Scheepe J R, van den Hoek J, Jünemann K P, Alken P
Department of Urology and Pediatric Urology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Neurourol Urodyn. 2006;25(5):468-72. doi: 10.1002/nau.20257.
Endothelin (ET) is a strong constrictor of smooth muscle structures. The relevance of Endothelin-A receptors in the bladder was demonstrated in several in vitro studies. The aim of this functional study was to evaluate the acute effect of the selective ET-A-antagonist LU 302146 (LU) on neurostimulation-induced bladder contractions in vivo.
Eight male mini pigs were anesthesized. The bladder was exposed and a double lumen catheter was inserted to perform intravesical pressure (pves) measurements. Laminectomy was performed for sacral anterior root stimulation (SARS) of S2. Four animals received the selective ET-A-antagonist LU, three atropine and one animal was treated with vehicle. Pves was recorded before and after drug administration as well as before and during neurostimulation. At the end of each LU trial, a supplementary application of 4 mg atropine was administered followed by a final SARS.
In all experiments reproducible pves values were elicited during electrostimulation before administration of the test substance. The selective ET-A-antagonist reduced stimulation-induced bladder contraction by a mean of 57%. Additional administration of atropine inhibited the detrusor contraction almost completely during SARS. The vehicle had no effect on bladder contraction.
In the presented animal model, ET-1 inhibition with the selective ET receptor-A-antagonist LU 302146 decreases stimulation-induced bladder contraction in vivo. The results suggest that the selective ET-A antagonist LU acts on the atropine-resistant component of efferent detrusor activation since additional administration of atropine almost completely abolish detrusor contraction. This observation in addition to the involvement of ET-1 in bladder smooth muscle proliferation, raises the possibility that ET-receptor antagonists might be beneficial in patients with neurogenic bladder dysfunction or in patients with functional or anatomical BOO.
内皮素(ET)是平滑肌结构的强效收缩剂。多项体外研究证实了内皮素A受体在膀胱中的相关性。本功能研究的目的是评估选择性ET-A拮抗剂LU 302146(LU)对体内神经刺激诱导的膀胱收缩的急性作用。
八只雄性小型猪麻醉后,暴露膀胱并插入双腔导管以测量膀胱内压(pves)。进行椎板切除术以刺激S2的骶前根(SARS)。四只动物接受选择性ET-A拮抗剂LU,三只动物接受阿托品,一只动物接受赋形剂治疗。在给药前和给药后以及神经刺激前和刺激期间记录pves。在每个LU试验结束时,额外给予4mg阿托品,然后进行最后的SARS。
在所有实验中,在给予测试物质之前的电刺激期间可引出可重复的pves值。选择性ET-A拮抗剂使刺激诱导的膀胱收缩平均降低57%。额外给予阿托品在SARS期间几乎完全抑制了逼尿肌收缩。赋形剂对膀胱收缩无影响。
在本动物模型中,用选择性ET受体-A拮抗剂LU 302146抑制ET-1可降低体内刺激诱导的膀胱收缩。结果表明,选择性ET-A拮抗剂LU作用于传出性逼尿肌激活的阿托品抵抗成分,因为额外给予阿托品几乎完全消除了逼尿肌收缩。这一观察结果以及ET-1参与膀胱平滑肌增殖,增加了ET受体拮抗剂可能对神经源性膀胱功能障碍患者或功能性或解剖性膀胱出口梗阻患者有益的可能性。