Regulation of Urinary Bladder Smooth Muscle by K+ Channels

描述（由申请人提供）：该项目的长期目标是为我们对正常和病理条件下调节人类膀胱功能的机制的理解增加新的维度，并开发新的治疗策略来控制膀胱过度活动症（OAB）。OAB、逼尿肌过度活动（DO）和相关的尿失禁（UI）影响约17%的美国人口，其特征在于膀胱平滑肌（UBSM）收缩性增加。钾离子（K+）通道是最具多样性的离子通道超家族，是UBSM细胞膜兴奋性和动作电位的关键调节因子，决定了UBSM收缩性的阶段性。一般来说，这些离子通道的抑制导致膜兴奋性和阶段性收缩增加，而它们的激活使细胞膜超极化并降低收缩性。我们的基础科学研究小组与临床科学家合作，处于一个独特的地位，定期利用来自供体患者的人类UBSM组织，以研究人类K+通道功能，并将基础科学发现与患者的尿动力学特征相关联。本课题的总体目标是阐明两种主要的K+通道，即小电导Ca 2+激活的（SK）K+通道和中电导Ca 2+激活的K+（IK）通道在正常和病理条件下人类UBSM中的作用及其调节机制。该提议将测试新的假设，即SK/IK通道是人类UBSM兴奋性和收缩性的主要调节剂，因此SK/IK通道活性或调节机制的变化可能导致OAB/DO和相关UI。此外，SK/IK通道可能代表了一种新的药理学操纵和治疗干预人类UBSM的机会。具体目标1将阐明SK/IK通道在正常和病理生理条件下UBSM功能中的作用;具体目标2将阐明β 2-肾上腺素能受体向SK/IK通道发出信号以促进UBSM松弛的机制。该项目将使用来自无症状膀胱（AUA症状评分<8;膀胱癌的膀胱炎）、OAB（定义为频率增加、尿急和排尿困难）和DO（定义为尿动力学显示的过度活动）患者的UBSM组织。我们将采用一种综合的方法，使用最先进的技术，以确定SK/IK通道的作用及其在UBSM功能从单个分子和分离的细胞完整的组织和整个生物体的调节机制。 公共卫生相关性：膀胱过度活动症（OAB）影响约17%的美国人口，其特征是膀胱平滑肌收缩力增加。我们的项目将利用膀胱组织中的特定钾通道来开发新的治疗方法来控制或缓解OAB。

DESCRIPTION (provided by applicant): The long-term goal of this project is to add a new dimension to our understanding of the mechanisms that regulate human urinary bladder function under normal and pathological conditions and to develop novel therapeutic strategies to control overactive bladder (OAB). OAB, detrusor overactivity (DO), and related urinary incontinence (UI), which affects about 17% of the US population, is characterized with increased urinary bladder smooth muscle (UBSM) contractility. Potassium ion (K+) channels, the most diverse ion channel superfamily, are key regulators of UBSM cell membrane excitability and action potentials that determine the phasic nature of UBSM contractility. In general, inhibition of these ion channels leads to increased membrane excitability and phasic contractions, whereas their activation hyperpolarizes the cell membrane and decreases contractility. Our basic science research group, in collaboration with clinical scientists, is in a unique position to regularly make use of human UBSM tissues from donor patients in order to study K+ channel function in humans and correlate the basic science findings with the urodynamic profile of the patients. The overall goal of this project is to illuminate the role of two major K+ channels, the small conductance Ca2+-activated (SK) K+ channel and the intermediate conductance Ca2+-activated K+ (IK) channel, and their regulatory mechanisms in human UBSM under normal and pathological conditions. This proposal will test the novel hypothesis that the SK/IK channels are major regulators of human UBSM excitability and contractility, and therefore changes in the SK/IK channels activity or regulatory mechanisms may lead to OAB/DO and related UI. Furthermore, the SK/IK channels may represent an opportunity for novel pharmacological manipulation and therapeutic intervention in human UBSM. Specific Aim 1 will elucidate the role of the SK/IK channels in UBSM function under normal and pathophysiological conditions; and Specific Aim 2 will elucidate the mechanism by which 2-adrenergic receptors signal the SK/IK channels to promote UBSM relaxation. This project will use UBSM tissues from patients with asymptomatic bladder (AUA symptom score <8; cystectomy for bladder cancer), OAB (defined as increased frequency, urgency, and nocturia), and DO (defined as urodynamically demonstrated overactivity). We will employ a combined approach, using state-of- the-art techniques, to determine the role of SK/IK channels and their regulatory mechanisms in UBSM function from single molecules and isolated cells to intact tissue and the whole organism. PUBLIC HEALTH RELEVANCE: Overactive bladder (OAB) affects about 17% of the US population, and is characterized by increased urinary bladder smooth muscle contractility. Our project will exploit specific potassium channels in urinary bladder tissue to develop novel therapies to control or alleviate OAB.