Muscarinic receptors: Their distribution and function in body systems, and the implications for treating overactive bladder

Paul Abrams, Karl Erik Andersson, Jerry J. Buccafusco, Christopher Chapple, William Chet De Groat, Alison D. Fryer, Gary Kay, Alan Laties, Neil M. Nathanson, Pankaj Jay Pasricha, Alan J. Wein

Research output: Contribution to journalReview article

353 Scopus citations

Abstract

1 The effectiveness of antimuscarinic agents in the treatment of the overactive bladder (OAB) syndrome is thought to arise through blockade of bladder muscarinic receptors located on detrusor smooth muscle cells, as well as on nondetrusor structures. 2 Muscarinic M 3 receptors are primarily responsible for detrusor contraction. Limited evidence exists to suggest that M 2 receptors may have a role in mediating indirect contractions and/or inhibition of detrusor relaxation. In addition, there is evidence that muscarinic receptors located in the urothelium/suburothelium and on afferent nerves may contribute to the pathophysiology of OAB. Blockade of these receptors may also contribute to the clinical efficacy of antimuscarinic agents. 3 Although the role of muscarinic receptors in the bladder, other than M 3 receptors, remains unclear, their role in other body systems is becoming increasingly well established, with emerging evidence supporting a wide range of diverse functions. Blockade of these functions by muscarinic receptor antagonists can lead to similarly diverse adverse effects associated with antimuscarinic treatment, with the range of effects observed varying according to the different receptor subtypes affected. 4 This review explores the evolving understanding of muscarinic receptor functions throughout the body, with particular focus on the bladder, gastrointestinal tract, eye, heart, brain and salivary glands, and the implications for drugs used to treat OAB. The key factors that might determine the ideal antimuscarinic drug for treatment of OAB are also discussed. Further research is needed to show whether the M 3 selective receptor antagonists have any advantage over less selective drugs, in leading to fewer adverse events.

Original languageEnglish (US)
Pages (from-to)565-578
Number of pages14
JournalBritish Journal of Pharmacology
Volume148
Issue number5
DOIs
StatePublished - Jul 5 2006

Keywords

  • Antimuscarinics
  • Bladder
  • Brain
  • Eye
  • Gastrointestinal tract
  • Heart
  • Muscarinic receptors
  • Overactive bladder
  • Salivary glands
  • Selective M antagonists

ASJC Scopus subject areas

  • Pharmacology

Fingerprint Dive into the research topics of 'Muscarinic receptors: Their distribution and function in body systems, and the implications for treating overactive bladder'. Together they form a unique fingerprint.

  • Cite this

    Abrams, P., Andersson, K. E., Buccafusco, J. J., Chapple, C., De Groat, W. C., Fryer, A. D., Kay, G., Laties, A., Nathanson, N. M., Pasricha, P. J., & Wein, A. J. (2006). Muscarinic receptors: Their distribution and function in body systems, and the implications for treating overactive bladder. British Journal of Pharmacology, 148(5), 565-578. https://doi.org/10.1038/sj.bjp.0706780