Expressions of urothelial functional proteins in idiopathic detrusor overactivity patients refractory to antimuscarinic therapy with different urodynamic characteristics

摘要

Aims This study investigated the expressions of PGP9.5, P 2 ?X? 3 , muscarinic receptor (M3) and beta‐3 adrenoreceptor (AR) in idiopathic detrusor overactivity (IDO) patients refractory to antimuscarinic treatment, and analyzed the correlation between protein expressions and clinical symptoms of IDO bladders with different urodynamic characteristics. Methods Specimens of 48 IDO and 10 control patients without lower urinary tract symptoms were included. The levels of these proteins from bladder mucosa were determined by Western blotting. Results The expression levels of β3‐AR and M3 receptor were similar between IDO patients and controls. When IDO patients were divided into two subgroups, phasic DO and terminal DO, the results showed that β3‐AR level in the patients with phasic DO was significantly higher than that of the controls and terminal DO (Both P? ?0.05). PGP9.5 and P 2 ?X? 3 levels were also significantly increased in phasic DO subgroup than controls. P 2 ?X? 3 receptor was positively correlated with PGP9.5 and β3‐AR, and negatively correlated with the first sensation of bladder filling and voided volume in phasic DO. Conclusions Similar expression M3 receptor and increased P 2 ?X? 3 levels in phasic DO, compared with the controls, indicate that dysregulation of purinergic bladder signaling may contribute to the pathogenesis of phasic DO refractory to antimuscarinics. Elevated expression of β3‐AR in phasic DO but not in terminal DO patients may explain the different urodynamic characteristics of DO between the two subgroups. Our findings suggest that β3‐AR agonist or P 2 ?X? 3 antagonist might be a good treatment choice for patients with phasic DO refractory to antimuscarinic therapy.