Bandari Jathin, Bansal Utsav, Zhang Zhaocun, Shen Bing, Wang Jicheng, Lamm Vladimir, Chang Victor, Roppolo James R, de Groat William C, Tai Changfeng
Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Urology, Qilu Hospital, Shandong University, Jinan, China.
Neuromodulation. 2017 Jan;20(1):81-87. doi: 10.1111/ner.12534. Epub 2016 Oct 12.
To determine the role of opioid, β-adrenergic, and metabotropic glutamate 5 receptors in sacral neuromodulation of bladder overactivity.
In α-chloralose anesthetized cats, intravesical infusion of 0.5% acetic acid (AA) irritated the bladder and induced bladder overactivity. Electric stimulation (5 Hz, 0.2 ms, 0.16-0.7V) of S1 or S2 sacral dorsal roots inhibited the bladder overactivity. Naloxone, propranolol, or MTEP were given intravenously (i.v.) to determine different neurotransmitter mechanisms.
AA significantly (p < 0.05) reduced bladder capacity to 7.7 ± 3.3 mL from 12.0 ± 5.0 mL measured during saline infusion. S1 or S2 stimulation at motor threshold intensity significantly (p < 0.05) increased bladder capacity to 179.4 ± 20.0% or 219.1 ± 23.0% of AA control, respectively. Naloxone (1 mg/kg) significantly (p < 0.001) reduced the control capacity to 38.3 ± 7.3% and the bladder capacity measured during S1 stimulation to 106.2 ± 20.8% of AA control, but did not significantly change the bladder capacity measured during S2 stimulation. Propranolol (3 mg/kg) significantly (p < 0.01) reduced bladder capacity from 251.8 ± 32.2% to 210.9 ± 33.3% during S2 stimulation, but had no effect during S1 stimulation. A similar propranolol effect also was observed in naloxone-pretreated cats. In propranolol-pretreated cats during S1 or S2 stimulation, MTEP (3 mg/kg) significantly (p < 0.05) reduced bladder capacity and naloxone (1 mg/kg) following MTEP treatment further reduced bladder capacity. However, a significant inhibition could still be induced by S1 or S2 stimulation after all three drugs were administered.
Neurotransmitter mechanisms in addition to those activating opioid, β-adrenergic, and metabotropic glutamate 5 receptors also are involved in sacral neuromodulation.
确定阿片类、β-肾上腺素能和代谢型谷氨酸5受体在骶神经调节膀胱过度活动中的作用。
在α-氯醛糖麻醉的猫中,膀胱内注入0.5%乙酸(AA)刺激膀胱并诱发膀胱过度活动。电刺激(5Hz,0.2ms,0.16 - 0.7V)S1或S2骶背根可抑制膀胱过度活动。静脉注射(i.v.)纳洛酮、普萘洛尔或MTEP以确定不同的神经递质机制。
AA显著(p < 0.05)将膀胱容量从盐水灌注时测得的12.0±5.0mL降低至7.7±3.3mL。在运动阈值强度下刺激S1或S2可使膀胱容量分别显著(p < 0.05)增加至AA对照组的179.4±20.0%或219.1±23.0%。纳洛酮(1mg/kg)显著(p < 0.001)将对照容量降低至38.3±7.3%,并将S1刺激期间测得的膀胱容量降低至AA对照组的106.2±20.8%,但未显著改变S2刺激期间测得的膀胱容量。普萘洛尔(3mg/kg)在S2刺激期间显著(p < 0.01)将膀胱容量从251.8±32.2%降低至210.9±33.3%,但在S1刺激期间无作用。在纳洛酮预处理的猫中也观察到类似的普萘洛尔效应。在普萘洛尔预处理的猫中,在S1或S2刺激期间,MTEP(3mg/kg)显著(p < 0.05)降低膀胱容量,MTEP治疗后纳洛酮(1mg/kg)进一步降低膀胱容量。然而,在给予所有三种药物后,S1或S2刺激仍可诱导显著的抑制作用。
除了激活阿片类、β-肾上腺素能和代谢型谷氨酸5受体的神经递质机制外,骶神经调节还涉及其他神经递质机制。