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Ventura S, Oliver VL, White CW, Xie JH, Haynes JM, Exintaris B. Novel drug targets for the pharmacotherapy of benign prostatic hyperplasia (BPH). Br J Pharmacol 2011; 163:891-907. [PMID: 21410684 DOI: 10.1111/j.1476-5381.2011.01332.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is the major cause of lower urinary tract symptoms in men aged 50 or older. Symptoms are not normally life threatening, but often drastically affect the quality of life. The number of men seeking treatment for BPH is expected to grow in the next few years as a result of the ageing male population. Estimates of annual pharmaceutical sales of BPH therapies range from $US 3 to 10 billion, yet this market is dominated by two drug classes. Current drugs are only effective in treating mild to moderate symptoms, yet despite this, no emerging contenders appear to be on the horizon. This is remarkable given the increasing number of patients with severe symptoms who are required to undergo invasive and unpleasant surgery. This review provides a brief background on prostate function and the pathophysiology of BPH, followed by a brief description of BPH epidemiology, the burden it places on society, and the current surgical and pharmaceutical therapies. The recent literature on emerging contenders to current therapies and novel drug targets is then reviewed, focusing on drug targets which are able to relax prostatic smooth muscle in a similar way to the α(1) -adrenoceptor antagonists, as this appears to be the most effective mechanism of action. Other mechanisms which may be of benefit are also discussed. It is concluded that recent basic research has revealed a number of novel drug targets such as muscarinic receptor or P2X-purinoceptor antagonists, which have the potential to produce more effective and safer drug treatments.
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Affiliation(s)
- S Ventura
- Medicinal Chemistry and Drug Action, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
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Jankovic SM, Jankovic SV, Stojanovic V, Stojadinovic D, Stojadinovic M, Canovic D, Stefanovic S. Contractile effects of endothelins on isolated human ureter. Physiol Res 2011; 60:933-9. [PMID: 21995893 DOI: 10.33549/physiolres.932144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of our study was to investigate mechanism of action of endothelins 1, 2 and 3 on spontaneous activity, tone and intraluminal pressure of human ureter. Both longitudinal tension and intraluminal pressure were recorded from the isolated segments of proximal human ureter. Endothelins 1, 2 and 3 (5.35x10(-11) M - 5.05x10(-8) M) produced concentration-dependent tonic contraction and sustained increase in intraluminal pressure of isolated preparations of human ureter. Endothelins 1 and 3 produced also concentration-dependent inhibition of spontaneous, phasic contractions of the isolated preparations. Selective antagonist of ET(A) receptors BQ123 and selective antagonist of ET(B) receptors BQ788 produced significant inhibition of endothelin-1-induced tonic contraction (pA(2)=8.80 and 6.55, respectively) and increase in intraluminal pressure (pA(2)=8.68 and 7.02, respectively), while they did not affect endothelin-1-induced inhibition of spontaneous activity. Endothelin 1 produces increase in tone and intraluminal pressure of isolated human ureter acting on both ET(A) and ET(B) receptors, the first one being functionally more important. Only endothelins 1 and 3 inhibit spontaneous, phasic activity of human ureter, but this effect was not blocked by selective antagonists of ET(A) and ET(B) receptors.
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Affiliation(s)
- S M Jankovic
- Pharmacology Department, Medical Faculty, University of Kragujevac, Kragujevac, Serbia.
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Abstract
Numerous neuropeptide/receptor systems including vasoactive intestinal polypeptide, pituitary adenylate cyclase-activating polypeptide, calcitonin gene-related peptide, substance P, neurokinin A, bradykinin, and endothelin-1 are expressed in the lower urinary tract (LUT) in both neural and nonneural (e.g., urothelium) components. LUT neuropeptide immunoreactivity is present in afferent and autonomic efferent neurons innervating the bladder and urethra and in the urothelium of the urinary bladder. Neuropeptides have tissue-specific distributions and functions in the LUT and exhibit neuroplastic changes in expression and function with LUT dysfunction following neural injury, inflammation, and disease. LUT dysfunction with abnormal voiding, including urinary urgency, increased voiding frequency, nocturia, urinary incontinence, and pain, may reflect a change in the balance of neuropeptides in bladder reflex pathways. LUT neuropeptide/receptor systems may represent potential targets for therapeutic intervention.
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Sánchez A, Recio P, Orensanz LM, Bustamante S, Navarro-Dorado J, Climent B, Benedito S, García-Sacristán A, Prieto D, Hernández M. Mechanisms involved in the effects of endothelin-1 in pig prostatic small arteries. Eur J Pharmacol 2010; 640:190-6. [PMID: 20493185 DOI: 10.1016/j.ejphar.2010.04.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 04/08/2010] [Accepted: 04/25/2010] [Indexed: 11/26/2022]
Abstract
Since endothelin-1 (ET-1) is involved in prostatic disorders, the current study investigated the mechanisms underlying the ET-1-induced effects in pig prostatic small arteries. The experiments were performed in rings mounted in microvascular myographs containing physiological saline solution at 37oC for isometric force recordings. On basal tension, ET-1 (0.1-30 nM) evoked concentration-dependent contractions, which were enhanced by endothelium removal. ET-1 contractions were inhibited by blockade of endothelin ETA and ETB receptors, extracellular Ca2+ removal and blockade of voltage-dependent (L-type)- and non-voltage-dependent-Ca2+ channels. On endothelium intact rings precontracted with noradrenaline, the ETB endothelin receptor agonist BQ3020 promoted a concentration-dependent relaxation which was reduced by blockade of ETB receptors, nitric oxide synthase, guanylyl cyclase and prostanoids synthesis. Endothelium removal abolished its relaxant response and unmasked a BQ3020-induced contraction. Tetraethylammonium and 4-aminopyridine, blockers of non-selective K+ channels and voltage-dependent K+ (Kv) channels, respectively, inhibited the relaxations to BQ3020. Iberiotoxin, apamin and glibenclamide, blockers of large and small Ca2+-activated- and ATP-dependent- K+ channels, respectively, failed to modify these responses. These data suggest that ET-1 promotes contraction of pig prostatic small arteries by activating vascular smooth muscle contractile endothelin ETA and ETB receptors coupled to extracellular Ca2+ entry, via voltage-dependent (L-type)- and non-voltage-dependent Ca2+ channels, also being due to intracellular Ca2+ mobilization. In addition, a population of endothelial ETB receptors mediates vasorelaxation via NO-cGMP pathway, vasodilator cyclooxygenase product(s) and Kv channels.
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Affiliation(s)
- Ana Sánchez
- Departamento de Fisiología, Facultad de Farmacia, Universidad Complutense de Madrid, and Departamento de Investigación, Hospital Universitario Ramón y Cajal 28040-Madrid, Spain
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Ukai M, Yuyama H, Fujimori A, Koakutsu A, Sanagi M, Ohtake A, Sato S, Sudoh K, Sasamata M, Miyata K. In vitro and in vivo effects of endothelin-1 and YM598, a selective endothelin ETA receptor antagonist, on the lower urinary tract. Eur J Pharmacol 2008; 580:394-400. [DOI: 10.1016/j.ejphar.2007.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 10/26/2007] [Accepted: 11/10/2007] [Indexed: 10/22/2022]
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Wada Y, Takahashi W, Latifpour J, Yamada G, Kai N, Honda J, Nakanishi J, Weiss RM. Regional differences in the functional and biochemical properties of endothelin receptor subtypes in the rabbit prostatic urethra. BJU Int 2007; 100:430-7. [PMID: 17559559 DOI: 10.1111/j.1464-410x.2007.07064.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the regional differences in the functional (pharmacological) and biochemical properties of endothelin (ET) receptors in the rabbit prostatic urethra. MATERIALS AND METHODS The properties of ET receptors in 6-month-old male rabbit prostatic urethras were examined using isolated muscle-bath and radioligand receptor-binding techniques. Using plasma membrane suspensions, saturation and inhibition experiments with [(125)I]ET-1 and unlabelled agonists and antagonists (ET(A)-selective antagonist BQ123, and ET(B)-selective agonist sarafotoxin 6c, STX6c) were done to determine the ET receptor densities and their subtype specificities in the different regions of the urethra. RESULTS The ETs (ET-1 and ET-3) produced significant concentration-dependent contractile responses in the smooth muscle strips from the different regions of the urethra. Although the maximum contractile responses induced by ET-1 were similar in the different regions, the maximum contractile responses induced by ET-3 were greater in the distal region than in the proximal or middle regions, suggesting that the contractile response to ET-1 is more potent than that to ET-3 in all regions, and that there are region-specific differences in the responses to ET-3 but not ET-1. Moreover, the ET-3-induced contractile response was suppressed by BQ788 (a selective antagonist of the ET(B) receptor) suggesting that the ET(B) receptor subtype contributes to the contractile responses mediated by ET-3. The ET receptors were expressed in higher concentrations in the distal than in the proximal or middle regions. BQ123 and STX6c inhibited [(125)I]ET-1 binding in all regions with high and low affinity constants, indicating the presence of both ET(A) and ET(B) receptor subtypes. The proportions of high-affinity binding sites for BQ123, representing ET(A) receptors, were approximately 68%, 63% and 42% in the proximal, middle and distal regions, respectively. By contrast, the proportions of high-affinity binding sites for STX6c, representing ET(B) receptors, were approximately 27%, 35% and 52% in the proximal, middle, and distal regions, respectively. These data indicate the presence of regional differences in the densities and subtype specificities of ET receptor subtypes, and the existence of regional differences in the rabbit prostatic urethra. CONCLUSION The results suggest regional differences in ET(B) receptor subtypes that mediate contractile responses to ET-3, reflecting differences in the densities and specificities of the ET receptor subtypes in the rabbit prostatic urethra.
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Affiliation(s)
- Yoshihiro Wada
- Department of Urology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
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Ukai M, Yuyama H, Noguchi Y, Someya A, Okutsu H, Watanabe M, Yoshino T, Ohtake A, Suzuki M, Sato S, Sasamata M. Participation of endogenous endothelin and ETA receptor in premicturition contractions in rats with bladder outlet obstruction. Naunyn Schmiedebergs Arch Pharmacol 2006; 373:197-203. [PMID: 16736156 DOI: 10.1007/s00210-006-0064-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2005] [Accepted: 03/27/2006] [Indexed: 01/23/2023]
Abstract
A relationship between endogenous endothelins and bladder overactivity has recently been suggested, but the related endothelin receptor subtype has not been identified. Here, to evaluate the involvement of endothelin-1 and its receptors in bladder overactivity, we investigated endothelin-1 levels and the expression of its receptors in the bladder of rats with bladder outlet obstruction (BOO), a model for bladder overactivity. We also investigated the effects of a selective endothelin ET(A) receptor antagonist, (E)-N-[6-methoxy-5-(2-methoxyphenoxy)[2,2'-bipyrimidin]-4-yl]-2-phenylethenesulfonamide monopotassium salt (YM598), on bladder functions in conscious BOO rats. Partial obstruction of the urethra led to a progressive increase in bladder weight from weeks 1 to 6. Binding assays performed using plasma membranes prepared from these bladders to estimate endothelin receptor density from the maximum [(125)I]endothelin-1 binding showed increased endothelin receptor density (about double) at 1, 2, and 6 weeks after the operation in the BOO bladder. The densities of endothelin ET(A) receptors in the bladder of sham-operated and BOO rats at 2 weeks after operation were about 3.5 and 5 times those of endothelin ET(B) receptors respectively. Furthermore, the endothelin-1 level was also increased in the BOO bladder. Two weeks after operation, BOO rats showed an increase in maximum bladder capacity and micturition volume and the generation of premicturition contractions. The frequency of premicturition contractions was dose-dependently reduced by YM598 (0.1-3 mg/kg, i.v.) without any effect on other voiding parameters in BOO rats. These data suggest that endothelin-1 and endothelin ET(A) receptors might be involved in the generation of premicturition contractions in BOO rats, and that endothelin ET(A) receptor antagonists such as YM598 may have ameliorating effects in patients with bladder overactivity associated with BOO.
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Affiliation(s)
- Masashi Ukai
- Pharmacology Research Labs, Institute for Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki, 305-8585, Japan.
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Yono M, Latifpour J, Takahashi W, Pouresmail M, Afiatpour P, Weiss RM. Age-related changes in the properties of the endothelin receptor system at protein and mRNA levels in the rat vas deferens. J Recept Signal Transduct Res 2005; 24:53-66. [PMID: 15344879 DOI: 10.1081/rrs-120034106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
As age-related changes occur in the properties of the endothelin (ET) receptor system in several mammalian tissues, and as there are significant amounts of functional ET receptors in the vas deferens, we investigated the age-related changes in the ET receptor system at the protein and mRNA levels in the rat vas deferens. The ET system was investigated in the vasa deferentia of 3 weeks, 3 months and 22 months old rats. ET receptors were characterized and quantified at the protein level by radioligand receptor binding, and gene transcript levels of ET-1, ET-3, ET converting enzyme-1 (ECE-1), and ET(A) and ET(B) receptor subtypes were quantified by real-time reverse transcription polymerase chain reaction (RT-PCR). The results of radioligand receptor binding assays demonstrate that there is a higher density of total ET receptors in the vas deferens of 3 weeks old rats than in 3 months and 22 months old rats, and that the predominant ET receptor is of the ET(A) subtype in all three ages. Real-time RT-PCR data show that the predominant mRNA expression of ETs and their receptors in all age groups studied are ET-1 and the ET(A) receptor subtype, respectively. Furthermore, ET-1, ET-3, ECE-1, and ET(A) and ET(B) receptor subtype mRNAs are expressed at higher levels in the 3 weeks old rats as compared with the other two age groups. These results demonstrate the presence of age-related changes in the properties of the ET receptor system at both protein and mRNA levels in the rat vas deferens.
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Affiliation(s)
- Makoto Yono
- Section of Urology, Yale University School of Medicine, New Haven, Connecticut 06520, USA
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Wada Y, Latifpour J, Sanematsu H, Afiatpour P, Wang Z, Saito M, Nishi K, Weiss RM. Age-related changes in contractile responses of rabbit lower urinary tract to endothelin. J Urol 2000; 164:806-13. [PMID: 10953160 DOI: 10.1097/00005392-200009010-00054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE As there are significant amounts of endothelin (ET) receptors in the mammalian urinary tract, we investigated the pharmacological properties and localization of ET receptors in the rabbit lower urinary tract as a function of age. MATERIALS AND METHODS The characteristics of ET receptors in bladder dome, trigone and urethra of 6 weeks and 6 months old male rabbits were determined using muscle bath and autoradiographic techniques. RESULTS ET-1 produces significant contractile responses in smooth muscle strips from bladder dome, trigone, and urethra in both 6 weeks and 6 months old rabbits. Although there was no significant difference in the maximum contractile response of urethral muscle strips to ET-1 between 6 weeks and 6 months old rabbits, the maximum responses to ET-1 were higher in both bladder dome and trigone of 6 weeks than 6 months old rabbits. A selective ETA receptor antagonist, BQ 610, shifted the concentration response curve to ET-1 to the right without decreasing maximal contractile responses in all regions from both age groups, whereas a selective ETB receptor antagonist, IRL 1038, had no significant effect on the contractile response in these tissues. Autoradiographic studies indicate that both ET receptor subtypes are expressed in bladder dome, trigone, and urethra with the ETA subtype being located only in the smooth muscle layers and the ETB subtype being located in both the urothelial and smooth muscle layers. CONCLUSION Our data indicate the presence of region- and age-dependent differences in the contractile properties of ET receptors in the male rabbit lower urinary tract. Although both ETA and ETB receptor subtypes are present in the smooth muscle layers, the ETA receptor is the sub-type that is primarily involved in the mediation of contractions.
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Affiliation(s)
- Y Wada
- Section of Urology, Yale University School of Medicine New Haven, CT 06520-8041, USA
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WADA YOSHIHIRO, LATIFPOUR JAMSHID, SANEMATSU HIROMI, AFIATPOUR PARVIZ, WANG ZEJING, SAITO MOTOAKI, NISHI KAZUHIKO, WEISS ROBERTM. AGE-RELATED CHANGES IN CONTRACTILE RESPONSES OF RABBIT LOWER URINARY TRACT TO ENDOTHELIN. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67319-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- YOSHIHIRO WADA
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
| | - JAMSHID LATIFPOUR
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
| | - HIROMI SANEMATSU
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
| | - PARVIZ AFIATPOUR
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
| | - ZEJING WANG
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
| | - MOTOAKI SAITO
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
| | - KAZUHIKO NISHI
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
| | - ROBERT M. WEISS
- From the Section of Urology, Yale University School of Medicine New Haven, Connecticut
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Sullivan ME, Mumtaz FH, Khan MA, Dashwood MR, Thompson CS, Mikhailidis DP, Morgan RJ. Endothelins in the urinary tract. BJU Int 2000; 86:97-106. [PMID: 10886092 DOI: 10.1046/j.1464-410x.2000.00730.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- M E Sullivan
- Departments of Urology, Royal Free Hampstead NHS Trust, London, UK
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Mumtaz FH, Khan MA, Sullivan ME, Thompson CS, Mikhailidis DP, Morgan RJ, Dashwood MR. Potential role of endothelin and nitric oxide in physiology and pathophysiology of the lower urinary tract. ENDOTHELIUM : JOURNAL OF ENDOTHELIAL CELL RESEARCH 1999; 7:1-9. [PMID: 10599556 DOI: 10.3109/10623329909165307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Endothelium-derived vasoactive mediators (endothelin-1 with its vasoconstrictive and mitogenic properties and nitric oxide with its vasodilatory and antiproliferative properties) play an important role in the regulation of vascular smooth muscle tone and cellular proliferation. Several recent studies have now demonstrated the presence of these vasoactive agents in the urinary tract where they are thought to play a prominent role in urinary tract physiology and disease. This article reviews the synthesis, localisation and actions of endothelin and nitric oxide in the lower urinary tract and examines the possible role of these mediators in disease.
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Affiliation(s)
- F H Mumtaz
- Department of Urology, Royal Free and University College Medical School, University College London
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