A COMPARISON OF THE MODE OF ACTION OF ATP AND CARBACHOL ON ISOLATED HUMAN DETRUSOR SMOOTH MUSCLE

Purpose: The objectives of the study were: i) to examine the ability of carbachol and ATP to raise intracellular [Ca 2+ ] in isolated detrusor myocytes; ii) to determine the origin of the intracellular Ca 2+ and iii) to address the question of whether the appearance of purinergic contractions in detrusor from unstable and obstructed human bladders is reflected in the sensitivity of the cell to the two agonists. Materials and Methods: Intracellular Ca 2+ transients generated by extracellular ATP and carbachol were recorded from isolated human detrusor myocytes. Cells were dissociated by collagenase disruption of the biopsy. Intracellular Ca 2+ was measured by epifluorescence microscopy using Fura-2 and electrophysiological recordings were made with patch electrodes. Results: In cells from stable bladder biopsies the half-maximal concentrations (EC 50 ) for ATP and carbachol to generate Ca 2+ transients were 0.10 and 0.25 μM respectively. With cells from unstable bladders the EC 50 values for both agonists and the magnitude of the Ca 2+ transients were not significantly different from those obtained in cells from normal bladders. The transient in ATP was preceded by a transient depolarisation generated by a large inward current. The carbachol-Ca 2+ transient was independent of changes to membrane potential, except in a subset of cells where complex membrane potential changes followed the rise of intracellular Ca 2+ . The ATP-Ca 2+ transient was partially abolished by nicardipine and completely abolished by zero-Ca solutions, the carbachol-Ca 2+ transient was unaffected by nicardipine and less completely attenuated by zero-Ca solutions. Prior exposure to caffeine suggested that the carbachol-Ca 2+ transient, but not the ATP-Ca 2+ transient, originated from intracellular stores. Conclusions: It is concluded that both agonists are equipotent in increasing intracellular Ca 2+ , but by different routes. The generation of purinergic contractions in detrusor from unstable bladder is not due to altered sensitivities of the detrusor myocyte to ATP or cholinergic agonists.