Pehrson Rikard, Lehmann Anders, Andersson Karl-Erik
Department of Clinical Pharmaology, Lund University Hospital, Sweden.
J Urol. 2002 Dec;168(6):2700-5. doi: 10.1016/S0022-5347(05)64247-4.
Using baclofen (Sigma-Aldrich, Steinheim, Germany), a gamma-aminobutyrate B (GABA(B)) receptor agonist, and CGP62349 (AstraZeneca R & D Mölndal, Sweden), a GABA(B) receptor antagonist, in a rat model of conscious micturition we addressed certain questions, including whether there is a tonic GABA(B) receptor influence on normal bladder function, how baclofen affects normal and C-fiber activated micturition, and where the sites of GABA(B) receptor action are.
Nonanesthetized female Sprague-Dawley rats were used. The bladder was catheterized and other catheters were placed intravenously, intrathecally or intracerebroventricularly. At 3 days the rats underwent cystometric investigation in a metabolic cage. Micturition was stimulated by infusing saline intravesically. Overactivity caused by C-fiber activation was induced by intravesical oxyhemoglobin. Drugs were given intravenously, intrathecally or intracerebroventricularly. Micturition parameters were recorded and compared before and after drug administration.
Baclofen at doses of 0.5 microg. intrathecally and 0.3 microg. intracerebroventricularly increased bladder capacity and threshold pressure. Overflow incontinence developed in 4 of 7 rats after 0.5 microg. baclofen intrathecally and in 5 of 7 after 1 microg. baclofen intracerebroventricularly. CGP62349 at a dose of 30 microg. intrathecally and intracerebroventricularly had a stimulatory effect on micturition, which was attenuated by baclofen. While intravenous baclofen at 1 mg. (-1)kg. was devoid of effects, intravenous baclofen at 4 mg. kg. (-1)tended to decrease micturition pressure, bladder capacity and micturition volume. Infusion volume decreased significantly, demonstrating a diuretic effect, which was abolished by pretreatment with subcutaneous desmopressin at 25 ng. kg. (-1). CGP62349 at 2 mg. kg. (-1) intravenously had a stimulatory effect on micturition, which was inhibited by baclofen. Intravesical oxyhemoglobin at 250 microM. induced bladder overactivity, which was attenuated by baclofen at 4 mg. kg. (-1) intravenously and abolished by baclofen 0.5 microg intrathecally.
In the normal rat stimulation of GABA(B) receptors, mainly in the central nervous system, inhibits micturition. Antagonism of GABA(B) receptors stimulates micturition, suggesting that the receptors are under tonic GABAergic influence. Baclofen intrathecally attenuated oxyhemoglobin induced detrusor overactivity, suggesting that the inhibitory actions of GABA(B) receptor agonists in the spinal cord may be useful for controlling micturition disorders caused by C-fiber activation in the urothelium and/or suburothelium.
使用巴氯芬(德国施泰因海姆西格玛奥德里奇公司),一种γ-氨基丁酸B(GABA(B))受体激动剂,以及CGP62349(瑞典阿斯利康研发莫恩达尔公司),一种GABA(B)受体拮抗剂,在清醒排尿大鼠模型中,我们探讨了某些问题,包括是否存在GABA(B)受体对正常膀胱功能的紧张性影响,巴氯芬如何影响正常和C纤维激活的排尿,以及GABA(B)受体作用位点在哪里。
使用未麻醉的雌性斯普拉格-道利大鼠。膀胱插管,其他导管分别经静脉、鞘内或脑室内放置。3天后,大鼠在代谢笼中进行膀胱测压研究。通过膀胱内注入生理盐水刺激排尿。膀胱内注入氧合血红蛋白诱导C纤维激活引起的膀胱过度活动。药物经静脉、鞘内或脑室内给药。记录给药前后的排尿参数并进行比较。
鞘内注射0.5微克和脑室内注射0.3微克的巴氯芬增加了膀胱容量和阈压力。鞘内注射0.5微克巴氯芬后,7只大鼠中有4只出现充溢性尿失禁;脑室内注射1微克巴氯芬后,7只大鼠中有5只出现充溢性尿失禁。鞘内和脑室内注射30微克的CGP62349对排尿有刺激作用,这种作用被巴氯芬减弱。静脉注射1毫克·千克⁻¹的巴氯芬无作用,而静脉注射4毫克·千克⁻¹的巴氯芬倾向于降低排尿压力、膀胱容量和排尿量。输注量显著减少,表明有利尿作用,皮下注射25纳克·千克⁻¹的去氨加压素预处理可消除这种作用。静脉注射2毫克·千克⁻¹的CGP62349对排尿有刺激作用,这种作用被巴氯芬抑制。膀胱内注入250微摩尔的氧合血红蛋白诱导膀胱过度活动,静脉注射4毫克·千克⁻¹的巴氯芬可减弱这种作用,鞘内注射0.5微克的巴氯芬可消除这种作用。
在正常大鼠中,主要在中枢神经系统刺激GABA(B)受体会抑制排尿。拮抗GABA(B)受体会刺激排尿,表明这些受体受到紧张性GABA能的影响。鞘内注射巴氯芬可减弱氧合血红蛋白诱导的逼尿肌过度活动,表明GABA(B)受体激动剂在脊髓中的抑制作用可能有助于控制由尿路上皮和/或黏膜下层C纤维激活引起的排尿障碍。