title: Therapeutic targets for overactive bladder other than smooth muscle.
abstract: BACKGROUND
  For a long time, our concepts of regulation of urinary bladder function in health and disease as well as of the target structures of therapeutics have focused on detrusor smooth muscle cells. However, other structures including urothelium, afferent nerves and bladder blood vessels may also be important in pathophysiology and its treatment.
  
  
  METHODS
  Based on a selective review of literature, we discuss the role of urothelium, afferent nerve fibers and bladder blood vessels in bladder pathophysiology and as targets for treatment.
  
  
  CONCLUSIONS
  There is solid evidence now that multiple anatomical structures within the urinary bladder contribute to the regulation of its function and hence may be targets for established and emerging drugs. However, most previous studies have looked at the various target structures in isolation. In contrast, we propose that they should be seen as a network sensing and responding to alterations in the cellular environment or to xenobiotics. Studies are emerging in which the interaction of two of these structures is explored. Major advances in our understanding of bladder function are expected to result from studies integrating multiple such structures but these may be technically challenging and difficult to perform and interpret.
authors.affiliation: Department of Pharmacology, Johannes Gutenberg University , Mainz , Germany marmiche@uni-mainz.de.
authors.forename: Martin C
authors.initials: MC
authors.lastname: Michel
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Igawa
mesh_terms: D000344:Afferent Pathways / Q000378:metabolism; D000818:Animals; D015195:Drug Design; D006801:Humans; D058990:Molecular Targeted Therapy; D032389:Myocytes, Smooth Muscle / Q000378:metabolism; D009412:Nerve Fibers / Q000378:metabolism; D001743:Urinary Bladder / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology; D019459:Urothelium / Q000187:drug effects / Q000378:metabolism
keywords: afferent nerve; bladder vasculature; overactive bladder; urothelium