1
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Chai Y, Zhou Z, Cui Y, Che X, Zhang Y. Outcomes and complications of naftopidil versus tamsulosin for elderly men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: A systematic review and meta-analysis. Andrologia 2021; 53:e14166. [PMID: 34189764 DOI: 10.1111/and.14166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/16/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022] Open
Abstract
We conducted a systematic review and meta-analysis to assess the outcomes and complications of naftopidil in treating elderly men with lower urinary tract symptoms secondary to benign prostatic hyperplasia and compared them with those administered with tamsulosin. A literature review was performed to identify the available randomised controlled trials concerning the comparison between naftopidil and tamsulosin for men with LUTS/BPH. We searched the following databases: the Cochrane Library Database, PubMed, Embase and Web of Science. Eleven publications involving 1,114 men (557 in the naf group and 557 in the tam group) were pooled in our analysis. We found no significant differences in the total IPSS, IPSS storage score, IPSS voiding score, quality of life index, peak urinary flow rate, average flow rate and post-void residual volumes. We assessed cardiovascular and sexual adverse events, acute urinary retention, surgical intervention, withdrawals due to any reason and withdrawals due to adverse events. The incidence of adverse events was similar among patients in naf and tam groups. In conclusion, naftopidil shared comparable efficacy and similar incidence of adverse events with tamsulosin and appears to be a promising agent for and alternative to tam. However, more prospective trials with high quality and long-term treatment duration are needed to verify this observation.
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Affiliation(s)
- Yumeng Chai
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongbao Zhou
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuanshan Cui
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Xuanyan Che
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Zhang
- Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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2
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Watanabe M, Yamaguchi S, Kakizaki H, Hirabayashi N, Ishida H. Evaluation of Alpha 1 Adrenoceptor Antagonist Dose Increase Therapy: An Essential Strategy for Patients with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia. Curr Urol 2020; 14:113-121. [PMID: 33224003 DOI: 10.1159/000499250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction There have been a number of reports on dose increase therapy (DI-T) with the alpha 1 adrenoceptor antagonists (α1-blockers) naftopidil and tamsulosin for lower urinary tract symptoms associated with benign prostatic hyperplasia. Methods and Results The reports on DI-T (naftopidil 75 mg/d, tamsulosin 0.4 mg/d) in non-responders to low-dose initial therapy (LI-T, naftopidil 50 mg/d, tamsulosin 0.2 mg/d) were summarized. In each study, a non-responder was defined as a patient without sufficient improvements on the International Prostate Symptom Score (IPSS), IPSS Quality of Life, maximum flow rate of urine, or treatment satisfaction. These reports showed that 22.4-76.1% of patients were non-responders to LI-T, indicating that a novel treatment strategy for such patients is important. Moreover, 22.5-90.0% of non-responders to LI-T showed a response to DI-T, which achieved the same level of efficacy as low-dose maintenance therapy. Specifically, the improvements of the IPSS voiding symptom sub-score and maximum flow rate of urine were superior. The predictive factors for non-response to α1-blockers LI-T were insufficient improvement of subjective symptoms and objective findings during LI-T. These patients require high-dose initial therapy or DI-T at an early stage, since adverse events associated with naftopidil and tamsulosin do not show a dose-response relationship. Conclusions DI-T with α1-blockers has high potential as an essential treatment strategy for lower urinary tract symptoms associated with benign prostatic hyperplasia.
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Affiliation(s)
- Masaki Watanabe
- Department of Urology, Hokkaido Social Welfare Association Furano Hospital, Furano
| | | | - Hidehiro Kakizaki
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa
| | - Naoki Hirabayashi
- Medical Affairs Department, Asahi Kasei Pharma Corporation, Tokyo, Japan
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3
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Docherty JR. The pharmacology of α 1-adrenoceptor subtypes. Eur J Pharmacol 2019; 855:305-320. [PMID: 31067439 DOI: 10.1016/j.ejphar.2019.04.047] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/17/2019] [Accepted: 04/29/2019] [Indexed: 01/30/2023]
Abstract
This review examines the functions of α1-adrenoceptor subtypes, particularly in terms of contraction of smooth muscle. There are 3 subtypes of α1-adrenoceptor, α1A- α1B- and α1D-adrenoceptors. Evidence is presented that the postulated α1L-adrenoceptor is simply the native α1A-adrenoceptor at which prazosin has low potency. In most isolated tissue studies, smooth muscle contractions to exogenous agonists are mediated particularly by α1A-, with a lesser role for α1D-adrenoceptors, but α1B-adrenoceptors are clearly involved in contractions of some tissues, for example, the spleen. However, nerve-evoked responses are the most crucial physiologically, so that these studies of exogenous agonists may overestimate the importance of α1A-adrenoceptors. The major α1-adrenoceptors involved in blood pressure control by sympathetic nerves are the α1D- and the α1A-adrenoceptors, mediating peripheral vasoconstrictor actions. As noradrenaline has high potency at α1D-adrenceptors, these receptors mediate the fastest response and seem to be targets for neurally released noradrenaline especially to low frequency stimulation, with α1A-adrenoceptors being more important at high frequencies of stimulation. This is true in rodent vas deferens and may be true in vasopressor nerves controlling peripheral resistance and tissue blood flow. The αlA-adrenoceptor may act mainly through Ca2+ entry through L-type channels, whereas the α1D-adrenoceptor may act mainly through T-type channels and exhaustable Ca2+ stores. α1-Adrenoceptors may also act through non-G-protein linked second messenger systems. In many tissues, multiple subtypes of α-adrenoceptor are present, and this may be regarded as the norm rather than exception, although one receptor subtype is usually predominant.
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Affiliation(s)
- James R Docherty
- Department of Physiology, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.
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4
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Sidler M, Aitken KJ, Forward S, Vitkin A, Bagli DJ. Non-invasive voiding assessment in conscious mice. Bladder (San Franc) 2018; 5:e33. [PMID: 32775475 PMCID: PMC7401987 DOI: 10.14440/bladder.2018.582] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/15/2017] [Accepted: 01/22/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To review available options of assessing murine bladder function and to evaluate a non-invasive technique suitable for long-term recording. METHODS We reviewed previously described methods to record rodent bladder function. We used modified metabolic cages to capture novel recording tracings of mouse micturition. We evaluated our method in a pilot study with female mice undergoing partial bladder outlet obstruction or sham operation, respectively; half of the partial obstruction and sham group received treatment with an S6K-inhibitor, targeting the mTOR pathway, which is known to be implicated in bladder response to obstruction. RESULTS Our non-invasive method using continuous urine weight recording reliably detected changes in murine bladder function resulting from partial bladder outlet obstruction or treatment with S6K-inhibitor. We found obstruction as well as treatment with S6K-inhibitor to correlate with a hyperactive voiding pattern. CONCLUSIONS While invasive methods to assess murine bladder function largely disturb bladder histology and intrinsically render post-cystometry gene expression analysis of questionable value, continuous urine weight recording is a reliable, inexpensive, and critically non-invasive method to assess murine bladder function, suitable for a long-term application.
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Affiliation(s)
- Martin Sidler
- The Hospital for Sick Children, Research Institute, Developmental and Stem Cell Biology, Toronto, Canada.,The Hospital for Sick Children, Pediatric Urology, Toronto, Canada.,Institute of Medical Science, University of Toronto, Canada.,Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - Karen J Aitken
- The Hospital for Sick Children, Research Institute, Developmental and Stem Cell Biology, Toronto, Canada
| | - Sarah Forward
- Department of Medical Biophysics, University of Toronto, Canada
| | - Alex Vitkin
- Department of Medical Biophysics, University of Toronto, Canada
| | - Darius J Bagli
- The Hospital for Sick Children, Research Institute, Developmental and Stem Cell Biology, Toronto, Canada.,The Hospital for Sick Children, Pediatric Urology, Toronto, Canada.,Institute of Medical Science, University of Toronto, Canada
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5
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Mechanisms of action for α1-adrenoceptor blockers in storage symptoms with new insights into the micturition reflex. Life Sci 2017; 191:90-96. [DOI: 10.1016/j.lfs.2017.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/07/2017] [Accepted: 10/11/2017] [Indexed: 01/22/2023]
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6
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Effects of naftopidil on inhibitory transmission in substantia gelatinosa neurons of the rat spinal dorsal horn in vitro. J Neurol Sci 2017; 380:205-211. [DOI: 10.1016/j.jns.2017.07.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/07/2017] [Accepted: 07/22/2017] [Indexed: 01/14/2023]
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7
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Tanuma Y, Tanaka Y, Takeyama K, Okamoto T. The predictive factors of α1-D/A adrenoceptor antagonist, naftopidil, dose increase therapy for male lower urinary tract symptoms caused by benign prostatic hyperplasia: INFORM study. Urol Ann 2017; 9:261-267. [PMID: 28794594 PMCID: PMC5532895 DOI: 10.4103/ua.ua_23_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: We evaluated the predictive factors which affect the efficacy of naftopidil 50 mg/day therapy and dose increase therapy to administration of 75 mg/day after an initial dose of 50 mg/day. Materials and Methods: A total of 92 patients with male lower urinary tract symptoms/benign prostatic hyperplasia were administrated naftopidil 50 mg/day for 4 weeks (50 mg therapy). At week 4, the patients were divided into an effective and an ineffective group (Group E and Group I, respectively). For further 4 weeks, the dosage of naftopidil was increased to 75 mg/day in all patients. At week 8, the patients of Group E and Group I were divided into an effective and an ineffective group (Group EE, Group EI, Group IE, and Group II, respectively). Results: Postvoid residual (PVR) urine volume at baseline was a predictive factor for efficacy of 50 mg therapy. In Group E, change in International Prostate Symptom Score storage symptoms subscore from baseline to week 4 was a predictive factor for efficacy of this dose increase therapy. In Group I, change in maximum flow rate from baseline to week 4 was a predictive factor for efficacy of this dose increase therapy. Conclusions: The short term of naftopidil 50 mg therapy was ineffective for the patients who had large PVR. The predictive factor of this dose increase therapy might be a dynamic variable in 50 mg/day of dose period, but not a baseline variable at the time of 75 mg/day dosage starts.
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Affiliation(s)
- Yasushi Tanuma
- Department of Urology, Hokkaido Social Welfare Association Hakodate Hospital, Hakodate, Japan
| | - Yoshinori Tanaka
- Department of Urology, Hokkaido Prefectural Esashi Hospital, Esashi, Japan
| | - Ko Takeyama
- Department of Urology, Hakodate National Hospital, Hakodate, Japan
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8
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Ito H, Pickering AE, Igawa Y, Kanai AJ, Fry CH, Drake MJ. Muro-Neuro-Urodynamics; a Review of the Functional Assessment of Mouse Lower Urinary Tract Function. Front Physiol 2017; 8:49. [PMID: 28220079 PMCID: PMC5292568 DOI: 10.3389/fphys.2017.00049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/18/2017] [Indexed: 12/17/2022] Open
Abstract
Background: Mouse urodynamic tests are fundamental to understanding normal lower urinary tract (LUT) function. These experiments also contribute to our understanding of neurological dysfunction, pathophysiological processes, and potential mechanisms of therapy. Objectives: Systematic assessment of published evidence on urodynamics, advantages and limitations of different urodynamic measurements in mice, and consideration of potential implications for the clinical field. Methods: A search using specific search-terms for urodynamic studies and mice was conducted on PubMed (from inception to 1 July 2016). Results: We identified 55 studies examining or describing mouse neuro-urodynamics. We summarize reported features of mouse urodynamic function deriving from frequency-volume chart (FVC) measurements, voiding spot assays, filling cystometry, and pressure-flow studies. Similarly, an influence of the diurnal cycle on voiding is observed in mice and should be considered when interpreting rodent urodynamic studies, especially FVC measurements and voiding spot assays. Anaesthesia, restraint conditions, or filling rate influence mouse neuro-urodynamics. Mouse cystometric studies have observed intravesical pressure oscillations that accompany urine flow, attributed to high frequency opening and closing of the urethra. This characterization is not seen in other species, except rats. In contrast to human clinical urodynamics, the terminology of these examinations has not been standardized although many rodent urodynamic studies have been described. Conclusion: Mice have many anatomical and physiological similarities to humans and they are generally cost effective, and allow investigation of the effects of aging because of their short lifespan. There are some differences between mouse and human urodynamics. These must be considered when interpreting LUT function in mice, and translational value of murine disease models.
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Affiliation(s)
- Hiroki Ito
- Department of Physiology, Pharmacology and Neuroscience, University of Bristol Bristol, UK
| | - Anthony E Pickering
- Department of Physiology, Pharmacology and Neuroscience, University of Bristol Bristol, UK
| | - Yasuhiko Igawa
- Department of Continence Medicine, University of Tokyo Graduate School of Medicine Tokyo, Japan
| | - Anthony J Kanai
- Department of Pharmacology and Chemical Biology, University of Pittsburgh Pennsylvania, PA, USA
| | - Christopher H Fry
- Department of Physiology, Pharmacology and Neuroscience, University of Bristol Bristol, UK
| | - Marcus J Drake
- Department of Physiology, Pharmacology and Neuroscience, University of Bristol Bristol, UK
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9
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Comparison of Silodosin and Naftopidil for Efficacy in the Treatment of Benign Prostatic Enlargement Complicated by Overactive Bladder: A Randomized, Prospective Study (SNIPER Study). J Urol 2017; 197:452-458. [DOI: 10.1016/j.juro.2016.08.111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 12/18/2022]
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10
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Durnin L, Hayoz S, Corrigan RD, Yanez A, Koh SD, Mutafova-Yambolieva VN. Urothelial purine release during filling of murine and primate bladders. Am J Physiol Renal Physiol 2016; 311:F708-F716. [PMID: 27465992 DOI: 10.1152/ajprenal.00387.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/26/2016] [Indexed: 01/15/2023] Open
Abstract
During urinary bladder filling the bladder urothelium releases chemical mediators that in turn transmit information to the nervous and muscular systems to regulate sensory sensation and detrusor muscle activity. Defects in release of urothelial mediators may cause bladder dysfunctions that are characterized with aberrant bladder sensation during bladder filling. Previous studies have demonstrated release of ATP from the bladder urothelium during bladder filling, and ATP remains the most studied purine mediator that is released from the urothelium. However, the micturition cycle is likely regulated by multiple purine mediators, since various purine receptors are found present in many cell types in the bladder wall, including urothelial cells, afferent nerves, interstitial cells in lamina propria, and detrusor smooth muscle cells. Information about the release of other biologically active purines during bladder filling is still lacking. Decentralized bladders from C57BL/6 mice and Cynomolgus monkeys (Macaca fascicularis) were filled with physiological solution at different rates. Intraluminal fluid was analyzed by high-performance liquid chromatography with fluorescence detection for simultaneous evaluation of ATP, ADP, AMP, adenosine, nicotinamide adenine dinucleotide (NAD+), ADP-ribose, and cADP-ribose content. We also measured ex vivo bladder filling pressures and performed cystometry in conscious unrestrained mice at different filling rates. ATP, ADP, AMP, NAD+, ADPR, cADPR, and adenosine were detected released intravesically at different ratios during bladder filling. Purine release increased with increased volumes and rates of filling. Our results support the concept that multiple urothelium-derived purines likely contribute to the complex regulation of bladder sensation during bladder filling.
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Affiliation(s)
- Leonie Durnin
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, Nevada
| | - Sebastien Hayoz
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, Nevada
| | - Robert D Corrigan
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, Nevada
| | - Andrew Yanez
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, Nevada
| | - Sang Don Koh
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, Nevada
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11
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Kountz TS, Lee KS, Aggarwal-Howarth S, Curran E, Park JM, Harris DA, Stewart A, Hendrickson J, Camp ND, Wolf-Yadlin A, Wang EH, Scott JD, Hague C. Endogenous N-terminal Domain Cleavage Modulates α1D-Adrenergic Receptor Pharmacodynamics. J Biol Chem 2016; 291:18210-21. [PMID: 27382054 DOI: 10.1074/jbc.m116.729517] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Indexed: 01/11/2023] Open
Abstract
The α1D-adrenergic receptor (ADRA1D) is a key regulator of cardiovascular, prostate, and central nervous system functions. This clinically relevant G protein-coupled receptor has proven difficult to study, as it must form an obligate modular homodimer containing the PDZ proteins scribble and syntrophin or become retained in the endoplasmic reticulum as non-functional protein. We previously determined that targeted removal of the N-terminal (NT) 79 amino acids facilitates ADRA1D plasma membrane expression and agonist-stimulated functional responses. However, whether such an event occurs in physiological contexts was unknown. Herein, we report the ADRA1D is subjected to innate NT processing in cultured human cells. SNAP near-infrared imaging and tandem-affinity purification revealed the ADRA1D is expressed as both full-length and NT truncated forms in multiple human cell lines. Serial truncation mapping identified the cleavage site as Leu(90)/Val(91) in the 95-amino acid ADRA1D NT domain, suggesting human cells express a Δ1-91 ADRA1D species. Tandem-affinity purification MS/MS and co-immunoprecipitation analysis indicate NT processing of ADRA1D is not required to form scribble-syntrophin macromolecular complexes. Yet, label-free dynamic mass redistribution signaling assays demonstrate that Δ1-91 ADRA1D agonist responses were greater than WT ADRA1D. Mutagenesis of the cleavage site nullified the processing event, resulting in ADRA1D agonist responses less than the WT receptor. Thus, we propose that processing of the ADRA1D NT domain is a physiological mechanism employed by cells to generate a functional ADRA1D isoform with optimal pharmacodynamic properties.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nathan D Camp
- Genome Sciences, University of Washington School of Medicine, Seattle, Washington 98195
| | - Alejandro Wolf-Yadlin
- Genome Sciences, University of Washington School of Medicine, Seattle, Washington 98195
| | | | - John D Scott
- the Departments of Pharmacology and From the Howard Hughes Medical Institute and
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12
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KADEKAWA K, SUGAYA K, MUKOYAMA H, SAKUMOTO M, SHIMABUKURO H, SHIMABUKURO S, MATAYOSHI Y, ONAGA T, ASHITOMI K, NISHIJIMA S. Influence of Naftopidil on Plasma Monoamine Levels and Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 2016; 8:100-5. [DOI: 10.1111/luts.12079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 07/22/2014] [Accepted: 08/19/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Katsumi KADEKAWA
- Southern Knights' Laboratory LLP; Okinawa Japan
- Department of Urology; Okinawa Kyodo Hospital; Okinawa Japan
| | - Kimio SUGAYA
- Southern Knights' Laboratory LLP; Okinawa Japan
- Department of Urology; Kitakami Central Hospital; Okinawa Japan
| | - Hideki MUKOYAMA
- Department of Urology; Nanbu Tokushukai Hospital; Okinawa Japan
| | | | | | | | | | - Tomohiro ONAGA
- Department of Urology; Okinawa Kyodo Hospital; Okinawa Japan
| | - Katsuhiro ASHITOMI
- Southern Knights' Laboratory LLP; Okinawa Japan
- Department of Urology; Okinawa Hokubu Hospital; Okinawa Japan
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13
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Sakauchi N, Kohara Y, Sato A, Suzaki T, Imai Y, Okabe Y, Imai S, Saikawa R, Nagabukuro H, Kuno H, Fujita H, Kamo I, Yoshida M. Discovery of 5-Chloro-1-(5-chloro-2-(methylsulfonyl)benzyl)-2-imino-1,2-dihydropyridine-3-carboxamide (TAK-259) as a Novel, Selective, and Orally Active α1D Adrenoceptor Antagonist with Antiurinary Frequency Effects: Reducing Human Ether-a-go-go-Related Gene (hERG) Liabilities. J Med Chem 2016; 59:2989-3002. [DOI: 10.1021/acs.jmedchem.5b01528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nobuki Sakauchi
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Yasuhisa Kohara
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Ayumu Sato
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Tomohiko Suzaki
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Yumi Imai
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Yuichi Okabe
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Shigemitsu Imai
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Reiko Saikawa
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Hiroshi Nagabukuro
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Haruhiko Kuno
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Hisashi Fujita
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Izumi Kamo
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Masato Yoshida
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 26-1, Muraoka-Higashi 2-Chome, Fujisawa, Kanagawa 251-8555, Japan
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14
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Tanuma Y, Tanaka Y, Takeyama K, Okamoto T. Does prostate volume affect the efficacy of α1D/A: Adrenoceptor antagonist naftopidil? Urol Ann 2016; 8:20-5. [PMID: 26834396 PMCID: PMC4719506 DOI: 10.4103/0974-7796.157979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: There have been reports that one of the factors affecting the efficacy of α1-adrenoceptor antagonists (α1-blocker; α1-B) was prostate volume (PV). However, there are few reports of short-term prospective trials comparing the efficacy of α1-B by PV. We examined the influence of PV on the short-term efficacy of naftopidil dose increase therapy to administration of 75 mg/day after an initial dose of 50 mg/day. Materials and Methods: A total of 85 patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) received 50 mg/day of naftopidil for 4 weeks. After 4 weeks, the dosage of naftopidil was increased to 75 mg/day for a further 4 weeks. We divided the patients into two groups of PV ≥40 mL at baseline (Group L) and PV <40 mL at baseline (Group S). Results: International Prostate Symptom Score (IPSS), IPSS storage symptoms, and IPSS quality-of-life score were significantly improved at 4 and 8 weeks compared with baseline in both Groups. IPSS voiding symptoms (IPSS-VS) were significantly improved at 4 and 8 weeks compared with baseline in Group S. IPSS and IPSS-VS were significantly improved at 8 weeks compared with 4 weeks only in Group L. IPSS-VS and intermittency at 4 weeks were significantly decreased in Group S compared with Group L. Maximum flow rate was significantly improved at 8 weeks compared with baseline in Group L. Conclusions: PV is a predictive factor affecting the efficacy of naftopidil 50 mg/day for IPSS-VS, and the dose increase to 75 mg/day effective for IPSS-VS. A total of 50 mg/day of naftopidil is the maintenance dose for LUTS/BPH patients with a small PV, and 75 mg/day of dose increase therapy should be chosen for patients with a large PV.
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Affiliation(s)
- Yasushi Tanuma
- Department of Urology, Hokkaido Social Welfare Association Hakodate Hospital, Hakodate, Japan
| | - Yoshinori Tanaka
- Department of Urology, Hokkaido Prefectural Esashi Hospital, Esashi, Japan
| | - Ko Takeyama
- Department of Urology, Hakodate National Hospital, Hakodate, Japan
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15
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MAJIMA T, YAMAMOTO T, FUNAHASHI Y, TAKAI S, MATSUKAWA Y, YOSHIDA M, GOTOH M. Effect of Naftopidil on Bladder Microcirculation in a Rat Model of Bladder Outlet Obstruction. Low Urin Tract Symptoms 2015; 9:111-116. [DOI: 10.1111/luts.12119] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 07/27/2015] [Accepted: 08/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Tsuyoshi MAJIMA
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Tokunori YAMAMOTO
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Yasuhito FUNAHASHI
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Shun TAKAI
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Yoshihisa MATSUKAWA
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Masaki YOSHIDA
- Department of Urology; National Center for Geriatrics and Gerontology; Ohbu Japan
| | - Momokazu GOTOH
- Department of Urology; Nagoya University Graduate School of Medicine; Nagoya Japan
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Abstract
Spinal cord injury (SCI) results not only in motor and sensory deficits but also in autonomic dysfunctions. The disruption of connections between higher brain centers and the spinal cord, or the impaired autonomic nervous system itself, manifests a broad range of autonomic abnormalities. This includes compromised cardiovascular, respiratory, urinary, gastrointestinal, thermoregulatory, and sexual activities. These disabilities evoke potentially life-threatening symptoms that severely interfere with the daily living of those with SCI. In particular, high thoracic or cervical SCI often causes disordered hemodynamics due to deregulated sympathetic outflow. Episodic hypertension associated with autonomic dysreflexia develops as a result of massive sympathetic discharge often triggered by unpleasant visceral or sensory stimuli below the injury level. In the pelvic floor, bladder and urethral dysfunctions are classified according to upper motor neuron versus lower motor neuron injuries; this is dependent on the level of lesion. Most impairments of the lower urinary tract manifest in two interrelated complications: bladder storage and emptying. Inadequate or excessive detrusor and sphincter functions as well as detrusor-sphincter dyssynergia are examples of micturition abnormalities stemming from SCI. Gastrointestinal motility disorders in spinal cord injured-individuals are comprised of gastric dilation, delayed gastric emptying, and diminished propulsive transit along the entire gastrointestinal tract. As a critical consequence of SCI, neurogenic bowel dysfunction exhibits constipation and/or incontinence. Thus, it is essential to recognize neural mechanisms and pathophysiology underlying various complications of autonomic dysfunctions after SCI. This overview provides both vital information for better understanding these disorders and guides to pursue novel therapeutic approaches to alleviate secondary complications.
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Affiliation(s)
- Shaoping Hou
- Spinal Cord Research Center, Department of Neurobiology & Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania
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17
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Differential Response to Medical Therapy for Male Lower Urinary Tract Symptoms. CURRENT BLADDER DYSFUNCTION REPORTS 2015. [DOI: 10.1007/s11884-015-0295-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Wagg A. Pharmacological Treatment of Voiding Dysfunction in Older Men. CURRENT GERIATRICS REPORTS 2015. [DOI: 10.1007/s13670-015-0119-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Huppertz ND, Tolba RH, Grosse JO. Micturition in Göttingen minipigs: first reference in vivo data for urological research and review of literature. Lab Anim 2015; 49:336-44. [PMID: 25660835 DOI: 10.1177/0023677215570993] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One possible symptom of overactive bladder (OAB) is urinary incontinence, which is generally considered to be an age-associated disease and which is rapidly increasing with demographic changes. Rodent models are commonly used for the investigation of lower urinary tract functions, although the use of these species has limitations in several translational aspects. In biomedical research and preclinical toxicology, Göttingen minipigs are used increasingly. But in urological research, only few data are available for Göttingen minipigs. To the best of our knowledge, this study is one of the first to provide reference data of micturition in female Göttingen minipigs. Micturition frequency and volumes were monitored and analyzed in five female Göttingen minipigs. Voided volume was 520 ± 383 mL (mean ± standard deviation of mean [SD]) and micturition frequency 6.17 ± 3.68 (mean ± SD). We also performed a review of the literature to compare our data with data from different species (humans, pigs, rats and mice). Our findings revealed that micturition volume and frequency of Göttingen minipigs are more comparable with that of humans, leading to the conclusion that Göttingen minipigs may be the better choice for translational research in different research fields, such as urology, neurology and nephrology, etc. The provision of in vivo reference values meets with the 3R concept of 'reduction, refinement and replacement' of laboratory animals, because they allow comprehensive statistical power calculations (reduction), planning of telemetric approaches (refinement), and generation of computer-based modulation for the development of intravesical drug delivery systems (replacement).
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Affiliation(s)
- N D Huppertz
- Department of Urology, University Hospital RWTH Aachen, Aachen, Germany
| | - R H Tolba
- Institute for Laboratory Animal Science & Experimental Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - J O Grosse
- Department of Urology, University Hospital RWTH Aachen, Aachen, Germany
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Tanaka T, Kuratsukuri K, Yoshimura R, Adachi T, Yamaguchi T, Ohmachi T, Yamamoto S, Nakamura T, Tamada S, Nakatani T. Efficacy of naftopidil for nocturia in male patients with lower urinary tract symptoms: Comparison of morning and evening dosing. Int J Urol 2014; 22:317-21. [DOI: 10.1111/iju.12669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/25/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Tomoaki Tanaka
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
| | - Katsuyuki Kuratsukuri
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
| | - Rikio Yoshimura
- Department of Urology; Osaka Railway Hospital; Osaka Osaka Japan
| | - Takahisa Adachi
- Department of Urology; Juso Municipal Hospital; Osaka Osaka Japan
| | | | - Tetsuji Ohmachi
- Department of Urology; Bell land General Hospital; Sakai Osaka Japan
| | - Shinji Yamamoto
- Department of Urology; Ikuwakai Memorial Hospital; Osaka Osaka Japan
| | - Takahiro Nakamura
- Department of Urology; Perfect Liberty Hospital; Tondabayashi Osaka Japan
| | - Satoshi Tamada
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
| | - Tatsuya Nakatani
- Department of Urology; Osaka City University Graduate School of Medicine; Osaka Osaka Japan
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21
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Alpha 1-adrenoceptor blocker may improve not only voiding but also storage lower urinary tract symptoms caused by (125) I brachytherapy for prostate cancer. ISRN UROLOGY 2014; 2014:140654. [PMID: 25006516 PMCID: PMC4004040 DOI: 10.1155/2014/140654] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 03/02/2014] [Indexed: 01/10/2023]
Abstract
Purpose. To assess changes in lower urinary tract symptoms (LUTS) within 1 year after brachytherapy in patients receiving alpha 1-adrenoceptor antagonists. Methods. We retrospectively evaluated 116 patients who underwent 125I prostate brachytherapy in our institute. Seventy-one patients were treated with a combination of external beam radiation therapy and brachytherapy. Alpha 1-adrenoceptor antagonists were prescribed to all patients after brachytherapy. International Prostate Symptom Score (IPSS) forms and postvoid residual urine volume were recorded at all follow-up visits. Results. Forty-nine patients were given tamsulosin hydrochloride, 32 were given silodosin hydrochloride, and 35 were given naftopidil for up to 6 months after seed implantation. Patients given tamsulosin or naftopidil tended to show a higher peak IPSS and slower recovery to baseline values than those given silodosin. The patients given naftopidil showed an insufficient recovery in storage symptoms in naftopidil group in comparison with tamsulosin group at 3 months and with silodosin group at 6 and 9 months. Conclusions. In the management of LUT after brachytherapy, silodosin may provide a more favorable improvement. Silodosin and tamsulosin may have an advantage in improving not only voiding but also storage lower urinary tract symptoms after brachytherapy.
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Kurizaki Y, Ishizuka O, Imamura T, Ichino M, Ishikawa M, Ogawa T, Nishizawa O. Correlation Between Bladder Mucosal Alpha-1D/Alpha-1A Adrenoceptor mRNA Ratio and Lower Urinary Tract Function in Benign Prostatic Obstruction Patients. Low Urin Tract Symptoms 2013; 5:60-4. [PMID: 26663371 DOI: 10.1111/j.1757-5672.2012.00164.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Alpha-1 adrenoceptor (AR) antagonists are commonly used as therapeutic agents for patients with benign prostatic obstruction (BPO). Our objective was to investigate the correlation between the ratio of bladder mucosal alpha-1D/alpha-1A adrenoceptor mRNA and lower urinary tract function in BPO patients. METHODS In 20 BPO patients, the expression level of alpha-1 AR mRNAs in the bladder mucosal biopsies was investigated by reverse transcriptase polymerase chain reaction. The subjects were divided into two groups. In Group 1, the ratio of alpha-1D mRNA to alpha-1A mRNA was greater than one. In Group 2, the ratio was less than one. We determined the correlation by Schäfer nomogram between Group 1 and Group 2 patients and lower urinary tract function as determined by a video urodynamic study. RESULTS Two patients were excluded due to inability to void. Another was excluded because the alpha-1D/alpha-1A mRNA ratio was one. On the Schäfer nomogram, six of nine Group 1 cases had obstructions less than IV and normal or weak detrusor contractility. For Group 2, six of eight cases had obstructions more than IV and normal or strong detrusor contractility. CONCLUSION Patients with higher levels of alpha-1D AR mRNA were distinct from those with higher alpha-1A AR mRNA levels with regard to obstruction and detrusor activity. The results suggest that the Schäfer nomogram might be useful in determining which alpha-1 AR antagonists are better for BPO patients suffering from storage symptoms.
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Affiliation(s)
- Yoshiki Kurizaki
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuya Imamura
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Midori Ichino
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masakuni Ishikawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Teruyuki Ogawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Osamu Nishizawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
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Kadekawa K, Sugaya K, Nishijima S, Ashitomi K, Miyazato M, Ueda T, Yamamoto H. Effect of naftopidil, an alpha1D/A-adrenoceptor antagonist, on the urinary bladder in rats with spinal cord injury. Life Sci 2013; 92:1024-8. [DOI: 10.1016/j.lfs.2013.03.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 03/05/2013] [Accepted: 03/29/2013] [Indexed: 11/16/2022]
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Hara N, Mizusawa T, Obara K, Takahashi K. The role of naftopidil in the management of benign prostatic hyperplasia. Ther Adv Urol 2013; 5:111-9. [PMID: 23554846 DOI: 10.1177/1756287212461681] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Naftopidil, which to a certain extent shows an affinity to α1D-adrenoceptor subtype in addition to a high affinity to α1A-adrenoceptor, has been used for the treatment of benign prostatic obstruction and benign prostatic hyperplasia (BPH) associated lower urinary tract symptoms (LUTS). The aim of the present review is to systematically refer to the published studies on this unique agent for BPH. Based on a randomized prazosin-controlled study and another double-blind placebo-controlled study, which verified the dose-dependent effects of naftopidil, the Japanese Ministry of Health, Labor and Welfare approved naftopidil for treating men with BPH in 1996. Several tamsulosin-controlled studies have suggested treatment effects of naftopidil similar to those of tamsulosin and potentially higher efficacy for alleviating storage symptoms by naftopidil. Although well-designed, randomized studies are warranted to confirm the long-term outcomes and effector/target of naftopidil, the α1A-antagonist naftopidil, which also blocks α1D-adrenoceptor, improves voiding symptoms, and may also be useful for the management of men with storage symptoms represented by nocturia, retrieving their quality of life impaired by BPH-associated LUTS.
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Affiliation(s)
- Noboru Hara
- Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi 1, Niigata 951-8510, Japan
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25
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An alpha1-adrenoceptor blocker terazosin improves urine storage function in the spinal cord in spinal cord injured rats. Life Sci 2013. [DOI: 10.1016/j.lfs.2012.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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26
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Efficacy of Silodosin for Relieving Benign Prostatic Obstruction: Prospective Pressure Flow Study. J Urol 2013; 189:S117-21. [DOI: 10.1016/j.juro.2012.11.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Indexed: 11/17/2022]
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Sakai T, Kasahara KI, Tomita KI, Ikegaki I, Kuriyama H. Naftopidil inhibits 5-hydroxytryptamine-induced bladder contraction in rats. Eur J Pharmacol 2013; 700:194-200. [DOI: 10.1016/j.ejphar.2012.12.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 12/07/2012] [Accepted: 12/18/2012] [Indexed: 11/15/2022]
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28
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Ishizuka O, Imamura T, Kurizaki Y, Nishizawa O, Andersson KE. Male lower urinary tract symptoms and α1D-adrenoceptors. Int J Urol 2012. [PMID: 23205498 DOI: 10.1111/j.1442-2042.2012.03223.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Historically, α(1)-adrenoceptors have been classified into three subtypes (α(1)(A), α(1)(B) and α(1)(D)) that are widely distributed in various organs. Research on the α(1)(D)-adrenoceptors in the bladder, urethra and prostate has focused on the relationship between expression levels and symptoms of bladder outlet obstruction, and the implications and functional roles of α(1)(D)-adrenoceptors subtypes in these organs. The α(1)(D)-adrenoceptor messenger ribonucleic acid and protein seem to be increased in obstructed bladders or small capacity bladders. In contrast, α(1)(D)-adrenoceptor subtype knock-out mice have been found to have a prolonged voiding interval. Interestingly, an α(1)(D)-adrenoceptor antagonist was found to inhibit the facilitation of afferent nerve activity for the micturition reflex induced by intravesical infusion of acetic acid. Clinically, patients who felt urgency at low filling volumes and had a small bladder capacity were found to have more α(1)(D)-adrenoceptor messenger ribonucleic acid in their bladder mucosa than patients who felt urgency at high filling volumes and had a large bladder capacity. An α(1)(D)-adrenoceptor antagonist was found to increase the first desired volume and the maximum desired volume while decreasing detrusor overactivity in pressure flow studies. Thus, α(1)(D)-adrenoceptors in the lower urinary tract might play an important role in the pathophysiology of lower urinary tract disorders.
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Affiliation(s)
- Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
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29
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Yamaguchi O. Latest treatment for lower urinary tract dysfunction: therapeutic agents and mechanism of action. Int J Urol 2012. [PMID: 23190275 DOI: 10.1111/iju.12008] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Recent studies suggest that antimuscarinics might suppress bladder afferent activity by blocking muscarinic receptors in the urothelium, myofibroblasts and detrusor, thereby improving overactive bladder symptoms. β(3)-Adrenoceptors are predominantly expressed in the human bladder and mediate relaxation of detrusor muscle. β(3)-Adrenoceptor agonists increase bladder capacity and prolong micturition interval. It is assumed that β(3)-adrenoceptor agonists could exert an inhibitory effect on bladder afferent through β(3)-adrenoceptors in the urothelium and detrusor, which eventually improve the symptom of urgency. Mirabegron is a potent and selective β(3)-adrenoceptor agonist. A Japanese phase 3 study showed that mirabegron has excellent efficacy and safety for treating overactive bladder. α(1)-Adrenoceptor antagonists (α(1)-blockers) have become a mainstay of male lower urinary tract symptoms treatment. The α(1)(A) subtype is known to mediate functional obstruction as a result of benign prostatic enlargement. Recent studies have suggested that α(1)(A)-adrenoceptors are additionally involved in the generation of storage symptoms. The α(1)(D) subtype is thought to play a role in the facilitation of voiding reflex; that is; storage symptoms. α(1)-Blockers often fail to alleviate overactive bladder symptoms. In this context, combination therapy with α(1)-blockers and antimuscarinics has been recommended. Treatment with 5α-reductase inhibitor for 1 year improves urinary symptoms and flow rate by reducing prostatic volume in men with benign prostatic enlargement. A pooled analysis showed that the long-term (2 or 4 years) treatment with 5α-reductase inhibitor reduced the rate of progression to acute urinary retention and surgery. Combination therapy with 5α-reductase inhibitor and α(1)-blocker was shown to provide a rapid improvement in lower urinary tract symptoms, and reduce the relative risk of acute urinary retention and benign prostatic hyperplasia-related surgery. Phosphodiesterase inhibitors might target a nitric oxide-cyclic guanosine monophosphate pathway in the prostate, urethra and bladder. Phosphodiesterase-5 inhibitors (sildenafil or tadalafil) were shown to provide clinically relevant improvements in both male lower urinary tract symptoms and erectile dysfunction.
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Affiliation(s)
- Osamu Yamaguchi
- Division of Bioengineering and LUTD Research, Nihon University School of Engineering, Koriyama, Japan.
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Yamaguchi S, Osanai H, Numata A, Watanabe M, Kakizaki H. α1D/A-adrenoceptor antagonist naftopidil for the male lower urinary tract symptoms associated with benign prostatic hyperplasia: efficacy of dose increase therapy. Int J Urol 2012; 20:513-9. [PMID: 23078534 DOI: 10.1111/j.1442-2042.2012.03188.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 09/11/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the efficacy of dose increase therapy in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia who responded poorly to 50 mg/day of naftopidil. METHODS A total of 95 patients received 50 mg/day of naftopidil for 8 weeks. After this treatment period, they were divided into two groups: the poor responders were defined as those who either had an International Prostate Symptom Score-Quality of Life ≥ 4 or with an International Prostate Symptom Score-Quality of Life of 3 whose International Prostate Symptom Score-Quality of Life improved <2 points (group A). All other patients were defined as responders to naftopidil 50 mg/day (group B). The dose of naftopidil was increased to 75 mg/day in group A, and maintained at 50 mg/day in group B. The treatment was continued for a further 8 weeks. RESULTS The prostate volume at the baseline was significantly larger in group A than group B. The improvement of International Prostate Symptom Score total score, International Prostate Symptom Score-Quality of Life, and voided volume after 8 weeks was significantly better in group B than in group A. However, there was no significant difference in the changes of all parameters between the two groups after 16 weeks. CONCLUSIONS A dose increase to 75 mg/day is an effective treatment strategy in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia who responded poorly to an initial dose of 50 mg/day of naftopidil. Furthermore, a starting dose of 75 mg/day should be considered in patients with a large prostate volume, as this is a predictive factor for dose increase.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Urology, Hokkaido Social Welfare Association Furano Hospital, Furano, Hokkaido, Japan.
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31
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Uvin P, Everaerts W, Pinto S, Alpízar YA, Boudes M, Gevaert T, Voets T, Nilius B, Talavera K, De Ridder D. The use of cystometry in small rodents: a study of bladder chemosensation. J Vis Exp 2012:e3869. [PMID: 22929055 DOI: 10.3791/3869] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The lower urinary tract (LUT) functions as a dynamic reservoir that is able to store urine and to efficiently expel it at a convenient time. While storing urine, however, the bladder is exposed for prolonged periods to waste products. By acting as a tight barrier, the epithelial lining of the LUT, the urothelium, avoids re-absorption of harmful substances. Moreover, noxious chemicals stimulate the bladder's nociceptive innervation and initiate voiding contractions that expel the bladder's contents. Interestingly, the bladder's sensitivity to noxious chemicals has been used successfully in clinical practice, by intravesically infusing the TRPV1 agonist capsaicin to treat neurogenic bladder overactivity. This underscores the advantage of viewing the bladder as a chemosensory organ and prompts for further clinical research. However, ethical issues severely limit the possibilities to perform, in human subjects, the invasive measurements that are necessary to unravel the molecular bases of LUT clinical pharmacology. A way to overcome this limitation is the use of several animal models. Here we describe the implementation of cystometry in mice and rats, a technique that allows measuring the intravesical pressure in conditions of controlled bladder perfusion. After laparotomy, a catheter is implanted in the bladder dome and tunneled subcutaneously to the interscapular region. Then the bladder can be filled at a controlled rate, while the urethra is left free for micturition. During the repetitive cycles of filling and voiding, intravesical pressure can be measured via the implanted catheter. As such, the pressure changes can be quantified and analyzed. Moreover, simultaneous measurement of the voided volume allows distinguishing voiding contractions from non-voiding contractions. Importantly, due to the differences in micturition control between rodents and humans, cystometric measurements in these animals have only limited translational value. Nevertheless, they are quite instrumental in the study of bladder pathophysiology and pharmacology in experimental pre-clinical settings. Recent research using this technique has revealed the key role of novel molecular players in the mechano- and chemo-sensory properties of the bladder.
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Affiliation(s)
- Pieter Uvin
- Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Belgium
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The effect of diabetes mellitus on α1-adrenergic receptor subtypes in the bladder of rats. Urology 2012; 80:951.e9-16. [PMID: 22901825 DOI: 10.1016/j.urology.2012.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 05/22/2012] [Accepted: 06/12/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To detect the possible alterations on density or sensitivity of α1-adrenergic subtypes in diabetic bladder by reverse transcriptase-polymerase chain reaction technology and in vitro studies. METHODS Experimental diabetes was induced by administration of streptozotocin with a single injection through the tail vein. Rats were divided into control and diabetic groups. Contractile responses of bladder strips from each group were obtained for postassium chloride, adenosine triphosphate, and electrical field stimulation (0.5-32 Hz) in organ bath. Electrical field stimulation responses of strips were evaluated in the presence of PPADS (nonselective P2 antagonist), atropine (cholinergic antagonist), 5 MU (α-1a-adrenergic antagonist), BMY-7378 (α-1d-adrenergic antagonist), and finally CED (α-1b-adrenergic antagonist). mRNA expression of α1-adrenergic subtypes was determined for each group. RESULTS The difference between contractile responses related to electrical field stimulation with incubation with PPADS, atropine, 5 MU, BMY-7378, and CED, respectively, was not significant in the control and diabetic groups (P > .05). The electrical field stimulation responses of strips at 0.5-2 Hz without incubation were significantly different between the control and diabetic groups (P < .05). The contractile responses of strips with PPADS + atropine + 5 MU and BMY-7378 incubations in the diabetic group were significantly lower than in the control group in all doses (P < .05), The mRNA expression of α-1a-adrenergic in the diabetic group was significantly lower than in the control group (P < .05). No change was found in the expression of mRNA of α-1b-adrenergic. CONCLUSION These results support the probability of changes in presynaptic and autonomic receptor sensitivity. We believe that α-1a-adrenergic and α-1d-adrenergic subtypes should be kept in mind in the treatment of diabetic cystopathy.
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SHIGEMURA K, YAMAMICHI F, MATSUMOTO M, TANAKA K, YAMASHITA M, ARAKAWA S, FUJISAWA M. Comparison of Naftopidil 75 mg with Tamsulosin Hydrochloride 0.2 mg in the Treatment of Lower Urinary Tract Symptoms with Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 2012; 4:136-9. [DOI: 10.1111/j.1757-5672.2012.00149.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Effects of Spinal and Peripheral Injection of α1A or α1D Adrenoceptor Antagonists on Bladder Activity in Rat Models with or without Bladder Outlet Obstruction. Int Neurourol J 2011; 15:199-205. [PMID: 22259733 PMCID: PMC3256304 DOI: 10.5213/inj.2011.15.4.199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 12/23/2011] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Antagonists of α1-adrenergic receptors (α1ARs) relax prostate smooth muscle and relieve voiding and storage symptoms. Recently, increased expression of α1ARs with change of its subtype expression has been proved in bladder outlet obstruction (BOO). To search for the evidence of changes in α1ARs subtype expression and activity in the peripheral and spinal routes, the effects of spinal and peripheral administration of tamsulosin (an α1A/D-selective AR), naftopidil (an α1A/D-selective AR), and doxazosin (non-selective AR) on bladder activity were investigated in a rat model with or without BOO. METHODS A total of 65 female Sprague-Dawley rats were divided into the BOO surgery group (n=47) and the sham surgery group (n=18). After 6 weeks, cystometry was assessed before and after intrathecal and intra-arterial administrations of tamsulosin, naftopidil, and doxazosin. RESULTS After intra-arterial administrations of all three drugs, bladder capacity (BC) was increased and maximal intravesical pressure (Pmax) was decreased in both BOO and the sham rat models (P<0.05). After intrathecal administration of all three drugs, BC was increased and Pmax was decreased in only the BOO group. The episodes of involuntary contraction in the BOO rat models were decreased by intra-arterial administration (P=0.031). The increase of BC after intrathercal and intra-arterial administrations of α1ARs was significantly greater in the BOO group than in the sham group (P=0.023, P=0.041). In the BOO group, the increase of BC and decrease in Pmax were greater by intra-arterial administration than by intrathecal administration (P=0.035). There were no significant differences of the degrees of changes in the cystometric parameters among the three different α1ARs. CONCLUSIONS Up-regulations of the α1ARs in BOO were observed by the greater increases of BC after α1AR antagonist administrations in the BOO group than in the sham group. However, there were no subtype differences of the α1ARs in functional parameters of bladder activity. In addition, α1ARs also act on the lumbosacral cord which implies that the sensitivity of α1ARs is increased in pathologic models such as BOO. Further evaluation including differential expression of α1ARs in BOO models are need.
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Homma Y, Gotoh M, Yokoyama O, Masumori N, Kawauchi A, Yamanishi T, Ishizuka O, Seki N, Kamoto T, Nagai A, Ozono S. JUA clinical guidelines for benign prostatic hyperplasia. Int J Urol 2011. [DOI: 10.1111/j.1442-2042.2011.02861.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Funahashi Y, Hattori R, Yoshino Y, Matsukawa Y, Sassa N, Gotoh M. Symptoms Predictive for Efficacy of Naftopidil in Patients with Benign Prostate Hyperplasia. Low Urin Tract Symptoms 2011; 3:113-7. [PMID: 26676397 DOI: 10.1111/j.1757-5672.2011.00097.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the lower urinary tract symptoms predicting the efficacy of the α1-adrenoreceptor (AR) antagonist naftopidil in patients with benign prostate hyperplasia. METHODS The efficacy of naftopidil was examined on the basis of changes in the international prostate symptom score (IPSS). All patients received naftopidil (50 mg/day) for 12 weeks. We defined a "responder" as a patient whose total IPSS improved by five or more points and assessed the lower urinary tract symptoms predicting the efficacy of treatment by performing multivariate and probit analyses. RESULTS Among 132 patients whose data could be analyzed, the efficacy rate was 50.8%. All IPSS items except the urgency score were significantly higher in the responders than the non-responders before treatment, and all IPSS items were lower in the responders after treatment. In the responder group, significant improvements were observed in the total IPSS score, quality of life (QOL) index, maximum flow rate (Qmax ), residual urine volume, and all IPSS items after treatment. In contrast, in the non-responder group, no parameter except the QOL index improved significantly. The probit analysis demonstrated that the score for weak stream (≥3) or nocturia (≥4) in the IPSS were factors predicting an effective response to naftopidil treatment. CONCLUSIONS Weak stream and/or nocturia are the key symptoms that predict the efficacy of naftopidil treatment in patients with benign prostatic hyperplasia. Those with a score of ≥3 for weak stream or of ≥4 for nocturia are expected to achieve a good response in the subjective symptoms with administration of naftopidil.
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Affiliation(s)
- Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Ryohei Hattori
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Yasushi Yoshino
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Naoto Sassa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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Clinical feature of men who benefit from dose escalation of naftopidil for lower urinary tract symptoms: a prospective study. Adv Urol 2011; 2011:804583. [PMID: 21603217 PMCID: PMC3095445 DOI: 10.1155/2011/804583] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Revised: 01/31/2011] [Accepted: 02/11/2011] [Indexed: 11/18/2022] Open
Abstract
Objectives. To examine the feature of men who benefit from dose escalation of naftopidil for lower urinary tract symptoms (LUTSs). Methods. Based on the IPSS, men reporting LUTS were prospectively studied using 50 mg/day of naftopidil for the first 4 weeks; satisfied patients continued its 50 mg/day (n = 11), and those reporting unsatisfactory improvement received its 75 mg/day (n = 35) for the next 4 weeks. Results. The 75 mg group showed improvement in the total IPSS and QOL score in a dose-dependent manner (at 4 weeks: P < .001, at 4 weeks versus 8 weeks: P < .05). In the 50 mg group, both scores reduced at 4 weeks, thereafter unchanged. The baseline slow stream score alone was higher in the 75 mg group (P = .013). The rate of change in the QOL score during the initial 4 weeks (ΔQOL) and Δnocturia was smaller in the 75 mg group (P < .05). Conclusions. Men with high slow stream score and unsatisfactory improvement in nocturia may benefit from dose escalation of naftopidil.
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Smith PP, Kuchel GA. Continuous uroflow cystometry in the urethane-anesthetized mouse. Neurourol Urodyn 2011; 29:1344-9. [PMID: 20127833 DOI: 10.1002/nau.20850] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE In vivo animal cystometry represents an accepted methodology for the study of lower urinary tract physiology. A particular advantage of the mouse model is the availability of genetically modified strains, offering the possibility of linking individual genes to relevant physiological events. However, small voided volumes complicate the ability to obtain reliable pressure-flow data by gravimetric methods, due to non-continuous drop formation and release during voiding. We investigated the feasibility of a simple non-gravimetric continuous urine collection system during cystometry under urethane anesthesia, and compared urethane-anesthetized with awake cystometry. METHODS Cystometry was performed in awake and urethane-anesthetized female mice using a suprapubic tube. A simple, novel non-gravimetric method of urine collection was used in urethane-anesthetized animals to assess voided volume and permit flow rate calculations. Pressure and time-related variables were compared between groups. RESULTS Voided urine collection appears to be complete and continuous in this model. Mean voided volume was 0.09 ± 0.020 ml, with an average flow rate of 0.029 ± 0.007 ml/sec. Urethane anesthesia delayed cystometric pressure/volume responses. However, micturition reflexes were intact and otherwise comparable between groups. Female mice void with pulsatile pressurization previously described in rats. CONCLUSION Suprapubic voiding cystometry using a simple and reliable urine collection method under urethane anesthesia is feasible in mice, permitting the integration of voided volumes with pressure and time data. The inclusion of volume and flow data enhances the usefulness of the mouse model for in vivo assessment of detrusor and potentially sphincteric performance.
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Affiliation(s)
- Phillip P Smith
- Department of Surgery, University of Connecticut Health Center, Farmington, CT 06030, USA.
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Abstract
The urinary bladder "mucosa" or innermost portion of the bladder is composed of transitional epithelium, basement membrane, and the lamina propria. This chapter reviews the specialized anatomy of the bladder epithelium (urothelium) and speculates on possible communication mechanisms from urothelial cells to various cell types within the bladder wall. For example, beyond serving as a simple barrier, there is growing evidence that the urinary bladder urothelium exhibits specialized sensory properties and plays a key role in the detection and transmission of both physiological and nociceptive stimuli. Findings from a number of studies suggest that the urothelium exhibits both "sensor" (expressing receptors/ion channels capable of responding to thermal, mechanical, and chemical stimuli) and "transducer" (ability to release chemicals) properties. Thus, urothelial cells exhibit the ability to sense changes in their extracellular environment including the ability to respond to chemical, mechanical, and thermal stimuli that may communicate the state of the urothelial environment to the underlying nervous and muscular systems.
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Affiliation(s)
- Lori A Birder
- Department of Medicine and Pharmacology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
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Abstract
α(1)-Adrenoceptors have been identified and characterized extensively by functional, radioligand-binding, and molecular biological techniques. Molecular clones have been isolated for three α(1)-subtypes (α(1a), α(1b), and α(1d)), and these subtypes are also functionally characterized. α(1)-Adrenoceptors are present in the prostate, urethra, bladder (urothelium, smooth muscle, and afferent nerves), ureter, vas deferens, peripheral ganglia, nerve terminals, vascular tissues, and central nervous system (CNS), and they could all potentially influence overall urinary function and contribute to both the therapeutic and adverse effects of α(1)-adrenoceptor antagonists in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). This review aimed to discuss the relevant physiological and pharmacological roles and molecular biology of α(1)-adrenoceptor subtypes in the prostate, urethra, bladder, ureter, and CNS.
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Kurizaki Y, Ishizuka O, Imamura T, Ichino M, Ogawa T, Igawa Y, Nishizawa O, Andersson KE. Relation between expression of α1-adrenoceptor mRNAs in bladder mucosa and urodynamic findings in men with lower urinary tract symptoms. ACTA ACUST UNITED AC 2010; 45:15-9. [PMID: 20961266 DOI: 10.3109/00365599.2010.515611] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yoshiki Kurizaki
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuya Imamura
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Midori Ichino
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Teruyuki Ogawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yasuhiko Igawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Osamu Nishizawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
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Yazaki J, Aikawa K, Shishido K, Yanagida T, Nomiya M, Ishibashi K, Haga N, Yamaguchi O. Alpha1-Adrenoceptor Antagonists Improve Bladder Storage Function Through Reduction of Afferent Activity in Rats With Bladder Outlet Obstruction. Neurourol Urodyn 2010; 30:461-7. [DOI: 10.1002/nau.20984] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Accepted: 06/22/2010] [Indexed: 01/09/2023]
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Kadekawa K, Sugaya K, Ashitomi K, Nishijima S. Clinical Efficacy of α1-Adrenargic Receptor Antagonist Naftopidil 75 mg/day in Patients with Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 2010; 2:106-12. [PMID: 26676292 DOI: 10.1111/j.1757-5672.2010.00072.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The clinical efficacy and safety of 75 mg/day of naftopidil, an α1-adrenargic receptor antagonist, was assessed in patients with benign prostatic hyperplasia (BPH). METHODS A total of 28 patients (mean age, 71.1 years; range, 46-86 years) with BPH were studied. Inclusion criteria were: (i) International Prostate Symptom Score (IPSS) ≥8; and (ii) quality of life (QOL) index ≥3. IPSS, QOL index, Overactive Bladder Symptom Score (OABSS), and bladder diary (urinary frequency in daytime and nighttime, frequency of urinary incontinence and urgency) were evaluated before and 4 weeks after treatment with naftopidil at 75 mg/day. RESULTS Total IPSS and QOL index were significantly decreased after treatment. Total OABSS tended to decrease after treatment, with significant improvements in the "urgency" parameter. From the bladder diary, urinary frequency in daytime and nighttime and frequency of urgency were significantly decreased after treatment. Total IPSS and QOL index in patients with previous treatment were significantly improved after treatment, with significant improvements in the "incomplete emptying,""poor flow" and "nocturia" parameters of IPSS. One case with a mild adverse effect of dizziness was encountered. CONCLUSION These results suggest that administration of naftopidil at 75 mg/day was safe and effective for patients with BPH, regardless of the presence of previous treatment. This study indicates the feasibility of naftopidil at 75 mg/day as a first-line treatment for men with BPH, or a second-line treatment in cases with symptoms of incomplete emptying, poor flow and nocturia.
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Affiliation(s)
| | - Kimio Sugaya
- Southern Knights' Laboratory LLP, Okinawa, Japan
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Yokoyama O, Aoki Y, Tsujimura A, Takao T, Namiki M, Okuyama A. α1-Adrenoceptor blocker naftopidil improves sleep disturbance with reduction in nocturnal urine volume. World J Urol 2010; 29:233-8. [DOI: 10.1007/s00345-010-0544-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 03/19/2010] [Indexed: 11/27/2022] Open
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Tanaka M, Niimi A, Tomita K, Homma Y. Conversion to Silodosin in Men on Conventional α1 -Blockers for Symptomatic Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 2010; 2:11-5. [PMID: 26676213 DOI: 10.1111/j.1757-5672.2010.00055.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES α1 -blockers have commonly been used as first-line medical therapy for symptomatic benign prostatic hyperplasia (BPH). Recently, a highly selective α1A -adrenoceptor antagonist, silodosin, was developed in Japan. We examined the efficacy and safety of conversion from conventional α1 -blockers to silodosin in men with BPH. METHODS Conversion to silodosin was proposed to consecutive patients on conventional α1 -blockers for symptomatic BPH for at least 6 months. The effects of conversion were examined by the International Prostate Symptom Score, quality of life index, overactive bladder symptom score, peak flow rate, residual urine volume, and adverse events at 12 weeks. The efficacy of silodosin was also evaluated by patients' impression. RESULTS Eighty-one men underwent conversion, for the most part because of dissatisfaction with the efficacy of their current treatment in improving nocturia or weak stream. The International Prostate Symptom Score total score significantly improved from 12.7 ± 5.9 at baseline to 10.6 ± 5.4 at 4 weeks (P < 0.001) and 10.9 ± 5.8 at 12 weeks (P < 0.01). The progress was mostly due to improvement in voiding symptoms, although reduction of storage symptoms was also significant. The quality of life index also significantly decreased with conversion to silodosin. Efficacy as judged by patients' impression was 76% (37/49) at 12 weeks of treatment. None of the overactive bladder symptom score, peak flow rate, and residual urine volume exhibited significant change. No serious adverse events were observed during the study period. CONCLUSION Conversion to silodosin may be beneficial in men who are dissatisfied with conventional α1 -blockers for BPH, and be particularly useful in improving voiding symptoms.
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Affiliation(s)
- Masahiko Tanaka
- Urology Department, Japanese Red Cross Medical Center, Tokyo, JapanGraduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Niimi
- Urology Department, Japanese Red Cross Medical Center, Tokyo, JapanGraduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kyoichi Tomita
- Urology Department, Japanese Red Cross Medical Center, Tokyo, JapanGraduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukio Homma
- Urology Department, Japanese Red Cross Medical Center, Tokyo, JapanGraduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Funahashi Y, Hattori R, Matsukawa Y, Komatsu T, Sassa N, Gotoh M. Clinical efficacy of a loading dose of naftopidil for patients with benign prostate hyperplasia. World J Urol 2010; 29:225-31. [PMID: 20309563 DOI: 10.1007/s00345-010-0528-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 03/02/2010] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The efficacy of a loading dose of α(1)-adrenoreceptor antagonist for patients with benign prostate hyperplasia who did not improve at a low dose has not been determined. We performed a prospective study to estimate the efficacy of incremental naftopidil administration. METHODS The efficacy of naftopidil was examined based on changes in the International Prostate Symptom Score (IPSS). We defined a "responder" as a patient who improved by ≥5 points in IPSS total score. All patients were administered naftopidil at 50 mg/day for 12 weeks, and nonresponders at 50 mg/day were increased to 75 mg/day. Efficacy was finally evaluated after an additional 12 weeks of administration at 75 mg/day. RESULTS Among 122 patients whose data could be analyzed, the efficacy rate after administration at 50 mg/day was 52.5%. In all IPSS items except urgency score, the responders had significantly higher (poorer) values than nonresponders before the start of treatment. Of 40 patients whose dose was increased to 75 mg/day and whose data could be analyzed, prostate volume in the responder group (9 patients) was significantly smaller than that in the nonresponder group (31 patients). Multivariate analysis showed that patients with improved IPSS total score, voiding symptoms, urgency, and weak stream after administration of 50 mg/day naftopidil were more likely to improve after a dose increase. CONCLUSIONS A dose increment of naftopidil to 75 mg/day may be useful in patients with BPH who did not improve at 50 mg/day.
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Affiliation(s)
- Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
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Docherty JR. Subtypes of functional alpha1-adrenoceptor. Cell Mol Life Sci 2010; 67:405-17. [PMID: 19862476 PMCID: PMC11115521 DOI: 10.1007/s00018-009-0174-4] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 09/11/2009] [Accepted: 10/05/2009] [Indexed: 11/29/2022]
Abstract
In this review, subtypes of functional alpha1-adrenoceptor are discussed. These are cell membrane receptors, belonging to the seven-transmembrane-spanning G-protein-linked family of receptors, which respond to the physiological agonist noradrenaline. alpha1-Adrenoceptors can be divided into alpha1A-, alpha1B- and alpha1D-adrenoceptors, all of which mediate contractile responses involving Gq/11 and inositol phosphate turnover. A fourth alpha1-adrenoceptor, the alpha1L-, represents a functional phenotype of the alpha1A-adrenoceptor. alpha1-Adrenoceptor subtype knock-out mice have refined our knowledge of the functions of alpha-adrenoceptor subtypes, particuarly as subtype-selective agonists and antagonists are not available for all subtypes. alpha1-Adrenoceptors function as stimulatory receptors involved particularly in smooth muscle contraction, especially contraction of vascular smooth muscle, both in local vasoconstriction and in the control of blood pressure and temperature, and contraction of the prostate and bladder neck. Central actions are now being elucidated.
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MESH Headings
- Animals
- Blood Pressure/physiology
- Body Temperature Regulation
- Drug Inverse Agonism
- GTP-Binding Protein alpha Subunits, Gq-G11/metabolism
- Inositol Phosphates/metabolism
- Mice
- Mice, Knockout
- Muscle, Smooth/physiology
- Muscle, Smooth, Vascular/physiology
- Receptors, Adrenergic, alpha-1/classification
- Receptors, Adrenergic, alpha-1/metabolism
- Receptors, Adrenergic, alpha-1/physiology
- Second Messenger Systems/physiology
- Vasoconstriction/physiology
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Affiliation(s)
- James R Docherty
- Department of Physiology, Royal College of Surgeons in Ireland, 123, St. Stephen's Green, Dublin 2, Ireland.
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Matsukawa Y, Gotoh M, Komatsu T, Funahashi Y, Sassa N, Hattori R. Efficacy of Silodosin for Relieving Benign Prostatic Obstruction: Prospective Pressure Flow Study. J Urol 2009; 182:2831-5. [DOI: 10.1016/j.juro.2009.08.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Indexed: 11/30/2022]
Affiliation(s)
- Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomonori Komatsu
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoto Sassa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryohei Hattori
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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49
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Yamamoto G, Kai N, Shirasaki T, Soeda F, Takahama K. [Novel method of sequential urine collection and recording in freely moving mice]. Nihon Yakurigaku Zasshi 2009; 133:332-336. [PMID: 19521030 DOI: 10.1254/fpj.133.332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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50
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KAKIZAKI H, TANAKA H, MITSUI T, NONOMURA K. Clinical Efficacy of α 1-blocker Naftopidil in Patients with Overactive Bladder Associated with Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 2009. [DOI: 10.1111/j.1757-5672.2009.00008.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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