Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy.
Br J Pharmacol. 2013 May;169(1):230-8. doi: 10.1111/bph.12123.
α1 -adrenoceptor (-AR) antagonists may facilitate ureter stone passage in humans. We aimed to study effects by the α1 A -AR selective antagonist silodosin (compared to tamsulosin and prazosin) on ureter pressures in a rat model of ureter obstruction, and on contractions of human and rat isolated ureters.
After ethical approval, ureters of male rats were cannulated beneath the kidney pelvis for in vivo ureteral intraluminal recording of autonomous peristaltic pressure waves. A partial ureter obstruction was applied to the distal ureter. Mean arterial blood pressure (MAP) was recorded. Approximate clinical and triple clinical doses of the α1 -AR antagonists were given intravenously. Effects by the α1 -AR antagonists on isolated human and rat ureters were studied in organ baths.
Intravenous silodosin (0.1-0.3 mg kg(-1) ) or prazosin (0.03-0.1 mg kg(-1) ) reduced obstruction-induced increases in intraluminal ureter pressures by 21-37% or 18-40% respectively. Corresponding effects by tamsulosin (0.01 or 0.03 mg kg(-1) ) were 9-20%. Silodosin, prazosin and tamsulosin reduced MAP by 10-12%, 25-26% (P < 0.05), or 18-25% (P < 0.05) respectively. When effects by the α1 A -AR antagonists on obstruction-induced ureter pressures were expressed as a function of MAP, silodosin had six- to eightfold and 2.5- to eightfold better efficacy than tamsulosin or prazosin respectively. Silodosin effectively reduced contractions of both human and rat isolated ureters.
Silodosin inhibits contractions of the rat and human isolated ureters and has excellent functional selectivity in vivo to relieve pressure-load of the rat obstructed ureter. Silodosin as pharmacological ureter stone expulsive therapy should be clinically further explored.
α1-肾上腺素受体(AR)拮抗剂可能有助于人类输尿管结石排出。我们旨在研究α1A-AR 选择性拮抗剂西洛多辛(与坦索罗辛和哌唑嗪相比)对大鼠输尿管梗阻模型中输尿管压力的影响,以及对人和大鼠离体输尿管收缩的影响。
在获得伦理批准后,雄性大鼠的输尿管在肾盂下进行插管,以进行自主蠕动压力波的输尿管腔内记录。在输尿管远端施加部分梗阻。记录平均动脉血压(MAP)。静脉内给予近似临床和三倍临床剂量的α1-AR 拮抗剂。在器官浴中研究了α1-AR 拮抗剂对离体人及大鼠输尿管的作用。
静脉内给予西洛多辛(0.1-0.3mg/kg)或哌唑嗪(0.03-0.1mg/kg)可分别降低梗阻引起的腔内输尿管压力升高 21-37%或 18-40%。相应的坦索罗辛(0.01 或 0.03mg/kg)作用分别为 9-20%。西洛多辛、哌唑嗪和坦索罗辛分别降低 MAP 10-12%、25-26%(P<0.05)或 18-25%(P<0.05)。当α1A-AR 拮抗剂对梗阻引起的输尿管压力的作用作为 MAP 的函数表达时,西洛多辛的疗效比坦索罗辛或哌唑嗪分别好 6-8 倍和 2.5-8 倍。西洛多辛有效降低了人和大鼠离体输尿管的收缩。
西洛多辛抑制大鼠和人离体输尿管的收缩,在体内具有优异的功能选择性,可缓解大鼠梗阻性输尿管的压力负荷。西洛多辛作为药理学输尿管结石排出疗法应在临床上进一步探索。