Advances in Clinical and Experimental Medicine

Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2012, vol. 21, nr 4, July-August, p. 417–421

Publication type: editorial article

Language: English

The Basic Neurophysiologic Concept of Lower Urinary Tract Function – the Role of Vanilloid TRPV1 Receptors of Urinary Bladder Afferent Nerve Endings

Neurofizjologiczne aspekty funkcjonowania dolnych dróg moczowych – udział receptorów waniloidowych TRPV1 aferentnych zakończeń nerwowych pęcherza moczowego

Kajetan Juszczak1,, Kajetan Juszczak2,, Piotr J. Thor1,

1 Department of Pathophysiology, Jagiellonian University, Medical College, Kraków, Poland

2 Department of Urology, Rydygier Memorial Hospital, Kraków, Poland

Abstract

The pathophysiology of functional disorders of the urinary bladder is still relatively poorly understood, although the mechanisms controlling the lower urinary tract function have been quite accurately described. The rich innervation of afferent and efferent urinary tract, multi-level neural control of micturition process, the diversity of the autonomic nervous system neurotransmitters, as well as “neuronal activity” of the urotelium determines the correct filling and emptying of the bladder. Functional diseases (OAB – such as overactive bladder) include sensory and/or motor dysfunction of the urinary bladder, leading to sleep disturbances, psychosomatic disorders, lower quality of life, etc. It is known that sensory afferent C fibers and vanilloid TRPV1 receptors are important in the pathogenesis of OAB. Modulation of the activity of these fibers and/or TRPV1 receptors by a number of substances (such as capsaicin, lidocaine, etc.) reduces the symptoms of OAB. Detailed knowledge of the neurophysiology of the lower urinary tract is a prerequisite for proper treatment of functional disorders of the urinary tract. The paper discusses the neurophysiologic basis, the importance of afferent C fibers and vanilloid TRPV1 receptors in lower urinary tract.

Streszczenie

Patofizjologia schorzeń czynnościowych pęcherza moczowego nadal jest stosunkowo mało poznana, mimo że mechanizmy kontrolujące czynność dolnych dróg moczowych zostały dość dokładnie opisane. Bogate unerwienie aferentne i eferentne dolnych dróg moczowych, wielopoziomowość kontroli neuronalnej procesu mikcji, różnorodność neuroprzekaźników autonomicznego układu nerwowego, a także „czynność neuronalna” urotelium determinuje prawidłowe wypełnianie i opróżnianie pęcherza moczowego. Choroby czynnościowe (np. nadaktywny pęcherz moczowy: OAB – overactive bladder) obejmują dysfunkcję czuciową i/lub motoryczną pęcherza moczowego, prowadząc do zaburzenia snu, zaburzeń psychosomatycznych, zmniejszenia jakości życia itd. Wiadomo, że aferentne włókna czuciowe grupy C oraz receptory waniloidowe TRPV1 są istotne w patogenezie OAB. Modulacja aktywności tych włókien i/lub receptorów TRPV1 przez wiele substancji (m.in. kapsaicynę, lidokainę itd.) zmniejsza objawy OAB. Szczegółowa znajomość neurofizjologii dolnych dróg moczowych jest warunkiem koniecznym prawidłowego leczenia schorzeń czynnościowych dolnych dróg moczowych. W pracy omówiono podstawy neurofizjologiczne, znaczenie włókien grupy C i receptorów waniloidowych w funkcjonowaniu dolnych dróg moczowych.

Key words

neurophysiology, urinary bladder, afferent C-fibers, vanilloid receptor

Słowa kluczowe

neurofizjologia, pęcherz moczowy, aferentne włókna C, receptor waniloidowy

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