Alpha1-adrenergic receptor (alpha1-AR) antagonists are effective for treating patients with lower urinary tract symptoms associated with bladder outlet obstruction (BOO). In humans up-regulation of alpha1-AR function in the detrusor in patients with BOO has been suggested but to our knowledge it is not yet confirmed. We investigated the effect of phenylephrine, an alpha1-AR agonist, on isometric tension in small detrusor muscle biopsies from patients with lower urinary tract symptoms and BOO compared with controls.
Detrusor biopsies were obtained from 7 men with BOO undergoing prostatectomy and 7 undergoing cystectomy for bladder cancer (controls). Patients were characterized by symptom score and urodynamics. Isometric tension was measured in detrusor biopsies with an especially built mini myograph.
Mean International Prostate Symptom Score +/- SEM in patients with BOO and controls were 22.3 +/- 2.3 and 4.0 +/- 0.8, respectively. Phenylephrine (10(-6) to 10(-3) M) induced a significant contractile response increase in detrusor biopsies from patients with BOO compared with controls at all concentrations. Tamsulosin (0.1 to 3.0 nM) inhibited phenylephrine induced contraction in a dose dependent manner.
To our knowledge this functional study shows for the first time a highly significant increase in contractile force to phenylephrine in patients with BOO compared with controls. These results suggest up-regulation of alpha1-AR function in BOO since contractile responses were potently inhibited by the alpha1A/D-AR antagonist tamsulosin.
The Journal of Urology 03/2005; 173(2):657-61. DOI:10.1097/01.ju.0000143198.16610.84 · 3.75 Impact Factor
Most recently attention has turned to the secretory properties of smooth muscle cells. Monocyte chemoattractant protein-1 (MCP-1) is a potent chemokine that causes mast cells recruitment and provokes mast cells activation in vitro. We investigated whether MCP-1 is produced by human detrusor smooth muscle cells (HDSMCs) cultured under inflammatory conditions.
Using an explantation technique HDSMCs were isolated and short-term cultured. HDSMCs were incubated at 37C for 24 hours with the proinflammatory mediators interleukin-1 beta (IL-1 beta), tumor necrosis factor (TNF-alpha), lipopolysaccharide, histamine, leukotriene D4 and prostaglandin E2. The level of MCP-1 in cell supernatants were measured by enzyme linked immunoassay.
There was basal secretion of MCP-1 in unstimulated cultures. Following 24-hour incubation with IL-1 beta or TNF-alpha (1 pg/ml to 100 ng/ml) the level of MCP-1 increased in a dose dependent manner. IL-1 beta was more potent at inducing MCP-1 release in 8 of 10 experiments. Lipopolysaccharide (10 microg/ml), histamine (100 microM), leukotriene D4 (50 nM), prostaglandin E2 (1 microM) and KCl (30 to 100 mM) failed to induce MCP-1 production. When IL-1 beta (10 ng/ml) and TNF-alpha (10 ng/ml) were given in combination, a highly synergistic effect on MCP-1 production was observed.
To our knowledge this study shows for the first time that human detrusor smooth muscle cells cultivated under inflammatory conditions produce significant amounts of MCP-1. In addition to contractile function, HDSMCs have synthesis and secretory potential with the release of MCP-1. Thus, MCP-1 may contribute to the local inflammatory process by producing proinflammatory mediators. The release of cytokines and chemokines by human detrusor muscle even in small amounts may have important functional consequences.
The Journal of Urology 02/2004; 171(1):462-6. DOI:10.1097/01.ju.0000090192.36436.d5 · 3.75 Impact Factor
The role of intracellular Ca2+ in the activation of human detrusor smooth muscle cells (SMCs) is pivotal. Recently we showed that the mast cell derived pro-inflammatory mediator leukotriene D(4) (LTD(4)) induces increase in intracellular free Ca2+ ([Ca2+](i)) in human detrusor myocytes. In the current study we examined the mechanisms underlying LTD(4) induced increase in [Ca2+](i) and tested whether LTD(4) induces muscle contraction by measuring force development in human detrusor tissue.
Cultures of human detrusor SMCs were obtained from patients with benign bladder diseases undergoing cystoscopy. [Ca2+](i) was measured in fura-2 loaded SMCs using micro-spectrofluorometry and dynamic video imaging. Contractile force was monitored with an especially built mini-myograph.
Spontaneous oscillations in [Ca2+](i) and force were observed. In the absence of calcium these oscillations were absent. LTD(4) caused a concentration dependent increase in [Ca2+](i) and isometric force. Calcium was released exclusively from intracellular stores. Increases in [Ca2+](i) and force were inhibited in dose dependent fashion by the LTD(4) receptor antagonists montelukast and zafirlukast. Likewise, LTC(4) and LTE(4) induced an increase in [Ca2+](i) and contractile force in the rank order LTD(4) >LTC(4) >LTE(4). Inhibition of Ca2+ induced Ca2+ release (CICR) with thapsigargin and ryanodine suggested the presence of a functional CICR in SMCs.
To our knowledge this study demonstrates for the first time that the cysteinyl-leukotriene LTD(4) induces contraction in human detrusor SMCs. LTD(4) induced force and increased [Ca2+](i) were entirely dependent on Ca2+ release from intracellular stores. The action of LTD(4) on force development and increased [Ca2+](i) appeared to be specific, mediated by the binding and activation of specific LTD(4) receptors on SMCs. Also, to our knowledge this report is the first to show that human detrusor SMCs are sensitive to ryanodine, consistent with the hypothesis that a CICR is present and functional in these cells. The presence and role of endogenous cysteinyl leukotrienes for normal contractile functioning of the human detrusor during inflammation remains to be elucidated.
The Journal of Urology 09/2003; 170(2 Pt 1):638-44. DOI:10.1097/01.ju.0000076390.30043.ff · 3.75 Impact Factor