Mechanisms involved in new therapies for overactive bladder

• Tipo: Artigo em Revista Científica Internacional
• Data: 2004

Autores

Francisco Cruz (Autor) FMUP

Revista

Título: Urology

Vol. 63

Páginas: 65-73

ISSN: 0090-4295

Editora: Elsevier

Indexação

ISI Web of Knowledge - 58 Citações

Scopus - 76 Citações

Outras Informações

ID Authenticus: 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.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 9