Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
J Urol. 2013 Apr;189(4):1574-9. doi: 10.1016/j.juro.2012.09.095. Epub 2012 Sep 25.
We determined the role of opioid and metabotropic glutamate 5 receptors in the pudendal inhibition of bladder overactivity.
Cystometrograms were performed in 11 cats under α-chloralose anesthesia by slowly infusing the bladder with saline or 0.25% acetic acid. Pudendal nerve stimulation at intensities of multiple times the threshold to induce observable anal twitching was applied during cystometrogram to inhibit the bladder overactivity induced by acetic acid irritation. Naloxone (0.1, 0.3 and 1 mg/kg intravenously) was administered to block opioid receptors, followed by MTEP (3 and 10 mg/kg intravenously) to block metabotropic glutamate 5 receptors. After each drug dose, pudendal inhibition of bladder overactivity was examined during cystometrogram.
Acetic acid irritated the bladder, induced bladder overactivity and significantly decreased mean ± SE bladder capacity to 23.6% ± 2.7% of saline control capacity. Pudendal nerve stimulation at 1 to 1.5 and 4 × threshold suppressed bladder overactivity and significantly increased mean capacity to 57.5% ± 8.1% (p = 0.0005) and 106% ± 15% (p = 0.0002), respectively, of saline control capacity. Naloxone had no effect on pudendal inhibition but MTEP eliminated the inhibition induced by low intensity stimulation and significantly decreased the inhibition induced by high intensity stimulation (p <0.05). Neither naloxone nor MTEP altered baseline bladder overactivity.
Opioid receptors are not involved in pudendal inhibition of bladder overactivity but metabotropic glutamate 5 receptors are partially involved. Understanding neurotransmitter mechanisms could improve the efficacy of neuromodulation therapy for overactive bladder and identify molecular targets for developing new drugs for overactive bladder.
我们旨在确定阿片和代谢型谷氨酸 5 受体在阴部抑制膀胱过度活动中的作用。
11 只猫在α-氯醛糖麻醉下进行膀胱测压,通过缓慢向膀胱内输注生理盐水或 0.25%乙酸来进行。在膀胱测压过程中,应用阴部神经刺激,刺激强度为引起可观察到肛门抽搐的多倍阈值,以抑制乙酸刺激引起的膀胱过度活动。静脉给予纳洛酮(0.1、0.3 和 1mg/kg)以阻断阿片受体,随后给予 MTEP(3 和 10mg/kg)以阻断代谢型谷氨酸 5 受体。在每次药物剂量后,在膀胱测压过程中检查阴部对膀胱过度活动的抑制作用。
乙酸刺激膀胱,引起膀胱过度活动,并使平均容量显著下降至生理盐水对照容量的 23.6%±2.7%。阴部神经刺激强度为 1 至 1.5 和 4×阈值时抑制膀胱过度活动,并使平均容量分别显著增加至生理盐水对照容量的 57.5%±8.1%(p=0.0005)和 106%±15%(p=0.0002)。纳洛酮对阴部抑制无影响,但 MTEP 消除了低强度刺激诱导的抑制,并显著降低了高强度刺激诱导的抑制(p<0.05)。纳洛酮和 MTEP 均未改变基线膀胱过度活动。
阿片受体不参与阴部抑制膀胱过度活动,但代谢型谷氨酸 5 受体部分参与。了解神经递质机制可以提高神经调节疗法治疗膀胱过度活动的疗效,并确定开发治疗膀胱过度活动新药的分子靶点。