Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
Life Sci. 2013 Feb 7;92(2):125-30. doi: 10.1016/j.lfs.2012.11.006. Epub 2012 Nov 21.
To confirm the role of alpha1-adrenoceptor (α(1)-AR) in the spinal cord, we investigated the effect of intrathecal application of terazosin, a non-selective α(1)-AR blocker, on the micturition reflex, as well as the change of α(1)-AR subtypes mRNA in the lumbosacral spinal cord using spinal cord injury (SCI) rats.
Adult female Sprague-Dawley rats were used 4 weeks after Th9-10 spinal cord transection. 1) Continuous cystometry was performed under an awake condition to examine the effect of intrathecal terazosin, a non-selective α(1)-AR blocker, at the level of L6-S1 spinal cord. 2) We also investigated the effect of intravenous phenylephrine, an α1-AR agonist, with or without intrathecal terazosin. 3) Quantification of α(1)-AR subtype mRNA in the L6-S1 lumbosacral spinal cord was performed in normal and SCI rats.
These results suggest that α(1)-AR facilitates the micturition reflex in the spinal cord, and α(1)-AR blockers applied in the lumbosacral spinal inhibits this effect. Upregulation of α(1)-AR in the lumbosacral spinal cord could be involved in the genesis of detrusor overactivity after SCI. Therefore, if α(1)-AR blockers pass the blood-brain barrier, they could act in the spinal cord to improve storage function in patients with detrusor overactivity (DO).
为了确认α1-肾上腺素受体(α1-AR)在脊髓中的作用,我们研究了鞘内给予特拉唑嗪(一种非选择性α1-AR 阻滞剂)对排尿反射的影响,以及使用脊髓损伤(SCI)大鼠研究腰骶脊髓中α1-AR 亚型 mRNA 的变化。
成年雌性 Sprague-Dawley 大鼠在 Th9-10 脊髓横断后 4 周使用。1)在清醒状态下进行连续膀胱测压,以检查 L6-S1 脊髓水平鞘内给予非选择性 α1-AR 阻滞剂特拉唑嗪的效果。2)我们还研究了静脉注射苯肾上腺素(一种α1-AR 激动剂),有无鞘内给予特拉唑嗪的效果。3)在正常和 SCI 大鼠的 L6-S1 腰骶脊髓中定量检测 α1-AR 亚型 mRNA。
1)特拉唑嗪(0.01-10 μg)抑制非排尿性膀胱收缩次数,并使膀胱容量增加 73%。2)苯肾上腺素(0.1 mg/kg)使膀胱容量减少 17%,排尿效率减少 20%。鞘内给予特拉唑嗪阻断了静脉注射苯肾上腺素的作用。3)SCI 后,α1-AR 亚型 mRNA 水平均升高。
这些结果表明,α1-AR 促进脊髓中的排尿反射,而腰骶脊髓中的α1-AR 阻滞剂抑制这种作用。腰骶脊髓中α1-AR 的上调可能参与 SCI 后逼尿肌过度活动的发生。因此,如果 α1-AR 阻滞剂能通过血脑屏障,它们可能在脊髓中发挥作用,改善逼尿肌过度活动(DO)患者的储存功能。