Nitric oxide synthase and nitric oxide-mediated effects in lower urinary tract smooth muscles
Nitric oxide synthase and nitric oxide-mediated effects in lower urinary tract smooth muscles
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一氧化氮合酶和一氧化氮介导的下尿路平滑肌作用
DOI：
10.1007/bf00191207
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发表时间：
2004
影响因子：
3.4
通讯作者：
K. Persson
中科院分区：
文献类型：
--
作者：
Kelsey Andersson;K. Persson
摘要
在下尿路平滑肌中，可证实存在兴奋性和抑制性的非肾上腺素能、非胆碱能（NANC）神经及神经传递。一种抑制性、介导松弛的系统可能不仅服务于逼尿肌、膀胱三角区以及膀胱颈/尿道，而且对它们的整合功能也可能很重要。现有数据表明，一氧化氮合酶（NOS）位于下尿路的神经纤维中，尤其在流出区域，并且有证据积累表明，由L - 精氨酸衍生的一氧化氮（NO）是抑制性NANC反应的主要部分的原因。NOS阳性神经与表达乙酰胆碱酯酶、血管活性肠肽和神经肽Y的神经定位一致，这表明NO可能既作为一种直接作用的递质，又作为传出神经传递的调节剂发挥作用。此外，NO可能参与传入神经传递。从理论上讲，逼尿肌中神经释放的NO可能是在膀胱充盈期间使膀胱保持松弛的一个因素。然而，逼尿肌对NO和通过环鸟苷酸（cGMP）起作用的药物敏感性较低，这使得NO作为一种松弛性神经递质的可能性较小。这并不排除NO可能调节其他递质的作用，或者它具有传入功能。NO可有效松弛来自流出区域的离体平滑肌标本，这表明它可能参与与正常排尿相关的尿道内压降低，以及与可能与女性某些排尿障碍相关的过度尿道压力变化（“不稳定尿道”）。L - 精氨酸/NO系统也可能控制流出区域的传入活动，其中NO的缺乏可能降低传入冲动的阈值，从而导致膀胱不稳定。L - 精氨酸/NO途径可能具有功能作用的另一个可能部位是在尿道固有层。在这里，NO介导的松弛可能影响“尿道内部的柔软性”，从而影响尿道黏膜的密封功能。然而，应该强调的是，L - 精氨酸/NO系统在控制排尿的中枢和外周途径中的功能重要性仍有待确定。
SummaryIn the lower urinary tract smooth muscles, both excitatory and inhibitory non-adrenergic, non-cholinergic (NANC) nerves and neurotransmission can be demonstrated. An inhibitory, relaxation-mediating system may serve not only the detrusor, the trigone, and the bladder neck/urethra, but may also be of importance for their integrated function. Available data suggest that nitric oxide synthase (NOS) is localized in nerve fibres of the lower urinary tract, preferably in the outflow region, and evidence has accumulated that l-arginine-derived nitric oxide (NO) is responsible for the main part of the inhibitory NANC response. Coinciding localization of NOS positive nerves with nerves expressing acetylcholine esterase, vasoactive intestinal peptide, and neuropeptide Y, suggests that NO may have a role both as a directly acting transmitter and as a modulator of efferent neurotransmission. In addition, NO may be involved in afferent neurotransmission. Theoretically, NO released from nerves in the detrusor, could be one factor keeping the bladder relaxed during filling. However, the detrusor has a low sensitivity to NO and agents acting via cyclic GMP, which makes it less likely that NO has a role as a relaxant neurotransmitter. This does not exclude that NO may modulate the effects of other transmitters, or that it has an afferent function. NO effectively relaxes isolated smooth muscle preparations from the outflow region, suggesting that it may be involved in the decrease in intraurethral pressure associated with normal micturition, and with the excessive urethral pressure variations (“unstable urethra”), which may be associated with certain voiding disturbances in women. The l-arginine/NO system may also control afferent activity in the outlet region, where lack of NO may lower the threshold for afferent firing leading to bladder instability. Another possible site where the l-arginine/NO pathway can have a functional role is in the urethral lamina propria. Here, NO-mediated relaxation may influence the “inner urethral softness”, and thereby the sealing function of the urethral mucosa. However, it should be stressed that the functional importance of the l-arginine/NO system in the central and peripheral pathways controlling micturition remains to be established.
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影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
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影响因子：
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DOI：
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发表时间：
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影响因子：
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作者：
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通讯作者：
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