نبذة مختصرة : Objectives: To investigate the effect of vibegron, a new clinically approved β3-adrenoceptor agonist in lower urinary tract dysfunction in mice with spinal cord injury.
Methods: Investigators performed cystometry under awake conditions in 4-week spinal cord injury female mice. Two weeks after spinal cord injury, saline or vibegron (30 mg/kg) was orally administered for 2 weeks prior to the urodynamic study. Investigators removed L6-S1 dorsal root ganglia from the saline- or vibegron-treated spinal cord injury mice as well as from saline-treated normal (spinal intact) mice to evaluate the levels of transient receptor potential cation channel subfamily V member 1, transient receptor potential cation channel subfamily A member 1, activating transcription factor 3, and inducible nitric oxide synthase transcripts using real-time polymerase chain reaction.
Results: In vibegron-treated spinal cord injury mice, nonvoiding contractions during bladder filling, which were increased in spinal cord injury compared to spinal intact mice, were significantly decreased. Micturition pressure or voiding efficiency was not significantly increased in comparison to measurements in saline-treated spinal cord injury mice. The expression of transient receptor potential cation channel subfamily V member 1, transient receptor potential cation channel subfamily A member 1, activating transcription factor 3, and inducible nitric oxide synthase messenger RNA was increased in spinal cord injury mice compared to spinal intact mice, but significantly decreased after vibegron treatment.
Conclusions: Vibegron improves spinal cord injury-induced detrusor overactivity in addition to significantly reducing C-fiber afferent receptors such as transient receptor potential cation channel subfamily V member 1, transient receptor potential cation channel subfamily A member 1, and inflammatory cytokines/markers, such as activating transcription factor 3 and inducible nitric oxide synthase, in spinal cord injury mice. Thus, vibegron might be effective in the treatment of storage lower urinary tract dysfunction induced by C-fiber afferent activation after spinal cord injury.
(© 2021 The Japanese Urological Association.)
References: de Groat WC, Yoshimura N. Plasticity in reflex pathways to the lower urinary tract following spinal cord injury. Exp. Neurol. 2012; 235: 123-32.
de Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Compr. Physiol. 2015; 5: 327-96.
Andersson KE, Arner A. Urinary bladder contraction and relaxation: physiology and pathophysiology. Physiol. Rev. 2004; 84: 935-86.
Yoshida M, Takeda M, Gotoh M, Nagai S, Kurose T. Vibegron, a novel potent and selective β(3)-adrenoreceptor agonist, for the treatment of patients with overactive bladder: a randomized, double-blind, placebo-controlled phase 3 study. Eur. Urol. 2018; 73: 783-90.
Yoshida M, Kakizaki H, Takahashi S, Nagai S, Kurose T. Long-term safety and efficacy of the novel β(3) -adrenoreceptor agonist vibegron in Japanese patients with overactive bladder: a phase III prospective study. Int. J. Urol. 2018; 25: 668-75.
Maruyama I, Yamamoto S, Tsuchioka K, Yamazaki T. Effects of vibegron, a novel beta3-adrenoceptor agonist, and its combination with imidafenacin or silodosin in a rat with partial bladder outlet obstruction. Eur. J. Pharmacol. 2020; 878: 173096.
Gotoh D, Shimizu N, Wada N et al. Effects of a new β3-adrenoceptor agonist, vibegron, on neurogenic bladder dysfunction and remodeling in mice with spinal cord injury. Neurourol. Urodyn. 2020; 39: 2120-7.
Kadekawa K, Yoshimura N, Majima T et al. Characterization of bladder and external urethral activity in mice with or without spinal cord injury-a comparison study with rats. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2016; 310: R752-R758.
Kadekawa K, Majima T, Shimizu T et al. The role of capsaicin-sensitive C-fiber afferent pathways in the control of micturition in spinal-intact and spinal cord-injured mice. Am. J. Physiol. Renal Physiol. 2017; 313: F796-804.
Edmondson SD, Zhu C, Kar NF et al. Discovery of vibegron: a potent and selective beta3 adrenergic receptor agonist for the treatment of overactive bladder. J. Med. Chem. 2016; 59: 609-23.
Wada N, Shimizu T, Shimizu N et al. The effect of neutralization of nerve growth factor (NGF) on bladder and urethral dysfunction in mice with spinal cord injury. Neurourol. Urodyn. 2018; 37: 1889-96.
Igawa Y, Aizawa N, Michel MC. beta3 -Adrenoceptors in the normal and diseased urinary bladder-What are the open questions? Br J Pharmacol. 2019; 176: 2525-38.
Bragg R, Hebel D, Vouri SM, Pitlick JM. Mirabegron: a Beta-3 agonist for overactive bladder. Consult. Pharm. 2014; 29: 823-37.
Yamaguchi O. Beta3-adrenoceptors in human detrusor muscle. Urology 2002; 59: 25-9.
Birder LA, Nealen ML, Kiss S et al. Beta-adrenoceptor agonists stimulate endothelial nitric oxide synthase in rat urinary bladder urothelial cells. J. Neurosci. 2002; 22: 8063-70.
Aizawa N, Igawa Y, Nishizawa O, Wyndaele JJ. Effects of CL316,243, a beta 3-adrenoceptor agonist, and intravesical prostaglandin E2 on the primary bladder afferent activity of the rat. Neurourol. Urodyn. 2010; 29: 771-6.
Aizawa N, Igawa Y, Nishizawa O, Wyndaele JJ. Effects of nitric oxide on the primary bladder afferent activities of the rat with and without intravesical acrolein treatment. Eur. Urol. 2011; 59: 264-71.
Kanai A, Andersson KE. Bladder afferent signaling: recent findings. J. Urol. 2010; 183: 1288-95.
Tsujino H, Kondo E, Fukuoka T et al. Activating transcription factor 3 (ATF3) induction by axotomy in sensory and motoneurons: a novel neuronal marker of nerve injury. Mol Cell Neurosci. 2000; 15: 170-82.
Guo L, Lv J, Huang YF, Hao DJ, Liu JJ. Bioinformatics analyses of differentially expressed genes associated with spinal cord injury: a microarray-based analysis in a mouse model. Neural Regen. Res. 2019; 14: 1262-70.
Aizawa N, Homma Y, Igawa Y. Effects of l-arginine, mirabegron, and oxybutynin on the primary bladder afferent nerve activities synchronized with reflexic, rhythmic bladder contractions in the rat. Neurourol. Urodyn. 2015; 34: 368-74.
McCarthy CJ, Zabbarova IV, Brumovsky PR, Roppolo JR, Gebhart GF, Kanai AJ. Spontaneous contractions evoke afferent nerve firing in mouse bladders with detrusor overactivity. J. Urol. 2009; 181: 1459-66.
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