical extraction of impacted third molars in 26 awake unsedated patients. The EPI group experienced a 30-fold increase in plasma EPI levels by 2 min after injection; these concentrations were physiologically active, as evidenced by increased pulse rate and systolic blood pressure. However, compared to a no EPI control group the EPI group had a significantly reduced i beta END response to the stressor, as evaluated by comparison of plasma levels at individual time points, maximal increases in plasma i beta END levels, and areas under the time-response curve. Whereas there was no association between plasma levels of EPI and i beta END in the EPI group (r = 0.119; P = NS), EPI and i beta END levels were strongly related in the no EPI group (r = 0.82; P less than 0.001). These results do not support the hypothesis of a stimulatory effect for EPI on i beta END release and, instead, suggest that an inhibitory relationship may exist in humans experiencing stress. The association between EPI and i beta END responses observed in the control group during this form of stress appears to be due to activation of a common central neural element.