The inhibitory effect of trimetazidine on detrusor contractility - a potential repositioning of trimetazidine for the treatment of overactive bladder

J Pharm Pharmacol. 2022 Jan 5;74(1):94-102. doi: 10.1093/jpp/rgab072.

Abstract

Objectives: This study aimed to identify the effect of trimetazidine (TMZ), an antianginal drug, on detrusor smooth muscle (DSM) contractility and its possible mechanisms of action.

Methods: We performed in-vitro contractility studies on isolated mouse DSM strips and investigated the effect of TMZ on Ca2+ levels in fura-2-loaded A7r5 cells.

Key findings: TMZ (300 or 1000 µM) inhibited carbachol (CCh)- and KCl-induced contractions and produced a concentration-dependent (10-1000 µM) relaxation in KCl-precontracted DSM strips. TMZ-induced relaxation was markedly decreased by BaCl2, an inward-rectifying K+ channel blocker, but was not altered by preincubation with tetraethylammonium, glibenclamide, 4-aminopyridine, propranolol, L-NAME or methylene blue. TMZ (300 or 1000 µM) reduced both the CaCl2-induced contraction of depolarized DSM strips under Ca2+-free conditions and the CCh-induced contraction of DSM strips preincubated with nifedipine in Ca2+-containing Krebs solution. Furthermore, TMZ (1000 µM) significantly decreased the Ca2+ levels in fura-2-loaded A7r5 cells.

Conclusions: TMZ decreased DSM contractility and caused a concentration-dependent relaxation of the tissue possibly through its actions on Ca2+ transients and K+ channels. Our results provide preclinical evidence that TMZ would be a potential candidate to treat disorders related to the overactivity of the bladder.

Keywords: calcium; detrusor; fura-2; ion channels; isolated tissue bath; trimetazidine.

MeSH terms

  • Animals
  • Calcium Channel Blockers / pharmacology
  • Calcium Channels, T-Type / metabolism
  • Drug Repositioning / methods*
  • Ion Channels / metabolism
  • Mice
  • Muscle Contraction / drug effects
  • Muscle Contraction / physiology
  • Muscle, Smooth / drug effects
  • Nifedipine / pharmacology
  • Trimetazidine / pharmacology*
  • Urinary Bladder* / drug effects
  • Urinary Bladder* / pathology
  • Urinary Bladder* / physiopathology
  • Urinary Bladder, Overactive* / drug therapy
  • Urinary Bladder, Overactive* / physiopathology
  • Vasodilator Agents / pharmacology

Substances

  • Calcium Channel Blockers
  • Calcium Channels, T-Type
  • Ion Channels
  • Vasodilator Agents
  • Nifedipine
  • Trimetazidine