title: A quantitative study of atropine-resistant contractile responses in human detrusor smooth muscle, from stable, unstable and obstructed bladders.
abstract: OBJECTIVE
  The objective of the study was to quantify in vitro the magnitude of atropine-resistant contractions using human detrusor samples and to determine the cellular processes underlying these contractions.
  
  
  METHODS
  Isometric contractile responses were measured in isolated strips of human detrusor muscle obtained from patients with i) stable, ii) unstable or iii) obstructed bladders. Preparations were electrically stimulated or exposed to carbachol and ATP in the superfusate.
  
  
  RESULTS
  Force-frequency curves were shifted to the right in samples from unstable and obstructed bladders. These same tissue groups also showed significant atropine-resistant contractions which were abolished by the neurotoxin TTX, or the non-hydrolysable ATP analog, alpha,beta-methylene ATP, suggesting that these contractions were mediated by neurally released ATP. Sub-division of the patient group with unstable bladders demonstrated that those with neuropathic instability did not show atropine-resistance, whereas those with idiopathic instability or secondary instability after obstruction did show atropine-resistant contractions. The potency of carbachol in generating a contracture was significantly greater than ATP (mean EC50 0.65 microM and 151 microM respectively) however, for each agonist there was no difference in potency between the three patient groups. Direct muscle excitability was similar in all three patient groups.
  
  
  CONCLUSIONS
  It is concluded that purinergic, atropine-resistant contractions are present in some types of dysfunctional bladder, and these are not caused by a differential sensitivity of the muscle to ATP and cholinergic agonists.
authors.affiliation: Institute of Urology & Nephrology, University College London, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Bayliss
authors.forename: C
authors.initials: C
authors.lastname: Wu
authors.forename: D
authors.initials: D
authors.lastname: Newgreen
authors.forename: A R
authors.initials: AR
authors.lastname: Mundy
authors.forename: C H
authors.initials: CH
authors.lastname: Fry
mesh_terms: D000255:Adenosine Triphosphate / Q000031:analogs & derivatives / Q000494:pharmacology; D001285:Atropine / Q000494:pharmacology*; D002217:Carbachol / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects*; D009130:Muscle, Smooth / Q000187:drug effects*; D013779:Tetrodotoxin / Q000494:pharmacology; D001743:Urinary Bladder / Q000187:drug effects* / Q000502:physiology*; D001748:Urinary Bladder Neck Obstruction / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology*
chemical_list: D013779:Tetrodotoxin; D001285:Atropine; D000255:Adenosine Triphosphate; D002217:Carbachol; C002630:alpha,beta-methyleneadenosine 5'-triphosphate