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COX Inhibitors and Overactive Bladder: The Potential for Future Therapy

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Abstract

Studies spanning four decades suggest that prostaglandins (PGs) are synthesized at high levels within the bladder by cyclooxygenase (COX)-1 and COX-2 and that PG biosynthesis during bladder filling provides a non-neuronal vesicular volume signal. Evidence is presented that interstitial cells of Cajal within the bladder seem to play a key role in PG biosynthesis, that bladder PG concentration is a function of the degree of bladder wall stretch, and that PGs serve to 1) assist in detrusor smooth muscle length adaptation of tension during bladder storage by permitting synchronized spontaneous rhythmic contraction, 2) positively modulate sensory recognition of the bladder fill state, and 3) enhance voiding contraction. Provocative clinical and experimental data support a role for PGs in overactive bladder, but the data are of limited scope. Additional studies are needed to clarify the roles played by mechanical stretch, COX isotypes, PG species and receptor subtypes, and cell-to-cell communication in bladder biology.

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Authors and Affiliations

  1. Departments of Biochemistry and Molecular Biology and Pediatrics, Virginia Commonwealth University School of Medicine, 1101 East Marshall Street, P. O. Box 980614, Richmond, VA, 23298-0614, USA

    Paul H. Ratz

  2. Department of Mechanical Engineering, Virginia Commonwealth University, 401 West Main Street, P. O. Box 843015, Richmond, VA, 23284-3015, USA

    John E. Speich

  3. Department of Surgery, Urology Division, Virginia Commonwealth University School of Medicine, VCU Medical Center, P. O. Box 980118, Richmond, VA, 23298-0118, USA

    Adam P. Klausner

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  1. Paul H. Ratz
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Correspondence to Paul H. Ratz.

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Ratz, P.H., Speich, J.E. & Klausner, A.P. COX Inhibitors and Overactive Bladder: The Potential for Future Therapy. Curr Bladder Dysfunct Rep 5, 4–12 (2010). https://doi.org/10.1007/s11884-009-0037-8

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