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Afferent Nerve Regulation of Bladder Function in Health and Disease

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Sensory Nerves

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 194))

Abstract

The afferent innervation of the urinary bladder consists primarily of small myelinated (Aδ) and unmyelinated (C-fiber) axons that respond to chemical and mechanical stimuli. Immunochemical studies indicate that bladder afferent neurons synthesize several putative neurotransmitters, including neuropeptides, glutamic acid, aspartic acid, and nitric oxide. The afferent neurons also express various types of receptors and ion channels, including transient receptor potential channels, purinergic, muscarinic, endothelin, neurotrophic factor, and estrogen receptors. Patch-clamp recordings in dissociated bladder afferent neurons and recordings of bladder afferent nerve activity have revealed that activation of many of these receptors enhances neuronal excitability. Afferent nerves can respond to chemicals present in urine as well as chemicals released in the bladder wall from nerves, smooth muscle, inflammatory cells, and epithelial cells lining the bladder lumen. Pathological conditions alter the chemical and electrical properties of bladder afferent pathways, leading to urinary urgency, increased voiding frequency, nocturia, urinary incontinence, and pain. Neurotrophic factors have been implicated in the pathophysiological mechanisms underlying the sensitization of bladder afferent nerves. Neurotoxins such as capsaicin, resiniferatoxin, and botulinum neurotoxin that target sensory nerves are useful in treating disorders of the lower urinary tract.

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Authors and Affiliations

  1. Department of Pharmacology, University of Pittsburgh School of Medicine, West 1352 Starzl Biomedical Science Tower, Pittsburgh, PA, 15261, USA

    William C. de Groat

  2. Department of Urology, University of Pittsburgh School of Medicine, 700 Kaufman Building, Pittsburgh, PA, 15261, USA

    Naoki Yoshimura

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Correspondence to William C. de Groat .

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  1. Dept. Medicine, Johns Hopkins Asthma & Allergy Center, Hopkins Bayview Circle 5501, Baltimore, 21224, U.S.A.

    Brendan J. Canning

  2. School of Biomedical & Health Sciences, King's College London, Guy's Campus, London, SE1 9RT, United Kingdom

    Domenico Spina

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de Groat, W.C., Yoshimura, N. (2009). Afferent Nerve Regulation of Bladder Function in Health and Disease. In: Canning, B., Spina, D. (eds) Sensory Nerves. Handbook of Experimental Pharmacology, vol 194. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79090-7_4

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