[New methods of patient selection for improved anticholinergic therapy].
BACKGROUND
M3-specific inhibitors are currently preferred for anticholinergic therapy of OAB. However, not all of the patients profit from this regimen. This might reflect a heterogeneity of the patient group. The aim of this work is to define subgroups of patients with specific alterations of receptor expression and to profile the receptor expression individually. These receptor profiles might be used for the development of evidence-based "tailored" therapies.


METHODS
Detrusor probes from bladder carcinoma patients (BCa, n=9 F, n=7 male) and interstitial cystitis patients (IC, n=9 female) were examined using confocal immunofluorescence and PCR.


RESULTS
M2, M3, P2X1-3, and H1-3 mRNAs were demonstrated in detrusor tissue. As revealed by immunofluorescence, the M2 receptor expression was significantly higher in female compared to male BCa tissues. In addition, the M2 receptor was further upregulated in IC vs BCa in female detrusor.


CONCLUSIONS
IC patients showed specific alterations of their receptor profile. Individual receptor profiles might be used to optimize medicinal therapies.
Neuhaus
J
J
Klinik und Poliklinik für Urologie, Universitätsklinikum Leipzig AöR, Liebigstrasse 20, 04103 Leipzig. jochen.neuhaus@medizin.uni-leipzig.de
Schwalenberg
T
T
Schlichting
N
N
Schulze
M
M
Horn
L-C
LC
Stolzenburg
J-U
JU
D000199:Actins / Q000235:genetics; D000368:Aged; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D018856:Cystitis, Interstitial / Q000473:pathology; D005260:Female; D015870:Gene Expression; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D018579:Patient Selection; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000235:genetics; D011968:Receptors, Histamine / Q000187:drug effects / Q000235:genetics; D011976:Receptors, Muscarinic / Q000187:drug effects / Q000235:genetics; D011983:Receptors, Purinergic / Q000187:drug effects / Q000235:genetics; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000473:pathology; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000473:pathology; D053202:Urinary Incontinence, Urge / Q000188:drug therapy* / Q000473:pathology
C541116:ACTA2 protein, human; D000199:Actins; D018680:Cholinergic Antagonists; D012333:RNA, Messenger; D011968:Receptors, Histamine; D011976:Receptors, Muscarinic; D011983:Receptors, Purinergic