Keywordsa1L-adrenoceptor; a1A-adrenoceptor; benign prostatic hyperplasia (BPH); stress urinary incontinence (SUI); lower urinary tract; phenotype pharmacology a1-Adrenoceptors are involved in numerous physiological functions, including micturition. However, the pharmacological profile of the a1-adrenoceptor subtypes remains controversial. Here, we review the literature regarding a1-adrenoceptors in the lower urinary tract from the standpoint of a1L phenotype pharmacology. Among three a1-adrenoceptor subtypes (a1A, a1B and a1D), a1a-adrenoceptor mRNA is the most abundantly transcribed in the prostate, urethra and bladder neck of many species, including humans. In prostate homogenates or membrane preparations, a1A-adrenoceptors with high affinity for prazosin have been detected as radioligand binding sites. Functional a1-adrenoceptors in the prostate, urethra and bladder neck have low affinity for prazosin, suggesting the presence of an atypical a1-adrenoceptor phenotype (designated as a1L). The a1L-adrenoceptor occurs as a distinct binding entity from the a1A-adrenoceptor in intact segments of variety of tissues including prostate. Both the a1L-and a1A-adrenoceptors are specifically absent from Adra1A (a1a) gene-knockout mice. Transfection of a1a-adrenoceptor cDNA predominantly expresses a1A-phenotype in several cultured cell lines. However, in CHO cells, such transfection expresses a1L-and a1A-phenotypes. Under intact cell conditions, the a1L-phenotype is predominant when co-expressed with the receptor interacting protein, CRELD1a. In summary, recent pharmacological studies reveal that two distinct a1-adrenoceptor phenotypes (a1A and a1L) originate from a single Adra1A (a1a-adrenoceptor) gene, but adrenergic contractions in the lower urinary tract are predominantly mediated via the a1L-adrenoceptor. From the standpoint of phenotype pharmacology, it is likely that phenotype-based subtypes such as the a1L-adrenoceptor will become new targets for drug development and pharmacotherapy.
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IntroductionThe lower urinary tract is responsible for urine storage and voiding (Andersson and Wein, 2004). In mammalian species including humans, the bladder detrusor muscle contracts through a parasympathetic cholinergic mechanism during micturition (Abrams et al., 2006;Wess et al., 2007). Besides the importance of the cholinergic system as the major mechanism for bladder neck muscle tone control, the adrenergic systems play significant roles in the regulation of bladder neck tone (Fig. 1). During the storage phase, the urethra and outlet region of the bladder is contracted to Among impairments in urine storage, stress urinary incontinence (SUI) is recognized as one of the most frequently occurring conditions. Deficient urethral or bladder neck closure may result in this condition. However, drug treatments for SUI are scarce, at present (Andersson and Wein, 2004). The density of noradrenergic nerves increases markedly towards the bladder neck and ureth...