Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA.
BJU Int. 2010 Oct;106(8):1114-27. doi: 10.1111/j.1464-410X.2010.09650.x.
• The pathophysiology of lower urinary tract symptoms (LUTS), detrusor overactivity (DO), and the overactive bladder (OAB) syndrome is multifactorial and remains poorly understood. • The transient receptor potential (TRP) channel superfamily has been shown to be involved in nociception and mechanosensory transduction in various organ systems, and studies of the LUT have indicated that several TRP channels, including TRPV1, TRPV2, TRPV4, TRPM8, and TRPA1, are expressed in the bladder, and may act as sensors of stretch and/or chemical irritation. • However, the roles of these individual channels for normal LUT function and in LUTS/DO/OAB, have not been established. • TRPV1 is the channel best investigated. It is widely distributed in LUT structures, but despite extensive information on morphology and function in animal models, the role of this channel in normal human bladder function is still controversial. Conversely, its role in the pathophysiology and treatment of particularly neurogenic DO is well established. • TRPV1 is co-expressed with TRPA1, and TRPA1 is known to be present on capsaicin-sensitive primary sensory neurones. Activation of this channel can induce DO in animal models. • TRPV4 is a Ca(2+)-permeable stretch-activated cation channel, involved in stretch-induced ATP release, and TRPV4-deficient mice exhibit abnormal frequencies of voiding and non-voiding contractions in cystometric experiments. • TRPM8 is a cool receptor expressed in the urothelium and suburothelial sensory fibres. It has been implicated in the bladder-cooling reflex and in idiopathic DO. • The occurrence of other members of the TRP superfamily in the LUT has been reported, but information on their effects on LUT functions is scarce. There seem to be several links between activation of different members of the TRP superfamily and LUTS/DO/OAB, and further exploration of the involvement of these channels in LUT function, normally and in dysfunction, may be rewarding.
• 下尿路症状 (LUTS)、逼尿肌过度活动 (DO) 和膀胱过度活动症 (OAB) 综合征的病理生理学是多因素的,仍知之甚少。 • 瞬时受体电位 (TRP) 通道超家族已被证明参与各种器官系统的伤害感受和机械感觉转导,对 LUT 的研究表明,几种 TRP 通道,包括 TRPV1、TRPV2、TRPV4、TRPM8 和 TRPA1,在膀胱中表达,并且可能作为伸展和/或化学刺激的传感器。 • 然而,这些单个通道在正常 LUT 功能和 LUTS/DO/OAB 中的作用尚未确定。 • TRPV1 是研究最多的通道。它广泛分布于 LUT 结构中,但尽管在动物模型中对其形态和功能有广泛的信息,但该通道在正常人类膀胱功能中的作用仍存在争议。相反,其在神经源性 DO 的病理生理学和治疗中的作用已得到充分证实。 • TRPV1 与 TRPA1 共同表达,并且已知 TRPA1 存在于辣椒素敏感的初级感觉神经元上。该通道的激活可在动物模型中引起 DO。 • TRPV4 是一种 Ca(2+)-可渗透的张力激活阳离子通道,参与张力诱导的 ATP 释放,并且 TRPV4 缺陷小鼠在膀胱测压实验中表现出异常的排尿和非排尿收缩频率。 • TRPM8 是一种在尿路上皮和下尿路感觉纤维中表达的冷受体。它与膀胱冷却反射和特发性 DO 有关。 • 在 LUT 中已经报道了 TRP 超家族的其他成员的存在,但关于它们对 LUT 功能的影响的信息很少。不同 TRP 超家族成员的激活与 LUTS/DO/OAB 之间似乎存在多种联系,进一步探索这些通道在 LUT 功能中的正常和功能障碍中的作用可能是有益的。