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Myosin light
chain kinase,
smooth muscle
Adenylyl
Cyclase
PKA complex
PKA complex
Protein kinase
C
beta-3
adrenergic
receptor
G protein
complex
Myosin LC-P
Myosin light
chain 3
Inositol 1,4,5-
trisphosphate
receptor type 1
Voltage-
dependent
L-type calcium
channel subunit
beta-1
Voltage-
dependent
L-type calcium
channel subunit
alpha-1C
Myosin light
chain
phosphatase
Calmodulin
Intermediate
conductance
calcium-
activated
potassium
channel protein
4
Phospholipase C
Guanine
nucleotide-
binding protein
alpha
Calmodulin
Guanine
nucleotide-
binding protein
G(I)/G(S)/G(T)
subunit beta-1
Guanine
nucleotide-
binding protein
G(I)/G(S)/G(O)
subunit
gamma-12
Voltage-
dependent
calcium channel
subunit
alpha-2/delta-1
Mirabegron
Ca
+
Ca
+
Ca
+
K
+
K
+
Mirabegron
GDP
GTP
ATP
cAMP
Inositol 1,4,5-trisphosphate
Phosphatidylinositol
4,5-bisphosphate
Diacylglycerol
GTP
P
i
P
i
P
i
Calcium
Ca
+
Muscle
Contraction
Muscle
Relaxation
Magnesium
Calcium
Manganese
Sarcoplasmic Reticulum
Cytosol
Detrusor Smooth Muscle Cell
Mirabegron binds to beta-3
adrenergic receptor. It is
administered as an oral
tablet.
The G protein complex
separates into alpha and
beta/gamma subunits.
GDP is replaced with GTP on
the alpha subunit.
Activated PKA can
phosphorylate calcium
activated potassium channels
causing potassium efflux and
promoting hyperpolarization.
Activated PKA phosphorylates
the IP3 receptor to reduce
its affinity for IP3.
Activated PKA phosphorylates
phospholipase C.
There is an overall decrease
in calcium levels in the
cytosol.
Decreased calcium is unable
to bind readily to
calmodulin.
The inhibition of myosin
light chain kinase prevents
the synthesis of Myosin LC-P
which leads to a high
concentration of myosin
light chain and muscle
relaxation.
Myosin unbinds from actin
causing the sarcomere
filaments to slide resulting
in muscle relaxation.
Actin Filament
Myosin Filament
MYLK
ADCY9
PRKAR1A
PRKAR2A
PRKCA
GPR109B
GNB1
MYL3
MYL3
ITPR1
CACNB1
CACNA1C
PPP1CB
CALM1
KCNN4
PLCB1
GNAS
CALM1
GNB1
GNG12
CACNA2D1
Mirabegron
Calcium
Calcium
Calcium
Potassium
Potassium
Mirabegron
Guanosine
diphosphate
Guanosine
triphosphate
Adenosine
triphosphate
cAMP
Inositol 1,4,5-
trisphosphate
Phosphatidylinositol
4,5-
bisphosphate
Diacylglycerol
Guanosine
triphosphate
Phosphate
Phosphate
Phosphate
Calcium
Muscle
Contraction
Muscle
Relaxation