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Bozkurt M, Polat EC, Ozcan L, Ozer M, Ozturk GY, Yildirim F, Otunctemur A. Effect of Nintedanib on healing and fibrosis in rats with experimentally induced urethral injury. Prog Urol 2023:S1166-7087(23)00065-9. [PMID: 36959024 DOI: 10.1016/j.purol.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/21/2023] [Accepted: 02/25/2023] [Indexed: 03/25/2023]
Abstract
AIM We aimed to determine the effectiveness of Nintedanib treatment, which has known antifibrotic effect, in preventing fibrosis after urethral trauma. MATERIAL AND METHODS Twenty-three adult Sprague-Dawley rats were divided randomly into 3 different groups: Sham, Urethral injury group (UI) and Urethral injury+ Nintedanib (UI+N). The urethral injury model was made with a pediatric urethrotome knife. Nintedanib was administered at a dose of 50mg/kg by oral gavage for 14 days at the same time every day. After 14 days of treatment, all rats were performed penectomy under general anesthesia. Urethral tissue was evaluated histopathologically (congestion, inflammatory cell infiltration and spongiofibrosis) and immunohistochemically (transforming growth factor (TBF) Beta-1 and vascular endothelial growth factor receptor 2 (VEBFR2)). RESULTS Histopathological findings: Group UI had higher scores in all categories (congestion, inflammatory cell infiltration, and spongiofibrosis), followed by Group UI+N and Group Sham, respectively. A statistically significant difference was found between Group UI and Group UI+N in terms of the scores of histopathological parameters (p<0.05). Immunohistochemical findings: Group UI had higher scores in both categories, followed by Group UI+N and Group Sham, respectively. A statistically significant difference was found between Group UI and Group UI+N in TGF Beta-1 and VEGF scores (p<0.05). CONCLUSION We found that Nintedanib administration after urethral trauma reduced inflammation and fibrosis histologically and immunohistochemically. The positive effect of Nintedanib on inflammation and fibrosis after urethral trauma reported in this animal study is encouraging for a potential clinical human application.
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Affiliation(s)
- M Bozkurt
- Department of Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
| | - E C Polat
- Department of Urology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - L Ozcan
- Department of Urology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - M Ozer
- Department of Urology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - G Y Ozturk
- Department of Pathology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - F Yildirim
- Department of Pathology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - A Otunctemur
- Department of Urology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
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Chen YH, Dong RN, Hou J, Lin TT, Chen SH, Chen H, Zhu JM, Chen JY, Ke ZB, Lin F, Xue XY, Wei Y, Xu N. Mesenchymal Stem Cell-Derived Exosomes Induced by IL-1β Attenuate Urethral Stricture Through Let-7c/PAK1/NF-κB-Regulated Macrophage M2 Polarization. J Inflamm Res 2021; 14:3217-3229. [PMID: 34285545 PMCID: PMC8286124 DOI: 10.2147/jir.s308405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/29/2021] [Indexed: 01/07/2023] Open
Abstract
Background Urethral stricture is a clinical challenge for both patients and clinicians. Post-traumatic urethral stricture is associated with formation of scar tissue caused by excessive inflammation. The aim of this study is exploring potential therapeutic strategies for this condition. Methods In vivo experiments on New Zealand rabbits and in vitro experiments on THP-1 monocytes and urethral fibroblasts were performed to investigate the effects on post-traumatic urethral stricture of exosomes isolated from IL-1β-treated mesenchymal stem cells (Exo-MSCsIL-1β) and the role of macrophage M2 polarization in this process. Additionally, related signaling and mechanism behind were explored. Results In a New Zealand rabbit model of post-traumatic urethral stricture, injection of Exo-MSCsIL-1β significantly reduced urethral stricture and collagen fiber accumulation compared with Exo-MSCs. Addition of Exo-MSCsIL-1β to THP-1 monocytes in vitro induced M2 macrophage polarization, which, in turn, inhibited activation of urethral fibroblasts and synthesis of collagen. Mechanistically, Exo-MSCsIL-1β were found to contain high levels of the microRNA let-7c, and luciferase reporter assays showed that let-7c interacted with the 3'UTR of PAK1 mRNA. Transfection of THP-1 cells with a let-7c mimic downregulated PAK1 expression and inhibited activation of the NF-κB signaling pathway. Conclusion These results support a role for let-7c-containing Exo-MSCsIL-1β in reducing urethral stricture via inhibition of PAK1-NF-κB signaling, M2 macrophage polarization, and differentiation of urethral myofibroblasts.
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Affiliation(s)
- Ye-Hui Chen
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Ru-Nan Dong
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Jian Hou
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Ting-Ting Lin
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Shao-Hao Chen
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Hang Chen
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Jun-Ming Zhu
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Jia-Yin Chen
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Zhi-Bin Ke
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Fei Lin
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Xue-Yi Xue
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Yong Wei
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Ning Xu
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China.,Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People's Republic of China
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Kurt O, Gevher F, Yazici CM, Erboga M, Dogru M, Aktas C. Effect of Mitomycin - C and Triamcinolone on Preventing Urethral Strictures. Int Braz J Urol 2017; 43:939-945. [PMID: 28537690 PMCID: PMC5678528 DOI: 10.1590/s1677-5538.ibju.2016.0191] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 07/17/2016] [Indexed: 08/26/2023] Open
Abstract
Urethral stricture is a common disease with high recurrence rate. Several manipulations were defined to prevent the recurrence but the results were disappointing. This study aimed to evaluate the efficacy of triamcinolone and mitomycin-C on urethral stricture formation and their effect on inhibition of urethral fibrosis. A total of 24 New Zealand rabbits were divided into 3 groups. Urethras of rabbits were traumatized with pediatric resectoscope. Resection area was irrigated with 10mL saline, swapped with a cotton wool soaked with 0.5mg/mL MMC and injected by 40mg triamcinolone in groups 1, 2 and 3 respectively. Retrograde urethrogram was performed at 28th day of procedure and the urethra was removed for histopathologic evaluation. There were significant differences in urethral diameters and in lumen reduction rate between the control and study groups (p<0.001). Compared to control group, all treatment groups showed mild fibrosis, less collagen bundle irregularity, and lower numbers of fibroblasts (p=0.003). The Tunnel assay showed that the number of apoptotic cells in the submucosal connective tissue was quantitatively higher in control groups (p=0.034). In the view of efficacy and safety, MMC and triamcinolone have the potential to replace the use of stents, clean intermittent catheterization, or long term catheters following internal urethrotomy. There were no statistically significant differences between two agents in terms of preventing urethral stricture formation in the present study. Mitomycin C and triamcinolone decreased the recurrence rates of urethral stricture.
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Affiliation(s)
- Omer Kurt
- Department of Urology, Namik Kemal University, School of Medicine, Tekirdag, Turkey
| | | | - Cenk Murat Yazici
- Department of Urology, Namik Kemal University, School of Medicine, Tekirdag, Turkey
| | - Mustafa Erboga
- Department of Histology, Namik Kemal University, School of Medicine, Tekirdag, Turkey
| | - Mucahit Dogru
- Department of Radiology, Namik Kemal University, School of Medicine, Tekirdag, Turkey
| | - Cevat Aktas
- Department of Histology, Namik Kemal University, School of Medicine, Tekirdag, Turkey
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Kurt O, Yesildag E, Yazici CM, Aktas C, Ozcaglayan O, Bozdemir Y. Effect of Tadalafil on Prevention of Urethral Stricture After Urethral Injury: An Experimental Study. Urology 2016; 91:243.e1-6. [DOI: 10.1016/j.urology.2016.02.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 10/22/2022]
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Fu D, Chong T, Li H, Zhang H, Wang Z. Docetaxel inhibits urethral stricture formation, an initial study in rabbit model. PLoS One 2014; 9:e112097. [PMID: 25375859 PMCID: PMC4223003 DOI: 10.1371/journal.pone.0112097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 10/12/2014] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Urethral stricture, a frequent source of lower urinary tract disorders in men, is still a difficult problem for urologists. Based the anti-restenosis effect of paclitaxel on coronary artery, the role of docetaxel, a semi-synthetic analogue of paclitaxel, in limiting urethral stricture formation was studied. METHODS Forty adult New Zealand male rabbits were involved in this study, which were randomly assigned into 3 groups, namely a high dose docetaxel (DH, 0.1 mg/d), a low dose docetaxel (DL, 0.01 mg/d) and a control (C) group, with 16, 16, 8 rabbits in each group, respectively. All animals underwent a 10 mm-long circumferential electrocoagulation of the bulbar urethra with a 13Fr pediatric resectoscope. Drugs were given by urethral irrigation daily and continuous for 28 days. Stricture formation was assessed by retrograde urethrography and videourethroscopy. Urethra pathology was evaluated by hematoxylin and eosin staining and Sirius red staining. RESULTS At the end of this study, 15, 14 and 7 rabbits remained for evaluation in DH, DL and C group, respectively. Urethral diameters in DH, DL and C group were (7.17±1.63) mm, (6.55±0.62) mm, (3.23±1.36) mm, with a normal urethral diameter of (9.08±1.29) mm. Lumen reduction in DH, DL and C group were (36.93±11.58)%, (48.03±7.89)% and (84.66±14.95)%, respectively. Statistically difference could be found between every two groups (p<0.05) both in urethral diameters and in lumen reduction, except for compare of urethral diameters between DH and DL group. Histological examination confirmed mass fibrous tissue and collagen content at the stricture sit in C group, whereas less in docetaxel treated rabbits. CONCLUSIONS Docetaxel could limit urethral stricture formation, which may be due to inhibition of fibrous tissue and collagen expression. Docetaxel may become a new choice in the prevention of urethral stricture formation.
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Affiliation(s)
- Delai Fu
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Tie Chong
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Hecheng Li
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Huibo Zhang
- Department of Urology, the Affiliated Hospital of Shaanxi Traditional Chinese Medical Collage, Xianyang, Shaanxi, People’s Republic of China
| | - Ziming Wang
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
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Hu WF, Li CL, Zhang HP, Li TT, Zeng XY. An Experimental Model of Urethral Stricture in Rabbits Using Holmium Laser under Urethroscopic Direct Visualization. Urol Int 2014; 93:108-12. [DOI: 10.1159/000355353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 08/28/2013] [Indexed: 11/19/2022]
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Faydaci G, Tarhan F, Tuncer M, Eryildirim B, Celik O, Keser SH, Ozgül A. Comparison of two experimental models for urethral stricture in the anterior urethra of the male rabbit. Urology 2012; 80:225.e7-11. [PMID: 22626583 DOI: 10.1016/j.urology.2012.04.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 04/11/2012] [Accepted: 04/11/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare 2 urethral stricture models and determine the appropriate model for the generation of urethral stricture in rabbits. METHODS A total of 28 adult male New Zealand rabbits were included in the present study. They were separated randomly into 3 groups. Urethroscopy was performed using a pediatric resectoscope (13F). In 1 group (10 rabbits), circumferential electrocoagulation of the anterior urethra 2-3 mm long was performed until ulceration of the mucosa occurred. In the second group (10 rabbits), 2-3 mm wide resection from the anterior urethra was performed that was deep enough to expose the periurethral tissue to allow urine leakage from the lumen. The remaining 8 rabbits as the control group underwent only urethroscopy. On the 30th day, retrograde urethrography and urethroscopy were performed to evaluate urethral stricture formation. Histologic examination was done to evaluate the urethral pathologic changes. RESULTS According to the urethrography and urethroscopy findings, no rabbits in the electrocoagulation or control group developed urethral stricture; however, significant stricture formation was observed in every case of the electroresection group. Regenerating urothelium at the luminal side of the urethra was seen in 6 rabbits in the electrocoagulation group and 4 showed normal urethra. In the electroresection group, extensive fibrosis that obstructed the urethral lumen and nodular collagen bundles in the urethral wall were seen. CONCLUSION The electroresection method is more reliable than the electrocoagulation method in developing urethral stricture in the rabbit model. A 2-3-mm-wide resection from the anterior urethra can successfully generate urethral stricture with respect to electrocoagulation. Electroresection offers an ideal animal model for generating urethral stricture.
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Affiliation(s)
- Gökhan Faydaci
- Urology Clinic, Lutfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey.
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Chong T, Fu DL, Li HC, Zhang HB, Zhang P, Gan WM, Wang ZM. Rapamycin inhibits formation of urethral stricture in rabbits. J Pharmacol Exp Ther 2011; 338:47-52. [PMID: 21464336 DOI: 10.1124/jpet.110.178624] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Rapamycin has been reported to inhibit hepatic fibrosis, lung fibrosis, renal fibrosis, and subglottic stenosis. Fibrosis is also involved in urethral stricture. Therefore, we investigated the effect of rapamycin on the inhibition of urethral stricture formation in a rabbit model. First, models of urethral stricture were successfully established by electrocoagulation of the bulbar urethra in adult New Zealand male rabbits. Forty-six model rabbits were randomly assigned to four groups: high-dose rapamycin (R(H), 1.0 mg/day), low-dose rapamycin (R(L), 0.1 mg/day), dimethyl sulfoxide (DMSO) alone (DMSO, solvent control), and normal saline (NS). Urethral stricture was assessed by a retrograde urethrogram and video-urethroscopy. Urethra pathology was evaluated by hematoxylin and eosin and Sirius red staining. After 28 days of treatment, lumen reduction in the R(H), R(L), DMSO, and NS groups was 36.0, 56.5, 69.1, and 82.9, respectively. Comparison of the rapamycin groups (R(H) and R(L)) and control groups (DMSO and NS) indicated significantly less restriction in the rapamycin groups. Histopathological analysis confirmed the presence of fibroblasts and an increase in collagen at the stricture site in the two control groups but not in the R(H) or R(L) groups. These results indicate that rapamycin inhibits experimentally induced urethral stricture formation in rabbits. This effect may be due to its inhibition of fibroblast proliferation and collagen expression.
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Affiliation(s)
- Tie Chong
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi, People's Republic of China
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