上调的 5-HT 受体调节完全性脊髓损伤后大鼠的下尿路功能。
Upregulated 5-HT Receptors Regulate Lower Urinary Tract Function in Rats after Complete Spinal Cord Injury.
机构信息
Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
出版信息
J Neurotrauma. 2023 May;40(9-10):845-861. doi: 10.1089/neu.2022.0329. Epub 2023 Mar 14.
Spinal cord injury (SCI) above the lumbosacral level often leads to dysfunction of the lower urinary tract (LUT) including detrusor hyper-reflexia, wherein bladder compliance is low, baseline pressures are increased, and filling is accompanied by numerous non-voiding contractions (NVCs) referred to as neurogenic detrusor overactivity. Here, we investigate the expression levels of the serotonin 1A (5-HT) receptor in segments both rostral and caudal to the injured site, as well as the effects on micturition of blocking 5-HT receptor using pharmacological interventions in spinally intact rats or T8 complete SCI rats. The activities of detrusor and external urethral sphincter (EUS) were assessed with the rats in a conscious condition. Adult female rats were divided into two groups: (1) sham control (T8 laminectomy only) and (2) T8 complete spinal cord transection. The observation period was 2 months after the original SCI. In Western blot analyses, we identified significant upregulation of the 5-HT receptor in the T10-L2 and L6/S1 segments after chronic complete SCI. In pharmacological studies, a dose-response study of the 5-HT receptor antagonist, WAY100635, indicated alterations in detrusor and EUS activities in spinally intact rats. Interestingly, blocking the 5-HT receptor alone resulted in inhibitory effects on NVCs with a reduced number and decreased amplitude, but in an increased interval between NVCs in SCI rats. In addition, the duration of EUS bursting was also significantly increased by WAY100635. These inhibitory effects of WAY100635 on NVCs were diminished by subsequent application of a beta-adrenergic blocker (propranolol). The reduction of NVCs observed by WAY100635 may be the result of blocking the constitutive activities of the 5-HT receptor but activating the beta-adrenergic sympathetic pathway, which in turn relaxes bladder activity. Together, the neuroplasticity of the 5-HT receptor can be a potential therapeutic target for treatment of bladder dysfunction after SCI.
脊髓损伤(SCI)位于腰骶段以上常导致下尿路(LUT)功能障碍,包括逼尿肌反射亢进,其中膀胱顺应性低,基础压升高,充盈时伴有大量非排空收缩(NVCs),称为神经原性逼尿肌过度活动。在这里,我们研究了损伤部位前后节段的 5-羟色胺 1A(5-HT)受体的表达水平,以及使用药理学干预在脊髓完整的大鼠或 T8 完全 SCI 大鼠中阻断 5-HT 受体对排尿的影响。在清醒状态下评估逼尿肌和尿道外括约肌(EUS)的活动。成年雌性大鼠分为两组:(1)假对照(仅 T8 椎板切除术)和(2)T8 完全脊髓横断。观察期为原始 SCI 后 2 个月。在 Western blot 分析中,我们发现慢性完全 SCI 后 T10-L2 和 L6/S1 节段 5-HT 受体显著上调。在药理学研究中,5-HT 受体拮抗剂 WAY100635 的剂量反应研究表明,脊髓完整大鼠的逼尿肌和 EUS 活性发生改变。有趣的是,单独阻断 5-HT 受体可导致 SCI 大鼠 NVC 产生抑制作用,减少 NVC 的数量和幅度,并增加 NVC 之间的间隔。此外,WAY100635 还显著增加了 EUS 爆发的持续时间。WAY100635 对 NVC 的这种抑制作用在随后应用β-肾上腺素能阻滞剂(普萘洛尔)时减弱。WAY100635 观察到的 NVC 减少可能是由于阻断 5-HT 受体的组成型活性但激活β-肾上腺素能交感神经通路,从而使膀胱活动松弛。总之,5-HT 受体的神经可塑性可能成为 SCI 后膀胱功能障碍治疗的潜在治疗靶点。