Yokoyama Osamu, Yusup Anwar, Oyama Nobuyuki, Aoki Yoshitaka, Tanase Kazuya, Matsuta Yosuke, Miwa Yoshiji, Akino Hironobu
Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan.
Neurourol Urodyn. 2006;25(5):461-7. doi: 10.1002/nau.20253.
Alpha1-blockers improve voiding symptoms through the reduction of prostatic and urethral smooth muscle tone; however, the underlying mechanism of improvement of storage symptoms is not known. Using a rat model of detrusor overactivity caused by cerebral infarction (CI), we undertook the present study to determine whether the effect of an alpha1-blocker, naftopidil, is dependent on the suppression of C-fiber afferents.
To induce desensitization of C-fiber bladder afferents, we injected resiniferatoxin (0.3 mg/kg, RTX) sub-cutaneously to female Sprague-Dawley rats 2 days prior to left middle cerebral artery occlusion (MCAO) (RTX-CI rats). As controls we used rats without RTX treatment (CI rats). MCAO and insertion of a polyethylene catheter through the bladder dome were performed under halothane anesthesia. We investigated the effects on cystometrography (CMG) of intravenous (i.v.), intracerebroventricular (i.c.v.), or intrathecal (i.t.) administration of naftopidil in conscious CI rats.
Bladder capacity (BC) was markedly reduced after MCAO in both RTX-CI and CI rats. I.v. administration of naftopidil significantly increased BC in CI rats without an increase in residual volume, but it had no effects on BC in RTX-CI rats. I.t. administration of naftopidil significantly increased BC in CI but not in RTX-CI rats.
These results suggest that naftopidil has an inhibitory effect on C-fiber afferents in the lumbosacral spinal cord, improving BC during the storage phase.
α1受体阻滞剂通过降低前列腺和尿道平滑肌张力改善排尿症状;然而,其改善储尿期症状的潜在机制尚不清楚。我们使用脑梗死(CI)所致逼尿肌过度活动的大鼠模型进行本研究,以确定α1受体阻滞剂萘哌地尔的作用是否依赖于对C纤维传入神经的抑制。
为诱导C纤维膀胱传入神经脱敏,在雌性Sprague-Dawley大鼠左侧大脑中动脉闭塞(MCAO)前2天皮下注射树脂毒素(0.3 mg/kg,RTX)(RTX-CI大鼠)。作为对照,我们使用未接受RTX治疗的大鼠(CI大鼠)。在氟烷麻醉下进行MCAO及经膀胱顶部插入聚乙烯导管。我们研究了在清醒的CI大鼠中静脉内(i.v.)、脑室内(i.c.v.)或鞘内(i.t.)给予萘哌地尔对膀胱压力容积测定(CMG)的影响。
RTX-CI大鼠和CI大鼠MCAO后膀胱容量(BC)均显著降低。静脉注射萘哌地尔可显著增加CI大鼠的BC,且残余尿量无增加,但对RTX-CI大鼠的BC无影响。鞘内注射萘哌地尔可显著增加CI大鼠而非RTX-CI大鼠的BC。
这些结果表明,萘哌地尔对腰骶脊髓中的C纤维传入神经具有抑制作用,可改善储尿期的BC。