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Urinary Tract pp 375–393Cite as

Ion Channel Modulators and Urinary Tract Function

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Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 2011))

Abstract

The membrane potential fulfils an important role in initiating smooth muscle contraction, through its depolarization and the subsequent influx of Ca2+ through voltage-gated Ca2+ channels. Changes in membrane potential can also coordinate contraction across great distances, utilizing the speed of electrical current flow through gap junctions. Hence, regulating membrane potential can greatly influence smooth muscle function. In this chapter, we will consider the influence of ion channels, as dynamic gatekeepers of membrane permeability, on urogenital function. Through their ability to act as key regulators of both the resting membrane potential and its dynamic changes, they provide important pharmacological targets for influencing urogenital function.

Urogenital smooth muscle and urothelia contain a diverse range of molecularly and functionally distinct K+ channels, which are key to regulating the resting membrane and for re-establishing the normal membrane potential following both active and passive changes. The voltage-gated Ca2+ channels are key to initiating contraction and causing rapid depolarization, supplemented in some smooth muscles by rapid Na+ conductances. The Cl− channels, often assumed to be passive, can actively change the membrane potential, and hence, cellular function, because Cl− is not usually at its equilibrium potential. The useful ways in which these ion channels can be targeted therapeutically in the ureter, bladder and urethra are discussed, focussing particularly on treatments for ureteric obstruction and detrusor overactivity. Current treatments for many urinary tract disorders, particularly the overactive bladder, are complicated by side effects. While ion channels have traditionally been considered as poor therapeutic targets by the pharmaceutical industry, our increasing knowledge of the molecular diversity of K+ and Cl− channels gives new hope for more narrowly focused drug targeting, while the exciting discoveries of active currents in interstitial cells give us a new set of cellular targets for drugs.

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Authors and Affiliations

  1. Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, UK

    A. F. Brading

  2. School of Clinical and Experimental Medicine, University of Birmingham, IBR Wolfson Drive, Medical School, Birmingham, B15 2TT, UK

    K. L. Brain

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  1. A. F. Brading
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  2. K. L. Brain
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Correspondence to A. F. Brading .

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Editors and Affiliations

  1. Wake Forest University, Medical Center Blvd., Winston-Salem, 27157-1088, North Carolina, USA

    Karl-Erik Andersson

  2. Academic Medical Center, Dept. Pharmacology & Pharmacotherapy, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ, Netherlands

    Martin C. Michel

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Brading, A.F., Brain, K.L. (2011). Ion Channel Modulators and Urinary Tract Function. In: Andersson, KE., Michel, M. (eds) Urinary Tract. Handbook of Experimental Pharmacology, vol 2011. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16499-6_18

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