Vol. 50, Issue 4, 683-722, December 1998

Myogenic and Neurogenic Factors in the Control of Pyeloureteral Motility and Ureteral Peristalsis

Paolo Santicioli^a and Carlo Alberto Maggi

Pharmacology Department, Menarini Ricerche, Florence, Italy

I. Introduction
II. The Myogenic Theory of Ureteral Peristalsis
    A. The Pacemaker Function of the Renal Pelvis
    B. Propagation of the Pacemaker Signal
    C. Latent Pacemakers and Antiperistalsis
III. Myogenic Factors Regulating Motility of Renal Pelvis and Ureter
    A. Action Potentials Recorded from the Smooth Muscle of the Pyeloureteral Tract
        1. Action potentials in the renal pelvis.
        2. Action potentials in the ureter.
    B. Characterization of Ionic Currents/Channels
        1. The calcium current.
        2. Potassium (K) currents.
        3. Sodium currents.
    C. Excitation-Contraction Coupling in the Renal Pelvis and Ureter
        1. Role of extracellular calcium.
        2. Role of the internal calcium store.
        3. Sodium/calcium exchange.
        4. Role of intracellular pH.
    D. The Refractory Period of the Ureter
    E. Modulatory Influence of Prostanoids
    F. An Integrated View of Myogenic Factors Regulating Excitation-Contraction Coupling in the Renal Pelvis and Ureter
IV. Innervation of the Renal Pelvis and Ureter
    A. Sources of Innervation to the Pyeloureteral Tract
    B. Distribution of Nerves
    C. Ureteric Ganglia
    D. Cholinergic Nerves
    E. Noradrenergic Nerves
    F. Tachykinins and Calcitonin Gene-Related Peptide
    G. Neuropeptide Y
    H. Vasoactive Intestinal Polypeptide
    I. Nitroxergic Nerves
    J. Efferent Roles of Nerves in the Pyeloureteral Tract
V. Sensory Neuropeptides in the Pyeloureteral Complex: Release, Actions, and Receptors
    A. Adequate Stimuli and Mechanisms Regulating the Release of Sensory Neuropeptides
    B. Actions and Neurotransmitter Role of Sensory Neuropeptides in the Pyeloureteral Tract
    C. Mechanisms of the Inhibitory Action of CGRP
        1. CGRP, hyperpolarization and blockade of phasic contractions.
        2. CGRP and cAMP accumulation.
        3. Role of intracellular calcium in the action of calcitonin gene-related peptide.
        4. Influence of "exercise" and glucose metabolism on the action of calcitonin gene-related peptide.
    D. Sensory Nerves and Inflammation
VI. Pyeloureteral Reflexes
    A. Afferent Nerves and Reflexes Arising from the Renal Pelvis
    B. Afferent Nerves and Reflexes Arising from the Ureter
VII. Ureteral Pain
VIII. Pathophysiological Significance of the Sensory Innervation of the Pyeloureteral Complex
Acknowledgments
References