Morphofunctional and Clinical Significance of the Interstitial Cells of Cajal in the Urinary Bladder (Review Article)

Abstract

The therapy of symptoms of the lower urinary tract that in most cases are caused by benign prostatic hyperplasia is one of challenges for modern medicine. Knowing the origin of bladder muscle hyperactivity will promote the treatment in this group of patients. The studies of interstitial cells of Cajal in the urinary bladder open up new opportunities to widen our understanding of bladder physiology. The purpose of this study is to conduct an analytical review of the literature on the role of interstitial cells of Cajal in the physiology of the urinary bladder. We investigated the current literature highlighting the morphological and physiological significance of interstitial cells of Cajal in the urinary bladder. Interstitial cells of Cajal are in close proximity to muscle cells, vegetative nerve endings and urothelial cells. There is increasing evidence that interstitial cells of Cajal play a role in the development of lower urinary tract symptoms. Interstitial cells of Cajal may be responsible for generating electrical potentials and inducing detrusor muscle contractions. New pathomechanisms of the development of bladder hyperactivity were put forward, namely: impairment of spontaneous contractility caused by altered signal transduction of interstitial Cajal cells between nerves and detrusor muscle cells; change in signal transmission through suburothelial interstitial cells of Cajal. The c–kit receptor is not only a marker for identifying these cells, but may also play a critical role in controlling bladder function. Interstitial cells of Cajal, discovered more than 100 years ago, are still remaining a poorly studied object. Having long processes, interstitial cells of Cajal form multiple contacts with smooth muscle and nerve cells, building up a specific network. Current knowledge about interstitial cells of Cajal in the urinary bladder suggest that these cells and c–kit receptors may become a new “target” for the pharmaceutical therapy of lower urinary tract symptoms and overactive bladder.