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首页> 外文期刊>Nature clinical practice:Urology >Drug Insight: biological effects of botulinum toxin A in the lower urinary tract.
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Drug Insight: biological effects of botulinum toxin A in the lower urinary tract.

机译：药物见解：肉毒杆菌毒素A在下尿路的生物学作用。

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Botulinum toxins can effectively and selectively disrupt and modulate neurotransmission in striated muscle. Recently, urologists have become interested in the use of these toxins in patients with detrusor overactivity and other urological disorders. In both striated and smooth muscle, botulinum toxin A (BTX-A) is internalized by presynaptic neurons after binding to an extracellular receptor (ganglioside and presumably synaptic vesicle protein 2C). In the neuronal cytosol, BTX-A disrupts fusion of the acetylcholine-containing vesicle with the neuronal wall by cleaving the SNAP-25 protein in the synaptic fusion complex. The net effect is selective paralysis of the low-grade contractions of the unstable detrusor, while still allowing high-grade contraction that initiates micturition. Additionally, BTX-A seems to have effects on afferent nerve activity by modulating the release of ATP in the urothelium, blocking the release of substance P, calcitonin gene-related peptide and glutamate from afferent nerves,and reducing levels of nerve growth factor. These effects on sensory feedback loops might not only help to explain the mechanism of BTX-A in relieving symptoms of overactive bladder, but also suggest a potential role for BTX-A in the relief of hyperalgesia associated with lower urinary tract disorders.
机译：肉毒杆菌毒素可以有效和选择性地破坏和调节横纹肌中的神经传递。最近，泌尿科医师对在逼尿肌过度活跃和其他泌尿系统疾病患者中使用这些毒素产生了兴趣。在横纹肌和平滑肌中，肉毒杆菌毒素A（BTX-A）在结合到细胞外受体（神经节苷脂和可能的突触小泡蛋白2C）后，都被突触前神经元内化。在神经元胞质中，BTX-A通过在突触融合复合物中切割SNAP-25蛋白来破坏含乙酰胆碱的囊泡与神经元壁的融合。最终效果是不稳定逼尿肌的低级收缩选择性麻痹，同时仍允许引发排尿的高级收缩。此外，BTX-A似乎通过调节尿路上皮中ATP的释放，阻断P物质，降钙素基因相关肽和谷氨酸从传入神经中的释放以及降低神经生长因子的水平，对传入神经活动产生影响。这些对感觉反馈回路的影响可能不仅有助于解释BTX-A缓解膀胱过度活动症症状的机制，而且还暗示BTX-A在缓解与下尿路疾病有关的痛觉过敏中的潜在作用。

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