The Rise of On-Demand Research and Specific Applications: Optogenetics in Urology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creative-commons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution , and reproduction in any medium, provided the original work is properly cited. Optogenetics is a promising new field of research being applied in the treatment of various neurologic diseases. It has inspired many useful discoveries about sensory and motor neural circuits , enhancing our understanding of the underlying mechanisms of these diseases. However, studies of micturition centers and the central-peripheral neural circuits that control lower urinary tract are lacking. Therefore, the development of animal models using optogenetics—to investigate and map the central neural circuits associated with voiding–are needed, in order to advance optogenetics in neurourology. Moreover, such studies will be crucial in identifying the target neural cells activated and inhibited by optic stimulation in the brain centers. In particular, inhibition of the neural hyperactivity in the micturition centers regulated by optogenetic application is a new therapeutic approach used to treat irreversible neurogenic bladder dysfunction. As a result, it is the first step in developing an optic treatment of bladder failure [1]. The review by Lee et al. [2] in this issue is the first to introduce the optogenetic method for treating lower urinary tract dysfunction. The attempt to apply optogenetics to diagnose and treat voiding dysfunction is a valuable step in expanding the urologic field of research. However, there are several obstacles to overcome, e.g., developing specific therapeutic targets using optogenetics in real-world applications. The urothelium is controlled by neurotransmitters, releases chemical mediators, and responds to external stimuli by expressing sensory molecules. Jung et al. [3] suggest that aquapo-rin (AQP) 1 and caveolin (CAV) 1 might be closely related to bladder signaling activity and may play a specific role in bladder dysfunction. This article proposes potential roles of AQP1 and CAV1 in the urinary bladder. Phosphodiesterase (PDE)-5 inhibitors are widely prescribed for the treatment of erectile dysfunction. Researchers have attempted to identify additional related clinical applications for the PDE-5 inhibitors. Of these, mirodenafil is the most recently developed PDE-5 inhibitor and has proven clinical efficacy in the treatment of ED. The article by Choi et al. [4] in this issue suggests that mirodenafil may be useful in the clinical treatment of bladder dysfunction caused by chronic bladder ischemia. The autonomic nervous system has a prominent influence on both the filling and voiding phases of micturition. …