Urinary bladder smooth muscle is innervated by both sympathetic and parasympathetic nerves. Acetylcholine released from postganglionic parasympathetic nerve terminals activates postjunctional muscarinic receptors in urinary bladder, which modulate urinary bladder contraction during the voiding phase and control detrusor tone during the filling phase. Five muscarinic receptor subtypes (M 1 -M 5 ) have been identified by both molecular biological and pharmacological investigations.1) The urinary bladder smooth muscle contains a mixed population of muscarinic M 2 and M 3 receptors.2) Although muscarinic M 2 receptors are numerically predominant, muscarinic M 3 receptors are considered to predominate in the mediation of bladder contraction.3,4) An important functional role of the muscarinic M 3 receptor in mediating bladder contraction has also been suggested in experiments using mutant mice lacking the muscarinic M 3 receptor gene. 5)Overactive bladder is characterized by symptoms of urgency and urinary frequency with or without urge incontinence. It has a profoundly negative effect on the quality of life of those affected. Muscarinic receptor antagonists are the most widely used therapy for overactive bladder.6-8) Solifenacin succinate [YM905; (3R)-1-azabicyclo[2.2.2]oct-3-yl(1S)-1-phenyl-3,4-dihydroisoquinoline-2(1H)-carboxylate monosuccinate] is a new muscarinic receptor antagonist developed for the treatment of overactive bladder. Affinity constants (K i values) of this drug for human muscarinic M 1 , M 2 and M 3 receptors only have been reported, along with its antagonism of the contractile effect of carbachol in isolated guinea pig urinary bladder.9) The present study was therefore undertaken to investigate the affinity of solifenacin for all human muscarinic receptor subtypes (M 1 -M 5 ) and its functional muscarinic M 3 receptor antagonism in rats, and to compare the results with those for tolterodine, oxybutynin, darifenacin, propiverine and atropine. Additionally, we also investigated the effect of solifenacin on voiding function in anesthetized rats. MATERIALS AND METHODS MaterialsSolifenacin succinate (YM905, Vesicare ® ), tolterodine tartrate, darifenacin and propiverine hydrochloride were prepared by Astellas Pharma Inc. (Tokyo, Japan). Oxybutynin chloride, atropine sulfate and carbachol (carbamylcholine chloride) were purchased from Sigma-Aldrich (St. Louis, MO, U.S.A.). Darifenacin was dissolved in dimethyl sulfoxide and the others were dissolved in dimethyl sulfoxide, Krebs-Henseleit solution or physiological saline.Animals Male Wistar rats and male Sprague-Dawley rats were purchased from Charles River Laboratories Japan (Kanagawa, Japan) and Japan SLC (Shizuoka, Japan), respectively. In in vitro studies, rats were sacrificed by exsanguination under ether anesthesia. All animal experiments were performed in compliance with the regulations of the Institutional Animal Ethical Committee of Astellas Pharma Inc.Radioligand Receptor Binding Assay Membranes of Chinese hamster ovary (CHO)-K1 cells expressi...
To investigate the pharmacological properties of mirabegron in in vitro and in vivo, the effects on cAMP accumulation in Chinese hamster ovary (CHO) cells expressing rat β-adrenoceptors, the relaxant activity in isolated rat bladder smooth muscle, and the voiding effects in cerebral infarcted rats were evaluated. Mirabegron increased cAMP accumulation with EC(50) value and intrinsic activity of 19 nmol/L and 1.0, respectively, in CHO cells expressing rat β(3)-adrenoceptors. The EC(50) values and the intrinsic activities of mirabegron were 610 nmol/L and 0.6 for rat β(1)-adrenoceptors and were sumless and 0.1 for β(2)-adrenoceptors, respectively. Mirabegron showed concentration-dependent relaxant and full agonistic effects in rat bladder strips under passive tension with EC(50) value of 290 nmol/L. The concentration-response curve of mirabegron was affected neither by the β(1)-adrenoceptor selective antagonist CGP-20712A nor by the β(2)-adrenoceptor selective antagonist ICI-118,551. In in vivo studies with cerebral infarcted rats, a significant decrease in the volume voided per micturition compared with sham-operated rats was observed. Mirabegron dose-dependently increased the volume voided per micturition. In conclusion, we have extended the selectivity profile of mirabegron to rats and demonstrated that it is effective via stimulation of β(3)-adrenoceptors in a rat cerebral infarction model of detrusor overactivity.
This survey aimed to explore patient and physician attitudes towards male androgenetic alopecia (AGA), satisfaction with currently available male AGA treatments and investigate the factors affecting treatment choice. The survey was carried out in five countries (Japan, South Korea, Taiwan, Mexico and Brazil) between November and December 2015 using a standard market research methodology. Questionnaires were completed by patients with male AGA or hair loss/thinning and practicing physicians who were responsible for prescribing AGA treatment. In total, 835 patients and 338 physicians completed the questionnaire. Overall, 37.6% of patients reported satisfaction with the treatments they had used. The highest patient satisfaction was reported for 5‐alpha‐reductase inhibitors (53.9% of patients satisfied). In all countries, physicians were more likely than patients to think that male AGA has a major impact on patient confidence (89.3% vs 70.4%, respectively). There was agreement by physicians and patients that male AGA patients who are involved in their treatment decisions have better outcomes. Patients who were satisfied with AGA treatments were more likely to have the level of involvement they desired in treatment decisions (69.1% of satisfied patients) than dissatisfied patients (56.4% of dissatisfied patients). This survey provides valuable insights into the attitudes of patients and physicians in Asia and Latin America about male AGA and its treatments. The survey identified areas of disconnect between physicians and patients regarding the impact of male AGA, treatment consultations and the importance of treatment attributes. It also highlights the need for physicians to spend sufficient time with patients discussing AGA treatment approaches.
Mirabegron, a selective β(3)-adrenoceptor agonist, facilitates urine storage function by exerting a relaxing effect on bladder smooth muscle. Here, we investigated the effect of mirabegron on bladder function during the storage phase. We assessed the effect of mirabegron on the resting intravesical pressure in anesthetized rats and also tested antimuscarinics (oxybutynin and tolterodine) under the same experimental conditions. Mirabegron dose-dependently decreased the resting intravesical pressure, while oxybutynin and tolterodine showed no statistically significant effects on resting intravesical pressure. We also investigated the effect of mirabegron on bladder function using cystometry technique in conscious rats with bladder outlet obstruction. While mirabegron dose-dependently decreased the frequency of nonvoiding contractions, considered an index of abnormal response in bladder storage, no significant effects were noted on the amplitude of nonvoiding contractions, micturition pressure, threshold pressure, voided volume, residual volume, or bladder capacity. Neither oxybutynin nor tolterodine affected the frequency of nonvoiding contractions; however, oxybutynin increased residual volume and tended to decrease voided volume in a dose-dependent manner, and tolterodine dose-dependently decreased voided volume. Taken together, these results shed light on the suggestion of mirabegron as a therapeutic agent, compared with antimuscarinics, with its most prominent effect being the facilitation of bladder storage.
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