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  1. Article ; Online: Targeting neurotrophin and nitric oxide signaling to promote recovery and ameliorate neurogenic bladder dysfunction following spinal cord injury - Mechanistic concepts and clinical implications.

    Kanai, A J / Andersson, K-E / Fry, C H / Yoshimura, N

    Continence (Amsterdam, Netherlands)

    2023  Volume 6

    Abstract: This review summarizes the presentations made to a workshop entitled "Targeting Neurotrophin and Nitric Oxide Signaling to Promote Recovery and Ameliorate Neurogenic Bladder Dysfunction following Spinal Cord Injury - Mechanistic Concepts and Clinical ... ...

    Abstract This review summarizes the presentations made to a workshop entitled "Targeting Neurotrophin and Nitric Oxide Signaling to Promote Recovery and Ameliorate Neurogenic Bladder Dysfunction following Spinal Cord Injury - Mechanistic Concepts and Clinical Implications" at the International Continence Society (ICS) 2022 Vienna Meeting. Spinal cord injury (SCI; T8-T9 contusion/transection) causes impaired mobility, neurogenic detrusor overactivity (NDO), detrusor sphincter dyssynergia (DSD) and subsequent decreased quality of life. This workshop discussed the potential of future therapeutic agents that manage the lesion and its consequences, in particular possibilities to reduce the lesion itself and manage pathophysiological changes to the lower urinary tract (LUT). Attenuation of the spinal cord lesion itself was discussed with respect to the potential of a trio of agents: LM11A-3, a p75 neurotrophin receptor modulator to counter activation of local apoptotic pathways; LM22B-10 to promote neuronal growth by targeting tropomyosin-related kinase (Trk) receptors; and cinaciguat, a soluble guanylate cyclase (sGC) activator as an agent promoting angiogenesis at the injury site. The workshop also discussed targets on the bladder to block selectivity sites associated with detrusor overactivity and poor urinary filling profiles, such as purinergic pathways controlling excess contractile activity and afferent signaling, as well as excess fibrosis. Finally, the importance of increased mechanosensitive signaling as a contributor to DSD was considered, as well as potential drug targets. Overall, an emphasis was placed on targets that help restore function and reduce pathological LUT consequences, rather than downregulate normal function.
    Language English
    Publishing date 2023-05-20
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2772-9737
    ISSN (online) 2772-9737
    DOI 10.1016/j.cont.2023.100703
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Soluble Guanylate Cyclase Activators to Treat Benign Prostatic Hyperplasia and associated LUTS.

    Kanai, A J / Andersson, K-E / Birder, L A / Fry, C H

    Continence (Amsterdam, Netherlands)

    2023  Volume 6

    Abstract: This review summarises the presentations during a workshop session entitled "The Use of Soluble Guanylate Cyclase Activators to Treat Benign Prostatic Hyperplasia, Obstruction and Fibrosis - Mechanistic Concepts and Clinical Implications" at the ... ...

    Abstract This review summarises the presentations during a workshop session entitled "The Use of Soluble Guanylate Cyclase Activators to Treat Benign Prostatic Hyperplasia, Obstruction and Fibrosis - Mechanistic Concepts and Clinical Implications" at the International Continence Society (ICS) 2021 Melbourne Virtual meeting. Benign prostatic hyperplasia (BPH) is a highly prevalent condition that can result in bladder outflow obstruction (BOO) and development of lower urinary tract symptoms (LUTS), and by 80 years of age is present in about 75% of men. Current pharmacological therapies include
    Language English
    Publishing date 2023-05-17
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2772-9737
    ISSN (online) 2772-9737
    DOI 10.1016/j.cont.2023.100699
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Serotonergic paraneurones in the female mouse urethral epithelium and their potential role in peripheral sensory information processing.

    Kullmann, F A / Chang, H H / Gauthier, C / McDonnell, B M / Yeh, J-C / Clayton, D R / Kanai, A J / de Groat, W C / Apodaca, G L / Birder, L A

    Acta physiologica (Oxford, England)

    2017  Volume 222, Issue 2

    Abstract: Aim: The mechanisms underlying detection and transmission of sensory signals arising from visceral organs, such as the urethra, are poorly understood. Recently, specialized ACh-expressing cells embedded in the urethral epithelium have been proposed as ... ...

    Abstract Aim: The mechanisms underlying detection and transmission of sensory signals arising from visceral organs, such as the urethra, are poorly understood. Recently, specialized ACh-expressing cells embedded in the urethral epithelium have been proposed as chemosensory sentinels for detection of bacterial infection. Here, we examined the morphology and potential role in sensory signalling of a different class of specialized cells that express serotonin (5-HT), termed paraneurones.
    Methods: Urethrae, dorsal root ganglia neurones and spinal cords were isolated from adult female mice and used for immunohistochemistry and calcium imaging. Visceromotor reflexes (VMRs) were recorded in vivo.
    Results: We identified two morphologically distinct groups of 5-HT
    Conclusion: These morphological and functional findings provide insights into a putative paraneurone-neural network within the urethra that utilizes 5-HT signalling, presumably from paraneurones, to modulate primary sensory pathways carrying nociceptive and non-nociceptive (mechano-sensitive) information to the central nervous system.
    MeSH term(s) Afferent Pathways/cytology ; Animals ; Chemoreceptor Cells/cytology ; Chemoreceptor Cells/metabolism ; Epithelial Cells/cytology ; Female ; Mice ; Serotonin/metabolism ; Urethra/cytology ; Urethra/innervation
    Chemical Substances Serotonin (333DO1RDJY)
    Language English
    Publishing date 2017-08-08
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2218636-0
    ISSN 1748-1716 ; 1748-1708
    ISSN (online) 1748-1716
    ISSN 1748-1708
    DOI 10.1111/apha.12919
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: The function of suburothelial myofibroblasts in the bladder.

    Fry, C H / Sui, G-P / Kanai, A J / Wu, C

    Neurourology and urodynamics

    2007  Volume 26, Issue 6 Suppl, Page(s) 914–919

    Abstract: The properties of suburothelial myofibroblasts are described, and their possible role in shaping sensory responses from the bladder wall are discussed. Suburothelial myofibroblasts consist of long spindle-shaped cells that form a distinctive layer below ... ...

    Abstract The properties of suburothelial myofibroblasts are described, and their possible role in shaping sensory responses from the bladder wall are discussed. Suburothelial myofibroblasts consist of long spindle-shaped cells that form a distinctive layer below the urothelium and are connected to each other through connexin 43 gap junctions. Isolated cells from guinea pig or human bladders display spontaneous fluctuations of membrane potential and intracellular [Ca(2+)], and respond in a similar way to exogenous application of adenosine triphosphate (ATP) or lowering of extracellular pH. ATP generates an intracellular Ca(2+) transient via activation of a P2Y receptor, which in turn initiates a Ca(2+)-sensitive Cl(-) current inward at the normal membrane potential of -50 to -60 mV. Of the P2Y receptor subtypes identified by immunolabeling, the most prominent was the P2Y(6) receptor. Cell pairs, without the formation of gap junctions, elicit augmented responses to exogenous agonists. Mechanical stimulation of the suburothelial layer in intact cross-sections of the bladder elicited Ca(2+) waves that propagated across the suburothelial layer before invading the detrusor layer. This indicates that the suburothelial layer forms a discrete functional layer of cells capable of propagating signals over many cell lengths. A function for suburothelial myofibroblasts is proposed whereby they act as an amplification stage in the sensory response to bladder-wall stretch, as occurs during bladder filling.
    MeSH term(s) Animals ; Cell Communication/physiology ; Fibroblasts/physiology ; Humans ; Membrane Potentials/physiology ; Stress, Mechanical ; Urinary Bladder/cytology ; Urinary Bladder/physiology
    Language English
    Publishing date 2007-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604904-7
    ISSN 1520-6777 ; 0733-2467
    ISSN (online) 1520-6777
    ISSN 0733-2467
    DOI 10.1002/nau.20483
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Is the urothelium intelligent?

    Birder, L A / Kanai, A J / Cruz, F / Moore, K / Fry, C H

    Neurourology and urodynamics

    2010  Volume 29, Issue 4, Page(s) 598–602

    Abstract: The urothelium separates the urinary tract lumen from underlying tissues of the tract wall. Previously considered as merely an effective barrier between these two compartments it is now recognized as a more active tissue that senses and transduces ... ...

    Abstract The urothelium separates the urinary tract lumen from underlying tissues of the tract wall. Previously considered as merely an effective barrier between these two compartments it is now recognized as a more active tissue that senses and transduces information about physical and chemical conditions within the urinary tract, such as luminal pressure, urine composition, etc. To understand this sensory function it is useful to consider the urothelium and suburothelium as a functional unit; containing uroepithelial cells, afferent and efferent nerve fibers and suburothelial interstitial cells. This structure responds to alterations in its external environment through the release of diffusible agents, such as ATP and acetylcholine, and eventually modulates the activity of afferent nerves and underlying smooth muscles. This review considers different stresses the urothelium/suburothelium responds to; the particular chemicals released; the cellular receptors that are consequently affected; and how nerve and muscle function is modulated. Brief consideration is also to regional differences in the urothelium/suburothelium along the urinary tract. The importance of different pathways in relaying sensory information in the normal urinary tract, or whether they are significant only in pathological conditions is also discussed. An operational definition of intelligence is used, whereby a system (urothelium/suburothelium) responds to external changes, to maximize the possibility of the urinary tract achieving its normal function. If so, the urothelium can be regarded as intelligent. The advantage of this approach is that input-output functions can be mathematically formulated, and the importance of different components contributing to abnormal urinary tract function can be calculated.
    MeSH term(s) Afferent Pathways/physiology ; Animals ; Efferent Pathways/physiology ; Humans ; Urethra/cytology ; Urethra/innervation ; Urethra/physiology ; Urothelium/cytology ; Urothelium/innervation ; Urothelium/physiology
    Language English
    Publishing date 2010-04-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 604904-7
    ISSN 1520-6777 ; 0733-2467
    ISSN (online) 1520-6777
    ISSN 0733-2467
    DOI 10.1002/nau.20914
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Modulation of spontaneous activity in the overactive bladder: the role of P2Y agonists.

    Fry, C H / Young, J S / Jabr, R I / McCarthy, C / Ikeda, Y / Kanai, A J

    American journal of physiology. Renal physiology

    2012  Volume 302, Issue 11, Page(s) F1447–54

    Abstract: Spinal cord transection (SCT) leads to an increase in spontaneous contractile activity in the isolated bladder that is reminiscent of an overactive bladder syndrome in patients with similar damage to the central nervous system. An increase in ... ...

    Abstract Spinal cord transection (SCT) leads to an increase in spontaneous contractile activity in the isolated bladder that is reminiscent of an overactive bladder syndrome in patients with similar damage to the central nervous system. An increase in interstitial cell number in the suburothelial space between the urothelium and detrusor smooth muscle layer occurs in SCT bladders, and these cells elicit excitatory responses to purines and pyrimidines such as ATP, ADP, and UTP. We have investigated the hypothesis that these agents underlie the increase in spontaneous activity. Rats underwent lower thoracic spinal cord transection, and their bladder sheets or strips, with intact mucosa except where specified, were used for experiments. Isometric tension was recorded and propagating Ca(2+) and membrane potential (E(m)) waves were recorded by fluorescence imaging using photodiode arrays. SCT bladders were associated with regular spontaneous contractions (2.9 ± 0.4/min); ADP, UTP, and UDP augmented the amplitude but not their frequency. With strips from such bladders, a P2Y(6)-selective agonist (PSB0474) exerted similar effects. Fluorescence imaging of bladder sheets showed that ADP or UTP increased the conduction velocity of Ca(2+)/E(m) waves that were confined to regions of the bladder wall with an intact mucosa. When transverse bladder sections were used, Ca(2+)/E(m) waves originated in the suburothelial space and propagated to the detrusor and urothelium. Analysis of wave propagation showed that the suburothelial space exhibited properties of an electrical syncitium. These experiments are consistent with the hypothesis that P2Y-receptor agonists increase spontaneous contractile activity by augmenting functional activity of the cellular syncitium in the suburothelial space.
    MeSH term(s) Algorithms ; Animals ; Calcium Signaling/physiology ; Data Interpretation, Statistical ; Electric Stimulation ; Electrophysiological Phenomena ; Fluorescent Antibody Technique ; Microscopy, Confocal ; Mucous Membrane/drug effects ; Mucous Membrane/physiology ; Muscle Contraction/physiology ; Muscle, Smooth, Vascular/physiology ; Purinergic P2Y Receptor Agonists/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Signal Transduction/physiology ; Spinal Cord Injuries/physiopathology ; Uridine Diphosphate/therapeutic use ; Uridine Triphosphate/therapeutic use ; Urinary Bladder/drug effects ; Urinary Bladder/physiology ; Urinary Bladder, Overactive/drug therapy ; Urinary Bladder, Overactive/physiopathology ; Urothelium/physiology
    Chemical Substances Purinergic P2Y Receptor Agonists ; Uridine Diphosphate (58-98-0) ; Uridine Triphosphate (UT0S826Z60)
    Language English
    Publishing date 2012-02-22
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 603837-2
    ISSN 1522-1466 ; 0363-6127
    ISSN (online) 1522-1466
    ISSN 0363-6127
    DOI 10.1152/ajprenal.00436.2011
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  7. Article ; Online: Animal models and their use in understanding lower urinary tract dysfunction.

    Fry, C H / Daneshgari, F / Thor, K / Drake, M / Eccles, R / Kanai, A J / Birder, L A

    Neurourology and urodynamics

    2010  Volume 29, Issue 4, Page(s) 603–608

    Abstract: This review will highlight appropriate animal models for the study of a number of disorders involving changes to lower urinary tract function. A major hurdle to the development of animal models for human lower urinary tract disorders is that the clinical ...

    Abstract This review will highlight appropriate animal models for the study of a number of disorders involving changes to lower urinary tract function. A major hurdle to the development of animal models for human lower urinary tract disorders is that the clinical pathophysiology of the latter mostly remain idiopathic. Acute injury/inflammation of otherwise healthy animals has often been used to study effects on a target tissue/organ. However, these "acute" models may not adequately address the characteristics of "chronic" visceral disorders. In addition, the relevance of observed changes following acute injury/inflammation, in terms of possible therapeutic targets, may not reflect that which occurs in the human condition. We have therefore emphasized the situations when animal models are required to investigate lower urinary tract disorders and what they should set out to achieve. In particular we have discussed the merits and disadvantages of a number of paradigms that set out to investigate specific lower urinary tract disorders or situations associated with these conditions. These include animal models of overactive bladder, stress urinary incontinence, ageing and congenital defects of the urinary tract and bladder pain syndrome.
    MeSH term(s) Animals ; Congenital Abnormalities/physiopathology ; Disease Models, Animal ; Humans ; Urethra/physiopathology ; Urinary Bladder/physiopathology ; Urinary Bladder, Overactive/physiopathology ; Urinary Incontinence/physiopathology ; Urinary Tract/physiopathology ; Urologic Diseases/physiopathology
    Language English
    Publishing date 2010-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604904-7
    ISSN 1520-6777 ; 0733-2467
    ISSN (online) 1520-6777
    ISSN 0733-2467
    DOI 10.1002/nau.20903
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: DMSO: effect on bladder afferent neurons and nitric oxide release.

    Birder, L A / Kanai, A J / de Groat, W C

    The Journal of urology

    1997  Volume 158, Issue 5, Page(s) 1989–1995

    Abstract: Purpose: Interstitial cystitis (IC), a chronic disorder of the urinary bladder, is characterized by increased voiding frequency, urgency and pain. Patients with IC also exhibit reduced urinary nitric oxide synthase activity. Intravesical administration ... ...

    Abstract Purpose: Interstitial cystitis (IC), a chronic disorder of the urinary bladder, is characterized by increased voiding frequency, urgency and pain. Patients with IC also exhibit reduced urinary nitric oxide synthase activity. Intravesical administration of dimethyl sulfoxide (DMSO) has been used to provide symptomatic relief in patients with IC. The present experiments were undertaken to determine if intravesical DMSO affects neural pathways involved in bladder function in the rat and if DMSO can influence the release of nitric oxide in the bladder or from afferent neurons.
    Materials and methods: The effects of intravesical DMSO (10% solution in saline) on reflex bladder activity, firing on bladder nerves and c-fos gene expression in spinal neurons was examined in urethane anesthetized female Wistar rats. The effect of DMSO (1-10%) on nitric oxide release from urinary bladder strips or acutely dissociated dorsal root ganglion cells was monitored in vitro with a porphyrinic microsensor.
    Results: DMSO acutely increased reflex firing of pelvic nerve efferent axons, decreased bladder capacity and also increased neuronal c-fos expression in spinal cord regions that exhibit c-fos expression after chemical activation of capsaicin-sensitive bladder afferents. DMSO, like capsaicin, also directly released nitric oxide (NO) from both dissociated dorsal root ganglion neurons and from isolated strips of urinary bladder.
    Conclusions: These results suggest that DMSO induced stimulation of bladder afferent pathways and NO release from afferent neurons may be a reflection of the initial event in the desensitization of nociceptive pathways in the lower urinary tract (LUT).
    MeSH term(s) Administration, Intravesical ; Administration, Topical ; Animals ; Anti-Inflammatory Agents/therapeutic use ; Capsaicin/pharmacology ; Dimethyl Sulfoxide/therapeutic use ; Female ; In Vitro Techniques ; Neurons, Afferent/drug effects ; Neurons, Afferent/physiology ; Nitric Oxide/metabolism ; Proto-Oncogene Proteins c-fos/biosynthesis ; Rats ; Rats, Wistar ; Spinal Cord/metabolism ; Urinary Bladder/drug effects ; Urinary Bladder/innervation ; Urinary Bladder/metabolism ; Urinary Bladder/physiopathology
    Chemical Substances Anti-Inflammatory Agents ; Proto-Oncogene Proteins c-fos ; Nitric Oxide (31C4KY9ESH) ; Capsaicin (S07O44R1ZM) ; Dimethyl Sulfoxide (YOW8V9698H)
    Language English
    Publishing date 1997-11
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1016/s0022-5347(01)64199-5
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  9. Article: Altered inducible nitric oxide synthase expression and nitric oxide production in the bladder of cats with feline interstitial cystitis.

    Birder, L A / Wolf-Johnston, A / Buffington, C A / Roppolo, J R / de Groat, W C / Kanai, A J

    The Journal of urology

    2005  Volume 173, Issue 2, Page(s) 625–629

    Abstract: Purpose: Alterations in nitric oxide (NO) levels have been demonstrated in some humans with interstitial cystitis (IC) as well as in chemically induced animal models of cystitis. Thus, in the current study we investigated whether inducible NO synthase ( ... ...

    Abstract Purpose: Alterations in nitric oxide (NO) levels have been demonstrated in some humans with interstitial cystitis (IC) as well as in chemically induced animal models of cystitis. Thus, in the current study we investigated whether inducible NO synthase (iNOS) mediated NO production is altered in the bladder of cats with a naturally occurring model of IC termed feline IC (FIC).
    Materials and methods: We examined iNOS expression using Western immunoblotting and baseline NO production using an NO microsensor from smooth muscle and mucosal bladder strips in 9 healthy cats and 6 diagnosed with FIC.
    Results: There was a significant increase in baseline NO production in cats with FIC compared with that in healthy cats in smooth muscle and mucosal strips. This production was not ablated in the absence of extracellular Ca (100 microM egtazic acid) or following incubation with the calmodulin antagonist trifluoroperazine (20 microM), indicating iNOS mediated Ca independent NO production. Release was significantly decreased following incubation with the NOS antagonist L-NAME (N-nitro-L-arginine methyl ester) (100 microM). Furthermore, immunoblotting revealed a trend toward increased iNOS expression in smooth muscle and mucosal strips from FIC cats but not from healthy cats.
    Conclusions: In light of previous findings that the barrier property of the urothelial surface is disrupted in FIC and iNOS mediated increase in NO alters barrier function in other types of epithelium our findings suggest that iNOS dependent NO production may have a role in epithelial barrier dysfunction in FIC.
    MeSH term(s) Animals ; Cats ; Cystitis, Interstitial/metabolism ; Nitric Oxide/biosynthesis ; Nitric Oxide Synthase/biosynthesis ; Urinary Bladder/metabolism
    Chemical Substances Nitric Oxide (31C4KY9ESH) ; Nitric Oxide Synthase (EC 1.14.13.39)
    Language English
    Publishing date 2005-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/01.ju.0000145900.22849.1d
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Adrenergic- and capsaicin-evoked nitric oxide release from urothelium and afferent nerves in urinary bladder.

    Birder, L A / Apodaca, G / De Groat, W C / Kanai, A J

    The American journal of physiology

    1998  Volume 275, Issue 2, Page(s) F226–9

    Abstract: Nitric oxide (NO) has been implicated in the regulation of the lower urinary tract. However, the source(s) of NO production in the urinary bladder (UB) has not been determined. Accordingly, we used a porphyrinic microsensor placed on the surface of UB ... ...

    Abstract Nitric oxide (NO) has been implicated in the regulation of the lower urinary tract. However, the source(s) of NO production in the urinary bladder (UB) has not been determined. Accordingly, we used a porphyrinic microsensor placed on the surface of UB strips in vitro to directly measure endogenous NO production. The afferent neurotoxin, capsaicin, and the mixed alpha/beta-adrenergic agonist, norepinephrine (NE), both evoked transient (1-3 s) NO release (range 50 nM to 1.4 microM). Adrenergic-mediated release was not decreased following denervation of the UB but was abolished following selective removal of the mucosa. On the other hand, release evoked by capsaicin (range 50-900 nM) was significantly decreased after UB denervation. These data indicate that NE releases NO from UB epithelium, and capsaicin releases NO from epithelium as well as nervous tissue in the UB. In light of reports that NO may regulate epithelial integrity and function in other tissues, agonist regulation of a constitutive nitric oxide synthase activity in the UB may provide a novel mechanism for modulation of bladder and urothelial function.
    MeSH term(s) Adrenergic Agonists/pharmacology ; Afferent Pathways/drug effects ; Afferent Pathways/physiology ; Animals ; Biosensing Techniques ; Capsaicin/pharmacology ; Cells, Cultured ; Equipment Design ; Female ; In Vitro Techniques ; Male ; Muscle Denervation ; Nitric Oxide/metabolism ; Norepinephrine/pharmacology ; Porphyrins ; Rats ; Rats, Wistar ; Urinary Bladder/drug effects ; Urinary Bladder/innervation ; Urinary Bladder/physiology ; Urothelium/drug effects ; Urothelium/physiology
    Chemical Substances Adrenergic Agonists ; Porphyrins ; Nitric Oxide (31C4KY9ESH) ; Capsaicin (S07O44R1ZM) ; Norepinephrine (X4W3ENH1CV)
    Language English
    Publishing date 1998
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2948-8
    ISSN 0002-9513
    ISSN 0002-9513
    DOI 10.1152/ajprenal.1998.275.2.F226
    Database MEDical Literature Analysis and Retrieval System OnLINE

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