Intracellular Signaling Pathways of Muscarinic Acetylcholine Receptor-Mediated Detrusor Muscle Contractions.

Acetylcholine plays an essential role in the regulation of detrusor muscle contractions, and antimuscarinics are widely used in the management of overactive bladder syndrome. However, several adverse effects limit their application and patients' compliance. Thus, this study aimed to further analyze the signal transduction of M-2 and M3 receptors in the murine urinary bladder to eventually find more specific therapeutic targets. Experiments were performed on adult male wild-type, M-2, M-3, M-2/M-3, or G alpha(q/11) knockout (KO), and pertussis toxin (PTX)-treated mice. Contraction force and RhoA activity were measured in the urinary bladder smooth muscle (UBSM). Our results indicate that carbamoylcholine (CCh)-induced contractions were associated with increased activity of RhoA and were reduced in the presence of the Rho-associated kinase (ROCK) inhibitor Y-27632 in UBSM. CCh-evoked contractile responses and RhoA activation were markedly reduced in detrusor strips lacking either M-2 or M-3 receptors and abolished in M-2/M-3 KO mice. Inhibition of G alpha(i)-coupled signaling by PTX treatment shifted the concentration-response curve of CCh to the right and diminished RhoA activation. CCh-induced contractile responses were markedly decreased in G alpha(q/11) KO mice; however, RhoA activation was unaffected. In conclusion, cholinergic detrusor contraction and RhoA activation are mediated by both M-2 and M-3 receptors. Furthermore, whereas both G alpha(i) and G alpha(q/11) proteins mediate UBSM contraction, the activation at the RhoA-ROCK pathway appears to be linked specifically to G alpha(i). These findings may aid the identification of more specific therapeutic targets for bladder dysfunctions. NEW & NOTEWORTHY Muscarinic acetylcholine receptors are of utmost importance in physiological regulation of micturition and also in the development of voiding disorders. We demonstrate that the RhoA-Rho-associated kinase (ROCK) pathway plays a crucial role in contractions induced by cholinergic stimulation in detrusor muscle. Activation of RhoA is mediated by both M-2 and M-3 receptors as well as by G(i) but not G(q/11) proteins. The G(i)-RhoA-ROCK pathway may provide a novel therapeutic target for overactive voiding disorders.