Gup D I, Shapiro E, Baumann M, Lepor H
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri.
J Urol. 1990 Jan;143(1):179-85. doi: 10.1016/s0022-5347(17)39906-8.
Radioligand receptor binding techniques were used to characterize alpha 1 adrenergic, alpha 2 adrenergic and muscarinic cholinergic (MCh) binding sites in human prostate adenomas obtained from men with symptomatic and asymptomatic benign prostatic hyperplasia (BPH). Prostate adenoma specimens were obtained from nine men with asymptomatic BPH undergoing cystoprostatectomy, 11 men with symptomatic BPH undergoing open prostatectomy, and 11 men with symptomatic BPH undergoing transurethral resection of the prostate (TURP). A quantitative symptoms score analysis and urinary flow rate determinations documented the absence of bladder outlet obstruction in men undergoing cystoprostatectomy and confirmed the presence of bladder outlet obstruction in men undergoing prostatectomy. The mean equilibrium dissociation constants (Kd) and the mean densities of 125I-Heat (alpha 1 adrenergic) and 3H-NMS (MCh) binding sites were similar in tissue homogenates obtained from men with asymptomatic and symptomatic BPH. The mean Kd of 3H-Rauwolscine (3H-Ra) was significantly greater in the prostatectomy specimens obtained from men with symptomatic BPH compared to the specimens obtained from men with asymptomatic BPH (p less than 0.05). The density of 3H-Ra (alpha 2 adrenergic) binding sites was significantly greater in the prostate adenomas obtained from men with symptomatic BPH compared to the prostate adenomas obtained from men with asymptomatic BPH (p less than 0.05). The difference in alpha 2 adrenoceptor density was accounted for by an increased receptor density in the open prostatectomy specimens. There was no significant correlation between alpha 2 adrenergic, alpha 1 adrenergic, and MCh receptor densities and prostate weight or patient age. This study indicates that the development of infravesical obstruction in men with BPH is not related to upregulation or altered binding affinity of alpha 1 adrenergic or MCh receptor binding sites. The significance of the observed upregulation of alpha 2 adrenoreceptors in the prostate adenomas obtained from men undergoing open prostatectomy is unknown, and requires further investigation.
采用放射性配体受体结合技术，对从有症状和无症状良性前列腺增生（BPH）男性患者获取的人前列腺腺瘤中的α1肾上腺素能、α2肾上腺素能和毒蕈碱胆碱能（MCh）结合位点进行特征分析。前列腺腺瘤标本取自9例接受膀胱前列腺切除术的无症状BPH男性患者、11例接受开放性前列腺切除术的有症状BPH男性患者以及11例接受经尿道前列腺切除术（TURP）的有症状BPH男性患者。定量症状评分分析和尿流率测定表明，接受膀胱前列腺切除术的男性不存在膀胱出口梗阻，而接受前列腺切除术的男性存在膀胱出口梗阻。在从无症状和有症状BPH男性患者获取的组织匀浆中，125I-Heat（α1肾上腺素能）和3H-NMS（MCh）结合位点的平均平衡解离常数（Kd）及平均密度相似。与从无症状BPH男性患者获取的标本相比，从有症状BPH男性患者获取的前列腺切除术标本中，3H-萝芙木碱（3H-Ra）的平均Kd显著更高（p<0.05）。与从无症状BPH男性患者获取的前列腺腺瘤相比，从有症状BPH男性患者获取的前列腺腺瘤中，3H-Ra（α2肾上腺素能）结合位点的密度显著更高（p<0.05）。α2肾上腺素能受体密度的差异是由开放性前列腺切除术标本中受体密度增加所致。α2肾上腺素能、α1肾上腺素能和MCh受体密度与前列腺重量或患者年龄之间无显著相关性。本研究表明，BPH男性患者膀胱下梗阻的发生与α1肾上腺素能或MCh受体结合位点的上调或结合亲和力改变无关。在接受开放性前列腺切除术的男性患者所获前列腺腺瘤中观察到的α2肾上腺素能受体上调的意义尚不清楚，需要进一步研究。
