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Olivas-Martinez A, Suarez B, Salamanca-Fernandez E, Reina-Perez I, Rodriguez-Carrillo A, Mustieles V, Olea N, Freire C, Fernández MF. Development and validation of brain-derived neurotrophic factor measurement in human urine samples as a non-invasive effect biomarker. Front Mol Neurosci 2023; 15:1075613. [PMID: 36710936 PMCID: PMC9878568 DOI: 10.3389/fnmol.2022.1075613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023] Open
Abstract
Background Brain-derived neurotrophic factor (BDNF), a neurotrophic growth factor mainly expressed in the brain, has been proposed as a potential effect biomarker; that is, as a measurable biomarker whose values could be associated with several diseases, including neurological impairments. The European Human Biomonitoring Initiative (HBM4EU) has also recognized effect biomarkers as a useful tool for establishing link between exposure to environmental pollutants and human health. Despite the well-establish protocol for measuring serum BDNF, there is a need to validate its assessment in urine, a non-invasive sample that can be easily repeated over time. The aim of this study was to develop, standardize and validate a methodology to quantify BDNF protein levels in urine samples before its implementation in biomonitoring studies. Methods Different experimental conditions and non-competitive commercial enzyme-linked immunosorbent assay (ELISA) kits were tested to determine the optimal analytical procedure, trying to minimize the shortcomings of ELISA kits. The fine-tune protocol was validated in a pilot study using both upon awakening (n = 150) and prior to sleeping (n = 106) urine samples from the same Spanish adolescent males in a well-characterized study population (the Spanish INMA-Granada cohort). Results The best results were obtained in 0.6 ml of urine after the acidification and extraction (pre-concentration) of samples. The highest reproducibility was obtained with the ELISA kit from Raybiotech. Urinary BDNF concentrations of adolescent males were within the previously reported range (morning = 0.047-6.801 ng/ml and night = 0.047-7.404 ng/ml). Urinary BDNF levels in the awakening and pre-sleep samples did not follow a normal distribution and were not correlated. Conclusion The developed methodology offers good sensitivity and reproducibility. Having reliable markers in urine may facilitate both diagnosis and monitoring possible diseases (and treatment). Further studies are needed to implement urinary BDNF in biomonitoring studies to further elucidate its usefulness and biological significance for neurological impairments.
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Affiliation(s)
- Alicia Olivas-Martinez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Beatriz Suarez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain
| | - Elena Salamanca-Fernandez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain
| | - Iris Reina-Perez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain
| | - Andrea Rodriguez-Carrillo
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain
| | - Vicente Mustieles
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Nicolás Olea
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Carmen Freire
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Mariana F. Fernández
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain,*Correspondence: Mariana F. Fernández,
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Stemberger Maric L, Kozmar A, Lenicek Krleza J, Rogic D, Colic M, Abdovic S. Urinary brain-derived neurotrophic factor and nerve growth factor as noninvasive biomarkers of overactive bladder in children. Biochem Med (Zagreb) 2022; 32:030706. [PMID: 36277428 PMCID: PMC9562800 DOI: 10.11613/bm.2022.030706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Overactive bladder (OAB) is the most common urinary disorder and the leading cause of functional daytime intermittent urinary incontinence in children. The aim of this study was to determine whether urinary brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) concentrations, normalized to urine creatinine, could be used as biomarkers for diagnosis and treatment monitoring of OAB in children. Materials and methods Urine samples of 48 pediatric patients with OAB were collected at the start of anticholinergic therapy (baseline), at follow-up visits (3 and 6 months), and from 48 healthy controls. Urinary BDNF and NGF concentrations were determined by ELISA method (Merck, Darmstadt, Germany) and Luminex method (Thermo Fisher Scientific, Waltham, USA). Differences of frequency between quantifiable analyte concentrations between subject groups were determined using Fisher’s exact test. Results There was no statistically significant difference between quantifiable analyte concentrations between patients at baseline and the control group for BDNF and NGF by either the ELISA or Luminex method (P = 1.000, P = 0.170, P = 1.000, and P = N/A, respectively). There was a statistically significant difference between quantifiable BDNF by the ELISA method between patients at baseline and complete success follow-up (P = 0.027), while BDNF by Luminex method and NGF by both methods were not statistically significant (P = 0.078, P = 0.519, and P = N/A, respectively). Conclusions This study did not demonstrate that urinary BDNF and NGF concentrations, can be used as biomarkers for diagnosis and therapy monitoring of OAB in children.
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Affiliation(s)
- Lorna Stemberger Maric
- Pediatric Infectious Diseases Department, University Hospital for Infectious Diseases “dr. Fran Mihaljevic”, Zagreb, Croatia
| | - Ana Kozmar
- Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Jasna Lenicek Krleza
- Department of Laboratory Diagnostics, Children’s Hospital Zagreb, Zagreb, Croatia
| | - Dunja Rogic
- Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Merima Colic
- Department of Pediatric Nephrology, Children’s Hospital Zagreb, Zagreb, Croatia
| | - Slaven Abdovic
- Department of Pediatric Nephrology, Children’s Hospital Zagreb, Zagreb, Croatia
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Jankiewicz K, Bogusiewicz M, Nowakowski Ł, Rechberger T, Rogowski A, Miotla P. Urine Nerve Growth Factor May Not Be Useful as a Biomarker of Overactive Bladder in Patients with Pelvic Organ Prolapse. J Clin Med 2022; 11:971. [PMID: 35207243 PMCID: PMC8880733 DOI: 10.3390/jcm11040971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/30/2022] [Accepted: 02/09/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Overactive bladder (OAB) symptoms are frequently present in women with pelvic organ prolapse (POP). Although urinary nerve growth factor (NGF) is a promising biomarker of OAB, little is known about its role in patients with OAB secondary to POP. The aim of the study was to evaluate urinary NGF levels in patients with POP involving the anterior vaginal wall and check if it may serve as a predicting factor for postoperative resolution of OAB symptoms. (2) Methods: Eighty-three Caucasian women included in the study were divided into three groups: pure OAB, one associated with POP (POP&OAB) and a control group composed of healthy volunteers. The urine NGF and creatinine were assessed with ELISA tests to calculate the NGF/creatinine ratio. (3) Results: The NGF/creatinine ratio was significantly higher in patients with pure OAB in comparison with other groups; however, it did not differ between the control group and the POP&OAB group. There was no correlation between NGF/creatinine ratio and age, menopausal status, BMI, parity or urodynamic findings. The NGF/creatinine ratio was not a prognostic factor for OAB symptoms' resolution after surgical treatment of POP. (4) Conclusions: Urinary NGF excretion is not increased in women with OAB secondary to POP; thus, it may not serve as an OAB biomarker in these patients.
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Affiliation(s)
- Katarzyna Jankiewicz
- 2nd Department of Gynecology, Medical University of Lublin, 20-954 Lublin, Poland; (M.B.); (T.R.); (P.M.)
| | - Michał Bogusiewicz
- 2nd Department of Gynecology, Medical University of Lublin, 20-954 Lublin, Poland; (M.B.); (T.R.); (P.M.)
| | - Łukasz Nowakowski
- 1st Military Clinical Hospital with Polyclinic, 20-049 Lublin, Poland;
| | - Tomasz Rechberger
- 2nd Department of Gynecology, Medical University of Lublin, 20-954 Lublin, Poland; (M.B.); (T.R.); (P.M.)
| | - Artur Rogowski
- Department of Minimally Invasive and Endoscopic Gynecology, Military Institute of Medicine, Legionowo Hospital, 05-119 Legionowo, Poland;
| | - Pawel Miotla
- 2nd Department of Gynecology, Medical University of Lublin, 20-954 Lublin, Poland; (M.B.); (T.R.); (P.M.)
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Tsiapakidou S, Apostolidis A, Pantazis K, Grimbizis GF, Mikos T. The use of urinary biomarkers in the diagnosis of overactive bladder in female patients. A systematic review and meta-analysis. Int Urogynecol J 2021; 32:3143-3155. [PMID: 34363496 DOI: 10.1007/s00192-021-04945-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/18/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and other proteins are related to overactive bladder (OAB) syndrome, as their urinary concentrations are significantly different from those of the general non-OAB population. This review aims to systematically assess whether NGF, BDNF, and other urinary by-products can be used as potential biomarkers to manage women with OAB. METHODS This was a systematic review and metanalysis that was conducted according to PRISMA guidelines. Studies were identified by electronic search of Medline, Scopus, ScienceDirect, Embase, and Cochrane Register until October 2020. The included studies investigated the correlation of OAB with NGF, BDNF, and other potential biomarkers in symptomatic women and their controls. RESULTS Twelve studies (581 female OAB patients and 394 female controls) were included. Urinary NGF, NGF/Cr, BDNF/Cr, ATP/Cr, and PGE2/Cr ratios were identified as potential biomarkers in female OAB patients. Results of the meta-analysis indicated that uNGF [standard mean difference (SMD) 1.45, 95% CI 0.53-2.36], NGF/Cr ratio (SMD 1.23, 95% CI 0.67-1.78), BDNF/Cr ratio (SMD 0.78, 95% CI 0.006-1.50), and BDNF/Cr ratio (RR 0.78, 95% CI 0.006-1.50) were increased in female OAB patients compared to healthy controls, whereas no difference was found for the PGE2/Cr and ATP/Cr ratios. Current data are inadequate to assess any other potential biomarkers, such as urinary MDA, ATP, and cytokines, in the management of OAB in female patients. CONCLUSIONS uNGF, NGF/Cr, and BDNF/Cr ratio could be used in the assessment of female OAB patients. Further studies are needed to specify OAB urinary titer levels in OAB subgroups and healthy women and their potential as diagnostic and management tools in OAB women.
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Affiliation(s)
- Sofia Tsiapakidou
- 1st Department of Obstetrics and Gynecology, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Ring Road, Nea Efkarpia, 56403, Thessaloniki, Greece
| | - Apostolos Apostolidis
- 2nd Department of Urology, Papageorgiou Hospital and Centre for Study of Continence and Pelvic Floor Dysfunctions, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Pantazis
- 2nd Department of Obstetrics and Gynecology, "Hippokrateio" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grigoris F Grimbizis
- 1st Department of Obstetrics and Gynecology, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Ring Road, Nea Efkarpia, 56403, Thessaloniki, Greece
| | - Themistoklis Mikos
- 1st Department of Obstetrics and Gynecology, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Ring Road, Nea Efkarpia, 56403, Thessaloniki, Greece.
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Rada MP, Ciortea R, Măluţan AM, Doumouchtsis SK, Bucuri CE, Clim A, Roman A, Mihu D. The profile of urinary biomarkers in overactive bladder. Neurourol Urodyn 2020; 39:2305-2313. [PMID: 32813897 DOI: 10.1002/nau.24487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/06/2020] [Indexed: 12/20/2022]
Abstract
AIMS In overactive bladder (OAB) research, different biomarkers have been proposed as diagnostic tools and may be used to create individual patient profiles. Assessing the diagnostic performance of biomarkers would better outline their utility. Therefore, our aim was to investigate the diagnostic value of four urinary biomarkers: human brain derived neurotrophic factor (hBDNF), malondialdehyde (MDA), h nerve growth factor (hNGF) and h 8-hydroxydeoxyguanosine in women with OAB. These are neurotrophins/oxidative stress markers that have been linked to lower urinary tract symptoms. METHODS A total of 105 women were included in the study and distributed in two groups: a group with OAB (n = 53) and a control group (n = 50). The levels of the biomarkers were determined using enzyme-linked immunosorbent assay technique and they were compared between the groups. If the Mann-Whitney test demonstrated a statistically significant difference, receiver operating curves (ROC) analysis was undertaken. RESULTS When normalized to urinary creatinine, hBDNF, MDA, and hNGF showed significantly increased values in women with OAB as compared to controls, whereas 8-OHdG showed no significant difference. The diagnostic performance of these biomarkers was analyzed based on the area under the ROC curve (AUC). MDA had the highest AUC (0.75), followed by hNGF (0.69) and hBDNF (0.67). CONCLUSIONS Our findings suggest that MDA, a relatively novel biomarker in OAB research, has a fair performance as a diagnostic tool for OAB. Moreover, urinary neurotrophins (NGF and BDNF) as biomarkers may have a role in the diagnostic pathways of women with OAB symptoms.
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Affiliation(s)
- Maria Patricia Rada
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Răzvan Ciortea
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Mihai Măluţan
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Stergios K Doumouchtsis
- Department of Obstetrics and Gynaecology, Epsom & St Helier University Hospitals NHS Trust, UK
- Institute of Medical and Biomedical Education, St George's University of London, London, UK
- Laboratory of Experimental Surgery and Surgical Research N S Christeas, Athens University Medical School, Athens, Greece
- American University of the Caribbean School of Medicine, Florida
| | - Carmen Elena Bucuri
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adelina Clim
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Roman
- Department of Radiology, "Prof. Dr. Ion Chiricuţă" Oncology Institute Cluj-Napoca, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dan Mihu
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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A Novel Alternative in the Treatment of Detrusor Overactivity? In Vivo Activity of O-1602, the Newly Synthesized Agonist of GPR55 and GPR18 Cannabinoid Receptors. Molecules 2020; 25:molecules25061384. [PMID: 32197469 PMCID: PMC7144400 DOI: 10.3390/molecules25061384] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of the research was to assess the impact of O-1602—novel GPR55 and GPR18 agonist—in the rat model of detrusor overactivity (DO). Additionally, its effect on the level of specific biomarkers was examined. To stimulate DO, 0.75% retinyl acetate (RA) was administered to female rats’ bladders. O-1602, at a single dose of 0.25 mg/kg, was injected intra-arterially during conscious cystometry. Furthermore, heart rate, blood pressure, and urine production were monitored for 24 h, and the impact of O-1602 on the levels of specific biomarkers was evaluated. An exposure of the urothelium to RA changed cystometric parameters and enhanced the biomarker levels. O-1602 did not affect any of the examined cystometric parameters or levels of biomarkers in control rats. However, the O-1602 injection into animals with RA-induced DO ameliorated the symptoms of DO and caused a reversal in the described changes in the concentration of CGRP, OCT3, BDNF, and NGF to the levels observed in the control, while the values of ERK1/2 and VAChT were significantly lowered compared with the RA-induced DO group, but were still statistically higher than in the control. O-1602 can improve DO, and may serve as a promising novel substance for the pharmacotherapy of bladder diseases.
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Abstract
PURPOSE Lower urinary tract symptoms are prevalent and burdensome, yet methods to enhance diagnosis and appropriately guide therapies are lacking. We systematically reviewed the literature for human studies of biomarkers associated with lower urinary tract symptoms. MATERIALS AND METHODS PubMed®, EMBASE® and Web of Science® were searched from inception to February 13, 2018. Articles were included if they were in English, performed in benign urological populations without neurological disorders or interstitial cystitis/bladder pain syndrome, and assessed a biomarker's association with or ability to predict specific lower urinary tract symptoms or urological conditions. Bioinformatic pathway analyses were conducted to determine whether individual biomarkers associated with symptoms are present in unifying pathways. RESULTS Of 6,150 citations identified 125 met the inclusion criteria. Most studies (93.6%) assessed biomarkers at 1 time point and were cross-sectional in nature. Few studies adjusted for potentially confounding clinical variables or assessed biomarkers in an individual over time. No individual biomarkers are currently validated as diagnostic tools for lower urinary tract symptoms. Compared to controls, pathway analyses identified multiple immune response pathways that were enriched in overactive bladder syndrome and cell migration/cytoskeleton remodeling pathways that were enriched in female stress incontinence. CONCLUSIONS Major deficiencies in the existing biomarker literature include poor reproducibility of laboratory data, unclear classification of patients with lower urinary tract symptoms and lack of adjustment for clinical covariates. Despite these limitations we identified multiple putative pathways in which panels of biological markers need further research.
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Deng C, Peng Q, Hu X, Gao L, Xu J, Su J, Xia X, Liu F, Li M. RETRACTED ARTICLE: Urinary nerve growth factor: a biomarker for overactive bladder in children? A meta-analysis and trail sequential analysis. Pediatr Surg Int 2019; 35:1033. [PMID: 30783750 DOI: 10.1007/s00383-019-04447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Changkai Deng
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China.
| | - Qiang Peng
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Xianliang Hu
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Li Gao
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Juan Xu
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Jing Su
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Xue Xia
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Feng Liu
- Department of Urology Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Maoxian Li
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No. 1617, Riyue Avenue, Qinyang District, Chengdu, China
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Deng C, Zhang W, Peng Q, Hu X, Li M, Gao L, Xu J, Su J, Xia X. Urinary nerve growth factor: a biomarker for detrusor overactivity in children? A meta-analysis and trail sequential analysis. Pediatr Surg Int 2019; 35:1027-1032. [PMID: 30729304 DOI: 10.1007/s00383-019-04448-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Based on, previously, a systematic review, urinary nerve growth factor (NGF) has emerged as one potentially noninvasive biomarker for detrusor overactivity (DO) in adults. We performed this systematic review to explore if NGF is a biomarker for DO in children. METHODS A literature search was conducted in PubMed, Embase, Web of science, and Cochrane Library. Copies of all relevant articles were retrieved for quality assessment and data abstraction by two reviewers. Primary outcome was pooled standardized mean difference (SMD) for NGF/Cr (NGF normalized to urine creatinine) level between DO group and controls. RESULTS Three case-control studies published from 2012 to 2016 were included with 74 patients and 70 controls. Children with DO had a significant higher baseline urinary NGF/Cr level compared to controls (SMD = 2.48, 95%CI = 0.85-4.10, P < 0.01). After treatment, the level of NGF/Cr decreased significantly compared to baseline level at 6th month time points (SMD = 0.94, 95%CI = 0.03-1.86, P = 0.04). We calculated the required information size to 99 patients for comparison of urinary NGF/Cr level between DO and controls by trail sequential analysis (TSA). CONCLUSION Based on this systematic review, NGF/Cr may be a noninvasive biomarker for DO in children in the future. However, based on TSA, more original studies are needed to clarify the role of NGF/Cr in the biomarker effect.
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Affiliation(s)
- Changkai Deng
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China.
| | - Wei Zhang
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Qiang Peng
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Xianliang Hu
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Maoxian Li
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Li Gao
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Juan Xu
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Jing Su
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
| | - Xue Xia
- Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, No.1617, Riyue Avenue, Qinyang District, Chengdu, China
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Antunes-Lopes T, Cruz F. Urinary Biomarkers in Overactive Bladder: Revisiting the Evidence in 2019. Eur Urol Focus 2019; 5:329-336. [PMID: 31231010 DOI: 10.1016/j.euf.2019.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/24/2019] [Accepted: 06/10/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT In overactive bladder (OAB), after an initial outbreak of research, it is more consensual that biomarkers may be better used to phenotype patients. Herein, we revisit this topic, including some of the most promising biomarkers. OBJECTIVE To provide a comprehensive analysis of the actual role of biomarkers in OAB. EVIDENCE ACQUISITION A PubMed-based literature search was conducted, including the most relevant articles published in the last 15 yr, on nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), adenosine triphosphate (ATP), genomics, and microbiota as OAB biomarkers. Articles with no full text available or not written in English were excluded. Additional reviews were included. EVIDENCE SYNTHESIS Urinary NGF, BDNF, and ATP are increased in many OAB patients. These biomarkers can help identify OAB phenotypes and select the ideal candidates for new therapies directed to neurotrophic and purinergic pathways. Circulating urinary miRNA may be useful for establishing the ideal moment for bladder outlet obstruction relief and will eventually lead to the development of therapeutic agents that inhibit or reverse fibrotic pathways in the bladder. Urinary microbiota seems to be related to OAB symptoms, in particular urgency urinary incontinence, and may have strong implications in the prevention, diagnosis, and treatment of OAB. CONCLUSIONS In the future, physicians may consider the use of biomarkers to identify distinct OAB phenotypes, with distinct causal mechanisms, selecting patients for specific target therapies with expected better outcomes. PATIENT SUMMARY Overactive bladder biomarkers can be useful for phenotype patients and for selecting more effective target therapies.
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Affiliation(s)
- Tiago Antunes-Lopes
- Department of Urology, Hospital de S. João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; I3S-Instituto de Investigação e Inovação em Saúde, Translational Neuro-Urology Group, University of Porto, Porto, Portugal.
| | - Francisco Cruz
- Department of Urology, Hospital de S. João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; I3S-Instituto de Investigação e Inovação em Saúde, Translational Neuro-Urology Group, University of Porto, Porto, Portugal
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11
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Neuroepithelial control of mucosal inflammation in acute cystitis. Sci Rep 2018; 8:11015. [PMID: 30030504 PMCID: PMC6054610 DOI: 10.1038/s41598-018-28634-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 05/03/2018] [Indexed: 12/18/2022] Open
Abstract
The nervous system is engaged by infection, indirectly through inflammatory cascades or directly, by bacterial attack on nerve cells. Here we identify a neuro-epithelial activation loop that participates in the control of mucosal inflammation and pain in acute cystitis. We show that infection activates Neurokinin-1 receptor (NK1R) and Substance P (SP) expression in nerve cells and bladder epithelial cells in vitro and in vivo in the urinary bladder mucosa. Specific innate immune response genes regulated this mucosal response, and single gene deletions resulted either in protection (Tlr4−/− and Il1b−/− mice) or in accentuated bladder pathology (Asc−/− and Nlrp3−/− mice), compared to controls. NK1R/SP expression was lower in Tlr4−/− and Il1b−/− mice than in C56BL/6WT controls but in Asc−/− and Nlrp3−/− mice, NK1R over-activation accompanied the exaggerated disease phenotype, due, in part to transcriptional de-repression of Tacr1. Pharmacologic NK1R inhibitors attenuated acute cystitis in susceptible mice, supporting a role in disease pathogenesis. Clinical relevance was suggested by elevated urine SP levels in patients with acute cystitis, compared to patients with asymptomatic bacteriuria identifying NK1R/SP as potential therapeutic targets. We propose that NK1R and SP influence the severity of acute cystitis through a neuro-epithelial activation loop that controls pain and mucosal inflammation.
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Re: Sheng W, Zhang H, Kirschner-Hermanns R. Could urinary nerve growth factor be a biomarker for overactive bladder? A meta-analysis. Neurourol Urodyn. 2017;9999:1-8. doi: 10.1002/nau.23210. Neurourol Urodyn 2017; 36:2190-2191. [DOI: 10.1002/nau.23268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 02/24/2017] [Indexed: 11/07/2022]
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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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Richter HE, Moalli P, Amundsen CL, Malykhina AP, Wallace D, Rogers R, Myers D, Paraiso M, Albo M, Shi H, Nolen T, Meikle S, Word RA. Urinary Biomarkers in Women with Refractory Urgency Urinary Incontinence Randomized to Sacral Neuromodulation versus OnabotulinumtoxinA Compared to Controls. J Urol 2017; 197:1487-1495. [PMID: 28089729 PMCID: PMC5433900 DOI: 10.1016/j.juro.2017.01.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE We measured urinary biomarker levels in women with refractory urgency urinary incontinence and controls at baseline and 6 months after treatment with sacral neuromodulation or intradetrusor injection of onabotulinumtoxinA. We also assessed the association of baseline biomarkers with posttreatment urgency urinary incontinence episodes and overactive bladder symptom bother outcomes. MATERIALS AND METHODS First morning urine samples were collected from consented trial participants and age matched women without urgency urinary incontinence. Biomarkers reflecting general inflammation, neuroinflammation, afferent neurotransmitters and tissue remodeling were measured using standardized enzyme-linked immunosorbent assay and activity assays as appropriate. Symptom bother was assessed by the overactive bladder questionnaire and urgency urinary incontinence episodes were determined by bladder diary. Linear models were used to examine differences in mean biomarker levels and the change in urgency urinary incontinence episodes and symptom bother between baseline and 6 months. Modest evidence of a potential association was represented by p ≤0.01 and p ≤0.004 represented moderate evidence of an association with outcomes. RESULTS Baseline biomarker levels differed little between cases and controls except tropoelastin (p = 0.001) and N-terminal telopeptide collagen type 1 (p <0.001). Changes in biomarker levels 6 months after intervention included decreases in collagenase (p <0.001) in both treatment groups and increases in interleukin-8 (p = 0.002) and matrix metalloprotease-9 (p <0.001) in the onabotulinumtoxinA group. Higher baseline calcitonin gene-related peptide across both treatments (p = 0.007) and nerve growth factor in the onabotulinumtoxinA arm (p = 0.007) were associated with less reduction in overactive bladder symptom bother. CONCLUSIONS Refractory urgency urinary incontinence is a complex condition. These data suggest that matrix remodeling and neuropeptide mediation may be involved in its pathophysiological mechanisms and response to treatment.
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Affiliation(s)
| | | | | | | | - Dennis Wallace
- RTI International, Research Triangle Park, North Carolina
| | | | | | | | - Michael Albo
- University of California-San Diego, San Diego, California
| | - Haolin Shi
- University of Texas Southwestern, Dallas, Texas
| | - Tracy Nolen
- RTI International, Research Triangle Park, North Carolina
| | - Susie Meikle
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Baltimore, Maryland
| | - R Ann Word
- University of Texas Southwestern, Dallas, Texas
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Sheng W, Zhang H, Ruth KH. Could urinary nerve growth factor be a biomarker for overactive bladder? A meta-analysis. Neurourol Urodyn 2017; 36:1703-1710. [DOI: 10.1002/nau.23210] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 11/26/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Wei Sheng
- University Clinic; Rheinisch Friedrich-Wilhelms University-Clinic of Urology/Neuro-Urology; Bonn Germany
| | - Hongwei Zhang
- Department of Urology; The First People's Hospital of Changde; Changde China
| | - Kirschner-Hermanns Ruth
- University Clinic; Rheinisch Friedrich-Wilhelms University-Clinic of Urology/Neuro-Urology; Bonn Germany
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