Iijima Kazuyoshi, De Wachter Stefan, Wyndaele Jean-Jacques
Department of Urology, Faculty of Medicine, University Antwerp, Antwerp, Belgium.
Eur Urol. 2007 Sep;52(3):842-7. doi: 10.1016/j.eururo.2007.02.057. Epub 2007 Mar 6.
Previous studies have revealed that intravesical and systemic administration of oxybutinin suppress pelvic afferent nerves. This study evaluates the efficacy of a selective M3 antimuscarinic, darifenacin, on bladder afferent activity.
Sixteen single bladder afferent fibers were isolated in nine female Sprague-Dawley rats. On the basis of their conduction velocities, they were grouped as Adelta or C fibers. The effect of repeat bladder filling was studied on the mechanosensitive properties of these units. The M3 receptor selective muscarinic antagonist darifenacin (0.1mg/kg) was administered intravenously. Unitary afferent activity was again analyzed 30, 60, 90, and 120 min after the drug administration.
Seven units corresponded to criteria for Adelta fibers, nine for C fibers. Repeat bladder filling did not change nerve activity in Adelta or C fibers. When nerve activity was expressed as a percent of control activity, afferent sensitivity changed after darifenacin in Adelta fibers: 86+/-27%, 30 min (p>0.05), 69 +/- 32%, 60 min (p<0.05), 56 +/- 36%, 90 min (p<0.05), and 61+/- 49%, 120 min (p>0.05), and in C fibers: 70+/-39%, 30 min (p<0.05), 57 +/- 49%, 60 min (p<0.05), 45 +/- 42%, 90 min (p<0.01), and 47 +/- 43%, 120 min (p<0.01).
In this study we show that darifenacin reduces bladder afferent activity in both Adelta and C fibers. The decrease in afferent spikes in C fibers may be more pronounced than that in Adelta fibers. These results may explain that the efficacy of darifenacin in overactive bladder symptoms is partly due to bladder afferent desensitization.
既往研究显示,膀胱内及全身应用奥昔布宁可抑制盆腔传入神经。本研究评估选择性M3抗毒蕈碱药物达非那新对膀胱传入活动的疗效。
在9只雌性Sprague-Dawley大鼠中分离出16条单膀胱传入纤维。根据其传导速度,将它们分为Aδ纤维或C纤维。研究重复膀胱充盈对这些单位机械敏感性的影响。静脉注射M3受体选择性毒蕈碱拮抗剂达非那新(0.1mg/kg)。给药后30、60、90和120分钟再次分析单位传入活动。
7个单位符合Aδ纤维标准,9个符合C纤维标准。重复膀胱充盈未改变Aδ或C纤维的神经活动。当神经活动以对照活动的百分比表示时,达非那新给药后Aδ纤维的传入敏感性发生变化:30分钟时为86±27%(p>0.05),60分钟时为69±32%(p<0.05),90分钟时为56±36%(p<0.05),120分钟时为61±49%(p>0.05);C纤维的传入敏感性变化为:当神经活动以对照活动的百分比表示时,达非那新给药后C纤维的传入敏感性发生变化:30分钟时为70±39%(p<0.05),60分钟时为57±49%(p<0.05),90分钟时为45±42%(p<0.01),120分钟时为47±43%(p<0.01)。
在本研究中,我们表明达非那新可降低Aδ和C纤维中的膀胱传入活动。C纤维中传入冲动的减少可能比Aδ纤维中更明显。这些结果可能解释了达非那新治疗膀胱过度活动症症状的疗效部分归因于膀胱传入脱敏。