Division of Urology, Tottori University School of Medicine, Yonago, Japan.
BJU Int. 2012 Jul;110(2 Pt 2):E118-24. doi: 10.1111/j.1464-410X.2011.10814.x. Epub 2011 Dec 7.
Recently, several studies have suggested that detrusor overactivity (DO) is the result of bladder ischaemia. Hypertension could affect pelvic arterial blood flow, resulting in loss of smooth muscle in the bladder with resultant loss of bladder compliance. Spontaneously hypertensive rats are considered a valuable tool for exploring the pathogenesis of DO. Some reports indicate that α(1) adrenoceptor antagonists improve chronic ischaemia of the lower urinary tract in patients with LUTS, with concomitant improvement of their symptoms as well as improvement of DO through an increased bladder blood flow (BBF) in the rat with bladder outlet obstruction. However, the mechanism of improvement of silodosin on storage or irritative symptoms is not well investigated and is still unclear. Silodosin prevents hypertension-related DO in the SHR via several possible mechanisms. One possible mechanism of the efficacy of silodosin to the DO includes the improvement of the BBF.
To investigate the effect of the α(1A) selective adrenoceptor antagonist, silodosin, on hypertension-related detrusor overactivity (DO) and its possible mechanism in spontaneously hypertensive rats (SHRs).
Twelve-week-old male SHRs received treatment with silodosin (100 µg/kg perorally) once daily for 6 weeks; vehicle-treated Wistar rats and vehicle-treated SHRs were used for our study. Six weeks after silodosin treatment, voiding functions were estimated by voiding behaviour and cystometric studies in all groups. The bladder blood flow was measured by the hydrogen clearance method, and tissue levels of nerve growth factor (NGF) and calcitonin gene-related peptide (CGRP) were measured by enzyme-linked immunosorbent assay (ELISA). Furthermore, the expressions of α1 adrenoceptor subtype mRNAs in the bladder were investigated by real-time PCR method.
The SHRs showed significant increases in blood pressure, micturition frequency and tissue levels of NGF and CGRP in the bladder. Moreover, the SHRs showed significant decreases in bladder blood flow and single voided volume estimated by both voiding behaviour and cystometric studies compared with those in the Wistar rats. Six weeks of treatment with silodosin significantly ameliorated hypertension-related alterations of these variables with concomitant small changes of blood pressure. The expression levels of α1 adrenoceptor subtype mRNAs in the bladder were similar in all the groups and the rank order was α1A = α1D > α1B in all groups. However, there were no significant differences in the expressions of α(1A) adrenoceptor mRNAs between any groups.
The data in the present study suggest that silodosin normalizes hypertension-related DO in SHRs, which could be related to its effect on the increased blood flow in the bladder.
研究 α1A 肾上腺素能受体拮抗剂——西洛多辛对自发性高血压大鼠(SHR)与高血压相关的逼尿肌过度活动(DO)的作用及其可能机制。
12 周龄雄性 SHR 给予西洛多辛(100μg/kg,口服,每日 1 次)治疗 6 周;采用 Wistar 大鼠和 Wistar 大鼠给予载体作为对照。西洛多辛治疗 6 周后,通过排尿行为和膀胱测压研究评估各组的排尿功能。采用氢清除法测量膀胱血流,酶联免疫吸附法(ELISA)测量神经生长因子(NGF)和降钙素基因相关肽(CGRP)的组织水平。此外,采用实时 PCR 方法研究膀胱内α1 肾上腺素能受体亚型 mRNA 的表达。
SHR 血压显著升高,排尿频率和膀胱组织中 NGF 和 CGRP 水平升高。此外,与 Wistar 大鼠相比,SHR 的膀胱血流和单次排尿量通过排尿行为和膀胱测压研究均显著降低。西洛多辛治疗 6 周可显著改善这些变量与高血压相关的改变,同时血压略有变化。膀胱内α1 肾上腺素能受体亚型 mRNA 的表达水平在各组间相似,各组的表达顺序为α1A=α1D>α1B。然而,各组间α1A 肾上腺素能受体 mRNA 的表达无显著差异。
本研究结果表明,西洛多辛可使 SHR 与高血压相关的 DO 正常化,这可能与其对膀胱血流增加的作用有关。