Prostatic α1-Adrenoceptors: New Concepts of Function, Regulation, and Intracellular Signaling

Prostatic alpha(1)-adrenoceptors are known to be involved in the pathophysiology of lower urinary tract symptoms (LUTS) in patients with benign prostate obstruction (BPO). It is widely accepted that enhanced alpha(1)-adrenergic smooth muscle contraction can contribute to bladder outlet obstruction; alpha(1)-adrenoceptor antagonists still represent a gold standard in the treatment of LUTS. Accordingly, expression and function of alpha(1)-adrenoceptors in the prostate have attracted large attention over the last three decades. However, recent preclinical studies have challenged our understanding of prostatic alpha(1)-adrenoceptors. In the current review article, we summarize modern'' concepts of prostatic alpha(1)-adrenoceptors which include novel intracellular mediators of contraction as well as non-contractile signaling and post-translational receptor regulation. Configuration of alpha(1)-adrenoceptors with binding partners may determine its function, leading to a dynamic receptor with high functional plasticity. Cooperative regulation of different intracellular effectors (MAPK, Akt, transcription factors) by alpha(1)-adrenoceptors, hormones or growth factors has been suggested. The prostatic alpha(1)-adrenoceptor is no longer being regarded as an isolated, static receptor exclusively mediating prostatic smooth muscle contraction by G proteins, but a dynamic receptor interacting with other receptors within a complex network of mediators. (C) 2013 Wiley Periodicals, Inc.