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Fang F, Zhao Z, Xiao J, Wen J, Wu J, Miao Y. Current practice in animal models for pelvic floor dysfunction. Int Urogynecol J 2023; 34:797-808. [PMID: 36287229 DOI: 10.1007/s00192-022-05387-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to explore the current practice of using animal models for female pelvic floor dysfunction (PFD). METHODS By applying PFD and animal models as the keywords, we made a computerized search using PubMed, Ovid-Medline and Ovid-Embase from 2000 to 2022. The publications on the construction and application of animal models for PFD were included, and the results are presented in narrative text. RESULTS Studies on PFD primarily use rodents, large quadrupeds, and nonhuman primates (NHPs). NHPs are closest to humans in anatomy and biomechanics of the pelvic floor, followed by large quadrupeds and rodents. Rodents are more suitable for studying molecular mechanism, histopathology of PFD, and mesh immune rejection. Large quadrupeds are adaptable to the study of pelvic floor biomechanics and the development of new surgical instruments for PFD. NHPs are suitable for studying the occurrence and pathogenesis of pelvic organ prolapse. Among modeling methods, violent destruction of pelvic floor muscles, regulation of hormone levels, and denervation were used to simulate the occurrence of PFD. Gene knockout can be used to study both the pathogenesis of PFD and the efficacy of treatments. Other methods such as abdominal wall defect, vaginal defect, and in vitro organ bath system are more frequently used to observe wound healing after surgery and to verify the efficacy of treatments. CONCLUSIONS The rat is currently the most applicable animal type for numerous modeling methods. Vaginal dilation is the most widely used modeling method for research on the pathogenesis, pathological changes, and treatment of PFD.
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Affiliation(s)
- Fei Fang
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, West China Second University Hospital, Sichuan University, West China Campus, Chengdu, 610041, Sichuan Province, China
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Zhiwei Zhao
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Jingyue Xiao
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Jirui Wen
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Jiang Wu
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Yali Miao
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, West China Second University Hospital, Sichuan University, West China Campus, Chengdu, 610041, Sichuan Province, China.
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Balog BM, Deng K, Askew T, Hanzlicek B, Kuang M, Damaser MS. Brain-Derived Neurotrophic Factor Is Indispensable to Continence Recovery after a Dual Nerve and Muscle Childbirth Injury Model. Int J Mol Sci 2023; 24:ijms24054998. [PMID: 36902428 PMCID: PMC10003675 DOI: 10.3390/ijms24054998] [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: 12/27/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
In women, stress urinary incontinence (SUI), leakage of urine from increased abdominal pressure, is correlated with pudendal nerve (PN) injury during childbirth. Expression of brain-derived neurotrophic factor (BDNF) is dysregulated in a dual nerve and muscle injury model of childbirth. We aimed to use tyrosine kinase B (TrkB), the receptor of BDNF, to bind free BDNF and inhibit spontaneous regeneration in a rat model of SUI. We hypothesized that BDNF is essential for functional recovery from the dual nerve and muscle injuries that can lead to SUI. Female Sprague-Dawley rats underwent PN crush (PNC) and vaginal distension (VD) and were implanted with osmotic pumps containing saline (Injury) or TrkB (Injury + TrkB). Sham Injury rats received sham PNC + VD. Six weeks after injury, animals underwent leak-point-pressure (LPP) testing with simultaneous external urethral sphincter (EUS) electromyography recording. The urethra was dissected for histology and immunofluorescence. LPP after injury and TrkB was significantly decreased compared to Injury rats. TrkB treatment inhibited reinnervation of neuromuscular junctions in the EUS and promoted atrophy of the EUS. These results demonstrate that BDNF is essential to neuroregeneration and reinnervation of the EUS. Treatments aimed at increasing BDNF periurethrally could promote neuroregeneration to treat SUI.
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Affiliation(s)
- Brian M. Balog
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Advanced Platform Technology Center, Research Service, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA
- Department of Biology, University of Akron, Akron, OH 44325, USA
| | - Kangli Deng
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Advanced Platform Technology Center, Research Service, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA
| | - Tessa Askew
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Biology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Brett Hanzlicek
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Advanced Platform Technology Center, Research Service, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA
| | - Mei Kuang
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Margot S. Damaser
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Advanced Platform Technology Center, Research Service, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA
- Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH 44311, USA
- Correspondence:
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Yuan X, Balog BM, Lin DL, Hanzlicek B, Kuang M, Yan H, Majerus SJA, Damaser MS. Brain-Derived Neurotrophic Factor Is an Important Therapeutic Factor in Mesenchymal Stem Cell Secretions for Treatment of Traumatic Peripheral Pelvic Injuries. Front Cell Neurosci 2022; 16:866094. [PMID: 35663428 PMCID: PMC9157419 DOI: 10.3389/fncel.2022.866094] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/12/2022] [Indexed: 11/18/2022] Open
Abstract
Traumatic neuromuscular injury to the pudendal nerve and urethra during childbirth does not regenerate well and contributes to stress urinary incontinence in women. Mesenchymal stem cells (MSCs) can improve neuroregeneration via their secretions, or secretome, which includes brain-derived neurotrophic factor (BDNF). In this study, we investigated whether BDNF is a key factor in the secretome of MSCs for the facilitation of functional recovery following a dual simulated childbirth injury. BDNF knockdown (KD) MSCs were created using an anti-BDNF shRNA lentivirus vector. A scrambled sequence was used as a transduction control (scrambled). Cells were cultured for 24 h before media was concentrated 50x to create concentrated conditioned media (CCM) containing MSC secretome. CCM of unmanipulated MSCs was screened for high BDNF expression (high BDNF CCM). Concentrated control media (CM) was created by concentrating media not conditioned by cells. Female Sprague-Dawley rats underwent bilateral pudendal nerve crush and vaginal distension (Injury) or sham injury. One hour and 1 week after injury, sham injured rats received CM, and injured rats received CM, high BDNF CCM, KD CCM, or scrambled CCM (300 μl intraperitoneally). Three weeks after injury, rats underwent leak point pressure (LPP) and pudendal nerve sensory branch potential (PNSBP) recordings. The urethra and pudendal nerve were harvested for anatomical assessment. ANOVA followed by the Student-Newman-Keuls test determined significant differences between groups (p < 0.05). BDNF KD CCM had significantly decreased BDNF concentration compared to scrambled CCM, while the concentration in high BDNF CCM was significantly increased. LPP was significantly decreased in CM and KD CCM treated animals compared to sham injury, but not with scrambled or high BDNF CCM. PNSBP firing rate showed a significant decrease with CM treatment compared to sham injury. Neuromuscular junctions in the urethral sphincter in KD CCM, scrambled CCM, and high BDNF CCM were healthier than CM treated rats. While anatomical and nerve function tests demonstrate regeneration of the pudendal nerve with any CCM treatment, LPP results suggest it takes longer to recover continence with reduced BDNF in CCM. BDNF in MSC CCM is an important factor for the acceleration of recovery from a dual nerve and muscle injury.
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Affiliation(s)
- Xiaoyi Yuan
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
- Department of Urology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Brian M. Balog
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
- Department of Biology, University of Akron, Akron, OH, United States
| | - Dan Li Lin
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Brett Hanzlicek
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Mei Kuang
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Hao Yan
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Steve J. A. Majerus
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Margot S. Damaser
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, United States
- *Correspondence: Margot S. Damaser
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