Researching Bladder Afferents-Determining the Effects of beta(3)-Adrenergic Receptor Agonists and Botulinum Toxin Type-A

Anthony Kanai*, Jean Jacques Wyndaele, Karl-Erik Andersson, Christopher Fry, Youko Ikeda, Irina Zabbarova, Stefan De Wachter

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Web of Science)

Abstract

A substantial portion of the current research on lower urinary tract dysfunction is focused on afferent mechanisms. The main goals are to define and modulate the signaling pathways by which afferent information is generated, enhanced and conveyed to the central nervous system. Alterations in bladder afferent mechanisms are a potential source of voiding dysfunction and an emerging source for drug targets. Established drug therapies such as muscarinic receptor antagonists, and two emerging therapies, beta(3)-adrenergic receptor agonists and botulinum toxin type-A, may act partly through afferent mechanisms. This review focuses on these two new principles and new and established methods for determining their sites of action. It also provides brief information on the innervation of the bladder, afferent receptors and transmitters and how these may communicate with the urothelium, interstitial cells and detrusor smooth muscle to regulate micturition. Peripheral and central mechanisms of afferent sensitization and myogenic mechanisms that lead to detrusor overactivity, overactive bladder symptoms and urgency sensations are also covered. This work is the result from 'Think Tank' presentations, and the lengthy discussions that followed, at the 2010 International Consultation on Incontinence Research Society meeting in Bristol, UK. Neurourol. Urodynam. 30:684-691, 2011.
Original languageEnglish
Pages (from-to)684-691
JournalNeurourology and Urodynamics
Volume30
Issue number5
DOIs
Publication statusPublished - 2011

Keywords

  • beta(3)-adrenergic receptor agonists
  • bladder afferents
  • botulinum toxin type-A
  • optical mapping

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