The pathophysiology of bladder outlet obstruction (BOO) in men with benign prostatic hyperplasia (BPH) has been attributed to both static and dynamic factors.1) Static obstruction arises from adenoma enlargement of the prostate, whereas dynamic obstruction is related to an elevation in tone of the prostatic and urethral smooth muscle. Because this latter effect is predominantly related to local a-adrenergic tone, a 1 -adrenoceptor antagonists are used to relax prostatic and urethral smooth muscle, and thereby ameliorate lower urinary tract symptoms (LUTS) such as voiding symptoms (e.g., slow stream, hesitancy, intermittency, terminal dribble) and storage symptoms (e.g. increased daytime frequency, nocturia, urgency).
2,3)Molecular and pharmacological studies have led to the classification of three a 1 -adrenoceptor subtypes: a 1A -, a 1B -and a 1D -adrenoceptors. 4,5) The a 1A -adrenoceptor subtype has been described as predominant in the human prostate and urethra, 6,7) and plays a predominant role in mediating the contractile response of the human prostate.
8)Tamsulosin is an a 1 -adrenoceptor antagonist developed primarily for the treatment of LUTS suggestive of BOO. [9][10][11] In radioligand binding assays, tamsulosin showed greater than 10-fold selectivity for a 1A -over a 1B -adrenoceptors, with intermediate affinity for a 1D -adrenoceptors. [12][13][14] Tamsulosin also shows clinical uroselectivity in comparison with terazosin and doxazosin, a 1 -adrenoceptor antagonists originally developed as antihypertensive agents. Thus, tamsulosin has been shown to improve LUTS with minimal hypotensive effects and a low incidence of circulatory adverse events.
15)Although it has been postulated that the a 1A -selectivity of tamsulosin 16) and its modified release formulation 11) contribute to its uroselectivity, these hypotheses remain controversial.Previously, we investigated the relationship between the pharmacokinetics of tamsulosin and its inhibitory effect on hypogastric nerve stimulation (HNS)-induced prostatic intraurethral pressure (IUP) elevation in anesthetized male dogs. 17) Results showed that this inhibitory effect lasted up to 4 h without attenuation, despite the fact that the plasma concentration of tamsulosin had decreased to near the low limit of quantitation (LLOQ) at this time. Interestingly, prostatic and urethral concentrations were 13-to 44-fold higher than the plasma concentration at this time point, suggesting that the sustained effect of tamsulosin on the IUP response is related to its prostatic and urethral retention. To date, however, the time course of LUT tissue concentration has not been investigated. In addition, interest has been shown in both the relationship between effects and LUT tissue concentrations of tamsulosin, as well as in its distribution in other tissues.Here, to evaluate the relationship between the functional effect of tamsulosin and its concentration in LUT tissues, we investigated the effect of orally administered tamsulosin on phenylephrine (PE)-induced IUP response ...