黏膜各层结构中信号通路与受体在膀胱过度活动症中的作用

The role of signal pathways and receptors in various layers of mucosa in overactive bladder

背景:已有证据表明在黏膜结构水平治疗膀胱过度活动症具有一定优势,因此关于黏膜可能参与调控膀胱传入信号传导进而改善膀胱过度活动症相关症状的实验研究逐渐成为热点。目的:综述黏膜各层结构中信号通路和受体在膀胱过度活动症发病机制中的作用功能。方法:以“膀胱过度活动症,黏膜,粘膜,尿路上皮,固有层,发病机制”等及“overactive bladder,mucosa,urothelium,lamina propria,mechanisms”等分别作为中、英文关键词,在中国知网数据库、万方数据库及PubMed数据库对2000至2020年发表的相关文献进行检索,最终纳入符合要求的49篇文献进行综述。结果与结论:①膀胱过度活动症的发病机制十分复杂的,目前研究较为深入和广泛的肌源性假说和神经源性假说是否与黏膜信号机制相互影响,或三者之间的关系报道较少;②尿路上皮信号通路是目前研究的重点,但基底膜层和固有层相关信号通路涉及较少,固有层中各类细胞及其功能尚未明确,黏膜信号与脊髓中枢和高级中枢的联系还没有得到充分研究,后期实验可对膀胱过度活动症3类发病机制之间的相互关系进行横向研究,深度纵向探究某一单条信号通路的上游或下游,为膀胱过度活动症的治疗提供更明确的作用靶点。

BACKGROUND:Evidence has shown that the treatment of overactive bladder at the level of mucosal structure has a certain advantage,so the study on the possible involvement of mucosa in regulating bladder afferent signal transduction and improving the symptoms associated with overactive bladder has gradually become a hot spot.OBJECTIVE:To review the role of signal pathways and receptors in various layers of mucosa in the pathogenesis of overactive bladder.METHODS:With the key words of“overactive bladder,mucosa,urothelium,lamina propria,mechanisms”in both English and Chinese,CNKI,WanFang and PubMed were searched for relevant literature published from 2000 to 2020,and eventually 49 articles meeting the requirements were reviewed.RESULTS AND CONCLUSION:The pathogenesis of overactive bladder is very complex.At present,there are few reports on whether the myogenic hypothesis and the neurogenic hypothesis interact with the mucosal signaling mechanism.Urothelial signaling pathway is the key of the current research,but the basement membrane layer and the lamina propria related signaling pathways are less reported.The various types of cells in the lamina propria and their functions have not been clear,and the relationship of mucosal signal with spinal cord center and senior center has not been fully research.Therefore,a horizontal study will be done on the relationship between the three types of pathogenesis of overactive bladder,and deeply and vertically explore the upstream or downstream of one of the three signal pathways,so as to provide a clearer target for the treatment of overactive bladder.