中枢神経系における排尿薬理機構の概説

抄録

The functions of the lower urinary tract (LUT), to store and periodically releaseurine, are dependent on the activity of smooth and striated muscles in theurinary bladder, urethra, and external urethral sphincter. This activity is inturn coordinated by neural circuits in the central nervous system (CNS). Variousneurotransmitters, including acetylcholine, norepinephrine, dopamine, serotonin,excitatory and inhibitory amino acids have been implicated in the CNS regulationof the LUT. Injuries or diseases of the CNS such as cerebral infarction,Parkinson disease, multiple sclerosis and spinal cord injury, as well aspsychological stress or depression, can produce LUT dysfunctions leading tostorage and voiding LUT symptoms such as urinary frequency, urgency, pain andincontinence or inefficient voiding and urinary retention. The recent researchadvancement in the field of CNS neuro-urology has led to the emergence of newconcepts regarding neural control of the LUT and the etiology of LUTdysfunction. In this symposium, I will overview the recent advancement towardsthe identification of disease-related changes in receptor function and newdelivery systems such as gene therapy techniques, which could lead to the futuretreatment of LUT dysfunction.