Seo K K, Lee M Y, Lim S W, Kim S C
Department of Urology, College of Medicine, Chung-Ang University, Seoul, Korea.
J Korean Med Sci. 1999 Feb;14(1):69-74. doi: 10.3346/jkms.1999.14.1.69.
Alpha1a-adrenergic receptor (AR) primarily mediates the contraction of the prostatic and cavernous smooth muscles. Among clinically available alpha1-AR antagonists for the medical management of benign prostatic hyperplasia (BPH), tamsulosin has a modest selectivity for alpha1A- and alpha1D- over alpha1B-ARs. To compare the effects of various alpha1-AR antagonists on relaxation responses of cavernous and trigonal smooth muscles, isometric tension studies with relatively selective (tamsulosin) and non-selective (prazosin, doxazosin, and terazosin) alpha1A-AR antagonists, were conducted in the cavernous and trigonal muscle strips of rabbits (n=10 each). Tamsulosin had the strongest inhibitory effect on contraction of trigonal smooth muscle among the various alpha1-AR antagonists, and the inhibitory activities of prazosin, doxazosin, and terazosin were not statistically different. All alpha1-AR antagonists caused concentration-dependent relaxation of the cavernous muscle strips. Tamsulosin was shown to have greater potency than prazosin (more than 100-fold), doxazosin (more than 1000-fold), and terazosin (more than 1000-fold), in relaxation of cavernous smooth muscle. In conclusion, tamsulosin might be the most effective drug among the four commonly used alpha1-AR antagonists for the medical management of BPH. Tamsulosin might be a potential substitute for phentolamine in combination with vasoactive agents as an intracavernous injection therapy for patients with erectile dysfunction.
α1a - 肾上腺素能受体(AR)主要介导前列腺和海绵体平滑肌的收缩。在临床上可用于治疗良性前列腺增生(BPH)的α1 - AR拮抗剂中,坦索罗辛对α1A - 和α1D - AR的选择性略高于α1B - AR。为比较各种α1 - AR拮抗剂对海绵体和三角区平滑肌舒张反应的影响,在兔的海绵体和三角区肌条(每组n = 10)上进行了等长张力研究,使用了相对选择性的(坦索罗辛)和非选择性的(哌唑嗪、多沙唑嗪和特拉唑嗪)α1A - AR拮抗剂。在各种α1 - AR拮抗剂中,坦索罗辛对三角区平滑肌收缩的抑制作用最强,哌唑嗪、多沙唑嗪和特拉唑嗪的抑制活性无统计学差异。所有α1 - AR拮抗剂均引起海绵体肌条浓度依赖性舒张。在海绵体平滑肌舒张方面,坦索罗辛的效力比哌唑嗪(超过100倍)、多沙唑嗪(超过1000倍)和特拉唑嗪(超过1000倍)更强。总之,坦索罗辛可能是四种常用α1 - AR拮抗剂中治疗BPH最有效的药物。坦索罗辛可能是酚妥拉明的潜在替代品,可与血管活性药物联合用于勃起功能障碍患者的海绵体内注射治疗。