Urinary amino acid excretion: comparison of normal individuals and patients with bladder cancer

The effect of amino acids on the bladder cycle: a concise review

The human bladder maintains a cycle of filling, storing, and micturating throughout an individual's lifespan. The cycle relies on the ability of the bladder to expand without increasing the intravesical pressure, which is only possible with the controlled relaxation of well-complaint muscles and the congruously organized construction of the bladder wall. A competent bladder outlet, which functions in a synchronous fashion with the bladder, is also necessary for this cycle to be completed successfully without deterioration. In this paper, we aimed to review the contemporary physiological findings on bladder physiology and examine the effects of amino acids on clinical conditions affecting the bladder, with special emphasis on the available therapeutic evidence and possible future roles of the amino acids in the treatment of the bladder-related disorders.

Concurrent alterations in TERT, KDM6A, and the BRCA pathway in bladder cancer

PURPOSE

Genetic analysis of bladder cancer has revealed a number of frequently altered genes, including frequent alterations of the telomerase (TERT) gene promoter, although few altered genes have been functionally evaluated. Our objective is to characterize alterations observed by exome sequencing and sequencing of the TERT promoter, and to examine the functional relevance of histone lysine (K)-specific demethylase 6A (KDM6A/UTX), a frequently mutated histone demethylase, in bladder cancer.

EXPERIMENTAL DESIGN

We analyzed bladder cancer samples from 54 U.S. patients by exome and targeted sequencing and confirmed somatic variants using normal tissue from the same patient. We examined the biologic function of KDM6A using in vivo and in vitro assays.

RESULTS

We observed frequent somatic alterations in BRCA1 associated protein-1 (BAP1) in 15% of tumors, including deleterious alterations to the deubiquitinase active site and the nuclear localization signal. BAP1 mutations contribute to a high frequency of tumors with breast cancer (BRCA) DNA repair pathway alterations and were significantly associated with papillary histologic features in tumors. BAP1 and KDM6A mutations significantly co-occurred in tumors. Somatic variants altering the TERT promoter were found in 69% of tumors but were not correlated with alterations in other bladder cancer genes. We examined the function of KDM6A, altered in 24% of tumors, and show depletion in human bladder cancer cells, enhanced in vitro proliferation, in vivo tumor growth, and cell migration.

CONCLUSIONS

This study is the first to identify frequent BAP1 and BRCA pathway alterations in bladder cancer, show TERT promoter alterations are independent of other bladder cancer gene alterations, and show KDM6A loss is a driver of the bladder cancer phenotype.

Urinary proteins as biological markers: bladder cancer diagnosis versus urinary tract infection

Urine specimens from normal individuals, and from patients with bladder cancer, bladder papillomas and urinary tract infections were assayed for the presence of bladder tumor-related antigens. Ten-fold concentrated urine specimens were reacted in Ouchterlony gel diffusion against various anti-human monospecific antisera. With these antisera urine specimens from normal individuals were distinguished from those from patients with bladder carcinoma as well as bladder papilloma. However, the urine samples from individuals with urinary tract infections showed significant reactivity with many of the monospecific antisera as did specimens from patients with bladder cancer and bladder papilloma. Thus, investigations involved in the assay of bladder cancer biological markers should take the proteinuria associated with urinary tract infection into consideration. The potential importance of detecting tumor-specific components for early diagnosis and treatment of bladder neoplasms is stressed.