Myogenic and neurogenic factors in the control of pyeloureteral motility and ureteral peristalsis

P Santicioli, CA Maggi - Pharmacological Reviews, 1998 - ASPET
P Santicioli, CA Maggi
Pharmacological Reviews, 1998ASPET
The main, and possibly only, function of the pyeloureteral complex is to ensure the
unidirectional transport of urine from the kidney to the urinary bladder. An extremely efficient
set of mechanisms operates to achieve this target: the basic process regulating ureteral
peristalsis is myogenic, being initiated by spontaneously active pacemaker cells in the renal
pelvis. In recent years, the mechanisms of excitability and electromechanical coupling in
ureter cells have been extensively investigated; several pharmacological tools have been …
The main, and possibly only, function of the pyeloureteral complex is to ensure the unidirectional transport of urine from the kidney to the urinary bladder. An extremely efficient set of mechanisms operates to achieve this target: the basic process regulating ureteral peristalsis is myogenic, being initiated by spontaneously active pacemaker cells in the renal pelvis. In recent years, the mechanisms of excitability and electromechanical coupling in ureter cells have been extensively investigated; several pharmacological tools have been instrumental for a further understanding of the myogenic regulation of pyeloureteral motility. A role of innervation in regulating pyeloureteral motility has been advocated from time to time (See Boyarsky and Labay, 1969; Weiss, 1992; Amann, 1993) but its definition has remained elusive until recently. In particular, a convincing proof for a local control of ureteral motility by cholinergic or noradrenergic nerves has not been obtained. The existence of a prominent sensory innervation of the renal pelvis and ureter is self-evident when considering that renal colic arising from the presence/passage of a stone along the ureter is one of the most intense and vivid forms of visceral pain. In the past few years, important advancements have been made through the recognition of the role of sensory innervation in determining local changes of pyeloureteral motility and in producing neurogenic inflammation. In both areas of investigation (myogenic and neurogenic regulation of pyeloureteral function), the use of novel drugs and pharmacological tools has been instrumental to unravel principles of physiological or pathophysiological relevance. Our purpose is to bring together the new information obtained regarding the myogenic and neurogenic factors regulating pyeloureteral motility, ureteral pain, and inflammation and to discuss this recently obtained information on the background of the previous literature.
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