Emerging pharmacological targets in overactive bladder therapy: experimental and clinical evidences

International Urogynecology Journal and Pelvic Floor Dysfunction
Emilio SaccoPierfrancesco Bassi

Abstract

Antimuscarinics are the mainstay of the medical therapy for overactive bladder, but their side effects and often modest success have prompted studies on novel pharmacological approaches. In this paper, we give a systematic literature review of peer-reviewed papers on the subject. Effective nonantimuscarinic treatments are currently scarce, but many new promising compounds are emerging, which target key molecular pathways involved in micturition control. The most promising potential therapeutic targets include: nervous GABAergic, glycinergic, dopaminergic, and serotonergic systems; b-adrenoceptors and cAMP metabolism; nonadrenergic-noncholinergic mechanisms such as purinergic and neuropeptidergic systems; vanilloid receptors; bladder afferent nerves; nonneuronal bladder signaling systems including urothelium and interstitial cells; prostanoids; Rho-kinase; and different subtypes of potassium and calcium channels. Despite the enormous amount of new biologic insight, very few drugs with mechanism of action other than antimuscarinics have passed as yet the proof-of-concept stage. Further preclinical and clinical studies are urgently needed in this rapidly moving field.

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Citations

Mar 19, 2009·World Journal of Urology·Ricardo NatalinCarlos A L D'Ancona
Jun 1, 2009·Therapeutic Advances in Urology·Karl-Erik Andersson
Dec 4, 2012·Therapeutic Advances in Urology·Emilio Sacco, Riccardo Bientinesi
Feb 18, 2016·International Urogynecology Journal·Emilio SaccoDiego Currò
Sep 12, 2015·Expert Opinion on Emerging Drugs·Roopali Karmarkar, Vik Khullar
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Nov 8, 2014·International Urogynecology Journal·Emilio Sacco, Riccardo Bientinesi
Oct 21, 2016·Naunyn-Schmiedeberg's Archives of Pharmacology·Riccardo BientinesiDiego Currò
Jan 13, 2012·Urologia·Emilio SaccoPierfrancesco Bassi
Jan 31, 2012·Urologia·Emilio Sacco
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Oct 12, 2018·Expert Opinion on Pharmacotherapy·Riccardo Bientinesi, Emilio Sacco
Feb 26, 2010·Expert Opinion on Therapeutic Patents·Dario DollerChristian Thomsen
Jan 26, 2021·American Journal of Physiology. Renal Physiology·Péter József MolnárZoltán Benyó

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