Department of Urology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Exp Neurol. 2010 Jul;224(1):282-91. doi: 10.1016/j.expneurol.2010.04.003. Epub 2010 Apr 9.
To determine the involvement of opioid receptors in the inhibitory pudendal-to-bladder reflex, the effect of naloxone (0.01-1 mg/kg, i.v.), an opioid receptor antagonist, on the inhibition of bladder activity evoked by pudendal nerve stimulation was investigated in alpha-chloralose anesthetized cats. The inhibition of reflex isovolumetric bladder contractions induced by pudendal nerve stimulation (5-10 Hz) at intensity threshold (T) for producing complete inhibition was significantly suppressed by naloxone at a high dose (0.3 mg/kg). However, the inhibition elicited at higher intensities (1.5-3 T) was not changed. Naloxone (1 mg/kg) did not alter the frequency dependence of the inhibitory effect of pudendal stimulation. During cystometrograms (CMGs) pudendal nerve stimulation significantly increased bladder capacity to 155.1+/-24.5% and 163.4+/-10% of the control at stimulation intensities of 1 T and 1.5-3 T, respectively. After administration of naloxone (1 mg/kg), the bladder capacity during pudendal nerve stimulation at inhibition threshold (1 T) was not significantly different from control, but it was significantly increased at higher intensities (1.5-3 T). Naloxone alone markedly reduced bladder capacity to 43+/-11.1% of the control, and pudendal stimulation completely reversed this facilitatory effect. This study revealed that activation of opioid receptors contributes to or facilitates the inhibitory pudendal-to-bladder reflex. The reduction in bladder capacity after naloxone treatment also indicates that endogenous opioid peptides mediate a tonic inhibition of micturition. Understanding the neurotransmitter mechanisms involved in the inhibitory pudendal-to-bladder reflex could promote the development of new treatments for bladder overactivity and incontinence.
为了确定阿片受体是否参与阴部神经至膀胱反射的抑制作用,本研究在氯醛糖麻醉猫中观察了阿片受体拮抗剂纳洛酮(0.01-1mg/kg,静脉注射)对阴部神经刺激诱发的膀胱活动抑制的影响。纳洛酮(0.3mg/kg)可显著抑制阴部神经刺激(5-10Hz)诱发的反射性等容膀胱收缩,该抑制反应的强度阈值(T)为产生完全抑制所需的最低刺激强度。然而,较高强度(1.5-3T)刺激诱发的抑制反应未发生改变。纳洛酮(1mg/kg)不改变阴部刺激抑制效应的频率依赖性。在膀胱测压图(CMG)中,阴部神经刺激可使膀胱容量分别增加至对照的 155.1+/-24.5%和 163.4+/-10%,刺激强度分别为 1T 和 1.5-3T。给予纳洛酮(1mg/kg)后,在抑制阈值(1T)时,阴部神经刺激期间的膀胱容量与对照相比无显著差异,但在较高强度(1.5-3T)时显著增加。纳洛酮本身可使膀胱容量显著减少至对照的 43+/-11.1%,而阴部刺激完全逆转了这种易化作用。本研究表明,阿片受体的激活有助于或促进阴部神经至膀胱反射的抑制。纳洛酮治疗后膀胱容量的减少也表明内源性阿片肽介导了对排尿的紧张性抑制。了解抑制性阴部神经至膀胱反射所涉及的神经递质机制可能有助于开发治疗膀胱过度活动症和尿失禁的新方法。