The role of α1-adrenergic receptor subtypes in lower urinary tract symptoms
The role of α1-adrenergic receptor subtypes in lower urinary tract symptoms
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DOI：
10.1046/j.1464-410x.2001.00116.x
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发表时间：
2001-09-01
影响因子：
4.5
通讯作者：
Schwinn, DA
中科院分区：
文献类型：
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作者：
Schwinn, DA
关于 LUTS 潜在生理机制的新理论越来越关注 o1a 肾上腺素能受体 (o1aAR) 亚型在介导症状中的可能作用 [1, 2]。有充分证据表明，选择性 o1aAR 拮抗剂可以放松前列腺平滑肌 [3]，从而缓解 BOO 并增强尿流 [4±6]。不幸的是，在存在或不存在 BOO 的情况下，使用高选择性 o1aAR 拮抗剂在缓解 LUTS 方面并不总是有效，这表明其他病理生理机制可能涉及炎症、刺激性和逼尿肌不稳定症状的发生 [3±8]。支持这一假设的研究表明，非亚型选择性 o1AR 拮抗剂可有效缓解 LUTS 相关症状。这一悖论强烈表明其他 o1-（非 o1a）AR 亚型可能在引起 LUTS 刺激症状方面发挥重要作用 [1,9,10]。 o1AR 亚型的组织特异性分布可能是理解和治疗下尿路疾病的各种不同症状的关键，而且重要的是，可能有助于避免在选定的人群亚组中出现严重的不良副作用 [1, 11]。
New theories about the potential physiological mechanisms responsible for LUTS have increasingly focused on the possible role of o1a adrenergic receptor (o1aAR) subtypes in mediating symptoms [1, 2]. It is well documented that selective o1aAR antagonists relax prostate smooth muscle [3], thus relieving BOO and enhancing the flow of urine [4ą6]. Unfortunately, the use of highly selective o1aAR antagonists is not uniformly effective in relieving LUTS in the presence or absence of BOO, suggesting that additional pathophysiological mechanisms may be involved in the development of inflammatory, irritative and detrusor instability symptoms [3ą8]. Supporting this hypothesis are studies that show that non-subtype-selective o1AR antagonists are effective in relieving symptoms associated with LUTS. This paradox strongly suggests that other o1-(non-o1a) AR subtypes may be important in eliciting irritative symptoms in LUTS [1, 9, 10]. The tissue-specific distribution of o1AR subtypes may be the key to understanding and treating the various diverse symptoms of the lower urinary tract disorders, and importantly, may help to avoid serious adverse side-effects in selected population subgroups [1, 11].