Urinary bladder intramural neurones: an electrophysiological study utilizing a tissue culture preparation

Purinergic signalling in the urinary tract in health and disease

Purinergic signalling is involved in a number of physiological and pathophysiological activities in the lower urinary tract. In the bladder of laboratory animals there is parasympathetic excitatory cotransmission with the purinergic and cholinergic components being approximately equal, acting via P2X1 and muscarinic receptors, respectively. Purinergic mechanosensory transduction occurs where ATP, released from urothelial cells during distension of bladder and ureter, acts on P2X3 and P2X2/3 receptors on suburothelial sensory nerves to initiate the voiding reflex, via low threshold fibres, and nociception, via high threshold fibres. In human bladder the purinergic component of parasympathetic cotransmission is less than 3 %, but in pathological conditions, such as interstitial cystitis, obstructed and neuropathic bladder, the purinergic component is increased to 40 %. Other pathological conditions of the bladder have been shown to involve purinoceptor-mediated activities, including multiple sclerosis, ischaemia, diabetes, cancer and bacterial infections. In the ureter, P2X7 receptors have been implicated in inflammation and fibrosis. Purinergic therapeutic strategies are being explored that hopefully will be developed and bring benefit and relief to many patients with urinary tract disorders.

Sacral nerve modulation in overactive bladder

This article represents a general overview of therapies for urinary urgency, frequency, and overactive bladder, with specific emphasis on sacral neuromodulation. The history of sacral neuromodulation is discussed along with an update of the current literature. Future directions for neuromodulation of the pelvic floor also are discussed.

Innervation of bladder and bowel

The autonomic neuromuscular junction is described and neurotransmission, co-transmission and neuromodulation are defined, as well as the 'chemical coding' of sympathetic, parasympathetic, sensory-motor and intrinsic neurons in the wall of the bladder and bowel. A detailed description of the patterns of innervation of smooth muscle of the bowel, bladder and urethra and of the urethral and anal sphincters by intramural and extrinsic autonomic nerves is presented, and the functional and pharmacological features of this innervation are summarized. Finally, changes in the pattern of innervation and expression of co-transmitters and receptors in the bladder and bowel that occur during development and old age and following trauma, surgery and disease are discussed.

Patch-clamp recordings from subpopulations of autonomic and afferent neurons identified by axonal tracing techniques

This study determined whether axonal tracing methods can be used in combination with patch-clamp techniques to examine the electrical properties of identified populations of autonomic and afferent neurons in the adult rat. Fluorescent dyes (Fast Blue, FB and Fluoro-Gold, FG) were injected into the wall of the urinary bladder or colon and into various somatic structures to label postganglionic neurons in the major pelvic ganglia (MPG) as well as visceral and somatic afferent neurons in the lumbosacral dorsal root ganglia (DRG) and trigeminal ganglia (TG). One to 3 weeks after dye injection, neurons were isolated from ganglia by enzymatic dissociation. Following dissociation, single neurons labelled with FB were identified in the three types of ganglion preparations; however FG was only identified consistently in TG neurons. FB was retained in neurons during short-term culture (1-5 days). Following 10 to 20 s exposure to UV light which was required for identification of the cells, whole-cell patch-clamp recordings revealed that the electrophysiological properties of FB-labelled cells did not differ from those of unlabelled cells. However, a more prolonged exposure (1-5 min) of the neurons to UV light produced irreversible damage to the cells which was evident as changes in the action potential, sodium current and resting membrane potential. These results indicate that patch-clamp recording in combination with axonal tracing is a useful approach for studying the electrical properties of identified populations of autonomic and afferent neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

Postnatal development of neuropeptide Y- and calcitonin gene-related peptide-immunoreactive nerves in the rat urinary bladder

The postnatal development of neuropeptide Y- and calcitonin gene-related peptide-immunoreactive (NPY-IR and CGRP-IR) nerve fibers in the rat urinary bladder was investigated using whole-mount preparations and cryostat sections. In newborn and 3-day-old rats, many NPY-IR nerve fibers were observed in the subserous and muscle layers. Many NPY-IR nerve cell bodies clustered at branching points of the subserous nerve bundles. Within 4 weeks after birth, these cell bodies drastically decreased in number and spread along the bundles, although the number of NPY-IR nerve fibers increased moderately. In contrast, CGRP-IR nerve fibers in newborn and 3-day-old rats were less developed, and no CGRP-IR nerve cell body was observed in any rat. However, CGRP-IR nerve fiber distribution in the urinary tissues conspicuously increased within 4 weeks after birth. Especially, an increase of the infraepithelial fibers showing a meshwork appearance was prominent in the fundus and corpus of the bladder. The infra- and intraepithelial CGRP-IR nerve meshwork of the ventral wall was more dense than that of the trigone. At 4 weeks, NPY-IR and CGRP-IR nerves were similar to those of the adult rat (8-12 weeks old). The present study suggests a correlation between the development of the peripheral nervous system in the urinary bladder and maturation of micturition behavior in the rat.

Nerve growth factor responsiveness of cultured major pelvic ganglion neurons from the adult rat

The bladder and other pelvic viscera are innervated in the rat by the major pelvic ganglion (MPG), a mixed sympathetic/parasympathetic population of neurons that participates in lower urinary pathophysiology. Neurons from the MPG of adult females were removed, dissociated and cultured in order to test retention of the neuronal phenotype and whether they responded to Nerve Growth Factor (NGF). The bladder-specific subset of MPG neurons were distinguished by retrograde labeling prior to culture. The adult ganglionic neurons adapted to culture with greater than 80% survival in the best cases. The cultured neurons retained excitability, as determined by measuring voltage-activated ionic currents. They were positive for neuron-specific beta-tubulin and many retained immunoreactivity for characteristic peptides and transmitter synthetic enzyme. The proportion of neurons in the different categories tested varied somewhat from that in vivo, but there was no evidence of selective death of a particular population. The cultured MPG neurons were responsive to NGF and anti-NGF antibody. NGF supported neuronal survival and expression of tyrosine hydroxylase. Added NGF also affected the expression of neuropeptide Y. Hypertrophied neurons from animals with experimental bladder outlet obstruction demonstrated increased responsiveness to NGF. The data suggest that NGF participates in adult neural plasticity due to continued responsiveness to the factor. Furthermore, questions concerning regulation of MPG neurons may be addressed in vitro.

The human prostate gland: a histochemical and immunohistochemical study of neuropeptides, serotonin, dopamine beta-hydroxylase and acetylcholinesterase in autonomic nerves and ganglia

Different regions of the prostate gland, namely the prostatic capsule, peripheral prostate, and proximal and distal central prostate, were obtained from 5 patients with carcinoma of the bladder and studied histochemically and immunohistochemically to localise acetylcholinesterase (AChE)-, dopamine beta-hydroxylase (DBH)-, serotonin- and peptide-containing nerves. Autonomic ganglia were found in all regions of the prostate studied. The greatest number of ganglia contained AChE and neuropeptide Y (NPY) followed (in decreasing order) by DBH; [Met]enkephalin (mENK) and [Leu]enkephalin (IENK); calcitonin gene-related peptide (CGRP) and vasoactive intestinal polypeptide (VIP); and serotonin, but not somatostatin. The greatest density of nerve fibres was found in the proximal central prostate, followed by the anterior capsule and distal central prostate, with the least in the peripheral prostate. The greatest number of nerve fibres contained ACh and NPY, followed in decreasing order by VIP and DBH; IENK, serotonin and CGRP; mENK; substance P and somatostatin. The functions of the neurotransmitter substances in the human prostate remain to be elucidated.

Colocalization of peptides and a catecholamine-synthesizing enzyme in intramural neurones of the newborn guinea-pig urinary bladder in culture

The patterns of colocalization of somatostatin (SOM), neuropeptide Y (NPY) and the catecholamine-synthesizing enzyme, dopamine beta-hydroxylase (DBH), were examined in intramural neurones in dissociated cell culture preparations from the detrusor muscle of the urinary bladder of the newborn guinea-pig using an elution-restaining immunocytochemical technique. Large numbers of the intramural neurones contained NPY-like (70-85% of the total neuronal population) and SOM-like (60-75%) immunoreactivities, in contrast to a small population (1-6%) of neurones containing immunoreactivity to DBH. Some neurones were immunoreactive to NPY (15-20%) and SOM (5-10%) alone, while 55-70% of the total neuronal population showed immunoreactivity to both NPY and SOM. NPY-like immunoreactive neuronal cell bodies that did not contain SOM were predominantly binucleate, whereas neuronal cell bodies immunoreactive to SOM alone were mainly mononucleate. Although not seen in every culture preparation, neuronal cell bodies containing both NPY-like and DBH-like immunoreactivities were also observed (less than 5% of the total neuronal population), and most, if not all, of these neuronal cell bodies were binucleate. SOM-like and DBH-like immunoreactivities were not seen in the same neuronal cell body throughout this study. These results show that intramural bladder neurones can be divided into distinct subpopulations based upon the coexistence of specific peptides and enzymes, and the possibility that they sustain local integrative and modulatory roles in bladder function is discussed.

Localization of muscarinic receptors on somatostatin-like immunoreactive neurones of the newborn guinea pig urinary bladder in culture

Muscarinic receptors were localized on cells cultured from the detrusor muscle of the newborn guinea pig urinary bladder by autoradiography using the irreversible muscarinic antagonist [3H]propylbenzilylcholine mustard, before being immunostained with an antibody to somatostatin. Many mononucleate and binucleate intramural neurones immunoreactive for somatostatin were observed (60-75% of the total population), a subpopulation of which (40-60%) expressed muscarinic receptors. Autoradiographic grains were distributed over the whole cell body surface and the entire length of the neurites. An even distribution of silver grains was also seen on cultured smooth muscle cell surfaces, but not on other cell types present in the culture preparations. The demonstration of muscarinic receptors on specific neuropeptide-containing cells in culture is consistent with the existence of specialized cholinergic, intraganglionic circuits within the bladder wall, and suggests that somatostatin may also be involved in the integration and/or modulation of bladder function.

Synaptic potentials induced by postganglionic stimulations in cat bladder parasympathetic neurones

Intracellular recording techniques were used to examine and compare synaptic potentials evoked by stimulating pre- and postganglionic nerve trunks in cat bladder parasympathetic ganglia. In the 76 ganglion cells examined, two types of responses were recorded on stimulating the postganglionic nerve: an antidromic action potential (type PostNS1; n = 30) or a fast excitatory postsynaptic potential (f-EPSP; type PostNS2; n = 46) which resulted in an orthodromic-like action potential. In some of the cells exhibiting a PostNS1 response (n = 19), a fast depolarization was superimposed on the antidromic spike. This depolarization was due to the synaptic activation of nicotinic receptors. In many of the cells exhibiting either PostNS1 or PostNS2 responses, repetitive stimulation of the postganglionic nerve induced a slow hyperpolarization. Applying nicotinic (hexamethonium, 0.5-1 mM) receptor muscarinic (atropine, 1 microM), alpha-adrenergic (phentolamine, 1 microM) and purinergic (caffeine, 0.5-1 mM) receptor antagonists completely inhibited the tetanus-induced slow hyperpolarization in some cells (n = 5). In other cells (n = 15), a slow hyperpolarization persisted in the presence of these antagonists. These results indicate that stimulation of the postganglionic nerve trunk of cat bladder parasympathetic ganglia can elicit not only an antidromic action potential, but also synaptic potentials which are mediated by the activation of cholinergic (nicotinic and muscarinic), noradrenergic and purinergic receptors, as well as non-cholinergic, non-alpha-adrenergic and non-purinergic synaptic potential.

A histochemical and immunohistochemical study of the autonomic innervation of the lower urinary tract of the female pig. Is the pig a good model for the human bladder and urethra?

The detrusor muscle, bladder neck, proximal, middle and distal regions of the urethra of the female pig were studied by histochemical and immunohistochemical methods to localize catecholamine-containing, acetylcholinesterase-positive and peptide-containing nerves. The peptides examined included: vasoactive intestinal polypeptide, substance P, somatostatin, [Met]enkephalin, bombesin and gastrin. The greatest density of nerves was found in the smooth muscle of the distal urethra, followed by the bladder neck, middle urethra, and proximal urethra, with the least in the detrusor muscle. The greatest number of nerve fibres stained for acetylcholinesterase, followed by vasoactive intestinal polypeptide- and catecholamine-containing fibres. Substance P-immunoreactive nerve fibres were confined to the bladder neck and distal urethral regions. [Met]enkephalin-and gastrin-immunoreactive nerves were most dense in the distal urethra but absent in detrusor muscle, while somatostatin-immunoreactive nerve fibres were sparsely distributed throughout the lower urinary tract. No nerve fibres showing immunoreactivity to bombesin were found. Catecholamine-containing, acetylcholinesterase-positive, vasoactive intestinal polypeptide-, substance P-, [Met]enkephalin- and gastrin-immunoreactive nerves were also found on the adventitial-medial border of blood vessels in the pig urinary tract. In the intrinsic external urethral sphincter, located in the distal urethra, vasoactive intestinal polypeptide- and gastrin-immunoreactive nerve fibres were found bordering a small number of individual striated muscle fibres, while catecholamine-containing nerves were found predominantly in the connective tissue surrounding the striated muscle fibres. Dense populations of acetylcholinesterase-positive nerve fibres were found associated with the striated muscle fibres, with end plates on some of them. Intramural ganglia, composed of two to 30 neurones, were found in the bladder neck and middle and distal regions of the urethra. In the smooth muscle, and in the vicinity of the striated muscle regions of the intrinsic external urethral sphincter, there were small ganglia, containing two to three neurones, which were vasoactive intestinal polypeptide-, [Met]enkephalin- and somatostatin-immunoreactive. The results are compared to the autonomic innervation of the human bladder and urethra as previously described and it is concluded that the lower urinary tract of the pig is a good model for some features of the lower urinary tract of man, but a poor model for others.

The use of cell and tissue culture techniques in the study of regulatory peptides

Cell and tissue culture preparations have a number of general advantages for the study of biological processes: cells are more accessible for study, diffusion delays and barriers to applied substances are minimised, the humoral and cellular components of the culture environment can be controlled and progressive changes in intracellular and intercellular events can be directly monitored. These significant advantages mean that culture preparations can provide unique opportunities for investigation of the properties and functions of regulatory peptides. Culture preparations also have disadvantages and not all cultures are suitable for use in all types of experiments; therefore, the choice of preparation must be made accordingly. Here we describe different types of culture preparation and give examples where cultures have been used to examine peptide synthesis, storage, secretion and receptor localisation, as well as the short-term and trophic actions of regulatory peptides.

Regional differences in the motor response to capsaicin in the guinea-pig urinary bladder: relative role of pre- and postjunctional factors related to neuropeptide-containing sensory nerves

Capsaicin induced a contraction of isolated strips from the guinea-pig urinary bladder which was more evident in the dome than in the neck and inhibited contractions induced by field stimulation, particularly in the neck. Both responses exhibited prompt desensitization and were tetrodotoxin-resistant, suggesting a specific action on transmitter release from sensory nerve terminals. Indeed, the contractile response in the dome was prevented by a substance P antagonist while the inhibitory response in the neck was prevented by immunoblockade with anticalcitonin gene-related peptide (CGRP) serum. Substance P produced a contraction of the guinea-pig bladder, being about 5 times more potent in the dome than in the neck, while CGRP inhibited the evoked contractions, being about 8 times more potent in the neck than in the dome. Further, the maximal effect of CGRP in the neck was almost double that in the dome. Substance P- and CGRP-like immunoreactivity were detected in both the dome and the neck with no regional differences for each peptide. CGRP-like immunoreactivity was 6.3 and 7.9 times higher than substance P-like immunoreactivity in the dome and the neck, respectively. Exposure to capsaicin evoked release of both substance P- and CGRP-like immunoreactivity from the dome and the neck. Peak CGRP-like immunoreactivity released by capsaicin was 12.3 and 8 times greater than substance P-like immunoreactivity in the dome and the neck, respectively. For each peptide, no difference was found in peak release in the dome vs neck. Total substance P-like immunoreactivity released from the neck was 25% lower than that released from the dome. The ability of CGRP to stimulate accumulation of 3',5' cyclic adenosine monophosphate in membranes prepared from the bladder muscle was greater in preparations from the neck than from the dome. These findings indicate that postjunctional mechanisms (type and number of receptors for sensory neuropeptides, coupling with second messengers) are a major determinant of the type of motor responses consequent of the release of sensory neuropeptides from capsaicin-sensitive nerves.

Neuropeptide Y-like immunoreactivity in intramural ganglia of the newborn guinea pig urinary bladder

Immunoreactive neuropeptide Y (NPY) was demonstrated in neuronal elements in the urinary bladder wall of the newborn guinea pig. Numerous intramural ganglia were found lying among the smooth muscle bundles and in the submucosa, and NPY-like immunoreactive nerve cell bodies were demonstrated within all of these ganglia. Nerve fibres containing NPY were also richly distributed in the detrusor muscle, submucosa and around blood vessels. In dissociated cell cultures from newborn guinea pig detrusor muscle, a subpopulation (70-85%) of both mononucleate and binucleate intramural neurones was shown to contain NPY-like immunoreactivity. A low percentage (1-6%) of the intramural bladder neurones contained dopamine-beta-hydroxylase. In conclusion, while some NPY-containing nerve fibres in the wall of the bladder are of sympathetic origin, especially those supplying blood vessels, the results of this present study establish that many of these NPY-containing nerve fibres originate from non-adrenergic cell bodies within the intramural bladder ganglia.

Postganglionic stimulation activates synaptic potentials in cat bladder parasympathetic neurons

Responses elicited by stimulating the pre-versus postganglionic nerves were compared in cat bladder parasympathetic neurons. We observed that synaptic potentials recorded on stimulating the postganglionic nerve trunk were different from those elicited with preganglionic nerve stimulation. These findings suggest that local neuronal interactions occur within bladder parasympathetic ganglia and may play a physiological role in the neuronal integration in bladder ganglia.