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[Changes in the receptor profile of the aging bladder]
C Hampel1, R Gillitzer, S Pahernik
1Urologische Klinik der Johannes-Gutenberg-Universität Mainz. hampel@urologie.klinik.uni-mainz.de
Der Urologe. Ausg. A
|April 28, 2004
Summary
Aging bladders experience increased lower urinary tract symptoms (LUTS) due to changes in detrusor muscle receptors. Purinergic and adrenergic receptor alterations significantly contribute to geriatric LUTS.
Area of Science:
- Urology
- Geriatric Medicine
- Pharmacology
Context:
- Future demographic shifts predict a rise in lower urinary tract symptoms (LUTS) primarily affecting the aging bladder.
- Geriatric bladder dysfunction is characterized by obstruction, instability, and hypocontractility, often linked to detrusor receptor profile changes.
- Age-associated comorbidities like benign prostatic hyperplasia and diabetes mellitus further influence bladder receptor function.
Purpose:
- To explore the pathophysiological changes in geriatric bladder dysfunction, focusing on receptor alterations in the detrusor.
- To investigate the roles of muscarinic, purinergic, and adrenergic receptors in age-related LUTS.
- To understand the impact of aging and bladder outlet obstruction (BOO) on bladder innervation and receptor sensitivity.
Summary:
- Aging and BOO may lead to partial cholinergic denervation, increasing muscarinic receptor sensitivity and causing bladder instability.
- The non-cholinergic component of detrusor contraction increases with age and BOO, highlighting the growing importance of purinergic receptors in geriatric LUTS.
- Aging modulates alpha(1)-adrenergic receptors, shifting towards the alpha(1d) subtype, which increases norepinephrine affinity and alpha-adrenergic susceptibility.
Impact:
- Findings emphasize the significant role of purinergic and adrenergic receptor changes in the pathophysiology of geriatric LUTS.
- Understanding these receptor dynamics is crucial for developing targeted therapies for age-related bladder dysfunction.
- Further research into sensory C-fiber receptors is needed, as their role in geriatric LUTS remains unclear despite ongoing clinical evaluations of blockers.