Is the urothelium intelligent?
- 22 April 2010
- journal article
- review article
- Published by Wiley in Neurourology and Urodynamics
- Vol. 29 (4), 598-602
- https://doi.org/10.1002/nau.20914
Abstract
The urothelium separates the urinary tract lumen from underlying tissues of the tract wall. Previously considered as merely an effective barrier between these two compartments it is now recognized as a more active tissue that senses and transduces information about physical and chemical conditions within the urinary tract, such as luminal pressure, urine composition, etc. To understand this sensory function it is useful to consider the urothelium and suburothelium as a functional unit; containing uroepithelial cells, afferent and efferent nerve fibers and suburothelial interstitial cells. This structure responds to alterations in its external environment through the release of diffusible agents, such as ATP and acetylcholine, and eventually modulates the activity of afferent nerves and underlying smooth muscles. This review considers different stresses the urothelium/suburothelium responds to; the particular chemicals released; the cellular receptors that are consequently affected; and how nerve and muscle function is modulated. Brief consideration is also to regional differences in the urothelium/suburothelium along the urinary tract. The importance of different pathways in relaying sensory information in the normal urinary tract, or whether they are significant only in pathological conditions is also discussed. An operational definition of intelligence is used, whereby a system (urothelium/suburothelium) responds to external changes, to maximize the possibility of the urinary tract achieving its normal function. If so, the urothelium can be regarded as intelligent. The advantage of this approach is that input–output functions can be mathematically formulated, and the importance of different components contributing to abnormal urinary tract function can be calculated. Neurourol. Urodynam. 29:598–602, 2010.Keywords
This publication has 62 references indexed in Scilit:
- ATP release from the human ureter on distension and P2X3 receptor expression on suburothelial sensory nervesPurinergic Signalling, 2008
- Modulation of bladder myofibroblast activity: implications for bladder functionAmerican Journal of Physiology-Renal Physiology, 2008
- Urotheliogenic modulation of intrinsic activity in spinal cord-transected rat bladders: role of mucosal muscarinic receptorsAmerican Journal of Physiology-Renal Physiology, 2008
- VEGF receptors and neuropilins are expressed in the urothelial and neuronal cells in normal mouse urinary bladder and are upregulated in inflammationAmerican Journal of Physiology-Renal Physiology, 2008
- Heterogeneity of muscarinic receptor-mediated Ca2+ responses in cultured urothelial cells from ratAmerican Journal of Physiology-Renal Physiology, 2008
- Role of gap junctions in spontaneous activity of the rat bladderAmerican Journal of Physiology-Renal Physiology, 2007
- Activation of Urothelial Transient Receptor Potential Vanilloid 4 by 4α-Phorbol 12,13-Didecanoate Contributes to Altered Bladder Reflexes in the RatJournal of Pharmacology and Experimental Therapeutics, 2007
- Apical Epidermal Growth Factor Receptor Signaling: Regulation of Stretch-dependent Exocytosis in Bladder Umbrella CellsMolecular Biology of the Cell, 2007
- Origin of spontaneous activity in neonatal and adult rat bladders and its enhancement by stretch and muscarinic agonistsAmerican Journal of Physiology-Renal Physiology, 2007
- Mechanisms of Disease: involvement of the urothelium in bladder dysfunctionNature Reviews Endocrinology, 2007