Cajal–like interstitial cells as a novel target in detrusor overactivity treatment: true or myth?

摘要

Introduction. The Cajal–like intestitial cells (ICCs) act as a pacemaker and are responsible for generatingsmooth muscle activity in the gastrointestinal tract (GI). Interstitial cells that resemble ICCs in the GIhave been identified in the urinary bladder.Materials and methods. This review is based on a systemic literature research. The medline/pubmed,scopus, embase, and Web of Science databases were browsed in order to identify original and reviewarticles, as well as editorials relating to cajal–like cells, urinary bladder, detrusor overactivity, overactivebladder, glivec, etc. The controlled vocabulary of the Medical Subject Headings (MeSH) database wasused to ensure the sensitivity of the searches. 40 papers met the criteria and were used for this review.Results. Cajal cells lie in close proximity to the muscle cells, autonomic nerve endings, and urothelialcells. There is increasing evidence that ICCs play role in urinary tract dysfunction development (e.g.detrusor overactivity, primary obstructive megaureter, congenital ureteropelvic junction obstruction,etc.). ICCs may be responsible for generating electrical potentials and induction of detrusor musclecontractions. Novel pathomechanisms of detrusor overactivity development have been postulated, asfollows: 1) the disturbance of spontaneous contractility caused by altered signal transduction of ICCsbetween nerves and detrusor muscle cells, and 2). the alteration in signal transduction between urotheliumand afferent nerve endings via suburothelial ICCs. The c–kit receptor is not only a detection markerof these cells, but may also play a crucial role in the control of bladder function.Conclusions. Cajal cells in urinary bladder suggest that the c–kit receptor may provide a novel targetfor treating detrusor overactivity. The review presents the current knowledge of ICCs, its role in urinarybladder function, and potential novel therapeutic strategy.