The basis for drug treatment of the overactive bladder
The basis for drug treatment of the overactive bladder
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DOI：
10.1007/pl00007101
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发表时间：
2001-11-01
影响因子：
3.4
通讯作者：
Wein, A
中科院分区：
文献类型：
--
作者：
Andersson, KE;Chapple, C;Wein, A
正常的膀胱功能、尿液的储存和排出，依赖于大脑和脊髓中协调逼尿肌以及流出区域的平滑肌和横纹肌的活动的神经回路。不同程度的紊乱可能导致膀胱过度活动症（OAB），其特点是急迫性、尿频和急迫性尿失禁。对于检测药物干预的目标，必须了解控制正常和异常排尿的机制。此类靶标可能存在于中枢神经系统（CNS）或外周。几种中枢神经系统递质可以调节排尿，但很少有具有明确中枢神经系统作用位点的药物被证明在临床上有用。传统上，治疗 OAB 的药物具有外周作用位点。抗毒蕈碱药物仍然是黄金标准，但其众所周知的副作用引起了人们对其他治疗方式的兴趣。一些原理已经获得了有希望的临床前结果，但到目前为止，还很少有积极的临床概念研究证明。
The normal bladder functions, storage and elimination of urine, are dependent on neural circuits in the brain and spinal cord that coordinate the activity of the detrusor and that of the smooth and striated muscles of the outflow region. Disturbances at different levels may cause the overactive bladder (OAB) syndrome, characterized by urge, frequency and urge incontinence. Knowledge about the mechanisms controlling both normal and abnormal micturition is mandatory for the detection of targets for pharmacological intervention. Such targets may be found in the central nervous system (CNS) or peripherally. Several CNS transmitters can modulate voiding, but few drugs with a defined CNS site of action have been demonstrated to be clinically useful. Traditionally, drugs for treatment of OAB have had a peripheral site of action. Antimuscarinics are still the gold standard, but their wellknown side effects have focused interest on other modalities of treatment. Promising preclinical results have been obtained for some principles, but so far there are few positive clinical proof of concept studies available.