Kumar Vivek, Chapple Christopher C, Chess-Williams Russell
Department of Urology, Royal Hallamshire Hospital, United Kingdom.
J Urol. 2004 Aug;172(2):744-7. doi: 10.1097/01.ju.0000131244.67160.f4abstract.
Although the sensory and motor roles of the purinergic system in the bladder are well proven in animal species, there is increasing evidence that it may have an important role in humans. In addition, it may be important in the pathophysiology of bladder dysfunction. We established the level of adenosine triphosphate (ATP) release from porcine and normal human bladders.
Bladder strips from patients with a urodynamically proven stable bladder undergoing surgery for stress incontinence and those undergoing cystectomy for cancer with no lower urinary tract symptoms were subjected to varying degrees of stretch (up to 50%) and electric field stimulation (10 to 40 Hz). A luciferase assay was used to quantify ATP release.
Significantly increased ATP release over baseline was induced by mechanical and electrical stimulation (each p <0.05). Mean ATP release +/- SE from porcine bladders (38.2 +/- 1.9 pM/gm tissue following stretch and 19.9 +/- 6.5 pM/gm following electrical stimulation) was comparable to the release from human bladders (26.1 +/- 2.4 pM/gm tissue following stretch and 29.9 +/- 1.0 pM/gm following electrical stimulation). The main source of ATP release was the urothelium and not the muscle (p <0.05). This ATP release following stretch was not tetrodotoxin sensitive.
The characteristics of ATP release from porcine and human bladders are similar and, therefore, the pig is a good model for humans. The main source of ATP release is urothelium from predominantly nonneuronal sources. This study supports a sensory role for ATP. An increased role for this purinergic neurotransmission may result in functional motor as well as sensory bladder disorders.
尽管嘌呤能系统在动物膀胱中的感觉和运动作用已得到充分证实,但越来越多的证据表明其在人类中可能也起着重要作用。此外,它在膀胱功能障碍的病理生理学中可能也很重要。我们测定了猪膀胱和正常人类膀胱中三磷酸腺苷(ATP)的释放水平。
对因压力性尿失禁接受手术且尿动力学证实膀胱稳定的患者以及因癌症接受膀胱切除术且无下尿路症状的患者的膀胱条进行不同程度的拉伸(高达50%)和电场刺激(10至40赫兹)。采用荧光素酶测定法对ATP释放进行定量。
机械和电刺激均能诱导ATP释放较基线水平显著增加(各p<0.05)。猪膀胱拉伸后平均ATP释放量±标准误为(38.2±1.9皮摩尔/克组织),电刺激后为(19.9±6.5皮摩尔/克组织),与人类膀胱释放量相当(拉伸后为26.1±2.4皮摩尔/克组织,电刺激后为29.9±1.0皮摩尔/克组织)。ATP释放的主要来源是尿路上皮而非肌肉(p<0.05)。拉伸后这种ATP释放对河豚毒素不敏感。
猪膀胱和人类膀胱ATP释放的特征相似,因此猪是人类的良好模型。ATP释放的主要来源是主要来自非神经元来源的尿路上皮。本研究支持ATP具有感觉作用。这种嘌呤能神经传递作用的增强可能导致膀胱功能运动及感觉障碍。