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Overactive bladder--pharmacological aspects.

Andersson, Karl-Erik LU (2002) In Scandinavian Journal of Urology and Nephrology, Supplementum Suppl 210(Supp 210). p.72-81
Abstract
The micturition reflex can be initiated by contraction or distension of detrusor smooth muscle cells, or by signals from the urothelium. It has been shown that bladder distension causes release of ATP from the urothelium and that ATP can activate P2X(3) receptors on suburothelial afferent nerve terminals to evoke a neural discharge. However, most probably the activation of afferent fibres during bladder filling involves not only ATP, but a cascade of inhibitory and stimulatory transmitters/mediators. These mechanisms may be targets for future drugs. Both in the normal and functionally disturbed bladder, muscarinic receptor stimulation produces the main part of detrusor contraction, but evidence is accumulating that in disease states, such... (More)
The micturition reflex can be initiated by contraction or distension of detrusor smooth muscle cells, or by signals from the urothelium. It has been shown that bladder distension causes release of ATP from the urothelium and that ATP can activate P2X(3) receptors on suburothelial afferent nerve terminals to evoke a neural discharge. However, most probably the activation of afferent fibres during bladder filling involves not only ATP, but a cascade of inhibitory and stimulatory transmitters/mediators. These mechanisms may be targets for future drugs. Both in the normal and functionally disturbed bladder, muscarinic receptor stimulation produces the main part of detrusor contraction, but evidence is accumulating that in disease states, such as neurogenic bladders, outflow obstruction, idiopathic detrusor instability, interstitial cystitis, and also in the ageing bladder, a non-cholinergic activation via purinergic receptors may occur. If this component of activation is responsible not only for part of the bladder contractions, but also for the symptoms of the overactive bladder, it should be considered an important target for therapeutic interventions. Drugs blocking different P2X receptor subtypes, or counteracting bladder contraction via other mechanisms. e.g. beta(3)-adrenoceptor stimulation, may be developed for treatment of the overactive bladder. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
micturition reflex, activation, muscarinic receptors, urothelium, purinergic receptors, bladder
in
Scandinavian Journal of Urology and Nephrology, Supplementum
volume
Suppl 210
issue
Supp 210
pages
72 - 81
publisher
Taylor & Francis
external identifiers
  • wos:000179459900014
  • scopus:0036025393
ISSN
0300-8886
DOI
10.1080/003655902320766006
language
English
LU publication?
yes
id
f302b413-5b32-4431-9a47-64375ab45bba (old id 111444)
date added to LUP
2007-07-04 14:28:04
date last changed
2017-10-08 03:44:25
@article{f302b413-5b32-4431-9a47-64375ab45bba,
  abstract     = {The micturition reflex can be initiated by contraction or distension of detrusor smooth muscle cells, or by signals from the urothelium. It has been shown that bladder distension causes release of ATP from the urothelium and that ATP can activate P2X(3) receptors on suburothelial afferent nerve terminals to evoke a neural discharge. However, most probably the activation of afferent fibres during bladder filling involves not only ATP, but a cascade of inhibitory and stimulatory transmitters/mediators. These mechanisms may be targets for future drugs. Both in the normal and functionally disturbed bladder, muscarinic receptor stimulation produces the main part of detrusor contraction, but evidence is accumulating that in disease states, such as neurogenic bladders, outflow obstruction, idiopathic detrusor instability, interstitial cystitis, and also in the ageing bladder, a non-cholinergic activation via purinergic receptors may occur. If this component of activation is responsible not only for part of the bladder contractions, but also for the symptoms of the overactive bladder, it should be considered an important target for therapeutic interventions. Drugs blocking different P2X receptor subtypes, or counteracting bladder contraction via other mechanisms. e.g. beta(3)-adrenoceptor stimulation, may be developed for treatment of the overactive bladder.},
  author       = {Andersson, Karl-Erik},
  issn         = {0300-8886},
  keyword      = {micturition reflex,activation,muscarinic receptors,urothelium,purinergic receptors,bladder},
  language     = {eng},
  number       = {Supp 210},
  pages        = {72--81},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology and Nephrology, Supplementum},
  title        = {Overactive bladder--pharmacological aspects.},
  url          = {http://dx.doi.org/10.1080/003655902320766006},
  volume       = {Suppl 210},
  year         = {2002},
}