Kadow Brian T, Lyon Timothy D, Zhang Zhaocun, Lamm Vladimir, Shen Bing, Wang Jicheng, Roppolo James R, de Groat William C, Tai Changfeng
Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania;
Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Urology, Qilu Hospital, Shandong University, Jinan, China; and.
Am J Physiol Renal Physiol. 2016 Jul 1;311(1):F78-84. doi: 10.1152/ajprenal.00180.2016. Epub 2016 May 11.
This study investigated the role of the hypogastric nerve and β-adrenergic mechanisms in the inhibition of nociceptive and non-nociceptive reflex bladder activity induced by pudendal nerve stimulation (PNS). In α-chloralose-anesthetized cats, non-nociceptive reflex bladder activity was induced by slowly infusing saline into the bladder, whereas nociceptive reflex bladder activity was induced by replacing saline with 0.25% acetic acid (AA) to irritate the bladder. PNS was applied at multiple threshold (T) intensities for inducing anal sphincter twitching. During saline infusion, PNS at 2T and 4T significantly (P < 0.01) increased bladder capacity to 184.7 ± 12.6% and 214.5 ± 10.4% of the control capacity. Propranolol (3 mg/kg iv) had no effect on PNS inhibition, but 3-[(2-methyl-4-thiazolyl)ethynyl]pyridine (MTEP; 1-3 mg/kg iv) significantly (P < 0.05) reduced the inhibition. During AA irritation, the control bladder capacity was significantly (P < 0.05) reduced to ∼22% of the saline control capacity. PNS at 2T and 4T significantly (P < 0.01) increased bladder capacity to 406.8 ± 47% and 415.8 ± 46% of the AA control capacity. Propranolol significantly (P < 0.05) reduced the bladder capacity to 276.3% ± 53.2% (at 2T PNS) and 266.5 ± 72.4% (at 4T PNS) of the AA control capacity, whereas MTEP (a metabotropic glutamate 5 receptor antagonist) removed the residual PNS inhibition. Bilateral transection of the hypogastric nerves produced an effect similar to that produced by propranolol. This study indicates that hypogastric nerves and a β-adrenergic mechanism in the detrusor play an important role in PNS inhibition of nociceptive but not non-nociceptive reflex bladder activity. In addition to this peripheral mechanism, a central nervous system mechanism involving metabotropic glutamate 5 receptors also has a role in PNS inhibition.
本研究调查了下腹神经和β-肾上腺素能机制在阴部神经刺激(PNS)诱导的伤害性和非伤害性反射膀胱活动抑制中的作用。在α-氯醛糖麻醉的猫中,通过向膀胱缓慢注入生理盐水诱导非伤害性反射膀胱活动,而通过用0.25%乙酸(AA)替代生理盐水刺激膀胱诱导伤害性反射膀胱活动。以多个阈值(T)强度施加PNS以诱导肛门括约肌抽搐。在生理盐水输注期间,2T和4T的PNS显著(P<0.01)增加膀胱容量至对照容量的184.7±12.6%和214.5±10.4%。普萘洛尔(3mg/kg静脉注射)对PNS抑制无影响,但3-[(2-甲基-4-噻唑基)乙炔基]吡啶(MTEP;1-3mg/kg静脉注射)显著(P<0.05)降低了这种抑制作用。在AA刺激期间,对照膀胱容量显著(P<0.05)降低至生理盐水对照容量的约22%。2T和4T的PNS显著(P<0.01)增加膀胱容量至AA对照容量的406.8±47%和415.8±46%。普萘洛尔显著(P<0.05)将膀胱容量降低至AA对照容量的276.3%±53.2%(在2T PNS时)和266.5±72.4%(在4T PNS时),而MTEP(一种代谢型谷氨酸5受体拮抗剂)消除了残余的PNS抑制作用。双侧切断下腹神经产生的效果与普萘洛尔产生的效果相似。本研究表明,下腹神经和逼尿肌中的β-肾上腺素能机制在PNS抑制伤害性而非非伤害性反射膀胱活动中起重要作用。除了这种外周机制外,涉及代谢型谷氨酸5受体的中枢神经系统机制在PNS抑制中也起作用。