Cheng C L, Ma C P, de Groat W C
Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Brain Res. 1995 Apr 24;678(1-2):40-8. doi: 10.1016/0006-8993(95)00212-9.
The role of capsaicin-sensitive bladder afferents in micturition was studied in unanesthetized chronic spinal rats. Reflex voiding in response to tactile stimulation of the perigenital region appeared 5-9 days after spinal cord injury (SCI) whereas voiding induced by bladder distension occurred 2-3 weeks after SCI. The frequency and amplitude of reflex bladder contractions recorded under isovolumetric conditions were similar in chronic spinal and urethane-anesthetized CNS-intact rats. However, cystometrograms (CMGs) performed 6-8 weeks after SCI revealed that the chronic spinal rats had larger bladder capacities (1.86 ml) than CNS-intact rats (0.48 ml) and also exhibited multiple, small-amplitude, nonvoiding bladder contractions that were not detected in CNS-intact rats. Administration of capsaicin (50 mg/kg s.c.) acutely (onset 14-40 min) suppressed reflex bladder activity induced by bladder distension or by perigenital stimulation in chronic spinal animals. However, pretreatment of chronic spinal rats with capsaicin (125 mg/kg s.c.) 4 days before the experiment did not depress voiding reflexes or change bladder capacity but did eliminate the nonvoiding contractions. Inhibition of reflex bladder contractions by mechanical stimulation of rectoanal canal or the uterine cervix-vagina was not altered by pretreatment with capsaicin. These data indicate that capsaicin-sensitive bladder afferents are not essential for the initiation of reflex micturition in chronic spinal rats. However, these afferents do contribute to hyperactivity of the bladder during the filling phase of the CMG. Thus, capsaicin-sensitive bladder afferents should be evaluated as possible targets for the pharmacological treatment of bladder hyperreflexia in patients with SCI.
在未麻醉的慢性脊髓大鼠中研究了辣椒素敏感的膀胱传入神经在排尿中的作用。脊髓损伤(SCI)后5 - 9天出现对生殖器周围区域触觉刺激的反射性排尿,而膀胱扩张诱导的排尿在SCI后2 - 3周出现。在等容条件下记录的慢性脊髓大鼠和氨基甲酸乙酯麻醉的中枢神经系统完整大鼠的反射性膀胱收缩频率和幅度相似。然而,SCI后6 - 8周进行的膀胱测压图(CMG)显示,慢性脊髓大鼠的膀胱容量(1.86 ml)比中枢神经系统完整大鼠(0.48 ml)大,并且还表现出多次小幅度的非排尿性膀胱收缩,而在中枢神经系统完整大鼠中未检测到。急性给予辣椒素(50 mg/kg皮下注射)(起效时间14 - 40分钟)可抑制慢性脊髓动物中由膀胱扩张或生殖器周围刺激诱导的反射性膀胱活动。然而,在实验前4天用辣椒素(125 mg/kg皮下注射)预处理慢性脊髓大鼠并没有抑制排尿反射或改变膀胱容量,但确实消除了非排尿性收缩。通过直肠肛管或子宫颈 - 阴道的机械刺激对反射性膀胱收缩的抑制作用不受辣椒素预处理的影响。这些数据表明,辣椒素敏感的膀胱传入神经对于慢性脊髓大鼠反射性排尿的启动不是必需的。然而,这些传入神经确实在CMG的充盈期对膀胱的活动亢进有贡献。因此,辣椒素敏感的膀胱传入神经应被评估为脊髓损伤患者膀胱反射亢进药物治疗的可能靶点。