Muscarinic agonists and antagonists: Effects on the urinary bladder

Research output: Chapter in Book/Report/Conference proceedingChapterResearchpeer-review

27 Citations (Scopus)

Abstract

Voiding of the bladder is the result of a parasympathetic muscarinic receptor activation of the detrusor smooth muscle. However, the maintenance of continence and a normal bladder micturition cycle involves a complex interaction of cholinergic, adrenergic, nitrergic and peptidergic systems that is currently little understood. The cholinergic component of bladder control involves two systems, acetylcholine (ACh) released from parasympathetic nerves and ACh from non-neuronal cells within the urothelium. The actions of ACh on the bladder depend on the presence of muscarinic receptors that are located on the detrusor smooth muscle, where they cause direct (M 3) and indirect (M 2) contraction; pre-junctional nerve terminals where they increase (M 1) or decrease (M 4) the release of ACh and noradrenaline (NA); sensory nerves where they influence afferent nerve activity; umbrella cells in the urothelium where they stimulate the release of ATP and NO; suburothelial interstitial cells with unknown function; and finally, other unidentified sites in the urothelium from where prostaglandins and inhibitory/relaxatory factors are released. Thus, the actions of muscarinic receptor agonists and antagonists on the bladder may be very complex even when considering only local muscarinic actions. Clinically, muscarinic antagonists remain the mainstay of treatment for the overactive bladder (OAB), while muscarinic agonists have been used to treat hypoactive bladder. The antagonists are effective in treating OAB, but their precise mechanisms and sites of action (detrusor, urothelium, and nerves) have yet to be established. Potentially more selective agents may be developed when the cholinergic systems within the bladder are more fully understood.

Original languageEnglish
Title of host publicationMuscarinic Receptors
EditorsA D Fryer, A Christopoulos, N M Nathanson
Place of PublicationGermany
PublisherSpringer
Pages375-400
Number of pages26
Volume208
ISBN (Print)9783642232732
DOIs
Publication statusPublished - 2012

Publication series

NameHandbook of Experimental Pharmacology
Volume208
ISSN (Print)01712004
ISSN (Electronic)18650325

Fingerprint

Muscarinic Agonists
Muscarinic Antagonists
Cholinergic Agents
Acetylcholine
Urinary Bladder
Muscarinic Receptors
Urothelium
Muscle
Overactive Urinary Bladder
Smooth Muscle
Adrenergic Agents
Prostaglandins
Norepinephrine
Adenosine Triphosphate
Chemical activation
Urination
Maintenance

Cite this

Sellers, D. J., & Chess-Williams, R. (2012). Muscarinic agonists and antagonists: Effects on the urinary bladder. In A. D. Fryer, A. Christopoulos, & N. M. Nathanson (Eds.), Muscarinic Receptors (Vol. 208, pp. 375-400). (Handbook of Experimental Pharmacology; Vol. 208). Germany: Springer. https://doi.org/10.1007/978-3-642-23274-9_16
Sellers, Donna J. ; Chess-Williams, Russ. / Muscarinic agonists and antagonists: Effects on the urinary bladder. Muscarinic Receptors. editor / A D Fryer ; A Christopoulos ; N M Nathanson. Vol. 208 Germany : Springer, 2012. pp. 375-400 (Handbook of Experimental Pharmacology).
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Sellers, DJ & Chess-Williams, R 2012, Muscarinic agonists and antagonists: Effects on the urinary bladder. in AD Fryer, A Christopoulos & NM Nathanson (eds), Muscarinic Receptors. vol. 208, Handbook of Experimental Pharmacology, vol. 208, Springer, Germany, pp. 375-400. https://doi.org/10.1007/978-3-642-23274-9_16

Muscarinic agonists and antagonists: Effects on the urinary bladder. / Sellers, Donna J.; Chess-Williams, Russ.

Muscarinic Receptors. ed. / A D Fryer; A Christopoulos; N M Nathanson. Vol. 208 Germany : Springer, 2012. p. 375-400 (Handbook of Experimental Pharmacology; Vol. 208).

Research output: Chapter in Book/Report/Conference proceedingChapterResearchpeer-review

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Sellers DJ, Chess-Williams R. Muscarinic agonists and antagonists: Effects on the urinary bladder. In Fryer AD, Christopoulos A, Nathanson NM, editors, Muscarinic Receptors. Vol. 208. Germany: Springer. 2012. p. 375-400. (Handbook of Experimental Pharmacology). https://doi.org/10.1007/978-3-642-23274-9_16