Mechanisms involved in new therapies for overactive bladder

• Type: Article in International Scientific Journal
• Date: 2004

Authors

Francisco Cruz (Author) FMUP

Journal

Title: Urology

Vol. 63

Pages: 65-73

ISSN: 0090-4295

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 55 Citations

Scopus - 70 Citations

Other information

Authenticus ID: P-000-BJ6

DOI: 10.1016/j.urology.2003.11.001

Abstract (EN): During the last few years, vanilloid substances and botulinum-A toxin were extensively investigated as new therapies for overactive bladder. Intravesical administration of capsaicin or resiniferatoxin-2 members of the vanilloid family-has been shown to increase bladder capacity and decrease urge incontinence in patients with neurogenic, as well as nonneurogenic, forms of detrusor overactivity. In addition, vanilloids have been shown also to reduce bladder pain in patients with hypersensitive disorders. Vanilloids are exogenous ligands of vanilloid receptor type 1 (VR1), an ion channel present in the membrane of type C primary afferent nerve fibers. This receptor, which plays a key role in pain perception and control of the micturition reflex, may be upregulated by nerve growth factor (NGF), a neurotrophic molecule detected in high concentrations in overactive detrusor tissue. Vanilloids, by reducing uptake of NGF through sensory neurons, may counteract VR1 upregulation. Intravesical injections of botulinum-A toxin, a neurotoxin produced by Clostridium botulinum, were shown to increase bladder capacity and to decrease urge incontinence episodes in patients with neurogenic detrusor overactivity. Botulinum-A toxin impedes the release of acetylcholine from cholinergic nerve endings at the neuromuscular junction, leading to paralysis of the detrusor smooth muscle.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9