Andersson K E
Department of Clinical Pharmacology, Lund University Hospital, Sweden.
Curr Opin Obstet Gynecol. 1996 Oct;8(5):361-5.
In addition to transmitters stored in and released from terminals of efferent nerves, transmitters of afferent nerves and their receptors are also involved in the control of lower urinary tract function. Tachykinins, such as substance P and neurokinins A and B, and other neuropeptides have been demonstrated in nerves of the the lower urinary tract and shown to be able to influence bladder function. Drugs affecting these nerves by causing release of tachykinins, and agents antagonizing tachykinin receptors, may be of therapeutic interest. New information on the alpha-adrenoceptor and muscarinic receptor subtypes mediating contraction of the human urethra and detrusor, respectively, has emerged, and may be the basis for the development of compounds with selectivity for the urethra or the bladder 'Non-classical' transmitters, such as nitric oxide, may also be of importance for bladder function. Nitric oxide derived from nerves seems to be involved in reflex relaxation of the outflow region at the start of micturition. However, nitric oxide derived from other sources may have a role in bladder disorders, such as interstitial cystitis.
除了存储在传出神经末梢并从其释放的递质外，传入神经的递质及其受体也参与下尿路功能的控制。速激肽，如P物质、神经激肽A和B，以及其他神经肽已在下尿路神经中得到证实，并显示能够影响膀胱功能。通过引起速激肽释放来影响这些神经的药物，以及拮抗速激肽受体的药物，可能具有治疗意义。关于分别介导人尿道和逼尿肌收缩的α-肾上腺素能受体和毒蕈碱受体亚型的新信息已经出现，这可能是开发对尿道或膀胱具有选择性的化合物的基础。“非经典”递质，如一氧化氮，对膀胱功能可能也很重要。神经源性一氧化氮似乎参与排尿开始时流出区域的反射性松弛。然而，其他来源的一氧化氮可能在膀胱疾病，如间质性膀胱炎中起作用。
