Urologie pro praxi 3/2002
Význam subtypů alfa 1A – adrenoceptorů v terapii symptomů dolních močových cest (LUTS) a benigní hyperplazie prostaty
The significance of the subtype alpha 1A adrenoreceptor in the therapy of low urinary tract symptoms (LUTS) and benign prostatic hyperplasia One of the basic groups of drugs for the treatment of benign hyperplasia of the prostate is represented by the alpha blockers. Drugs in use at the present time are, without exception, solely directed against the alpha 1 receptors. Many studies have demonstrated that the efficacy of each agent used is the same, but they differ by the range of side-effects experienced by their normal therapeutic doses. There has therefore been an effort to divide these alpha blockers according to their affinity for a particular subtype of alpha-1 receptor. The subtypes alpha 1-A, -B and -D, plus L and H (low and high affinity) have now been classified according to their structure and their sensitivity to prazosin. Recently, the interest in the prostate and the uvula of the urinary bladder, in which there is found a high concentration of the subtype alpha 1-A receptors, has diminished, while focus has now shifted towards the identification of other subtypes prevalent in other regions (detrusor of the bladder, spinal cord, central nervous system and cardiovascular system). It has been shown that during the development of obstruction (not only due to BHP) there has been a rearrangement of the proportion of particular subtypes of receptors (up or down regulation), and mainly in the bladder. The blockage of these receptors has been shown to lead to a significant improvement of some of the subjective symptoms of a patient. Thus, alpha blockers could be used in the management of obstruction caused by another aetiology, or could even be beneficial for similar problems in women. Key words: prostate, BHP, bladder, subtypes of alpha receptors.
