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Li J, Yi XYL, Chen ZY, Chen B, Huang Y, Liao DZ, Wang PZ, Cao DH, Ai JZ, Liu LR. The effect of bladder function on the efficacy of transurethral prostatectomy in patients with benign prostatic hyperplasia: a retrospective, single-center study. Asian J Androl 2024; 26:112-118. [PMID: 37594295 PMCID: PMC10846830 DOI: 10.4103/aja202327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/07/2023] [Indexed: 08/19/2023] Open
Abstract
We investigated the impact and predictive value of bladder function in patients with benign prostatic hyperplasia (BPH) on the efficacy of transurethral prostatectomy. Symptomatic, imaging, and urodynamic data of patients who underwent transurethral prostatectomy at West China Hospital of Sichuan University (Chengdu, China) from July 2019 to December 2021 were collected. Follow-up data included the quality of life (QoL), International Prostate Symptom Score (IPSS), and IPSS storage and voiding (IPSS-s and IPSS-v). Moreover, urinary creatinine (Cr), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and prostaglandin estradiol (PGE2) were measured in 30 patients with BPH and 30 healthy participants. Perioperative indicators were determined by subgroup analyses and receiver operating characteristic (ROC) curve analysis. Among the 313 patients with BPH included, patients with severe micturition problems had more improvements but higher micturition grades postoperatively than those with moderate symptoms. Similarly, good bladder sensation, compliance, and detrusor contractility (DC) were predictors of low postoperative IPSS and QoL. The urinary concentrations of BDNF/Cr, NGF/Cr, and PGE2/Cr in patients were significantly higher than those in healthy participants (all P < 0.001). After evaluation, only DC was significantly related to both urinary indicators and postoperative recovery of patients. Patients with good DC, as predicted by urinary indicators, had lower IPSS and IPSS-v than those with reduced DC at the 1 st month postoperatively (both P < 0.05). In summary, patients with impaired bladder function had poor recovery. The combined levels of urinary BDNF/Cr, NGF/Cr, and PGE2/Cr in patients with BPH may be valid predictors of preoperative bladder function and postoperative recovery.
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Affiliation(s)
- Jin Li
- West China School of Medicine, Sichuan University, Chengdu 610041, China
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xian-Yan-Ling Yi
- West China School of Medicine, Sichuan University, Chengdu 610041, China
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ze-Yu Chen
- West China School of Medicine, Sichuan University, Chengdu 610041, China
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bo Chen
- West China School of Medicine, Sichuan University, Chengdu 610041, China
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yin Huang
- West China School of Medicine, Sichuan University, Chengdu 610041, China
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Da-Zhou Liao
- West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - Pu-Ze Wang
- West China School of Medicine, Sichuan University, Chengdu 610041, China
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - De-Hong Cao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jian-Zhong Ai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Liang-Ren Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
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Koukourikis P, Papaioannou M, Papanikolaou D, Apostolidis A. Urine Biomarkers in the Management of Adult Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13030468. [PMID: 36766573 PMCID: PMC9914312 DOI: 10.3390/diagnostics13030468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Neurogenic lower urinary tract dysfunction requires lifelong surveillance and management for the perseveration of patients' quality of life and the prevention of significant morbidity and mortality. Urine biomarkers are an attractive noninvasive method of surveillance for these patients. The aim of this systematic review is to search for and critically appraise studies that investigate the clinical usefulness of urine biomarkers in the management of neurogenic lower urinary tract dysfunction (NLUTD) in adults. METHODS This review was conducted according to PRISMA and MOOSE guidelines. Search strategy included PubMed, CENTRAL, and Scopus (until October 2022). Studies investigating potential urine biomarkers for the management of adults with NLUTD were included. RESULTS Fifteen studies fulfilled the criteria. To date, a variety of different urine molecules have been investigated for the diagnosis and management of neurogenic overactive bladder and detrusor overactivity (nerve growth factor, brain-derived neurotrophic factor, prostaglandin E2, prostaglandin F2α, transformation growth factor β-1, tissue inhibitor metalloproteinase-2, matrix metalloproteinase-2, substance P, microRNA), diagnosis of vesicoureteral reflux (exosomal vitronectin), urinary tract infection (neutrophil gelatinase-associated lipocalin, interleukin 6) and bladder cancer screening (cytology, BTA stat, survivin) in neurological patients. CONCLUSION Further studies are needed to specify the utility of each molecule in the management algorithm of adult NLUTD.
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Affiliation(s)
- Periklis Koukourikis
- 2nd Department of Urology, Aristotle University of Thessaloniki, General Hospital ‘Papageorgiou’, Thessaloniki 56429, Greece
| | - Maria Papaioannou
- Department of Biological Chemistry, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Dimitrios Papanikolaou
- 2nd Department of Urology, Aristotle University of Thessaloniki, General Hospital ‘Papageorgiou’, Thessaloniki 56429, Greece
| | - Apostolos Apostolidis
- 2nd Department of Urology, Aristotle University of Thessaloniki, General Hospital ‘Papageorgiou’, Thessaloniki 56429, Greece
- Correspondence: ; Tel.: +30-2310-991-476; Fax: +30-2310-681-022
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Lombardo R, Tema G, Cornu JN, Fusco F, McVary K, Tubaro A, De Nunzio C. The urothelium, the urinary microbioma and men LUTS: a systematic review. MINERVA UROL NEFROL 2020; 72:712-722. [PMID: 32550631 DOI: 10.23736/s0393-2249.20.03762-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The pathophysiology and management of male patients with lower urinary tract symptoms (LUTS) is still a matter of debate. In the past few years, the urothelium and the urinary microbiota represented important areas of research to improve the understanding and management of these patients. Aim of the present review was to summarize the available data on the urothelium and the microbiota related to male LUTS. EVIDENCE ACQUISITION A National Center for Biotechnology Information (NCBI) PubMed search for relevant articles published between January 2000 and December 2019 was performed using the medical subjects heading "urothelium," "microbioma," "microbiota," "urobioma," "urobiota," "benign prostatic hyperplasia," "benign prostatic enlargement," "lower urinary tract symptoms," "lower urinary tract dysfunction," "men," "male," "overactive bladder," "receptors." Exclusion criteria included: animal studies and studies on muscarinic and adrenergic pathways. EVIDENCE SYNTHESIS The urothelium has been recently evaluated in humans to evaluate new possible markers and pathways. New possible targets for the treatment of male LUTS include the neural growth factor, the cannabinoid, the vanilloid and the ATP pathways. However, studies in humans are still needed to elucidate the exact role of these pathways in the management of male patients with LUTS. The available evidence on the urinary microbioma in male is poor. Standing to the available, urinary microbioma is evident in healthy urine in males. Moreover, the urinary microbioma varies depending on the method of collection, sexually transmitted disease status, inflammation and urinary symptoms. A possible role of probiotics in the management of LUTS in women has been proposed and may have a role in male patients as well. CONCLUSIONS The urothelium and the urinary microbiota are still poorly studied in men with LUTS. Most of the evidence and the hypothesis on the relationship between urothelium/urinary microbiota and LUTS comes from animal/in-vitro evidence while clinical trials are lacking. These pathways seem interesting even in LUTS pathogenesis in men but their possible role as a new therapeutic target is still an open debate.
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Affiliation(s)
- Riccardo Lombardo
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy -
| | - Giorgia Tema
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Jean N Cornu
- Charles Nicolle University Hospital, Rouen Cedex, France
| | - Ferdinando Fusco
- Department of Neurosciences, Human Reproduction and Odontostomatology, University of Naples, Naples, Italy
| | - Kevin McVary
- Department of Urology, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Coelho A, Oliveira R, Antunes-Lopes T, Cruz CD. Partners in Crime: NGF and BDNF in Visceral Dysfunction. Curr Neuropharmacol 2019; 17:1021-1038. [PMID: 31204623 PMCID: PMC7052822 DOI: 10.2174/1570159x17666190617095844] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/23/2019] [Accepted: 06/03/2019] [Indexed: 12/12/2022] Open
Abstract
Neurotrophins (NTs), particularly Nerve Growth Factor (NGF) and Brain-Derived Neurotrophic Factor (BDNF), have attracted increasing attention in the context of visceral function for some years. Here, we examined the current literature and presented a thorough review of the subject. After initial studies linking of NGF to cystitis, it is now well-established that this neurotrophin (NT) is a key modulator of bladder pathologies, including Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS. NGF is upregulated in bladder tissue and its blockade results in major improvements on urodynamic parameters and pain. Further studies expanded showed that NGF is also an intervenient in other visceral dysfunctions such as endometriosis and Irritable Bowel Syndrome (IBS). More recently, BDNF was also shown to play an important role in the same visceral dysfunctions, suggesting that both NTs are determinant factors in visceral pathophysiological mechanisms. Manipulation of NGF and BDNF improves visceral function and reduce pain, suggesting that clinical modulation of these NTs may be important; however, much is still to be investigated before this step is taken. Another active area of research is centered on urinary NGF and BDNF. Several studies show that both NTs can be found in the urine of patients with visceral dysfunction in much higher concentration than in healthy individuals, suggesting that they could be used as potential biomarkers. However, there are still technical difficulties to be overcome, including the lack of a large multicentre placebo-controlled studies to prove the relevance of urinary NTs as clinical biomarkers.
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Affiliation(s)
| | | | | | - Célia Duarte Cruz
- Address correspondence to this author at the Department of Experimental Biology, Experimental Biology Unit, Faculty of Medicine of the University of Porto, Alameda Hernâni Monteiro; Tel: 351 220426740; Fax: +351 225513655; E-mail:
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Gordon A, Skarecky D, Babaian KN, Dhaliwal H, Ahlering TE. Diminished long-term recovery of peak flow rate (PFR) after robotic prostatectomy in men with baseline PFR <10 mL/s and incidental association with high-risk prostate cancer. Low Urin Tract Symptoms 2017; 11:78-84. [PMID: 29193833 DOI: 10.1111/luts.12199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/18/2017] [Accepted: 08/03/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of robot-assisted radical prostatectomy (RARP) on uroflowmetry (UF) parameters among men with baseline peak flow rates (PFR) <10 mL/s. METHODS A single-surgeon RARP database of 1082 men who underwent prospective UF testing was analyzed. Men filled out International Prostate Symptom Score questionnaires and underwent uroflowmetry and post-void bladder ultrasound before surgery and at each follow-up visit. Patients were divided into 2 groups based on preoperative PFR: those with PFR <10 mL/s (n = 158) and those with PFR ≥10 mL/s (n = 924). Univariate and multivariate regression models tested the association of preoperative characteristics in predicting postoperative PFR improvement. Within the PFR <10 mL/s group, preoperative variables were analyzed to predict pathologic outcomes. RESULTS Three months after RARP, men with baseline PFR <10 mL/s had a 3-fold improvement in PFR (from mean of 7.0 to 24.2 mL/s), whereas in men with PFR ≥10 mL/s there was a 50% improvement (from mean of 19.7 to 28.9 mL/s; P < .001). Improvement in PFR remained stable for >5 years, but mean postoperative PFR was 20% lower in men with baseline PFR <10 mL/s. Preoperative prostate-specific antigen (odds ratio [OR] 0.75; 95% confidence interval [CI] 0.59-0.95) and PFR (OR 0.52; 95% CI 0.34-0.80) were independent predictors of the percentage improvement in men with baseline PFR <10 mL/s. Preoperative PFR ≤7 mL/s was an independent predictor of Gleason score ≥8 (P = .016), seminal vesicle invasion (P = .010), and lymph node invasion (0.029). CONCLUSIONS After RARP, PFR improved significantly, with the improvement persisting over long-term follow-up. However, men with baseline PFR <10 mL/s had a 20% lower postoperative PFR over 5 years, suggesting permanent damage to the bladder and the need for early treatment to maintain bladder health. There appears to be an association between baseline PFR ≤7 mL/s and adverse pathologic features.
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Affiliation(s)
- Adam Gordon
- Department of Urology, University of California Irvine, Orange, California.,Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Douglas Skarecky
- Department of Urology, University of California Irvine, Orange, California
| | - Kara N Babaian
- Department of Urology, University of California Irvine, Orange, California
| | - Harleen Dhaliwal
- Department of Urology, University of California Irvine, Orange, California
| | - Thomas E Ahlering
- Department of Urology, University of California Irvine, Orange, California
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Kubota Y, Hamakawa T, Osaga S, Okada A, Hamamoto S, Kawai N, Kohri K, Yasui T. A kit ligand, stem cell factor as a possible mediator inducing overactive bladder. Neurourol Urodyn 2017; 37:1258-1265. [DOI: 10.1002/nau.23449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 10/06/2017] [Accepted: 10/10/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Yasue Kubota
- Department of Clinical PhysiologyNagoya City University School of Nursing Graduate School of NursingNagoyaJapan
- Department of Nephro‐urologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Takashi Hamakawa
- Department of Nephro‐urologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Satoshi Osaga
- Clinical Research Management CenterNagoya City University HospitalNagoyaJapan
| | - Atsushi Okada
- Department of Nephro‐urologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Shuzo Hamamoto
- Department of Nephro‐urologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Noriyasu Kawai
- Department of Nephro‐urologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Kenjiro Kohri
- Department of Nephro‐urologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Takahiro Yasui
- Department of Nephro‐urologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
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Current Concepts in Urinary Biomarkers for Overactive Bladder: What Is the Evidence? CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0430-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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8
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Krebs J, Pavlicek D, Stoyanov J, Pannek J, Wöllner J. Nerve growth factor does not seem to be a biomarker for neurogenic lower urinary tract dysfunction after spinal cord injury. Neurourol Urodyn 2016; 36:659-662. [PMID: 26950046 DOI: 10.1002/nau.22987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/12/2016] [Indexed: 12/24/2022]
Abstract
AIM To prospectively investigate the association of bladder function with the nerve growth factor (NGF) concentration in the urine of individuals with neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI). METHODS Individuals with chronic SCI and NLUTD presenting for a routine urologic examination at a tertiary urologic referral center were recruited for the study. Patient characteristics, the current bladder evacuation method and urodynamic parameters were collected. As controls, individuals with normal bladder function were recruited from the staff of a SCI rehabilitation center. The urinary NGF concentration was measured in triplicates by enzyme linked immunosorbent assay with a minimal sensitivity of 10 pg/ml. RESULTS The data of 10 and 37 individuals with normal bladder function and NLUTD, respectively, were analyzed. The urinary NGF concentration was below 10 pg/ml in all investigated samples. CONCLUSIONS The urinary NGF concentration did not differentiate between individuals with normal bladder function and those with NLUTD. At least in patients with SCI, the urinary NGF concentration does not seem to be a clinically relevant biomarker for NLUTD. Neurourol. Urodynam. 36:659-662, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jörg Krebs
- Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland
| | | | | | - Jürgen Pannek
- Neurourology, Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Jens Wöllner
- Neurourology, Swiss Paraplegic Centre, Nottwil, Switzerland
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Kuo HC. Potential Biomarkers Utilized to Define and Manage Overactive Bladder Syndrome. Low Urin Tract Symptoms 2015; 4 Suppl 1:32-41. [PMID: 26676698 DOI: 10.1111/j.1757-5672.2011.00131.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Clinical diagnosis of overactive bladder (OAB) syndrome has great variation and usually can only be based on subjective symptoms. Measurement of urgency severity score in adjunct with voiding diary may reflect the occurrence of OAB and incontinence severity in daily life. Urodynamic study can detect detrusor overactivity (DO), but not in all OAB patients. A more objective way and less invasive tool to diagnose and assess therapeutic outcome in OAB patients is needed. Recent investigations of the potential biomarkers for OAB include urinary and serum biomarkers and bladder wall thickness. Evidence has also shown that urinary proteins, such as nerve growth factor (NGF) and prostaglandin E2 (PGE2 ) levels increase in patients with OAB, bladder outlet obstruction (BOO) and DO. Patients with OAB have significantly higher urinary NGFlevels and urinary NGF levels decrease after antimuscarinic therapy and further decrease after detrusor botulinum toxin injections. However, the sensitivity of single urinary protein in the diagnosis of OAB is not high and several lower urinary tract diseases may also have elevated urinary NGF levels. Searching for a group of inflammatory biomarkers by microsphere-based array in urine might be a better method in differential diagnosis of OAB from interstitial cystitis, urinary tract infection (UTI) or urolithiasis. Bladder wall thickness has been widely investigated in the diagnosis of BOO and pediatric voiding dysfunction.The role of bladder wall thickness in the diagnosis of OAB, however, has not reach a consistent conclusion. We hereby review the latest medical advances in this field.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Goi Y, Tomiyama Y, Yokoyama A, Tatemichi S, Maruyama K, Kobayashi M, Yamaguchi O. Effect of silodosin, a selective α1A-adrenoceptor antagonist, on voiding behavior and bladder blood flow in a rat model of bladder outlet obstruction. Eur J Pharmacol 2015; 764:489-496. [DOI: 10.1016/j.ejphar.2015.07.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/18/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022]
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11
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Urinary nerve growth factor and a variable solifenacin dosage in patients with an overactive bladder. Int Urogynecol J 2015; 27:275-80. [DOI: 10.1007/s00192-015-2825-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022]
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Vijaya G, Cartwright R, Bhide A, Derpapas A, Fernando R, Khullar V. Reliability and validity of urinary nerve growth factor measurement in women with lower urinary tract symptoms. Neurourol Urodyn 2015; 35:944-948. [DOI: 10.1002/nau.22832] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/25/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Gopalan Vijaya
- St. Mary's Hospital-Department of Urogynaecology; London United Kingdom
| | - Rufus Cartwright
- Imperial College London-Institute of Reproductive and Developmental Biology; London United Kingdom
| | - Alka Bhide
- St. Mary's Hospital-Department of Urogynaecology; London United Kingdom
| | - Alexandros Derpapas
- St. Mary's Hospital; Imperial College Healthcare NHS Trust-Urogynaecology; London United Kingdom
| | - Ruwan Fernando
- St. Mary's Hospital; Imperial College Healthcare NHS Trust-Urogynaecology; London United Kingdom
| | - Vik Khullar
- St. Mary's Hospital-Urogynaecology Ground Floor; Cambridge Wing St. Marys Hospital; London United Kingdom
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Patra PB, Patra S. Research Findings on Overactive Bladder. Curr Urol 2015; 8:1-21. [PMID: 26195957 PMCID: PMC4483299 DOI: 10.1159/000365682] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 01/09/2014] [Indexed: 12/19/2022] Open
Abstract
Several physiopathologic conditions lead to the manifestation of overactive bladder (OAB). These conditions include ageing, diabetes mellitus, bladder outlet obstruction, spinal cord injury, stroke and brain injury, Parkinson's disease, multiple sclerosis, interstitial cystitis, stress and depression. This review has discussed research findings in human and animal studies conducted on the above conditions. Several structural and functional changes under these conditions have not only been observed in the lower urinary tract, but also in the brain and spinal cord. Significant changes were observed in the following areas: neurotransmitters, prostaglandins, nerve growth factor, Rho-kinase, interstitial cells of Cajal, and ion and transient receptor potential channels. Interestingly, alterations in these areas showed great variation in each of the conditions of the OAB, suggesting that the pathophysiology of the OAB might be different in each condition of the disease. It is anticipated that this review will be helpful for further research on new and specific drug development against OAB.
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Affiliation(s)
- Phani B. Patra
- King of Prussia, Drexel University College of Medicine, Philadelphia, Pa., USA
| | - Sayani Patra
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pa., USA
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Peyronnet B, Bendavid C, Manunta A, Damphousse M, Cheensse C, Brochard C, Castel-Lacanal E, Siproudhis L, Bensalah K, Gamé X. [The role of urinary markers in the assessment and follow-up of lower urinary tract disorders: a literature review]. Prog Urol 2014; 25:188-99. [PMID: 25482921 DOI: 10.1016/j.purol.2014.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 11/07/2014] [Accepted: 11/10/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To conduct a literature review on the role of urinary biomarkers in the initial assessment and follow-up of lower urinary tract symptoms. METHODS A literature review was conducted in August 2014 using the Medline/Pubmed database limiting the search to work in English or French. RESULTS Most studies were of level of evidence 2 or 3 (prospective cohort, controlled or not) and mainly about overactive bladder and bladder pain syndrome. Nerve Growth Factor (NGF) was the most studied and apparently the most promising in the evaluation of overactive bladder (OAB) and neurogenic detrusor overactivity (NDO). Urinary levels of ATP, prostaglandin E2 (PGE2), Brain-Derived Neurotrophic Factor (BDNF) and some cytokines were also significantly higher in most studies in patients with NDO or OAB. Epidermal Growth Factor (EGF), Heparin-Binding EGF (HBEGF) and Antiproliferative Factor (APF) were the most studied urinary markers in bladder pain syndrome, with a significant increase (EGF APF) or decrease (HBEGF) in cases of interstitial cystitis (compared to healthy controls). The urinary N-terminal-telopeptide (NTx) could be predictive of a failed mid-urethral sling. However, few studies reported the diagnostic values of the markers, their association with urodynamic parameters were rarely evaluated and the existence of a publication bias is likely. No randomized controlled study has so far compared the urinary markers to urodynamic evaluation. CONCLUSION In the future, urinary markers could complete or replace urodynamic examination. However, to date, there is no high level of evidence study comparing these markers to urodynamics and their use can therefore not be recommended in daily practice.
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Affiliation(s)
- B Peyronnet
- Service d'urologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse, France.
| | - C Bendavid
- Service de biochimie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - A Manunta
- Service d'urologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - M Damphousse
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de médecine physique et rééducation, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - C Cheensse
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de médecine physique et rééducation, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - C Brochard
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de gastro-entérologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - E Castel-Lacanal
- Service de médecine physique et rééducation, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - L Siproudhis
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de gastro-entérologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - K Bensalah
- Service d'urologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse, France
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Wada N, Matsumoto S, Kita M, Hashizume K, Kakizaki H. Decreased urinary nerve growth factor reflects prostatic volume reduction and relief of outlet obstruction in patients with benign prostatic enlargement treated with dutasteride. Int J Urol 2014; 21:1258-62. [PMID: 25039474 DOI: 10.1111/iju.12570] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/17/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine urinary nerve growth factor before and after dutasteride treatment, and to analyze correlations between clinical parameters and change of urinary nerve growth factor in patients with benign prostatic enlargement. METHODS We prospectively studied 30 patients with benign prostatic enlargement who had not been satisfied with α-adrenergic antagonist monotherapy for more than 3 months. Before and 24 weeks after dutasteride add-on treatment, we assessed International Prostate Symptom Score, prostatic volume, filling cystometry and pressure-flow study. Urinary nerve growth factor was measured by enzyme-linked immunosorbent assay, and normalized to the urinary creatinine (nerve growth factor/creatinine) before and 24 weeks after dutasteride add-on treatment. RESULTS In baseline characteristics before dutasteride, there was no significant correlation between urinary nerve growth factor/creatinine and any clinical parameters including age, International Prostate Symptom Score, prostatic volume, presence of detrusor overactivity, detrusor pressure at maximum flow rate, bladder outlet obstruction index or bladder contractility index. Dutasteride significantly reduced prostatic volume (from 68 ± 31 mL to 49 ± 28 mL) and improved International Prostate Symptom Score (from 17.2 ± 8.7 to 13.1 ± 6.8), storage (from 8.0 ± 4.3 to 6.0 ± 2.9) and voiding symptom subscore of International Prostate Symptom Score (from 9.3 ± 5.7 to 7.1 ± 4.5). In urodynamic study, detrusor pressure at maximum flow rate (from 77 ± 32 cmH2 O to 59 ± 24 cmH2 O) and bladder outlet obstruction index (from 62 ± 32 to 42 ± 27) were significantly decreased after dutasteride treatment. Urinary nerve growth factor/creatinine was significantly decreased after dutasteride from 2.61 ± 2.50 to 1.64 ± 1.68. The change of urinary nerve growth factor/creatinine significantly correlated only with the change of prostatic volume (r = 0.38) and bladder outlet obstruction index (r = 0.36). CONCLUSIONS Urinary nerve growth factor decreases in association with reduction of prostatic volume and relief of bladder outlet obstruction. Urinary nerve growth factor might be useful as a biomarker to monitor the improvement of bladder outlet obstruction in patients with benign prostatic enlargement.
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Affiliation(s)
- Naoki Wada
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Japan
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Korzeniecka-Kozerska A, Wasilewska A. Urinary nerve growth factor in patients with detrusor overactivity. Ir J Med Sci 2014; 184:737-43. [PMID: 24951086 PMCID: PMC4611025 DOI: 10.1007/s11845-014-1162-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 06/15/2014] [Indexed: 12/15/2022]
Abstract
Background Detrusor overactivity (DO) is one of the most frequent bladder dysfunctions in children up to the age of 18. Nowadays, the only way to confirm DO is by urodynamic investigation, which is an invasive procedure. Among the many mediators influencing bladder function, nerve growth factor (NGF) plays an important role. The present study was designed to measure urinary NGF (uNGF) levels in patients with DO diagnosed by urodynamic study in comparison with healthy controls. Methods The investigation was conducted on 44 children, divided into two groups (24 patients with DO, 20 healthy children). Uroflowmetry was performed in all enrolled to the study and cystometry only to patients. uNGF levels were estimated in both studied groups. Results The median uNGF level in patients with DO before treatment was higher compared with healthy controls. There were no differences between uNGF levels in patients after anticholinergic treatment and the controls. We found differences in uroflowmetry parameters between the reference group and the patients. We found correlations between uroflowmetry parameters and uNGF/cr. level. Conclusions The uNGF level could be used for detecting DO in children and adolescents. Measuring uNGF level is a simple, noninvasive procedure and very useful for choosing therapy in patients with DO in various clinical conditions.
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Affiliation(s)
- A Korzeniecka-Kozerska
- Department of Pediatrics and Nephrology, Medical University of Bialystok, 17 Waszyngtona Street, 15-274, Bialystok, Poland.
| | - A Wasilewska
- Department of Pediatrics and Nephrology, Medical University of Bialystok, 17 Waszyngtona Street, 15-274, Bialystok, Poland
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Cruz CD. Neurotrophins in bladder function: what do we know and where do we go from here? Neurourol Urodyn 2013; 33:39-45. [PMID: 23775873 DOI: 10.1002/nau.22438] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 04/30/2013] [Indexed: 12/19/2022]
Abstract
AIMS Neurotrophins (NTs) have attracted considerable attention in the urologic community. The reason for this resides in the recognition of their ability to induce plastic changes of the neuronal circuits that govern bladder function. In many pathologic states, urinary symptoms, including urgency and urinary frequency, reflect abnormal activity of bladder sensory afferents that results from neuroplastic changes. Accordingly, in pathologies associated with increased sensory input, such as the overactive bladder syndrome (OAB) or bladder pain syndrome/interstitial cystitis (BPS/IC), significant amounts of NTs have been found in the bladder wall. METHODS Here, current knowledge about the importance of NTs in bladder function will be reviewed, with a focus on the most well-studied NTs, nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF). RESULTS Both NTs are present in the bladder and regulate bladder sensory afferents and urothelial cells. Experimental models of bladder dysfunction show that upregulation of these NTs is strongly linked to bladder hyperactivity and, in some cases, pain. NT manipulation has been tested in animal models of bladder dysfunction, and recently, NGF downregulation, achieved by administration of a monoclonal antibody, has also been tested in patients with BPS/IC and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). NTs have also been found in high quantities in the urine of OAB and BPS/IC patients, raising the possibility of NTs serving as biomarkers. CONCLUSIONS Available data show that our knowledge of NTs has greatly increased in recent years and that some results may have future clinical application.
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Affiliation(s)
- Célia Duarte Cruz
- Department of Experimental Biology, Faculty of Medicine of Porto, University of Porto, Porto, Portugal; IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
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Increased TRPV4 expression in urinary bladder and lumbosacral dorsal root ganglia in mice with chronic overexpression of NGF in urothelium. J Mol Neurosci 2013; 51:602-14. [PMID: 23690258 DOI: 10.1007/s12031-013-0033-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/09/2013] [Indexed: 12/19/2022]
Abstract
Transient receptor potential vanilloid (TRPV) family member 4 (TRPV4) expression has been demonstrated in urothelial cells and dorsal root ganglion (DRG) neurons, and roles in normal micturition reflexes as well as micturition dysfunction have been suggested. TRP channel expression and function is dependent upon target tissue expression of growth factors. These studies expand upon the target tissue dependence of TRPV4 expression in the urinary bladder and lumbosacral DRG using a recently characterized transgenic mouse model with chronic overexpression of nerve growth factor (NGF-OE) in the urothelium. Immunohistochemistry with image analyses, real-time quantitative polymerase chain reaction, and Western blotting were used to determine TRPV4 protein and transcript expression in the urinary bladder (urothelium + suburothelium, detrusor) and lumbosacral DRG from littermate wild-type (WT) and NGF-OE mice. Antibody specificity controls were performed in TRPV4(-/-) mice. TRPV4 transcript and protein expression was significantly (p ≤ 0.001) increased in the urothelium + suburothelium and suburothelial nerve plexus of the urinary bladder and in small- and medium-sized lumbosacral (L1, L2, L6-S1) DRG cells from NGF-OE mice compared to littermate WT mice. NGF-OE mice exhibit significant (p ≤ 0.001) increases in NGF transcript and protein in the urothelium + suburothelium and lumbosacral DRG. These studies demonstrate regulation of TRPV4 expression by NGF in lower urinary tract tissues. Ongoing studies are characterizing the functional roles of TRPV4 expression in the sensory limb (DRG, urothelium) of the micturition reflex.
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Urinary nerve growth factor: a biomarker of detrusor overactivity? A systematic review. Int Urogynecol J 2013; 24:1603-9. [DOI: 10.1007/s00192-013-2104-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/23/2013] [Indexed: 01/19/2023]
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Seth JH, Sahai A, Khan MS, van der Aa F, de Ridder D, Panicker JN, Dasgupta P, Fowler CJ. Nerve growth factor (NGF): a potential urinary biomarker for overactive bladder syndrome (OAB)? BJU Int 2013; 111:372-80. [PMID: 23444927 DOI: 10.1111/j.1464-410x.2012.11672.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
UNLABELLED WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The search for a biomarker in overactive bladder syndrome (OAB) is an emerging field of interest, as bladder dysfunction is a common complaint that causes significant morbidity. A biomarker may give us insight as a diagnostic tool, and also inform us about how severe the condition is, how it may progress and how it may best be treated. The protein of interest here is nerve growth factor (NGF) and it has been shown to be a dynamic molecule in the bladder of patients with OAB. Urinary levels have been seen to rise in patients with OAB and fall in those who respond to treatment. However, there have also been many studies that examine this trend in numerous other conditions, e.g. interstitial cystitis, bladder outflow obstruction, renal stone disease and patients with neurological impairment after stroke. As a result the specificity of this as a potential urinary biomarker for OAB is questioned. This is a review of published studies, which discusses the pros and cons of NGF as a potential urinary biomarker. The evidence is examined and the studies are summarised together in a Table. Questions remain about the reliability, practicality and specificity of NGF as a biomarker for OAB. These questions need to be addressed by further studies that could clarify the points raised. OBJECTIVE To review the current literature on the use of urinary nerve growth factor (NGF) as a potential biomarker for overactive bladder syndrome (OAB). METHOD A comprehensive electronic literature search was conducted using the PubMed database to identify publications relating to urinary NGF. RESULTS There are a growing number of publications that have measured urinary NGF levels in different types of bladder dysfunction. These range from OAB, bladder pain syndrome, idiopathic and neurogenic detrusor overactivity, bladder oversensitivity and bladder outflow obstruction. Urinary NGF levels do appear to be raised in these pathological states when compared with healthy control samples. In patients with OAB, these raised urinary NGF levels appear to also reduce after successful treatment with antimuscarinics and botulinum toxin A, which indicates a potential use in monitoring responses to treatment. However, raised levels are not limited to OAB, which questions its specificity. Urinary NGF measurements are performed with an enzyme-linked immunosorbent assay using polyclonal antibodies to NGF. The technique requires standardisation, and the different antibodies to NGF require validating. Also a definition of what is the 'normal' range of NGF in urine is still required before it can be used as a diagnostic and prognostic tool. CONCLUSIONS Whilst the evidence for an increased urinary NGF in OAB appears convincing, many questions about its validity remain including: specificity, sensitivity, cost- and time-effectiveness. Many criteria for what constitutes a biomarker still need to be evaluated and met before this molecule can be considered for this role.
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Affiliation(s)
- Jai H Seth
- Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK.
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Korzeniecka-Kozerska A, Porowski T, Michaluk-Skutnik J, Wasilewska A, Płoński G. Urinary nerve growth factor level in children with neurogenic bladder due to myelomeningocele. Scand J Urol 2013; 47:411-7. [DOI: 10.3109/00365599.2012.752402] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Frias B, Lopes T, Pinto R, Cruz F, Cruz CD. Neurotrophins in the lower urinary tract: becoming of age. Curr Neuropharmacol 2012; 9:553-8. [PMID: 22654715 PMCID: PMC3263451 DOI: 10.2174/157015911798376253] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 07/19/2010] [Accepted: 07/19/2010] [Indexed: 01/23/2023] Open
Abstract
The lower urinary tract (LUT) comprises a storage unit, the urinary bladder, and an outlet, the urethra. The coordination between the two structures is tightly controlled by the nervous system and, therefore, LUT function is highly susceptible to injuries to the neuronal pathways involved in micturition control. These injuries may include lesions to the
spinal cord or to nerve fibres and result in micturition dysfunction. A common trait of micturition pathologies, irrespective of its origin, is an upregulation in synthesis and secretion of neurotrophins, most notably Nerve Growth Factor (NGF) and Brain Derived Neurotrophic Factor (BDNF). These neurotrophins are produced by neuronal and non-neuronal cells and exert their effects upon binding to their high-affinity receptors abundantly expressed in the neuronal circuits regulating
LUT function. In addition, NGF and BDNF are present in detectable amounts in the urine of patients suffering from various LUT pathologies, suggesting that analysis of urinary NGF and BDNF may serve as likely biomarkers to be studied in tandem with other factors when diagnosing patients. Studies with experimental models of bladder dysfunction
using antagonists of NGF and BDNF receptors as well as scavenging agents suggest that those NTs may be key elements in the pathophysiology of bladder dysfunctions. In addition, available data indicates that NGF and BDNF might constitute future targets for designing new drugs for better treatment of bladder dysfunction.
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Affiliation(s)
- Bárbara Frias
- Department of Experimental Biology, Faculty of Medicine of Porto, Alameda Hernâni Monteiro, 4200-319 Porto, Portugal
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Effects of CYP-Induced Cystitis on PACAP/VIP and Receptor Expression in Micturition Pathways and Bladder Function in Mice with Overexpression of NGF in Urothelium. J Mol Neurosci 2012; 48:730-43. [DOI: 10.1007/s12031-012-9834-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 06/05/2012] [Indexed: 12/22/2022]
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Hamill RW, Tompkins JD, Girard BM, Kershen RT, Parsons RL, Vizzard MA. Autonomic dysfunction and plasticity in micturition reflexes in human α-synuclein mice. Dev Neurobiol 2012; 72:918-36. [PMID: 21916020 PMCID: PMC4028626 DOI: 10.1002/dneu.20978] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although often overshadowed by the motor dysfunction associated with Parkinson's disease (PD), autonomic dysfunction including urinary bladder and bowel dysfunctions are often associated with PD and may precede motoric changes; such autonomic dysfunction may permit early detection and intervention. Lower urinary tract symptoms are common in PD patients and result in significant morbidity. This studies focus on nonmotor symptoms in PD using a transgenic mouse model with overexpression of human α-synuclein (hSNCA), the peptide found in high concentrations in Lewy body neuronal inclusions, the histopathologic hallmark of PD. We examined changes in the physiological, molecular, chemical, and electrical properties of neuronal pathways controlling urinary bladder function in transgenic mice. The results of these studies reveal that autonomic dysfunction (i.e., urinary bladder) can precede motor dysfunction. In addition, mice with hSNCA overexpression in relevant neuronal populations is associated with alterations in expression of neurotransmitter/neuromodulatory molecules (PACAP, VIP, substance P, and neuronal NOS) within neuronal pathways regulating bladder function as well as with increased NGF expression in the urinary bladder. Changes in the electrical and synaptic properties of neurons in the major pelvic ganglia that provide postganglionic innervation to urogenital tissues were not changed as determined with intracellular recording. The urinary bladder dysfunction observed in transgenic mice likely reflects changes in peripheral (i.e., afferent) and/or central micturition pathways or changes in the urinary bladder. SYN-OE mice provide an opportunity to examine early events underlying the molecular and cellular plasticity of autonomic nervous system pathways underlying synucleinopathies.
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Affiliation(s)
- Robert W Hamill
- Department of Anatomy and Neurobiology, University of Vermont College of Medicine, Burlington, Vermont 05405, USA.
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Biomarkers in Overactive Bladder. CURRENT BLADDER DYSFUNCTION REPORTS 2012. [DOI: 10.1007/s11884-011-0112-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Vírseda Chamorro M, Salinas-Casado J, Zarza-Luciañez D, Méndez-Rubio S, Pelaquim H, Esteban-Fuertes M. [Participation of the pudendal innervation in the detrusor overactivity of the detrusor and in the overactive bladder syndrome]. Actas Urol Esp 2012; 36:37-41. [PMID: 22001690 DOI: 10.1016/j.acuro.2011.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 07/25/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The functional symptoms of the filling phase and detrusor overactivity are two inter-related dysfunctions of the lower urinary tract. We have aimed to study the participation of the lesion of the pudendal nerve in both urinary dysfunctions. MATERIAL AND METHODS A cross-sectional cutoff study in a series of 108 women was carried out. The study consisted in the questioning on the presence of functional symptoms of the lower urinary tract, cystomanometry and determination of peripheral pudendal nerve latency time, selective electromyography of the external anal sphincter and determination of the sacral reflex latency time. RESULTS A tendency was observed towards significance between the presence of pollakiuria amplitude of motor unit potentials (greater in presence of pollakiuria) and the presence of urgency-incontinence and time of sacral latency (greater in the presence of urge incontinence) and a significant relation between the score on the King's Health Questionnaire and peripheral pudendal nerve latency time. Regarding detrusor hyperactivity, greater sacral latency time was observed in patients with overactivity with tendency towards significance. CONCLUSIONS There is a relation between pudendal innervation alterations and presence of symptoms in the filling phase and detrusor overactivity. This relation would explain the therapeutic action of the perineal rehabilitation on these dysfunctions.
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Knippschild S, Frohme C, Olbert P, Hofmann R, Hegele A. [Value of nerve growth factor levels in overactive bladder syndrome: alterations after botulinum toxin therapy]. Urologe A 2011; 51:379-83. [PMID: 21979907 DOI: 10.1007/s00120-011-2726-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Several studies discussing the pathology of overactive bladder suggested changes in urinary proteins. The neurotrophin "nerve growth factor" (NGF) seems to be an important marker in overactive bladder syndrome (OAB). In this prospectively designed study we evaluated NGF blood levels (sNGF) initially and after injection of botulinum toxin type A (BTX-A) in the detrusor muscle in patients suffering from idiopathic OAB. MATERIALS AND METHODS Blood samples were obtained from 26 patients (66.5 years, 28-83) with idiopathic OAB. sNGF levels were measured before and 4 weeks after BTX-A treatment by enzyme-linked immunosorbent assay (ELISA). A group of 32 healthy persons with normal bladder function served as controls (41 years, 19-60). sNGF was evaluated in relation to clinical data and the severity of OAB (wet/dry). RESULTS Significantly higher sNGF levels were detected in patients with OAB compared to the control group (58.8 vs 2.0 pg/ml, p<0.005). Further, sNGF levels were elevated in patients with wet OAB compared to patients with dry OAB (85.0 vs 0.73 pg/ml, p<0.005). Patients > 60 years showed significantly higher sNGF levels (77.2 vs 8.9 pg/ml, p<0.05) compared to younger OAB patients. After BTX-A therapy sNGF levels decreased significantly compared to baseline (p<0.005). CONCLUSION NGF appears to play a decisive role in OAB. Its use as a biomarker in both the diagnostics and follow-up after therapy seems promising. To what extent sNGF can be useful as a biomarker or in therapy monitoring needs to be examined prospectively in a larger population.
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Affiliation(s)
- S Knippschild
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Gießen und Marburg GmbH - Standort Marburg, Baldingerstraße, 35043 Marburg, Deutschland
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Farag FF, Heesakkers JP. Non-invasive techniques in the diagnosis of bladder storage disorders. Neurourol Urodyn 2011; 30:1422-8. [PMID: 21780168 DOI: 10.1002/nau.21155] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 04/27/2011] [Indexed: 11/06/2022]
Abstract
AIMS To review clinical studies thus have been conducted to develop non-invasive diagnostic tools in the storage phase of the micturition cycle. METHODS Pub Med and Web of Science searches were carried out. The search covered the published data of non-invasive diagnostic techniques for detrusor overactivity (DO) and/or low compliance bladder in patients with urinary storage symptoms. The patho-physiological and clinical relevance of these methods were addressed. Diagnostic accuracy of these techniques was scrutinized. RESULTS Eighteen studies were included in the review. Ultrasonography and biomarkers were the most investigated techniques in the diagnosis of storage disorders. Assessment of diagnostic accuracy was possible in four studies. The heterogeneity in data reporting was too high to conduct a meta-analysis. Ultrasonographic parameters and cut-off values have been developed to define DO; such as bladder wall thickness (BWT), detrusor wall thickness and bladder weight. The likelihood ratio of vaginal ultrasonography in measurement of BWT was good. Guidelines are currently developing to standardize the methodologies applied in these techniques. Laboratory biomarkers of DO are gaining more attention recently, but their specificity for DO should be carefully defined. Near infrared spectroscopy (NIRS) is potential non-invasive diagnostic method that is able to detect the DO episodes in real time. However, a solution needs to be found for motion artifacts in this technique. CONCLUSION Non-invasive diagnostic techniques for storage disorders show limited progress with some limitations. Yet these techniques still cannot replace the standard filling cystometry in standard clinical practice.
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Affiliation(s)
- Fawzy F Farag
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Biomarkers in overactive bladder: a new objective and noninvasive tool? Adv Urol 2011; 2011:382431. [PMID: 21687625 PMCID: PMC3113283 DOI: 10.1155/2011/382431] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 03/28/2011] [Indexed: 11/21/2022] Open
Abstract
Overactive bladder syndrome (OAB) is a highly prevalent urinary
dysfunction, with considerable economic and human costs. Clinical diagnosis of OAB is still based on subjective symptoms. A new
accurate, objective and noninvasive test to diagnose OAB and assess therapeutic outcome is lacking. Recent studies in lower
urinary tract (LUT) dysfunctions, particularly in OAB patients, indicate that urinary proteins (neurotrophins, prostaglandins, and
cytokines), serum C reactive protein, and detrusor wall thickness are altered, and such changes could be used as biomarkers of the
disease. Nowadays, increasing emphasis has been given to the role of urinary neurotrophins, namely nerve growth factor (NGF) and
brain derived neurotrophic factor (BDNF), as key players in some urinary dysfunctions. Although recently considered to be a bladder
dysfunction biomarker, urinary NGF presents low sensitivity and specificity. Preliminary results suggest that BDNF may serve as a
more efficient biomarker. Even though we have to wait for future studies to confirm the potential role of NGF and BDNF as OAB
biomarkers, it is already clear that neurotrophins will contribute to elucidate the physiopathological basis of OAB. Herein are
reviewed the latest advances in this new and exciting field, the detection and clinical application of emerging OAB biomarkers.
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Ho DR, Chen CS, Lin WY, Chang PJ, Huang YC. Effect of hyaluronic acid on urine nerve growth factor in cyclophosphamide-induced cystitis. Int J Urol 2011; 18:525-31. [PMID: 21605172 DOI: 10.1111/j.1442-2042.2011.02779.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate how hyaluronic acid (HA) affects nerve growth factor (NGF) production and bladder overactivity in a cyclophosphamide (CYP)-induced cystitis rat model. METHODS Female Sprague-Dawley rats received three intermittent intraperitoneal injections of CYP (75 mg/kg) or saline. Before or after CYP injection, HA was given intravesically and urine NGF was checked with creatinine correction. Bladder function was evaluated by cystometrograms under Zoletil anesthesia. Furthermore, the effect of HA was counteracted with hyaluronidase (HYAL). Bladder structural change was compared among groups with trichrome stain. RESULTS The intercontraction interval (ICI) significantly decreased in CYP-injected rats in comparison to the saline-injected controls. In the CYP-injected groups, bladder HA instillation significantly increased the ICI, but did not change the maximum voiding pressure in comparison to the saline instillation. NGF production significantly increased in CYP-injected rats, but decreased significantly with HA treatment. Treatment with HA had a more significant effect on urine NGF and the use of HYAL would eliminate this effect. Specific staining showed mucosa swelling after CYP treatment. Little HA coating on bladder mucosa could be found in HA-treated rats. CONCLUSIONS Present findings raise the possibility that HA could be an effective treatment for CYP-related bladder overactivity through the involvement of NGF signaling.
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Affiliation(s)
- Dong-Ru Ho
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
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Ochodnický P, Cruz CD, Yoshimura N, Michel MC. Nerve growth factor in bladder dysfunction: Contributing factor, biomarker, and therapeutic target. Neurourol Urodyn 2011; 30:1227-41. [DOI: 10.1002/nau.21022] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 09/21/2010] [Indexed: 12/11/2022]
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Differential profile analysis of urinary cytokines in patients with overactive bladder. Int Urogynecol J 2011; 22:953-61. [PMID: 21487829 DOI: 10.1007/s00192-011-1401-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 02/20/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We hypothesize that overactive bladder (OAB) can produce inflammatory cytokines due to afferent neural plasticity or urothelial dysfunction. This study aimed to detect abnormal cytokine levels in urine of patients with OAB compared to urinary tract infections (UTI) and controls. METHODS This was a prospective, single blind study including 20 premenopausal women (control), 20 with OAB and 16 with UTI. Urine samples were collected, centrifuged, and stored (-80°C). Urinary total proteins were quantified and detected by antibody-based array chip for release of 120 human cytokines in the two groups relative to the controls. RESULTS Majority of cytokines showed the same expression in the OAB compared with the controls. Cytokines exclusively expressed in OAB were: monocyte chemoattractant protein (MCP) 1, TARC, PARC, and Fas/TNFRSF6. MCP-2, MCP-3, tumor necrosis factor-β, GCSF and eotaxin-3 showed a shared expression in UTI and OAB. Conversely, few of the cytokines were downregulated in OAB (IL-5, IL-6, IL-7, and GM-CSF). CONCLUSIONS Taken together, the results suggest that a subset of inflammatory cytokines and chemokines provides a framework for development of highly optimized urinary biomarker assay for differential diagnosis and treatment of OAB.
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Abstract
Biomarkers constitute any objectively measurable indicator of a biological process. The classic biomarker used in the diagnosis of overactive bladder (OAB) has been detrusor overactivity, which is assessed urodynamically. In the search for a reliable, noninvasive alternative to urodynamics, interest has focused on genetic, imaging, and urinary factors. Along with other cytokines detectable in urine, prostaglandin E2 and nerve growth factor are indicators of low-grade inflammation. Although they correlate with OAB symptom severity, they have not been shown to have independent prognostic benefit. Imaging biomarkers have been investigated since the earliest days of video urodynamics. Despite extensive research on the ultrasonographic estimation of bladder wall thickness, further standardization of the technique is required before conclusions can be reached regarding diagnostic accuracy. Genetic factors contribute approximately half of the total risk for urgency incontinence. Functional polymorphisms of the cytochrome P450 IID6 gene significantly alter the metabolism of some commonly used anticholinergic drugs, but no genetic loci that influence risk of OAB have been definitively identified. The first genome-wide association studies for OAB are in progress, and should identify new susceptibility genes. Although current putative biomarkers correlate with OAB severity, much future work is required to assess their prognostic value, and establish their role in clinical practice.
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Kuo HC, Liu HT, Guan Z, Tyagi P, Chancellor MB. Promise of Urinary Nerve Growth Factor for Assessment of Overactive Bladder Syndrome. Low Urin Tract Symptoms 2011; 3:2-9. [PMID: 26676344 DOI: 10.1111/j.1757-5672.2011.00087.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Overactive bladder syndrome (OAB) is highly prevalent bladder disorder in men and women. About 10-15% of the population suffers from urgency frequency with or without urgency urinary incontinence. It is estimated that 50-75% of patients with OAB may have urodynamic detrusor overactivity (DO). Urodynamic study invasive and most of the OAB patients might not accept it as a routine assessment. Therefore, a more objective and non-invasive test for diagnosis and assessing DO from OAB patients is needed. Recently, urinary nerve growth factor (NGF) has gained great interest in detecting DO in patients with OAB. Urinary NGF level was found to increase in OAB and urodynamic DO. Urinary NGF levels correlated with severity of OAB symptoms. Patients with either idiopathic or neurogenic DO may have increased urinary NGF levels. Urinary NGF levels have been shown to decrease in patients with patients with OAB and DO who have been well treated with antimuscarinics or botulinum toxin injection, but not in those with persistent OAB after treatment. Not all patients with OAB can have an elevated urinary NGF level; it may also be increased in patients with interstitial cystitis/painful bladder syndrome and other lower urinary tract diseases, suggesting urinary NGF expression could be a product of bladder inflammation and a limited specificity of urinary NGF for diagnosing DO. The source of urinary NGF has not yet been fully explored yet. Nevertheless, urinary NGF level is likely to be a promising biomarker for diagnosis of DO from OAB patients, to monitor therapeutic outcome and predict disease progression.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, State University Of New York Downstate, New York, New York, USADepartment of Urology, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Hsin-Tzu Liu
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, State University Of New York Downstate, New York, New York, USADepartment of Urology, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Zhonghong Guan
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, State University Of New York Downstate, New York, New York, USADepartment of Urology, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Pradeep Tyagi
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, State University Of New York Downstate, New York, New York, USADepartment of Urology, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Michael B Chancellor
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, State University Of New York Downstate, New York, New York, USADepartment of Urology, Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan, USA
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Girard BM, Malley SE, Vizzard MA. Neurotrophin/receptor expression in urinary bladder of mice with overexpression of NGF in urothelium. Am J Physiol Renal Physiol 2011; 300:F345-55. [PMID: 21048026 PMCID: PMC3043996 DOI: 10.1152/ajprenal.00515.2010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 10/28/2010] [Indexed: 01/03/2023] Open
Abstract
Urothelium-specific overexpression of nerve growth factor (NGF) in the urinary bladder of transgenic mice stimulates neuronal sprouting in the urinary bladder, produces increased voiding frequency, and results in increased referred somatic hypersensitivity. Additional NGF-mediated pleiotropic changes might contribute to the increased voiding frequency and pelvic hypersensitivity observed in these transgenic mice, such as modulation of other growth factor/receptor systems. Chronic overexpression of NGF in the urothelium was achieved through the use of a highly urothelium-specific uroplakin II promoter. In the present study, we examined NGF, brain-derived neurotrophic factor (BDNF), and associated receptor [p75(NTR), tyrosine kinase (Trk)A, TrkB] transcript and protein expression in urothelium and detrusor smooth muscle of NGF-overexpressing (OE) and littermate wild-type mice, using real-time quantitative reverse transcription-polymerase chain reaction, ELISAs, and semiquantitation of immunohistochemistry. We focused on these growth factor/receptors given the established roles of NGF/TrkA, NGF/p75(NTR), and BDNF/TrkB systems in bladder function. Increased voiding frequency in NGF-OE mice was confirmed by examining urination patterns. BDNF, TrkA, and TrkB protein expression was significantly (P ≤ 0.01) reduced and p75(NTR) protein expression was significantly (P ≤ 0.01) increased in urinary bladder of NGF-OE mice. The NGF-OE-induced changes in neurotrophic factor/receptor expression in urinary bladder may represent compensatory changes to reduce voiding frequency in the NGF-OE mouse.
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MESH Headings
- Animals
- Female
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Muscle, Smooth/metabolism
- Muscle, Smooth/physiology
- Nerve Growth Factors/analysis
- Nerve Growth Factors/metabolism
- Nerve Growth Factors/physiology
- Protein-Tyrosine Kinases/metabolism
- Protein-Tyrosine Kinases/physiology
- Receptor, trkA/metabolism
- Receptor, trkA/physiology
- Receptor, trkB/metabolism
- Receptor, trkB/physiology
- Receptors, Nerve Growth Factor/analysis
- Receptors, Nerve Growth Factor/metabolism
- Receptors, Nerve Growth Factor/physiology
- Urinary Bladder/chemistry
- Urinary Bladder/metabolism
- Urinary Bladder/physiology
- Urination/physiology
- Urothelium/chemistry
- Urothelium/metabolism
- Urothelium/physiology
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Affiliation(s)
- Beatrice M Girard
- Department of Anatomy and Neurobiology, University of Vermont College of Medicine, Burlington, VT 05405, USA
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Charrua A, Avelino A, Cruz F. Modulation of urinary bladder innervation: TRPV1 and botulinum toxin A. Handb Exp Pharmacol 2011:345-374. [PMID: 21290235 DOI: 10.1007/978-3-642-16499-6_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The persisting interest around neurotoxins such as vanilloids and botulinum toxin (BoNT) derives from their marked effect on detrusor overactivity refractory to conventional antimuscarinic treatments. In addition, both are administered by intravesical route. This offers three potential advantages. First, intravesical therapy is an easy way to provide high concentrations of pharmacological agents in the bladder tissue without causing unsuitable levels in other organs. Second, drugs effective on the bladder, but inappropriate for systemic administration, can be safely used as it is the case of vanilloids and BoNT. Third, the effects of one single treatment might be extremely longlasting, contributing to render these therapies highly attractive to patients despite the fact that the reasons to the prolonged effect are still incompletely understood. Attractive as it may be, intravesical pharmacological therapy should still be considered as a second-line treatment in patients refractory to conventional oral antimuscarinic therapy or who do not tolerate its systemic side effects. However, the increasing off-label use of these neurotoxins justifies a reappraisal of their pharmacological properties.
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Affiliation(s)
- Ana Charrua
- Institute of Histology and Embryology, Porto, Portugal
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Abstract
Much of the current research on lower urinary tract dysfunction is focused on afferent mechanisms. The main goals are to define and modulate the signaling pathways by which afferent information is generated and conveyed to the central nervous system. Alterations in bladder afferent mechanisms are a potential source of voiding dysfunction and an emerging source of drug targets. Even some established drug therapies such as muscarinic receptor antagonists, as well as emerging therapies such as botulinum toxin type-A, may act partly through afferent mechanisms. This review presents up-to-date findings on the localization of afferent fiber types within the bladder wall, afferent receptors and transmitters, and how these may communicate with the urothelium, interstitial cells, and detrusor smooth muscle to regulate micturition in normal and pathological bladders. Peripheral and central mechanisms of afferent sensitization and myogenic mechanisms that lead to detrusor overactivity, overactive bladder symptoms, and urgency sensations are also covered as well as new therapeutic approaches and new and established methods of measuring afferent activity.
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Affiliation(s)
- Anthony J Kanai
- University of Pittsburgh, School of Medicine, Pittsburgh, PA15261, USA.
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Urinary Nerve Growth Factor Levels in Overactive Bladder Syndrome and Lower Urinary Tract Disorders. J Formos Med Assoc 2010; 109:862-78. [DOI: 10.1016/s0929-6646(10)60133-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 04/08/2010] [Accepted: 04/13/2010] [Indexed: 11/18/2022] Open
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Yamauchi H, Akino H, Ito H, Aoki Y, Nomura T, Yokoyama O. Urinary Prostaglandin E2 Was Increased in Patients With Suprapontine Brain Diseases, and Associated With Overactive Bladder Syndrome. Urology 2010; 76:1267.e13-9. [DOI: 10.1016/j.urology.2010.06.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 06/07/2010] [Accepted: 06/09/2010] [Indexed: 11/29/2022]
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Watanabe T, Inoue M, Sasaki K, Araki M, Uehara S, Monden K, Saika T, Nasu Y, Kumon H, Chancellor MB. Nerve growth factor level in the prostatic fluid of patients with chronic prostatitis/chronic pelvic pain syndrome is correlated with symptom severity and response to treatment. BJU Int 2010; 108:248-51. [PMID: 20883485 DOI: 10.1111/j.1464-410x.2010.09716.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE • To explore whether levels of nerve growth factor (NGF) in expressed prostatic secretions (EPS) are correlated with symptom severity in chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS). PATIENTS AND METHODS • All patients with CP/CPPS underwent a complete history and physical examination, and were scored according to the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). • Expressed prostatic secretion samples from 20 patients with CP/CPPS and from four asymptomatic control patients were collected and frozen, and NGF levels in EPS were measured by enzyme-linked immunosorbent assay. • Patients were asked to complete NIH-CPSI questionnaires at baseline and 8 weeks after treatment and patients with at least a 25% decrease in total NIH-CPSI score from the baseline values were classified as responders to treatment. RESULTS • The mean (± sd) NGF levels in EPS of patients with CP/CPPS and asymptomatic control patients were 7409 (± 3788) pg/mL and 4174 (± 1349) pg/mL, respectively. The NGF level in patients with CP/CPPS correlated directly with pain severity (P= 0.014, r= 0.541). • There were no significant differences between NGF levels in EPS before and after treatment. However, successful treatment significantly decreased NGF levels in responders (P= 0.001). CONCLUSION • Nerve growth factor might contribute to the pathophysiology of CP/CPPS as changes in NGF level in EPS occurred in proportion to pain severity. Therefore, these results suggest that NGF could be used as a new biomarker to evaluate the symptoms of CP/CPPS and the effects of treatment.
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Affiliation(s)
- Toyohiko Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
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Kuo HC, Liu HT, Tyagi P, Chancellor MB. Urinary Nerve Growth Factor Levels in Urinary Tract Diseases With or Without Frequency Urgency Symptoms. Low Urin Tract Symptoms 2010; 2:88-94. [PMID: 26676289 DOI: 10.1111/j.1757-5672.2010.00065.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To measure urinary nerve growth factor (NGF) levels in patients with several urinary tract diseases under different conditions and compare with NGF levels in patients with overactive bladder (OAB) and interstitial cystitis/painful bladder syndrome (IC/PBS). METHODS Urinary NGF levels were measured using enzyme-linked immunosorbent assay (ELISA) and normalized by urinary creatinine concentration. Patients with acute bacterial cystitis, urinary tract stone, urothelial cell carcinoma, and OAB patients after antimuscarinic therapy were evaluated. The urinary NGF levels of OAB, IC/PBS and controls from previous studies were used for comparison. NGF levels were compared among subgroups and between urinary tract diseases with or without associated OAB symptoms. The urinary NGF levels were also compared among natural filling, after normal saline filling and after potassium chloride test in a group of OAB and IC/PBS patients. RESULTS Patients with acute bacterial cystitis, urinary tract stones or urothelial cell carcinoma had elevated NGF levels that were not associated with the presence of OAB symptoms. Symptomatic cystitis patients who had resolved OAB symptoms after antibiotic treatment had a significant decrease in urinary NGF levels. The urinary NGF levels decreased significantly in OAB patients with effective antimuscarinic treatment for 6 months, but remained stationary and higher than the controls for up to 12 months after treatment. CONCLUSION Urinary NGF is not produced solely in patients with OAB or IC/PBS. Acute bacterial cystitis, urinary tract stones and urothelial cell carcinoma can have high urinary NGF production.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA
| | - Hsin-Tzu Liu
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA
| | - Pradeep Tyagi
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA
| | - Michael B Chancellor
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, TaiwanDepartment of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA
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Schnegelsberg B, Sun TT, Cain G, Bhattacharya A, Nunn PA, Ford APDW, Vizzard MA, Cockayne DA. Overexpression of NGF in mouse urothelium leads to neuronal hyperinnervation, pelvic sensitivity, and changes in urinary bladder function. Am J Physiol Regul Integr Comp Physiol 2010; 298:R534-47. [PMID: 20032263 PMCID: PMC2838659 DOI: 10.1152/ajpregu.00367.2009] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 12/18/2009] [Indexed: 12/19/2022]
Abstract
NGF has been suggested to play a role in urinary bladder dysfunction by mediating inflammation, as well as morphological and functional changes, in sensory and sympathetic neurons innervating the urinary bladder. To further explore the role of NGF in bladder sensory function, we generated a transgenic mouse model of chronic NGF overexpression in the bladder using the urothelium-specific uroplakin II (UPII) promoter. NGF mRNA and protein were expressed at higher levels in the bladders of NGF-overexpressing (NGF-OE) transgenic mice compared with wild-type littermate controls from postnatal day 7 through 12-16 wk of age. Overexpression of NGF led to urinary bladder enlargement characterized by marked nerve fiber hyperplasia in the submucosa and detrusor smooth muscle and elevated numbers of tissue mast cells. There was a marked increase in the density of CGRP- and substance P-positive C-fiber sensory afferents, neurofilament 200-positive myelinated sensory afferents, and tyrosine hydroxylase-positive sympathetic nerve fibers in the suburothelial nerve plexus. CGRP-positive ganglia were also present in the urinary bladders of transgenic mice. Transgenic mice had reduced urinary bladder capacity and an increase in the number and amplitude of nonvoiding bladder contractions under baseline conditions in conscious open-voiding cystometry. These changes in urinary bladder function were further associated with an increased referred somatic pelvic hypersensitivity. Thus, chronic urothelial NGF overexpression in transgenic mice leads to neuronal proliferation, focal increases in urinary bladder mast cells, increased urinary bladder reflex activity, and pelvic hypersensitivity. NGF-overexpressing mice may, therefore, provide a useful transgenic model for exploring the role of NGF in urinary bladder dysfunction.
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Fiore M, Chaldakov GN, Aloe L. Nerve growth factor as a signaling molecule for nerve cells and also for the neuroendocrine-immune systems. Rev Neurosci 2009; 20:133-45. [PMID: 19774790 DOI: 10.1515/revneuro.2009.20.2.133] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Nerve growth factor (NGF) is a signaling molecule, originally discovered for its role on differentiation and survival of peripheral sensory and sympathetic neurons. It has also been associated with functional activities of cells of the immune and endocrine systems. NGF biological activity is mediated by two classes of receptors: (i) p75 neurotrophin receptor (p75(NTR)), a 75 kDa glycoprotein, belonging to a superfamily of cytokine receptors including TNF receptors, and (ii) TrkA, a transmembrane tyrosine kinase of 140 kDa. Both TrkA and p75(NTR) are known to play a marked action in neurodegenerative disorders, immune-related deficits, and neuroendocrine (including adipoendocrine) mechanisms. This review focuses on these cellular events and presents a working model which attempts to explain the close interrelationships of the neuro-endocrine-immune triad via a modulatory action of NGF.
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Affiliation(s)
- Marco Fiore
- Institute of Neurobiology and Molecular Medicine, National Research Council, Rome, Italy
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Liu HT, Chancellor MB, Kuo HC. Decrease of urinary nerve growth factor levels after antimuscarinic therapy in patients with overactive bladder. BJU Int 2009; 103:1668-72. [PMID: 19220267 DOI: 10.1111/j.1464-410x.2009.08380.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine urinary nerve growth factor (NGF) levels in patients with overactive bladder (OAB) and after treatment with antimuscarinics. PATIENTS AND METHODS Urinary NGF levels were measured in 38 'normal' controls and 70 patients with OAB. Patients were treated with tolterodine 4 mg once daily. Urinary NGF levels were measured by enzyme-linked immunosorbent assay method and normalized by urinary creatinine levels (NGF/Cr). The urinary NGF/Cr levels and urgency severity scale (USS) were compared at baseline, 1, 2 and 3 months after antimuscarinics, and 1 month after discontinuing treatment. RESULTS The urinary NGF/Cr level was very low in normal controls with a mean (sem) of 0.005 (0.003). Patients with OAB had significantly higher baseline urinary NGF/Cr levels than the controls. Urinary NGF/Cr levels were significantly reduced at 3 months in 50 responders (1.10 [0.26] before vs 0.41 [0.09] after, P = 0.008) but not in the 20 non-responders (1.38 [0.54] before vs 1.30 [0.46] after, P = 0.879). However, after discontinuing antimuscarinic treatment for 1 month, the urinary NGF/Cr level was elevated in 23 responders at 0.83 (0.33) and in five non-responders at 2.72 (1.41). The USS scores significantly changed with the change of urinary NGF/Cr levels in responders at different time points. The voided volume increased but maximum urinary flow rate and postvoid residual volume did not increase in responders after 3-months of antimuscarinic treatment. The limitation of this study was the lack of a control arm for comparison. CONCLUSIONS Changes in the urinary NGF levels were associated with the changes of the USS scores after antimuscarinic treatment and discontinued medication. The urinary NGF level could be a potential biomarker for evaluating therapeutic results of antimuscarinics therapy.
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Affiliation(s)
- Hsin-Tzu Liu
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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46
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Kuo HC. Recent Investigations of Urinary Nerve Growth Factor as a Biomarker for Overactive Bladder Syndrome. Korean J Urol 2009. [DOI: 10.4111/kju.2009.50.9.831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Liu HT, Kuo HC. Urinary nerve growth factor levels are elevated in patients with overactive bladder and do not significantly increase with bladder distention. Neurourol Urodyn 2008; 28:78-81. [DOI: 10.1002/nau.20599] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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