Male lower urinary tract symptoms and a1D-adrenoceptors

概要

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Historically, a1-adrenoceptors have been classified into three subtypes (a1A, a1B and a1D) that are widely distributed in various organs. Research on the a1D-adrenoceptors in the bladder, urethra and prostate has focused on the relationship between expression levels and symptoms of bladder outlet obstruction, and the implications and functional roles of a1D-adrenoceptors subtypes in these organs. The a1D-adrenoceptor messenger ribonucleic acid and protein seem to be increased in obstructed bladders or small capacity bladders. In contrast, a1D-adrenoceptor subtype knock-out mice have been found to have a prolonged voiding interval. Interestingly, an a1D-adrenoceptor antagonist was found to inhibit the facilitation of afferent nerve activity for the micturition reflex induced by intravesical infusion of acetic acid. Clinically, patients who felt urgency at low filling volumes and had a small bladder capacity were found to have more a1D-adrenoceptor messenger ribonucleic acid in their bladder mucosa than patients who felt urgency at high filling volumes and had a large bladder capacity. An a1D-adrenoceptor antagonist was found to increase the first desired volume and the maximum desired volume while decreasing detrusor overactivity in pressure flow studies. Thus, a1D-adrenoceptors in the lower urinary tract might play an important role in the pathophysiology of lower urinary tract disorders.
WILEY-BLACKWELLの論文