Effective treatment of overactive bladder has been achieved with botulinum toxin type A (BoTN/A) treatment, an affect attributed to blockade of acetylcholine (ACh) release. Besides treating the symptoms of bladder overactivity, patients also have reported benefits in reduced urgency sensation and pain. Lawrence et al. investigated the potential effect of BoTN/A on the release of ATP and its contribution to the sensory and antinociceptive effects observed in patients. With use of bladder strips, the authors pharmacologically dissected the mechanism of BoTN/A on smooth muscle spasms. They found that ACh and ATP provided all of the excitatory input and that equipotent blockage of ATP co-released with ACh from muscle efferents probably contributed to the effectiveness of BoTN/A, including nonresponders to anticholinergic drugs. As the purinergic receptors are known to mediate sensory efferent excitation, blockage of ATP release by BoTN/A would explain the antinociceptive and relief of urgency sensation reported by patients.
See article at J Pharmacol Exp Ther 2010, 334:1080–1086.
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