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Wu Q, Qin B, Wu X, Zhang M, Gan Z, Lan Y, Ma C, Fu W. Allograft inflammatory factor-1 enhances inflammation and oxidative stress via the NF-κB pathway of bladder urothelium in diabetic rat model. Cytokine 2024; 173:156438. [PMID: 37976702 DOI: 10.1016/j.cyto.2023.156438] [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: 08/24/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES To explore the role of allograft inflammatory factor-1 (AIF-1) both in diabetic rat bladder urothelium and in high-glucose-treated human urothelial cell line (SV-HUC-1). METHODS Inflammation and oxidative stress (OS) promote diabetic cystopathy (DCP), but the mechanisms are not fully understood. The expression level of AIF-1 in diabetic rat bladder urothelium and in the SV-HUC-1 cells treated with high glucose was detected using tissue immunofluorescence, immunohistochemistry and western blot assays. AIF-1 was knocked down and NF-κB was suppressed with the specific inhibitor BAY 11-7082 in high-glucose-treated SV-HUC-1 cells. RESULTS High-glucose condition induced AIF-1 upregulation in vivo and in vitro. The up-regulated AIF-1 induced the production of inflammatory factors IL-6 and TNF-α and elevation of ROS. Informatics analysis suggested that NF-κB pathway is implicated in DCP. Through knockdown of AIF-1, we confirmed that AIF-1 simulated NF-κB pathway by enhancing the phosphorylation of IκB (p-IκB) and promoting the translocation of NF-κB p65 from cytoplasm into nucleus. Additionally, High-glucose-induced inflammation in SV-HUC-1 cells was attenuated by the addition of NF-κB inhibitor. CONCLUSIONS This study provides novel information to understand the molecular regulation mechanisms of AIF-1 in DCP.
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Affiliation(s)
- Qinguo Wu
- Department of Urology of GuiGang City People Hospital, GuiGang 537199, China; Department of Urology, The First Affiliated Hospital of GuangXi Medical University, Nanning 530022, China.
| | - Bin Qin
- Department of Urology of GuiGang City People Hospital, GuiGang 537199, China.
| | - Xiaoyun Wu
- Department of Nursing, Guangxi Medical College, Nanning 530023, China.
| | - Mingjin Zhang
- Department of Urology, The First Affiliated Hospital of GuangXi Medical University, Nanning 530022, China.
| | - Zhaokai Gan
- Department of Urology of GuiGang City People Hospital, GuiGang 537199, China.
| | - Yibi Lan
- Department of Urology, The First Affiliated Hospital of GuangXi Medical University, Nanning 530022, China.
| | - Chunlei Ma
- Department of Urology, The First Affiliated Hospital of GuangXi Medical University, Nanning 530022, China.
| | - Weijin Fu
- Department of Urology, The First Affiliated Hospital of GuangXi Medical University, Nanning 530022, China.
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Yonekubo-Awaka S, Tezuka M, Tatemichi S, Takeda H. Therapeutic effects of silodosin and urapidil on underactive bladder associated with diabetic cystopathy. Low Urin Tract Symptoms 2022; 14:434-441. [PMID: 36059204 DOI: 10.1111/luts.12462] [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: 06/02/2022] [Revised: 07/21/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Pharmacological treatment options for underactive bladder (UAB) syndrome are limited. Urapidil is the only alpha1 -adrenoceptor (AR) antagonist that can be used for urinary disorders in women in some countries. However, no studies have directly verified the effects of alpha1 -AR antagonists on the female urethra and UAB-like dysfunctions. We investigated the effects of silodosin (alpha1A -AR antagonist) and urapidil (nonselective alpha1 -AR antagonist) on the voiding function in female rats with diabetes mellitus (DM). METHODS Changes in intraurethral pressure (IUP) induced by midodrine (alpha1 -AR agonist) and mean blood pressure (MBP) were continuously measured in normal female rats to verify the pharmacological profiles of the drugs. To establish a DM model, rats were administered streptozotocin (STZ; 50 mg/kg, intravenous). Eight weeks after STZ administration, drugs were subcutaneously delivered through an osmotic pump. Four weeks after drug administration, emptied bladder blood flow (BBF), intravesical pressure, and the micturition volume were measured. RESULTS Both silodosin and urapidil inhibited the midodrine-induced increase in IUP and decreased MBP in a dose-dependent manner. Silodosin had a more substantial effect on the lower urinary tract than on MBP. Twelve weeks after STZ administration, DM rats exhibited UAB-like dysfunction (increased bladder capacity/bladder weight and residual volume and decreased bladder voided efficiency) and decreased BBF. Both drug treatments controlled this dysfunction. CONCLUSIONS Alpha1 -AR antagonists induced dose-dependent urethral relaxation in female rats. These drugs ameliorated UAB-like dysfunction in STZ-induced DM rats. In addition, alpha1A -AR antagonists such as silodosin, which have limited effects on blood pressure, appear to be useful for treating UAB.
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Affiliation(s)
| | - Motohiro Tezuka
- Central Research Laboratories, Kissei Pharmaceutical Co, Ltd, Matsumoto, Japan
| | - Satoshi Tatemichi
- Central Research Laboratories, Kissei Pharmaceutical Co, Ltd, Matsumoto, Japan
| | - Hiroo Takeda
- Central Research Laboratories, Kissei Pharmaceutical Co, Ltd, Matsumoto, Japan
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Song QX, Sun Y, Deng K, Mei JY, Chermansky CJ, Damaser MS. Potential role of oxidative stress in the pathogenesis of diabetic bladder dysfunction. Nat Rev Urol 2022; 19:581-596. [PMID: 35974244 DOI: 10.1038/s41585-022-00621-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/09/2022]
Abstract
Diabetes mellitus is a chronic metabolic disease, posing a considerable threat to global public health. Treating systemic comorbidities has been one of the greatest clinical challenges in the management of diabetes. Diabetic bladder dysfunction, characterized by detrusor overactivity during the early stage of the disease and detrusor underactivity during the late stage, is a common urological complication of diabetes. Oxidative stress is thought to trigger hyperglycaemia-dependent tissue damage in multiple organs; thus, a growing body of literature has suggested a possible link between functional changes in urothelium, muscle and the corresponding innervations. Improved understanding of the mechanisms of oxidative stress could lead to the development of novel therapeutics to restore the redox equilibrium and scavenge excessive free radicals to normalize bladder function in patients with diabetes.
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Affiliation(s)
- Qi-Xiang Song
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Sun
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Kangli Deng
- Department of Urology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin-Yi Mei
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | | | - Margot S Damaser
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. .,Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. .,Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
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Erdogan BR, Liu G, Arioglu-Inan E, Michel MC. Established and emerging treatments for diabetes-associated lower urinary tract dysfunction. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2022; 395:887-906. [PMID: 35545721 PMCID: PMC9276575 DOI: 10.1007/s00210-022-02249-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 12/16/2022]
Abstract
Dysfunction of the lower urinary tract (LUT) including urinary bladder and urethra (and prostate in men) is one of the most frequent complications of diabetes and can manifest as overactive bladder, underactive bladder, urinary incontinence, and as aggravated symptoms of benign prostate hyperplasia. We have performed a selective literature search to review existing evidence on efficacy of classic medications for the treatment of LUT dysfunction in diabetic patients and animals, i.e., α1-adrenoceptor and muscarinic receptor antagonists, β3-adrenoceptor agonists, and phosphodiesterase type 5 inhibitors. Generally, these agents appear to have comparable efficacy in patients and/or animals with and without diabetes. We also review effects of antidiabetic medications on LUT function. Such studies have largely been performed in animal models. In the streptozotocin-induced models of type 1 diabetes, insulin can prevent and reverse alterations of morphology, function, and gene expression patterns in bladder and prostate. Typical medications for the treatment of type 2 diabetes have been studied less often, and the reported findings are not yet sufficient to derive robust conclusions. Thereafter, we review animal studies with emerging medications perhaps targeting diabetes-associated LUT dysfunction. Data with myoinositol, daidzein, and with compounds that target oxidative stress, inflammation, Rac1, nerve growth factor, angiotensin II receptor, serotonin receptor, adenosine receptor, and soluble guanylyl cyclase are not conclusive yet, but some hold promise as potential treatments. Finally, we review nonpharmacological interventions in diabetic bladder dysfunction. These approaches are relatively new and give promising results in preclinical studies. In conclusion, the insulin data in rodent models of type 1 diabetes suggest that diabetes-associated LUT function can be mostly or partially reversed. However, we propose that considerable additional experimental and clinical studies are needed to target diabetes itself or pathophysiological changes induced by chronic hyperglycemia for the treatment of diabetic uropathy.
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Affiliation(s)
- Betül R Erdogan
- Department of Pharmacology, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir, Turkey
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Ebru Arioglu-Inan
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Martin C Michel
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
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Xin C, Fan H, Xie J, Hu J, Sun X, Liu Q. Impact of Diabetes Mellitus on Lower Urinary Tract Symptoms in Benign Prostatic Hyperplasia Patients: A Meta-Analysis. Front Endocrinol (Lausanne) 2022; 12:741748. [PMID: 35178024 PMCID: PMC8844560 DOI: 10.3389/fendo.2021.741748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/27/2021] [Indexed: 12/30/2022] Open
Abstract
Background Benign prostatic hyperplasia (BPH) is a disease that causes lower urinary tract symptoms (LUTS), which are the most common urological problem in approximately one-third of the male population aged over 50 years. Some studies have suggested that diabetes may be a risk factor for the development of BPH. However, whether diabetes aggravates the LUTS of BPH patients is still controversial. Aim To investigate the impact of diabetes mellitus on LUTS in BPH patients. Methods A literature search was conducted using Web of Science, Embase, PubMed, and China National Knowledge Infrastructure literature databases. This meta-analysis was registered in PROSPERO (registration number: CRD 42020200794). Fixed- or random-effects models were used for analysis according to heterogeneity. The results of the systematic analysis are presented as weighted mean difference (WMD) with the corresponding 95% confidence intervals (CI). Results In total, 1308 studies were retrieved from databases and 18 articles comprising 1685 cases and 4653 controls were selected for meta-analysis. The results of the meta-analysis showed that the International Prostate Symptom Score (IPSS) value and prostate volume of BPH patients with diabetes was significantly higher than that of BPH patients without diabetes. Conclusions This systematic review is the first to evaluate the impact of diabetes mellitus on LUTS in BPH patients. The results of our meta-analysis support the hypothesis that LUTS in BPH patients is increased in patients with diabetes mellitus compared with controls, which suggests that physicians should pay more attention to BPH patients with diabetes mellitus. Systematic Review Registration PROSPERO [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=200794], identifier CRD 42020200794.
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Affiliation(s)
- Caihong Xin
- Department of Endocrinology and Metabolism, Fourth People’s Hospital of Shenyang, Shenyang, China
| | - Huaying Fan
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Xie
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jingcheng Hu
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Sun
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qiuchen Liu
- Department of Urology, First Affiliated Hospital of Soochow University, Suzhou, China
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Experimental long-term diabetes mellitus alters the transcriptome and biomechanical properties of the rat urinary bladder. Sci Rep 2021; 11:15529. [PMID: 34330963 PMCID: PMC8324824 DOI: 10.1038/s41598-021-94532-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 06/30/2021] [Indexed: 02/04/2023] Open
Abstract
Diabetes mellitus (DM) is the leading cause of chronic kidney disease and diabetic nephropathy is widely studied. In contrast, the pathobiology of diabetic urinary bladder disease is less understood despite dysfunctional voiding being common in DM. We hypothesised that diabetic cystopathy has a characteristic molecular signature. We therefore studied bladders of hyperglycaemic and polyuric rats with streptozotocin (STZ)-induced DM. Sixteen weeks after induction of DM, as assessed by RNA arrays, wide-ranging changes of gene expression occurred in DM bladders over and above those induced in bladders of non-hyperglycaemic rats with sucrose-induced polyuria. The altered transcripts included those coding for extracellular matrix regulators and neural molecules. Changes in key genes deregulated in DM rat bladders were also detected in db/db mouse bladders. In DM rat bladders there was reduced birefringent collagen between detrusor muscle bundles, and atomic force microscopy showed a significant reduction in tissue stiffness; neither change was found in bladders of sucrose-treated rats. Thus, altered extracellular matrix with reduced tissue rigidity may contribute to voiding dysfunction in people with long-term DM. These results serve as an informative stepping stone towards understanding the complex pathobiology of diabetic cystopathy.
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Shin JH, Ryu CM, Ju H, Yu HY, Song S, Hong KS, Chung HM, Park J, Shin DM, Choo MS. Therapeutic Efficacy of Human Embryonic Stem Cell-Derived Multipotent Stem/Stromal Cells in Diabetic Detrusor Underactivity: A Preclinical Study. J Clin Med 2020; 9:jcm9092853. [PMID: 32899334 PMCID: PMC7563486 DOI: 10.3390/jcm9092853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/31/2020] [Indexed: 01/23/2023] Open
Abstract
Mesenchymal stem/stromal cell (MSC) therapy is a promising approach for treatment of as yet incurable detrusor underactivity (DUA), which is characterized by decreased detrusor contraction strength and/or duration, leading to prolonged bladder emptying. In the present study, we demonstrated the therapeutic potential of human embryonic stem cell (ESC)-derived multipotent MSCs (M-MSCs) in a diabetic rat model of DUA. Diabetes mellitus (DM) was induced by intraperitoneal injection of streptozotocin (STZ) (50 mg/kg) into 8-week-old female Sprague-Dawley rats. Three weeks later, various doses of M-MSCs (0.25, 0.5, and 1 × 106 cells) or an equivalent volume of PBS were injected into the outer layer of the bladder. Awake cystometry, organ bath, histological, and gene expression analyses were evaluated 1 week (short-term) or 2 and 4 weeks (long-term) after M-MSC transplantation. STZ-induced diabetic rats developed DUA, including phenotypes with significantly longer micturition intervals, increased residual urine amounts and bladder capacity, decreased micturition pressure on awake cystometry, and contractile responses to various stimuli in organ bath studies. Muscle degeneration, mast cell infiltration, fibrosis, and apoptosis were present in the bladders of DM animals. A single local transplantation of M-MSCs ameliorated DUA bladder pathology, including functional changes and histological evaluation, and caused few adverse outcomes. Immunostaining and gene expression analysis revealed that the transplanted M-MSCs supported myogenic restoration primarily by engrafting into bladder tissue via pericytes, and subsequently exerting paracrine effects to prevent apoptotic cell death in bladder tissue. The therapeutic efficacy of M-MSCs was superior to that of human umbilical cord-derived MSCs at the early time point (1 week). However, the difference in efficacy between M-MSCs and human umbilical cord-derived MSCs was statistically insignificant at the later time points (2 and 4 weeks). Collectively, the present study provides the first evidence for improved therapeutic efficacy of a human ESC derivative in a preclinical model of DM-associated DUA.
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Affiliation(s)
- Jung Hyun Shin
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.H.S.); (J.P.)
| | - Chae-Min Ryu
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Hyein Ju
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Hwan Yeul Yu
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Sujin Song
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Ki-Sung Hong
- Department of Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (K.-S.H.); (H.-M.C.)
| | - Hyung-Min Chung
- Department of Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (K.-S.H.); (H.-M.C.)
| | - Juhyun Park
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.H.S.); (J.P.)
| | - Dong-Myung Shin
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
- Correspondence: (D.-M.S.); (M.-S.C.); Tel.: +82-2-3010-2086 (D.-M.S.); +82-2-3010-3735 (M.-S.C.); Fax: +82-2-3010-8493 (D.-M.S.); +82-2-477-8928 (M.-S.C.)
| | - Myung-Soo Choo
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.H.S.); (J.P.)
- Correspondence: (D.-M.S.); (M.-S.C.); Tel.: +82-2-3010-2086 (D.-M.S.); +82-2-3010-3735 (M.-S.C.); Fax: +82-2-3010-8493 (D.-M.S.); +82-2-477-8928 (M.-S.C.)
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Mossa AH, Galan A, Cammisotto PG, Velasquez Flores M, Shamout S, Barcelona P, Saragovi HU, Campeau L. Antagonism of proNGF or its receptor p75 NTR reverses remodelling and improves bladder function in a mouse model of diabetic voiding dysfunction. Diabetologia 2020; 63:1932-1946. [PMID: 32699962 DOI: 10.1007/s00125-020-05222-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/18/2020] [Indexed: 10/23/2022]
Abstract
AIMS/HYPOTHESIS Although 80% of diabetic patients will suffer from voiding difficulties and urinary symptoms, defined as diabetic voiding dysfunction (DVD), therapeutic targets and treatment options are limited. We hypothesise that the blockade of the pro-nerve growth factor (NGF)/p75 neurotrophin receptor (p75NTR) axis by an anti-proNGF monoclonal antibody or by a small molecule p75NTR antagonist (THX-B) can restore bladder remodelling (represented by bladder weight) in an animal model of DVD. Secondary outcomes of the study include improvements in bladder compliance, contractility and morphology, as well as in voiding behaviour, proNGF/NGF balance and TNF-α expression. METHODS In a streptozotocin-induced mouse model of diabetes, diabetic mice received either a blocking anti-proNGF monoclonal antibody or a p75NTR antagonist small molecule as weekly systemic injections for 4 weeks. Animals were tested at baseline (at 2 weeks of diabetes induction), and after 2 and 4 weeks of treatment. Outcomes measured were voiding function with voiding spot assays and cystometry. Bladders were assessed by histological, contractility and protein expression assays. RESULTS Diabetic mice showed features of DVD as early as 2 weeks after diabetes diagnosis (baseline) presented by hypertrophy, reduced contractility and abnormal cystometric parameters. Following treatment initiation, a twofold increase (p < 0.05) in untreated diabetic mouse bladder weight and thickness compared with non-diabetic controls was observed, and this change was reversed by p75NTR antagonism (37% reduction in bladder weight compared with untreated diabetic mice [95% CI 14%, 60%]) after 4 weeks of treatment. However, blocking proNGF did not help to reverse bladder hypertrophy. While diabetic mice had significantly worse cystometric parameters and contractile responses than non-diabetic controls, proNGF antagonism normalised bladder compliance (0.007 [Q1-Q3; 0.006-0.009] vs 0.015 [Q1-Q3; 0.014-0.029] ml/cmH2O in untreated diabetic mice, representing 62% reduction [95% CI 8%, 110%], p < 0.05) and contractility to KCl, carbachol and electrical field stimulation (p < 0.05 compared with the diabetic group) after 2 weeks of treatment. These effects were not observed after 4 weeks of treatment with proNGF antagonist. p75NTR antagonism did not show important improvements in cystometric parameters after 2 weeks of treatment. Slightly improved bladder compliance (0.01 [Q1-Q3; 0.009-0.012] vs 0.013 [Q1-Q3; 0.011-0.016] ml/cmH2O for untreated diabetic mice) was seen in the p75NTR antagonist-treated group after 4 weeks of treatment with significantly stabilised contractile responses to KCl, carbachol and electric field stimulation (p < 0.05 for each) compared with diabetic mice. Bladder dysfunction observed in diabetic mice was associated with a significant increase in bladder proNGF/NGF ratio (3.1 [±1.2] vs 0.26 [±0.04] ng/pg in control group, p < 0.05 at week 2 of treatment) and TNF-α (p < 0.05). The proNGF/NGF ratio was partially reduced (about 60% reduction) with both treatments (1.03 [±0.6] ng/pg for proNGF antibody-treated group and 1.4 [±0.76] ng/pg for p75NTR blocker-treated group after 2 weeks of treatment), concomitant with a significant decrease in the bladder levels of TNF-α (p < 0.05), despite persistent hyperglycaemia. CONCLUSIONS/INTERPRETATION Our findings indicate that blockade of proNGF and the p75NTR receptor in diabetes can impede the development and progression of DVD. The reported improvements in morphological and functional features in our DVD model validates the proNGF/p75NTR axis as a potential therapeutic target in this pathology. Graphical abstract.
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Affiliation(s)
- Abubakr H Mossa
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada
| | - Alba Galan
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada
| | - Philippe G Cammisotto
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada
| | - Monica Velasquez Flores
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada
| | - Samer Shamout
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada
- Division of Urology, Department, of Surgery, McGill University, Montreal, QC, Canada
| | - Pablo Barcelona
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada
| | - H Uri Saragovi
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
- Center for Experimental Therapeutics, Jewish General Hospital, Montreal, QC, Canada
- Department of Ophthalmology and Vision Sciences, McGill University, Montreal, QC, Canada
| | - Lysanne Campeau
- Lady Davis Research Institute, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal, QC, H3T 1E2, Canada.
- Division of Urology, Department, of Surgery, McGill University, Montreal, QC, Canada.
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Gou X, Wu J, Huang M, Weng Y, Yang T, Chen T, Li G, Fang K. microRNA-128 mediates CB1 expression and regulates NF-KB/p-JNK axis to influence the occurrence of diabetic bladder disease. J Transl Med 2020; 18:284. [PMID: 32678046 PMCID: PMC7367232 DOI: 10.1186/s12967-020-02406-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/05/2020] [Indexed: 12/03/2022] Open
Abstract
Background Diabetic bladder disease is common complications of diabetes, its symptoms are diverse, can be due to different stages. In this study we investigate the mechanism of miR-128 targeting CB1 expression to mediate the occurrence of diabetic bladder disease. Methods Bioinformatics analysis predicts related regulatory factors of miR-128 in diabetic bladder disease. Models of diabetic bladder lesions were constructed in male SD rats by intraperitoneal injection of streptozotocin at 65 mg/kg body weight. The expression of miR-128 and CB1 mRNA in bladder tissues of each group was detected by RT-qPCR, and CB1, NF-KB, p-JNK and Bcl2 protein expression was detected by Western Blotting. We tested the function of the bladder by urodynamics, detected the pathological characteristics of the bladder tissue by HE staining, and verified the targeting relationship between miR-128 and CB1 through the prediction of the biological website, dual luciferase reporter gene assay and RIP. Results miR-128 was highly expressed in the bladder tissue of diabetic rats. Inhibition of miR-128 could improve the occurrence of diabetic bladder lesions in rats. miR-128 could target the inhibition of CB1 expression, and high expression of CB1 could antagonize miR-128 against diabetic bladder. In the diabetic bladder, miR-128 can regulate the expression of NF-KB and p-JNK through CB1 and affect the level of apoptosis. miR-128 regulates NF-KB/p-JNK through CB1, thus affecting the occurrence of diabetic bladder disease. Conclusion The high expression of miR-128 can down-regulate the expression of CB1, promote the activation of NF-KB and p-JNK, increase the level of apoptosis and promote the occurrence of diabetic bladder disease.
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Affiliation(s)
- Xin Gou
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao, Kunming, Yunnan, 650101, People's Republic of China
| | - Jing Wu
- Department of Biochemistry and Molecular Biology, The Primary Medicine School of Kunming Medical University, Kunming, 650101, People's Republic of China
| | - Mingqing Huang
- Department of Urology, The 2nd Hospital of Kunming Medical University, Kunming, 650101, People's Republic of China
| | - Yuting Weng
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao, Kunming, Yunnan, 650101, People's Republic of China
| | - Tongxin Yang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao, Kunming, Yunnan, 650101, People's Republic of China
| | - Tao Chen
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao, Kunming, Yunnan, 650101, People's Republic of China
| | - Guiqing Li
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao, Kunming, Yunnan, 650101, People's Republic of China
| | - Kewei Fang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Dadao, Kunming, Yunnan, 650101, People's Republic of China.
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10
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Ding XW, Li R, Geetha T, Tao YX, Babu JR. Nerve growth factor in metabolic complications and Alzheimer's disease: Physiology and therapeutic potential. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165858. [PMID: 32531260 DOI: 10.1016/j.bbadis.2020.165858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/11/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023]
Abstract
As the population ages, obesity and metabolic complications as well as neurological disorders are becoming more prevalent, with huge economic burdens on both societies and families. New therapeutics are urgently needed. Nerve growth factor (NGF), first discovered in 1950s, is a neurotrophic factor involved in regulating cell proliferation, growth, survival, and apoptosis in both central and peripheral nervous systems. NGF and its precursor, proNGF, bind to TrkA and p75 receptors and initiate protein phosphorylation cascades, resulting in changes of cellular functions, and are associated with obesity, diabetes and its complications, and Alzheimer's disease. In this article, we summarize changes in NGF levels in metabolic and neuronal disorders, the signal transduction initiated by NGF and proNGF, the physiological and pathophysiological relevance, and therapeutic potential in treating chronic metabolic diseases and cognitive decline.
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Affiliation(s)
- Xiao-Wen Ding
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA
| | - Rongzi Li
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA
| | - Thangiah Geetha
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
| | - Ya-Xiong Tao
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
| | - Jeganathan Ramesh Babu
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA.
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11
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Sekido N, Otsuki T, Kida J, Mashimo H, Wakamatsu D, Okada H, Matsuya H. EP2 and EP3 receptors as therapeutic targets for underactive bladder/detrusor underactivity due to diabetic cystopathy in a type 1 diabetic rat model. Low Urin Tract Symptoms 2020; 12:285-291. [PMID: 32410343 DOI: 10.1111/luts.12317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/09/2020] [Accepted: 04/19/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Diabetic cystopathy (DC) is recognized as one of the major etiologies of underactive bladder (UAB)/detrusor underactivity (DU). Although DC was first reported about three decades ago, there is a distinct lack of effective pharmacological management methods for UAB/DU due to DC with a robust certainty of evidence. In this study, we investigated whether EP2 and EP3 receptors are promising targets of pharmacological management of UAB/DU due to DC. METHODS We used streptozotocin (STZ)-induced diabetic Sprague-Dawley rats with postvoid residual urine (PVR) greater than 0.1 mL. Sixteen weeks after induction of diabetes, we performed awake single cystometry after oral administration of the vehicle, an α-blocker (tamsulosin [TAM], 0.1 and 0.3 mg/kg), a cholinesterase inhibitor (distigmine [DIS], 0.3 and 1.0 mg/kg), or an EP2/3 dual agonist (ONO-8055, 0.01 and 0.03 mg/kg). We compared cystometric parameters after administration of the vehicle and drugs using a paired t test. P < .05 was considered to be statistically significant. RESULTS Compared with the vehicle, TAM significantly decreased maximum intravesical pressure during voiding (Pmax), while DIS significantly increased it. However, neither drug significantly affected PVR or the residual urine rate (RUR). On the other hand, ONO-8055 significantly decreased PVR and tended to decrease RUR, although it did not significantly affect Pmax. CONCLUSION The present study was unable to demonstrate that stimulation of EP2 and EP3 receptors caused major improvements in UAB/DU due to DC. However, this equivocal result could arise from inherent limitations of the STZ-induced diabetic rat as a UAB/DU model.
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Affiliation(s)
- Noritoshi Sekido
- Department of Urology, School of Medicine, Faculty of Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan
| | - Takeya Otsuki
- Discovery Research Laboratories, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | - Jun Kida
- Discovery Research Laboratories, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | - Hiroko Mashimo
- Discovery Research Laboratories, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | - Daisuke Wakamatsu
- Discovery Research Laboratories, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | - Hiroki Okada
- Discovery Research Laboratories, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | - Hidekazu Matsuya
- Discovery Research Laboratories, Ono Pharmaceutical Co, Ltd, Osaka, Japan
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12
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Elrashidy RA, Liu G. Long-term diabetes causes molecular alterations related to fibrosis and apoptosis in rat urinary bladder. Exp Mol Pathol 2019; 111:104304. [PMID: 31479659 DOI: 10.1016/j.yexmp.2019.104304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/23/2019] [Accepted: 08/30/2019] [Indexed: 02/05/2023]
Abstract
Diabetes induces time-dependent alterations in urinary bladders. Long-term diabetes causes an underactive bladder. However, the fundamental mechanisms are still elusive. This study aimed to examine the histological changes and the potential molecular pathways affected by long-term diabetes in the rat bladder. Diabetes was induced in 8-week-old male Lewis rats by streptozotocin, while age-matched control rats received citrate buffer only. Forty-four weeks after diabetes induction, bladders were harvested for histological and molecular analyses. The expressions of proteins related to fibrosis, apoptosis and oxidative stress as well as the cellular signaling pathway in the bladder were examined by immunoblotting. Histological examinations illustrated diabetes caused detrusor hypertrophy and fibrotic changes in the bladder. Immunoblotting analysis demonstrated higher collagen I but lower elastin expression in the bladder in diabetic rats. These were accompanied by an increase in the expression of transforming growth factor-beta1, along with the downregulation of matrix metalloptoteinase-1, and upregulation of tissue inhibitor of metalloproteinase-1. Diabetic rats showed an increase in nitrotyrosine, but decrease in nuclear factor erythroid-related factor 2 (Nrf2) levels in the bladder. Enhanced apoptotic signaling was observed, characterized by increased expression of Bcl-2-associated X protein (Bax), decreased expression of Bcl-2, in the diabetic bladder. The nerve growth factor level was decreased in the diabetic bladder. A significant suppression in the protein expressions of phosphorylated extracellular signal-regulated kinases 1/2 was found in diabetic bladders. This study demonstrated that long-term diabetes caused molecular changes that could promote fibrosis and apoptosis in the bladder. Oxidative stress may be involved in this context.
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Affiliation(s)
- Rania A Elrashidy
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA; Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
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13
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Hartigan SM, Reynolds WS, Dmochowski RR. Detrusor underactivity in women: A current understanding. Neurourol Urodyn 2019; 38:2070-2076. [PMID: 31432566 DOI: 10.1002/nau.24147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/05/2019] [Indexed: 12/29/2022]
Abstract
AIMS To examine the current understanding and management of detrusor underactivity (DUA) and underactive bladder (UAB) in women. METHODS A review of the current literature was performed with a specific focus on new management strategies and treatment options for women with DUA and UAB. RESULTS DUA has become an area of increased interest in recent years. Affecting up to 45% of older women undergoing urodynamic evaluation for non-neurogenic lower urinary tract symptoms, DUA is common. There are a variety of possible etiologies including neurogenic or myogenic dysfunction. As there is currently no cure for DUA and no way to restore the ability of the detrusor muscle to contract, management of DUA in women is mostly focused on effective bladder drainage by urinary catheterization. Clean intermittent catheterization is the gold standard for bladder drainage however for a variety of reasons, women with DUA often are managed with indwelling urethral catheter or suprapubic tube. Medications, sacral neuromodulation, and the inFlow urinary prosthesis are also treatment alternatives or additions to catheterization. Novel therapies using stem cells and gene therapy are also under investigation for the treatment of DUA and UAB. CONCLUSIONS DUA is likely more prevalent than recognized and undertreated in women. It is vital that further research in treatment options beyond catheterization be developed for these patients to offer patients a variety of treatment options.
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Affiliation(s)
- Siobhan M Hartigan
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - W Stuart Reynolds
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Roger R Dmochowski
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
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14
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Gray M, Lett KM, Garcia VB, Kyi CW, Pennington KA, Schulz LC, Schulz DJ. Changes in excitability and ion channel expression in neurons of the major pelvic ganglion in female type II diabetic mice. Auton Neurosci 2019; 220:102558. [PMID: 31331692 DOI: 10.1016/j.autneu.2019.102558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 06/05/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
Bladder cystopathy and autonomic dysfunction are common complications of diabetes, and have been associated with changes in ganglionic transmission and some measures of neuronal excitability in male mice. To determine whether type II diabetes also impacts excitability of ganglionic neurons in females, we investigated neuronal excitability and firing properties, as well as underlying ion channel expression, in major pelvic ganglion (MPG) neurons in control, 10-week, and 21-week Leprdb/db mice. Type II diabetes in Leprdb/db animals caused a non-linear change in excitability and firing properties of MPG neurons. At 10 weeks, cells exhibited increased excitability as demonstrated by an increased likelihood of firing multiple spikes upon depolarization, decreased rebound spike latency, and overall narrower action potential half-widths as a result of increased depolarization and repolarization slopes. Conversely, at 21 weeks MPG neurons of Leprdb/db mice reversed these changes, with spiking patterns and action-potential properties largely returning to control levels. These changes are associated with numerous time-specific changes in calcium, sodium, and potassium channel subunit mRNA levels. However, Principal Components Analysis of channel expression patterns revealed that rectification of excitability is not simply a return to control levels, but rather a distinct ion channel expression profile in 21-week Leprdb/db neurons. These data indicate that type II diabetes can impact the excitability of post-ganglionic, autonomic neurons of female mice, and suggest that the non-linear progression of these properties with diabetes may be the result of compensatory changes in channel expression that act to rectify disrupted firing patterns of Leprdb/db MPG neurons.
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Affiliation(s)
- Michael Gray
- Division of Biological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Kawasi M Lett
- Division of Biological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Virginia B Garcia
- Division of Biological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Cindy W Kyi
- Division of Biological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Kathleen A Pennington
- Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO 65211, USA
| | - Laura C Schulz
- Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO 65211, USA
| | - David J Schulz
- Division of Biological Sciences, University of Missouri, Columbia, MO 65211, USA.
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15
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Baumeister P, Kozomara M, Seifert B, Mehnert U, Kessler TM. Detrusor overactivity is missed by stopping urodynamic investigation at a bladder volume of 500 mL. BJU Int 2019; 124:870-875. [PMID: 31298777 DOI: 10.1111/bju.14868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate whether detrusor overactivity (DO) is missed in a relevant percentage of patients if the urodynamic investigation (UDI) is stopped at a filling volume of 500 mL due to the fear of bladder overdistention, in patients with lower urinary tract symptoms and high bladder capacity. PATIENTS AND METHODS A consecutive series of 1598 patients with a bladder capacity of >500 mL in the bladder diary undergoing UDI due to lower urinary tract dysfunction (LUTD) was prospectively investigated. UDI was performed according to Good Urodynamic Practices recommended by the International Continence Society. UDI was stopped at strong desire to void or in case of autonomic dysreflexia, vesico-uretero-renal reflux, bladder pain or discomfort. RESULTS Of the 1598 patients (594 women, 1004 men), 1282 (80%) and 316 (20%) had neurogenic and non-neurogenic LUTD, respectively. Overall, DO was detected in 66% (1048/1598), in 71% (910/1282) with neurogenic and in 44% (138/316) with non-neurogenic LUTD. DO occurred in 16% (263/1598, 95% confidence interval [CI] 14.7-18.4%) only at a bladder volume >500 mL. This phenomenon was significantly (P < 0.001) more frequent in patients with neurogenic (18% [236/1282], 95% CI 16.4-20.6%) compared with non-neurogenic (9% [27/316], 95% CI 5.9-12.1%) LUTD. CONCLUSIONS In both neurological and non-neurological patients with high bladder capacity, we strongly recommend not to stop UDI at a bladder volume of 500 mL, as DO might be missed in a relevant percentage leading to inappropriate patient treatment.
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Affiliation(s)
- Philipp Baumeister
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.,Department of Urology, Cantonal Hospital Luzern, Luzern, Switzerland
| | - Marko Kozomara
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.,Department of Urology, University Hospital Zürich, Zürich, Switzerland
| | - Burkhardt Seifert
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Ulrich Mehnert
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
| | - Thomas M Kessler
- Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
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16
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Time-Dependent Changes of Urethral Function in Diabetes Mellitus: A Review. Int Neurourol J 2019; 23:91-99. [PMID: 31260608 PMCID: PMC6606940 DOI: 10.5213/inj.1938050.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/04/2019] [Indexed: 12/12/2022] Open
Abstract
This article reviewed the current knowledge on time-course manifestation of diabetic urethral dysfunction (DUD), and explored an early intervention target to prevent the contribution of DUD to the progression of diabetes-induced impairment of the lower urinary tract (LUT). In the literature search through PubMed, key words used included “diabetes mellitus,” “diabetic urethral dysfunction,” and “diabetic urethropathy.” Polyuria and hyperglycemia induced by diabetes mellitus (DM) can cause the time-dependent changes in functional and morphological manifestations of DUD. In the early stage, it promotes urethral dysfunction characterized by increased urethral pressure during micturition. However, the detrusor muscle of the bladder tries to compensate for inducing complete voiding by increasing the duration and amplitude of bladder contractions. As the disease progresses, it can induce an impairment of coordinated micturition due to dyssynergic activity of external urethra sphincter, leading to detrusor-sphincter dyssynergia. The impairment of relaxation mechanisms of urethral smooth muscles (USMs) may additionally be attributable to decreased responsiveness to nitric oxide, as well as increased USM responsiveness to α1-adrenergic receptor stimulation. In the late stage, diabetic neuropathy may play an important role in inducing LUT dysfunction, showing that the decompensation of the bladder and urethra, which can cause the decrease of voiding efficiency and the reduced thickness of the urothelium and the atrophy of striated muscle bundles, possibly leading to the vicious cycle of the LUT dysfunction. Further studies to increase our understandings of the functional and molecular mechanisms of DUD are warranted to explore potential targets for therapeutic intervention of DM-induced LUT dysfunction.
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17
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Vale L, Jesus F, Marcelissen T, Rieken M, Geavlete B, Rahnama'i MS, Martens F, Cruz F, Antunes‐Lopes T. Pathophysiological mechanisms in detrusor underactivity: Novel experimental findings. Low Urin Tract Symptoms 2019; 11:92-98. [DOI: 10.1111/luts.12257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/29/2018] [Accepted: 01/07/2019] [Indexed: 01/20/2023]
Affiliation(s)
- Luís Vale
- Faculty of Medicine, University of PortoDepartment of Urology, Hospital São João Porto Portugal
| | - Filipa Jesus
- Faculty of Medicine, University of PortoDepartment of Urology, Hospital São João Porto Portugal
| | - Tom Marcelissen
- Department of UrologyMaastricht University Medical Centre Maastricht The Netherlands
| | - Malte Rieken
- Department of UrologyMedical University of Vienna Vienna Austria
| | - Bogdan Geavlete
- Department of UrologySaint John Emergency Clinical Hospital Bucharest Romania
| | - Mohammad Sajjad Rahnama'i
- Department of UrologyMaastricht University Maastricht The Netherlands
- Department of UrologyUniklinik Aachen RWTH Aachen Germany
| | - Frank Martens
- Department of Urology, Rabdoud University Medical Centre Nijmegen The Netherlands
| | - Francisco Cruz
- Faculty of Medicine, University of PortoDepartment of Urology, Hospital São João Porto Portugal
| | - Tiago Antunes‐Lopes
- Faculty of Medicine, University of PortoDepartment of Urology, Hospital São João Porto Portugal
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18
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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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19
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Klee NS, McCarthy CG, Lewis S, McKenzie JL, Vincent JE, Webb RC. Urothelial Senescence in the Pathophysiology of Diabetic Bladder Dysfunction-A Novel Hypothesis. Front Surg 2018; 5:72. [PMID: 30564582 PMCID: PMC6288180 DOI: 10.3389/fsurg.2018.00072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/12/2018] [Indexed: 12/11/2022] Open
Abstract
Diabetic bladder dysfunction (DBD) is a well-recognized and common symptom affecting up to 50% of all diabetic patients. DBD has a broad range of clinical presentations ranging from overactive to underactive bladder symptoms that develops in middle-aged to elderly patients with long standing and poorly controlled diabetes. Low efficacy of current therapeutics and lifestyle interventions combined with high national healthcare costs highlight the need for more research into bladder dysfunction pathophysiology and novel treatment options. Cellular senescence is an age-related physiologic process in which cells undergo irreversible growth arrest induced by replicative exhaustion and damaging insults. While controlled senescence negatively regulates cell proliferation and promotes tissue regeneration, uncontrolled senescence is known to result in tissue dysfunction through enhanced secretion of inflammatory factors. This review presents previous scientific findings and current hypotheses that characterize diabetic bladder dysfunction. Further, we propose the novel hypothesis that cellular senescence within the urothelial layer of the bladder contributes to the pro-inflammatory/pro-oxidant environment and symptoms of diabetic bladder dysfunction. Our results show increased cellular senescence in the urothelial layer of the bladder; however, whether this phenomenon is the cause or effect of DBD is unknown. The urothelial layer of the bladder is made up of transitional epithelia specialized to contract and expand with demand and plays an active role in transmission by modulating afferent activity. Transition from normal functioning urothelial cells to secretory senescence cells would not only disrupt the barrier function of this layer but may result in altered signaling and sensation of bladder fullness; dysfunction of this layer is known to result in symptoms of frequency and urgency. Future DBD therapeutics may benefit from targeting and preventing early transition of urothelial cells to senescent cells.
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Affiliation(s)
- Nicole S Klee
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Cameron G McCarthy
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Steven Lewis
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Jaine L McKenzie
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Department of Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Julie E Vincent
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - R Clinton Webb
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
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20
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Ellenbroek JH, Arioglu Inan E, Michel MC. A systematic review of urinary bladder hypertrophy in experimental diabetes: Part 2. Comparison of animal models and functional consequences. Neurourol Urodyn 2018; 37:2346-2360. [DOI: 10.1002/nau.23786] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/03/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Johanne H. Ellenbroek
- Department of Internal Medicine; Leiden University Medical Centre; Leiden The Netherlands
| | | | - Martin C. Michel
- Department of Pharmacology; Johannes Gutenberg University; Mainz Germany
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21
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Abstract
Underactive bladder (UAB) is an important and complex urological condition resulting from the urodynamic finding of detrusor underactivity. It can manifest in a wide range of lower urinary tract symptoms, from voiding to storage complaints, and can overlap with other conditions, including overactive bladder and bladder outlet obstruction. However, UAB continues to be poorly understood and inadequately researched. In this article, we review the contemporary literature pertaining to recent advances in defining, understanding, and managing UAB.
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Affiliation(s)
- Su-Min Lee
- Bristol Urological Institute, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Hashim Hashim
- Bristol Urological Institute, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
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22
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Improvement in bladder dysfunction after bladder transplantation of amniotic fluid stem cells in diabetic rats. Sci Rep 2018; 8:2105. [PMID: 29391467 PMCID: PMC5794746 DOI: 10.1038/s41598-018-20512-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 01/18/2018] [Indexed: 12/12/2022] Open
Abstract
To examine the effects of human amniotic fluid stem cells (hAFSCs) transplantation on bladder function and molecular changes in diabetic rats, 60 female Sprague-Dawley rats were used for study. Three groups were assigned including sham control rats, streptozotocin (STZ, 60 mg/kg)-induced diabetic rats and STZ-induced diabetic rats plus bladder hAFSCs transplantation. Compared to controls, diabetic rats had decreased body weight but increased bladder weight. Cystometries showed non-voiding contraction, residual volume, voided volume and intercontraction interval increased significantly in diabetic rats at week 4 and 12 after DM induction, but improved after hAFSCs transplantation. The immunoreactivities and mRNAs of nerve growth factor (NGF) decreased significantly in diabetic bladder at week 4 and 12 after DM induction, but recovered after hAFSCs transplantation. The immunoreactivities and mRNAs of M2 and M3 muscarinic receptor increased significantly in diabetic bladder at week 4 after DM induction but recovered after hAFSCs transplantation. The immunoreactivity of 8-hydroxy-20-deoxyguanosine increased significantly in diabetic bladder at week 4 and 12 after DM induction but reduced after hAFSCs transplantation. The present study showed bladder dysfunction in STZ-induced diabetic rats could be improved by hAFSCs transplantation into bladder, which may be related to the recovery of bladder NGF and muscarinic receptors.
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23
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WenBo W, Fei Z, YiHeng D, Wei W, TingMang Y, WenHao Z, QianRu L, HaiTao L. Human Umbilical Cord Mesenchymal Stem Cells Overexpressing Nerve Growth Factor Ameliorate Diabetic Cystopathy in Rats. Neurochem Res 2017; 42:3537-3547. [PMID: 28952006 DOI: 10.1007/s11064-017-2401-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 08/10/2017] [Accepted: 09/11/2017] [Indexed: 12/18/2022]
Abstract
Diabetic cystopathy is a common complication of voiding disorders in diabetes mellitus. Neuropathy and bladder remodeling underlie the lack of efficacy of pharmacological and surgical treatments. Previous studies have shown that decreased levels of nerve growth factor (NGF) are closely associated with disease progression. Besides, application of human umbilical cord mesenchymal stem cells (hUC-MSCs) is also considered a promising therapeutic strategy for treatment of diabetic neuropathy. In our study, we determine the therapeutic efficacy and mechanisms of hUC-MSCs which transfected with NGF geen in ameliorating diabetic cystopathy for the first time. We transducted hUC-MSCs with NGF-expressing lentivirus so that the hUC-MSCs can express NGF efficiently, then the NGF-expressing hUC-MSCs were intrathecally administrated in L6-S1 spinal cord of diabetic rats 3 days after induced by streptozotocin. Nine weeks later, the level of neurotrophins and voiding function of bladder were detected. Results show that improvements in voiding function were related to the neurotrophins and cytokines released by the intrathecally transplanted hUC-MSCs. In addition, the hUC-MSCs also differentiated into neurons and astrocytes within the spinal cord in rats. These two mechanisms play a combined role in neural regeneration and the amelioration of the symptoms of diabetic cystopathy.
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Affiliation(s)
- Wu WenBo
- Department of Urology, Shanghai General Hospital (Shanghai Peoples Hosp 1), Shanghai JiaoTong University School of Medicine, 100 Haining Rd, Shanghai, 200080, China
| | - Zhang Fei
- Department of Urology, The Affiliated Hospital of School of Medicine of NingBo University, Ningbo, China
| | - Du YiHeng
- Department of Urology, Shanghai General Hospital (Shanghai Peoples Hosp 1), Shanghai JiaoTong University School of Medicine, 100 Haining Rd, Shanghai, 200080, China
| | - Wang Wei
- Department of Urology, Shanghai General Hospital (Shanghai Peoples Hosp 1), Shanghai JiaoTong University School of Medicine, 100 Haining Rd, Shanghai, 200080, China
| | - Yan TingMang
- Department of Urology, Shanghai General Hospital (Shanghai Peoples Hosp 1), Shanghai JiaoTong University School of Medicine, 100 Haining Rd, Shanghai, 200080, China
| | - Zhou WenHao
- Department of Urology, Shanghai General Hospital (Shanghai Peoples Hosp 1), Shanghai JiaoTong University School of Medicine, 100 Haining Rd, Shanghai, 200080, China
| | - Liu QianRu
- QUFU Normal University, Jining, Shandong, China
| | - Liu HaiTao
- Department of Urology, Shanghai General Hospital (Shanghai Peoples Hosp 1), Shanghai JiaoTong University School of Medicine, 100 Haining Rd, Shanghai, 200080, China.
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24
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Alpha 1A-adrenoceptor antagonist improves underactive bladder associated with diabetic cystopathy via bladder blood flow in rats. BMC Urol 2017; 17:64. [PMID: 28835278 PMCID: PMC5569480 DOI: 10.1186/s12894-017-0256-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/11/2017] [Indexed: 01/25/2023] Open
Abstract
Background Patients with diabetes experience lower urinary tract symptoms. Cystopathy may evolve into underactive bladder (UAB), depending on the degree and duration of the symptoms. In the present study, we aimed to investigate the effects of silodosin, an alpha1A-adrenoceptor (AR) antagonist, on UAB in a rat model of diabetes mellitus (DM). Methods Female Sprague-Dawley rats (6 weeks old) were administered streptozotocin (STZ) (50 mg/kg, i.v.) to establish a DM model. One week after STZ administration, vehicle or silodosin (0.3 or 1 mg/kg/day) was delivered subcutaneously through an osmotic pump. Nine weeks after STZ administration (8 weeks after drug treatment), a catheter was implanted into the bladder under urethane anesthesia. After the measurement of emptied bladder blood flow (BBF), saline was continuously infused into the bladder and intravesical pressure and micturition volume were measured. In another experiment, the bladder was isolated and nerve markers were quantified. Results A cystometrogram showed that bladder capacity (BC), residual volume (RV), and bladder extension (BC/bladder weight) increased by 7.43, 10.47, and 3.59 times, respectively, in vehicle rats in comparison with normal rats. These findings suggested the occurrence of UAB-like symptoms in this model. Silodosin (1 mg/kg/day) inhibited the increase in BC and RV by 49.0% and 46.8%, respectively, and caused a decrease in BBF of approximately 25.5% (when the difference between normal and vehicle was set as 100%) in STZ rats. The nerve marker expression levels tended to be decreased in the bladders of STZ rats and these effects were ameliorated by silodosin. Conclusions The STZ rats showed increased bladder extension and RV, symptoms that were suggestive of UAB, and these symptoms were ameliorated by silodosin. These results suggested that the alpha1A-AR antagonist would be useful for the prevention or treatment of UAB.
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25
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Gotoh D, Torimoto K, Tatsumi Y, Hori S, Yamada A, Miyake M, Morizawa Y, Aoki K, Tanaka N, Hirayama A, Fujimoto K. Tadalafil, a phosphodiesterase type 5 inhibitor, improves bladder blood supply and restores the initial phase of lower urinary tract dysfunction in diabetic rats. Neurourol Urodyn 2017; 37:666-672. [DOI: 10.1002/nau.23372] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/03/2017] [Indexed: 01/01/2023]
Affiliation(s)
- Daisuke Gotoh
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Kazumasa Torimoto
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Yoshihiro Tatsumi
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Shunta Hori
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Atsushi Yamada
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Makito Miyake
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Yosuke Morizawa
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Katsuya Aoki
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Nobumichi Tanaka
- Department of Urology; Nara Medical University; Kashihara Nara Japan
| | - Akihide Hirayama
- Department of Urology; Kindai University Nara Hospital; Ikoma Nara Japan
| | - Kiyohide Fujimoto
- Department of Urology; Nara Medical University; Kashihara Nara Japan
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Underactive bladder, detrusor underactivity, definition, symptoms, epidemiology, etiopathogenesis, and risk factors. Curr Opin Urol 2017; 27:293-299. [DOI: 10.1097/mou.0000000000000381] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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27
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Underactive bladder: Pathophysiology and clinical significance. Asian J Urol 2017; 5:17-21. [PMID: 29379731 PMCID: PMC5780287 DOI: 10.1016/j.ajur.2017.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 01/22/2017] [Accepted: 02/20/2017] [Indexed: 12/13/2022] Open
Abstract
Underactive bladder (UAB) is a voiding disorder which generates disabling lower urinary tract symptoms (LUTS) due to the inability to produce an effective voiding contraction sufficient to empty the bladder. The underlying abnormality, that is usually appreciated when performing urodynamic studies, has been defined by the International Continence Society (ICS) as detrusor underactivity (DUA). DUA is a common yet under-researched bladder dysfunction. The prevalence of DUA in different patient groups suggests that multiple aetiologies are implicated. Currently there is no effective therapeutic approach to treat this condition. An improved understanding of the underlying mechanisms is needed to facilitate the development of new advances in treatment. The purpose of this review is to discuss the epidemiology, pathophysiology, common causes and risk factors potentially leading to DUA; to aid in the appropriate diagnosis of DUA to potentially improve treatment outcomes.
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28
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CHEN IH, CHENG JT, TONG YC. Metabolic Syndrome Induced Bladder Cannabinoid Receptor Changes in the Fructose-Fed Rats. Low Urin Tract Symptoms 2017; 10:198-203. [DOI: 10.1111/luts.12156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/11/2016] [Accepted: 08/01/2016] [Indexed: 12/16/2022]
Affiliation(s)
- I-Hung CHEN
- Department of Urology, National Cheng Kung University Hospital, College of Medicine; National Cheng Kung University; Tainan Taiwan
| | - Juei-Tang CHENG
- Department of Medical Research, Chi-Mei Medical Center; Tainan Taiwan
- Department of Pharmacology, Institute of Medical Sciences; Chang Jung Christian University; Tainan Taiwan
| | - Yat-Ching TONG
- Department of Urology, National Cheng Kung University Hospital, College of Medicine; National Cheng Kung University; Tainan Taiwan
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29
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Addressing challenges in underactive bladder: recommendations and insights from the Congress on Underactive Bladder (CURE-UAB). Int Urol Nephrol 2017; 49:777-785. [PMID: 28233085 DOI: 10.1007/s11255-017-1549-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 02/16/2017] [Indexed: 12/15/2022]
Abstract
Underactive bladder (UAB) is an expanding troublesome health issue, exerting a major influence on the health and independence of older people with a disproportionally low level of attention received. The 2nd International Congress on Underactive Bladder (CURE-UAB 2) convened in Denver, CO on December 3 and 4, 2015, and comprised of top clinicians, scientists, and other stakeholders to address the challenges in UAB. A series of workshops aimed to define UAB and its phenotype, define detrusor underactivity (DU) and create a subtyping of DU, evaluate existing animal models for DU, and lastly to establish research priorities for UAB.
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30
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Daneshgari F, Liu G, Hanna-Mitchell AT. Path of translational discovery of urological complications of obesity and diabetes. Am J Physiol Renal Physiol 2017; 312:F887-F896. [PMID: 28052873 DOI: 10.1152/ajprenal.00489.2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/15/2016] [Accepted: 01/01/2017] [Indexed: 01/07/2023] Open
Abstract
Diabetes mellitus (DM) is a prevalent chronic disease. Type 1 DM (T1DM) is a metabolic disorder that is characterized by hyperglycemia in the context of absolute lack of insulin, whereas type 2 DM (T2DM) is due to insulin resistance-related relative insulin deficiency. In comparison with T1DM, T2DM is more complex. The natural history of T2DM in most patients typically involves a course of obesity to impaired glucose tolerance, to insulin resistance, to hyperinsulinemia, to hyperglycemia, and finally to insulin deficiency. Obesity is a risk factor of T2DM. Diabetes causes some serious microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, angiopathy and stroke. Urological complications of obesity and diabetes (UCOD) affect quality of life, but are not well investigated. The urological complications in T1DM and T2DM are different. In addition, obesity itself affects the lower urinary tract. The aim of this perspective is to review the available data, combined with the experience of our research teams, who have spent a good part of last decade on studies of association between DM and lower urinary tract symptoms (LUTS) with the aim of bringing more focus to the future scientific exploration of UCOD. We focus on the most commonly seen urological complications, urinary incontinence, bladder dysfunction, and LUTS, in obesity and diabetes. Knowledge of these associations will lead to a better understanding of the pathophysiology underlying UCOD and hopefully assist urologists in the clinical management of obese or diabetic patients with LUTS.
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Affiliation(s)
- Firouz Daneshgari
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Ann T Hanna-Mitchell
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
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31
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Juszczak K, Drewa T. Pharmacotherapy in detrusor underactivity: A new challenge for urologists and pharmacologists (from lab to clinic). Pharmacol Rep 2016; 68:703-6. [DOI: 10.1016/j.pharep.2016.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/01/2016] [Accepted: 03/09/2016] [Indexed: 12/17/2022]
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32
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Wang D, Yuan X, Hu C, Zhang B, Gao H, Wang D, Chi J, Jing Q, Wu S, Wu CL. Endoplasmic reticulum stress is involved in apoptosis of detrusor muscle in streptozocin-induced diabetic rats. Neurourol Urodyn 2015; 36:65-72. [PMID: 26370333 DOI: 10.1002/nau.22886] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/27/2015] [Indexed: 12/31/2022]
Abstract
AIMS Endoplasmic reticulum stress (ERS) has been proven to be associated with apoptosis and plays a critical role in the development of many diabetic complications. In the pathogenesis of diabetic cystopathy (DCP), the role of ERS is still unclear. Our study is aimed at the investigation of the involvement of ERS-associated detrusor muscle apoptosis in streptozocin (STZ)-induced diabetic rats. METHODS At different timepoints (4, 8, 12, and 16 weeks after induction of type 1 diabetic rat models), hematoxylin & eosin (H&E) staining was performed to assess the histological changes of the diabetic detrusor; the sub-cellular ultrastructure, especially the zone of endoplasmic reticulum (ER), was observed by transmission electron microscopy (TEM), and the terminal deoxynucleotidyl transferase-mediated DNA nick-end labeling (TUNEL) staining was used to identify the enhanced apoptosis. Moreover, the expression of three hallmarks of ERS-associated apoptosis, including glucose-regulated protein 78 (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), and caspase12, was detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. RESULTS Light microscopic impairments of histology, including progressive loosely packed muscle bundles and increased fibrous tissue, can be seen; the ultrastructural changes featuring the swollen and fused cisternaes in ER zone and deformed nucleus were also observed in the detrusor smooth muscle (DSM). Increased apoptosis and elevated expression of GRP78, CHOP, and caspase12 at both protein and mRNA levels in a time-dependent fashion were detected. CONCLUSIONS The occurrence of ERS-associated apoptosis may be involved in the development of DCP and may contribute to the diabetic detrusor impairment. Neurourol. Urodynam. 36:65-72, 2017. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Dongwen Wang
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaobin Yuan
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Caoyang Hu
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Bin Zhang
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hongfei Gao
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dong Wang
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Junjie Chi
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiang Jing
- First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Shulin Wu
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Chin-Lee Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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33
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Yuan Z, Tang Z, He C, Tang W. Diabetic cystopathy: A review. J Diabetes 2015; 7:442-7. [PMID: 25619174 DOI: 10.1111/1753-0407.12272] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 11/21/2014] [Accepted: 01/12/2015] [Indexed: 02/05/2023] Open
Abstract
Herein we review and discuss epidemiological, clinical, and experimental studies on diabetic cystopathy, a common chronic complication of diabetes mellitus with a variety of lower urinary tract symptoms, providing directions for future research. A search of published epidemiological, clinical, or preclinical trial literature was performed using the key words "diabetes", "diabetic cystopathy", "diabetic bladder dysfunction", "diabetic lower urinary tract dysfunction", "diabetic detrusor instability". The classic symptoms of diabetic cystopathy are decreased bladder sensation, increased bladder capacity, and impaired bladder emptying with resultant increased post-void residual volume. However, recent clinical evidence indicates a presence of storage symptoms, such as overactive bladder symptoms. The pathophysiology of diabetic cystopathy is multifactorial, including disturbances of the detrusor, neuron, urothelium, and urethra. Hyperglycemia, oxidative stress, and polyuria play important roles in inducing voiding dysfunction in diabetic individuals. Treatment choice depends on clinical symptoms and urodynamic abnormalities. Urodynamic evaluation is the cornerstone of diagnosis and determines management strategies. Diabetes mellitus could cause a variety of lower urinary tract symptoms, leading to diabetic cystopathy with broadly varied estimates of the prevalence rates. The exact prevalence and pathogenesis of diabetic cystopathy remains to be further investigated and studied in multicenter, large-scaled, or randomized basic and clinical trials, and a validated and standardized workup needs to be made, improving diabetic cystopathy management in clinical practice. Further studies involving only female diabetics are recommended.
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Affiliation(s)
- Zhengyong Yuan
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ziwei Tang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Changxiao He
- Department of Urology, Dujiangyan Medical Center, Dujiangyan, China
| | - Wei Tang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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34
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Chen S, Zhu Y, Liu Z, Gao Z, Li B, Zhang D, Zhang Z, Jiang X, Liu Z, Meng L, Yang Y, Shi B. Grape Seed Proanthocyanidin Extract Ameliorates Diabetic Bladder Dysfunction via the Activation of the Nrf2 Pathway. PLoS One 2015; 10:e0126457. [PMID: 25974036 PMCID: PMC4431834 DOI: 10.1371/journal.pone.0126457] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/03/2015] [Indexed: 01/11/2023] Open
Abstract
Diabetes Mellitus (DM)-induced bladder dysfunction is predominantly due to the long-term oxidative stress caused by hyperglycemia. Grape seed proanthocyanidin extract (GSPE) has been reported to possess a broad spectrum of pharmacological and therapeutic properties against oxidative stress. However, its protective effects against diabetic bladder dysfunction have not been clarified. This study focuses on the effects of GSPE on bladder dysfunction in diabetic rats induced by streptozotocin. After 8 weeks of GSPE administration, the bladder function of the diabetic rats was improved significantly, as indicated by both urodynamics analysis and histopathological manifestation. Moreover, the disordered activities of antioxidant enzymes (SOD and GSH-Px) and abnormal oxidative stress levels were partly reversed by treatment with GSPE. Furthermore, the level of apoptosis in the bladder caused by DM was decreased following the administration of GSPE according to the Terminal Deoxynucleotidyl Transferase (TdT)-mediated dUTP Nick-End Labeling (TUNEL) assay. Additionally, GSPE affected the expression of apoptosis-related proteins such as Bax, Bcl-2 and cleaved caspase-3. Furthermore, GSPE showed neuroprotective effects on the bladder of diabetic rats, as shown by the increased expression of nerve growth factor (NGF) and decreased expression of the precursor of nerve growth factor (proNGF). GSPE also activated nuclear erythroid2-related factor2 (Nrf2), which is a key antioxidative transcription factor, with the concomitant elevation of downstream hemeoxygenase-1 (HO-1). These findings suggested that GSPE could ameliorate diabetic bladder dysfunction and decrease the apoptosis of the bladder in diabetic rats, a finding that may be associated with its antioxidant activity and ability to activate the Nrf2 defense pathway.
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Affiliation(s)
- Shouzhen Chen
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Yaofeng Zhu
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Zhifeng Liu
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
- Department of Urology, The Central Hospital of Tai’ an, Longtan Road, Tai’ an, Shandong Province, People’s Republic of China
| | - Zhaoyun Gao
- Department of Urology, People’s Hospital of Yinan County, Lishan Road, Yinan, Shandong Province, People’s Republic of China
| | - Baoying Li
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Dongqing Zhang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Zhaocun Zhang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Xuewen Jiang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Zhengfang Liu
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Lingquan Meng
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Yue Yang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Benkang Shi
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
- * E-mail:
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35
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Abstract
This article summarizes anatomical, neurophysiological, pharmacological, and brain imaging studies in humans and animals that have provided insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract. The functions of the lower urinary tract to store and periodically eliminate urine are regulated by a complex neural control system in the brain, spinal cord, and peripheral autonomic ganglia that coordinates the activity of smooth and striated muscles of the bladder and urethral outlet. The neural control of micturition is organized as a hierarchical system in which spinal storage mechanisms are in turn regulated by circuitry in the rostral brain stem that initiates reflex voiding. Input from the forebrain triggers voluntary voiding by modulating the brain stem circuitry. Many neural circuits controlling the lower urinary tract exhibit switch-like patterns of activity that turn on and off in an all-or-none manner. The major component of the micturition switching circuit is a spinobulbospinal parasympathetic reflex pathway that has essential connections in the periaqueductal gray and pontine micturition center. A computer model of this circuit that mimics the switching functions of the bladder and urethra at the onset of micturition is described. Micturition occurs involuntarily in infants and young children until the age of 3 to 5 years, after which it is regulated voluntarily. Diseases or injuries of the nervous system in adults can cause the re-emergence of involuntary micturition, leading to urinary incontinence. Neuroplasticity underlying these developmental and pathological changes in voiding function is discussed.
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Affiliation(s)
- William C. de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, School of Medicine Pittsburgh, Pennsylvania
| | - Derek Griffiths
- Department of Medicine (Geriatrics), University of Pittsburgh, School of Medicine Pittsburgh, Pennsylvania
| | - Naoki Yoshimura
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, School of Medicine Pittsburgh, Pennsylvania
- Department of Urology, University of Pittsburgh, School of Medicine Pittsburgh, Pennsylvania
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36
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Osman NI, Chapple CR. Contemporary concepts in the aetiopathogenesis of detrusor underactivity. Nat Rev Urol 2014; 11:639-48. [PMID: 25330789 DOI: 10.1038/nrurol.2014.286] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Detrusor underactivity (DUA) is a poorly understood, yet common, bladder dysfunction, referred to as underactive bladder, which is observed in both men and women undergoing urodynamic studies. Despite its prevalence, no effective therapeutic approaches exist for DUA. Exactly how the contractile function of the detrusor muscle changes with ageing is unclear. Data from physiological studies in animal and human bladders are contradictory, as are the results of the limited number of clinical studies assessing changes in urodynamic parameters with ageing. The prevalence of DUA in different patient groups suggests that multiple aetiologies are involved in DUA pathogenesis. Traditional concepts focused on either efferent innervation or myogenic dysfunction. By contrast, contemporary views emphasize the importance of the neural control mechanisms, particularly the afferent system, which can fail to potentiate detrusor contraction, leading to premature termination of the voiding reflex. In conclusion, the contemporary understanding of the aetiology and pathophysiology of DUA is limited. Further elucidation of the underlying mechanisms is needed to enable the development of new and effective treatment approaches.
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Affiliation(s)
- Nadir I Osman
- Department of Urology, Royal Hallamshire Hospital, Glossop Road, Sheffield, South Yorkshire S10 2JF, UK
| | - Christopher R Chapple
- Department of Urology, Royal Hallamshire Hospital, Glossop Road, Sheffield, South Yorkshire S10 2JF, UK
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37
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Tyagi P, Smith PP, Kuchel GA, de Groat WC, Birder LA, Chermansky CJ, Adam RM, Tse V, Chancellor MB, Yoshimura N. Pathophysiology and animal modeling of underactive bladder. Int Urol Nephrol 2014; 46 Suppl 1:S11-21. [PMID: 25238890 DOI: 10.1007/s11255-014-0808-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 07/17/2014] [Indexed: 12/17/2022]
Abstract
While the symptomology of underactive bladder (UAB) may imply a primary dysfunction of the detrusor muscle, insights into pathophysiology indicate that both myogenic and neurogenic mechanisms need to be considered. Due to lack of proper animal models, the current understanding of the UAB pathophysiology is limited, and much of what is known about the clinical etiology of the condition has been derived from epidemiological data. We hereby review current state of the art in the understanding of the pathophysiology of and animal models used to study the UAB.
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Affiliation(s)
- Pradeep Tyagi
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA
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38
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Powell CR. Is the Diabetic Bladder a Neurogenic Bladder? Evidence from the Literature. CURRENT BLADDER DYSFUNCTION REPORTS 2014; 9:261-267. [PMID: 30899338 DOI: 10.1007/s11884-014-0255-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Diabetes can often cause LUTS. This has been called diabetic cystopathy by many authors, but no concise grouping of symptoms for this condition has been agreed upon. The etiology of diabetic cystopathy remains unknown, but evidence from the literature strongly suggests a neurologic etiology as the primary factor, with other factors such as polyuria, damage to muscle from oxidative stress, and urothelial factors possibly contributing. Once a standard definition for diabetic cystopathy can be agreed upon, prospective, longitudinal studies will play a key role in the generation of hypotheses for the causes of diabetic cystopathy. Animal models will help test these hypotheses and possibly provide strategies for prevention.
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Affiliation(s)
- C R Powell
- Indiana University School of Medicine, Department of Urology, 535 Barnhill Dr. Suite 420, Indianapolis, IN 46077
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39
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Diabetes and Its Effect on Lower Urinary Tract Function: Pathophysiology and Management. CURRENT BLADDER DYSFUNCTION REPORTS 2014. [DOI: 10.1007/s11884-014-0251-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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40
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Nirmal J, Tyagi P, Chuang YC, Lee WC, Yoshimura N, Huang CC, Rajaganapathy B, Chancellor MB. Functional and molecular characterization of hyposensitive underactive bladder tissue and urine in streptozotocin-induced diabetic rat. PLoS One 2014; 9:e102644. [PMID: 25050870 PMCID: PMC4106869 DOI: 10.1371/journal.pone.0102644] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/19/2014] [Indexed: 02/07/2023] Open
Abstract
Background The functional and molecular alterations of nerve growth factor (NGF) and Prostaglandin E2 (PGE2) and its receptors were studied in bladder and urine in streptozotocin (STZ)-induced diabetic rats. Methodology/Principal Findings Diabetes mellitus was induced with a single dose of 45 mg/kg STZ Intraperitoneally (i.p) in female Sprague-Dawley rats. Continuous cystometrogram were performed on control rats and STZ treated rats at week 4 or 12 under urethane anesthesia. Bladder was then harvested for histology, expression of EP receptors and NGF by western blotting, PGE2 levels by ELISA, and detection of apoptosis by TUNEL staining. In addition, 4-hr urine was collected from all groups for urine levels of PGE2, and NGF assay. DM induced progressive increase of bladder weight, urine production, intercontraction interval (ICI) and residual urine in a time dependent fashion. Upregulation of Prostaglandin E receptor (EP)1 and EP3 receptors and downregulation of NGF expression, increase in urine NGF and decrease levels of urine PGE2 at week 12 was observed. The decrease in ICI by intravesical instillation of PGE2 was by 51% in control rats and 31.4% in DM group at week 12. Conclusions/Significance DM induced hyposensitive underactive bladder which is characterized by increased inflammatory reaction, apoptosis, urine NGF levels, upregulation of EP1 and EP3 receptors and decreased bladder NGF and urine PGE2. The data suggest that EP3 receptor are potential targets in the treatment of diabetes induced underactive bladder.
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Affiliation(s)
- Jayabalan Nirmal
- Department of Urology, Centre for Urology Research Excellence, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States of America
| | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Yao-Chi Chuang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- * E-mail:
| | - Wei-Chia Lee
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Chao-Cheng Huang
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Bharathi Rajaganapathy
- Department of Urology, Centre for Urology Research Excellence, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States of America
| | - Michael B. Chancellor
- Department of Urology, Centre for Urology Research Excellence, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States of America
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Al-Noah Z, McKenna D, Langdale C, Thor KB, Marson L, Burgard E, Kullmann FA. Nitrergic relaxations and phenylephrine contractions are not compromised in isolated urethra in a rat model of diabetes. Auton Neurosci 2014; 183:58-65. [PMID: 24656892 DOI: 10.1016/j.autneu.2014.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 02/07/2014] [Accepted: 03/02/2014] [Indexed: 12/16/2022]
Abstract
In vivo experiments in a diabetic rat model revealed compromised nitrergic urethral relaxations and increased sensitivity to adrenergic agonists. This study evaluated contractile and relaxation properties of urethral smooth muscle after streptozotocin (STZ)-induced diabetes, in vitro, with the aim of determining whether in vivo deficiencies are related to smooth muscle dysfunction. Urethral tissue was collected from adult female Sprague-Dawley rats naive, STZ-treated, vehicle-treated and sucrose-fed at 9-12 week post treatment. Strips from proximal, mid, and distal urethra were placed in tissue baths and stimulated using electric field stimulation (EFS) and pharmacological agents. nNOS staining was evaluated using immunohistochemistry. Phenylephrine (PE, 10μM) contracted all urethral strips with the highest amplitude in mid urethra, in all treatment groups. Likewise, EFS-induced relaxation amplitudes were larger and were observed more frequently in mid urethra. Relaxations were inhibited by the NOS inhibitor, L-NAME (1-100μM). Sodium nitroprusside (0.01-1μM), an NO donor, reversed PE-induced contractions. No statistical differences were observed between treatment groups with respect to any parameters. Qualitative immunohistochemistry showed no differences in the urethral nNOS innervation patterns across the treatment groups. In summary, nitrergic relaxations and adrenergic-induced contractions in the isolated diabetic rat urethra display similar properties to controls, suggesting no dysfunction on the nitrergic or alpha1 adrenergic receptor function in the smooth muscle. This further implies that compromised urethral relaxation and increased adrenergic agonist sensitivity observed in vivo in this model may be due to the disruption of neural signaling between the urethra and the spinal cord, or within the CNS.
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Affiliation(s)
- Z Al-Noah
- Urogenix, Inc., Durham, NC, United States
| | - D McKenna
- Urogenix, Inc., Durham, NC, United States
| | - C Langdale
- Urogenix, Inc., Durham, NC, United States
| | - K B Thor
- Urogenix, Inc., Durham, NC, United States
| | - L Marson
- Urogenix, Inc., Durham, NC, United States
| | - E Burgard
- Urogenix, Inc., Durham, NC, United States
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Chen S, Zhu Y, Feng X, Zhang Z, Li S, Shi B. Changes in alpha1-adrenoceptor and NGF/proNGF pathway: a possible mechanism in diabetic urethral dysfunction. Urol Int 2014; 93:344-51. [PMID: 24577043 DOI: 10.1159/000355711] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/17/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the changes in the α1-adrenoceptor and nerve growth factor (NGF)/NGF precursor (proNGF) pathway in the urethra after diabetes induction. MATERIALS AND METHODS Urethral relaxation function was determined by simultaneous recordings of intravesical pressure under isovolumetric conditions and urethral perfusion pressure (UPP) in diabetic rats. The expression of α1-adrenoceptor, NGF, proNGF, low-affinity p75 receptor for neurotrophins (p75(NTR)) and sortilin in the urethras was measured using real-time quantitative polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay and Western blotting. RESULTS In diabetic rats, the lowest urethral pressure (UPP nadir) during urethral relaxation was significantly higher. Intravenous administration of tamsulosin, an α1-adrenoceptor antagonist, significantly decreased the UPP nadir and baseline UPP in diabetic rats. RT-qPCR and Western blotting studies showed a statistically significant increase of α1a- and α1b-adrenoceptor in the urethras from the diabetic group (p < 0.05). The expression of NGF was significantly decreased in the urethras from the diabetic group while the expression of proNGF was significantly increased (p < 0.05). The p75(NTR) level in the urethras of diabetic rats was decreased compared with controls (p < 0.05) and there was no significant difference regarding sortilin between the two groups (p > 0.05). CONCLUSION This study validated the diabetic urethral dysfunction and furthermore indicated that the increase in the expression of α1-adrenoceptor and changes in the NGF/proNGF pathway may be involved in diabetic urethral dysfunction.
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Affiliation(s)
- Shouzhen Chen
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
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Yoshimura N, Ogawa T, Miyazato M, Kitta T, Furuta A, Chancellor MB, Tyagi P. Neural mechanisms underlying lower urinary tract dysfunction. Korean J Urol 2014; 55:81-90. [PMID: 24578802 PMCID: PMC3935075 DOI: 10.4111/kju.2014.55.2.81] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 01/27/2014] [Indexed: 12/28/2022] Open
Abstract
This article summarizes anatomical, neurophysiological, and pharmacological studies in humans and animals to provide insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract and alterations in these mechanisms in lower urinary tract dysfunction. The functions of the lower urinary tract, to store and periodically release urine, are dependent on the activity of smooth and striated muscles in the bladder, urethra, and external urethral sphincter. During urine storage, the outlet is closed and the bladder smooth muscle is quiescent. When bladder volume reaches the micturition threshold, activation of a micturition center in the dorsolateral pons (the pontine micturition center) induces a bladder contraction and a reciprocal relaxation of the urethra, leading to bladder emptying. During voiding, sacral parasympathetic (pelvic) nerves provide an excitatory input (cholinergic and purinergic) to the bladder and inhibitory input (nitrergic) to the urethra. These peripheral systems are integrated by excitatory and inhibitory regulation at the levels of the spinal cord and the brain. Therefore, injury or diseases of the nervous system, as well as disorders of the peripheral organs, can produce lower urinary tract dysfunction, leading to lower urinary tract symptoms, including both storage and voiding symptoms, and pelvic pain. Neuroplasticity underlying pathological changes in lower urinary tract function is discussed.
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Affiliation(s)
- Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Teruyuki Ogawa
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Minoru Miyazato
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Takeya Kitta
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Akira Furuta
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Michael B Chancellor
- Department of Urology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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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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Reduced number, G protein coupling, and antinociceptive efficacy of spinal mu-opioid receptors in diabetic rats are reversed by nerve growth factor. THE JOURNAL OF PAIN 2013; 14:720-30. [PMID: 23623572 DOI: 10.1016/j.jpain.2013.01.776] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/16/2013] [Accepted: 01/31/2013] [Indexed: 02/01/2023]
Abstract
UNLABELLED This study investigated putative mechanisms of impaired spinal opioid antinociception such as a downregulation of mu-opioid receptor (MOR) number, coupling, and efficacy in rats with advanced (12 weeks) streptozotocin (STZ)-induced diabetes. Intravenous injection of STZ (45 mg/kg) in Wistar rats led to selective degeneration of insulin-producing pancreatic ß-cells, elevated blood glucose, and mechanical hyperalgesia. In these animals, dose-dependent and naloxone-reversible intrathecal fentanyl antinociception was significantly impaired and associated with a loss in MOR immunoreactivity of calcitonin gene-related peptide-immunoreactive (CGRP-IR) sensory nerve terminals, membrane-bound MOR binding sites, and MOR-stimulated G protein coupling within the dorsal horn of the spinal cord. Intrathecal delivery of nerve growth factor (NGF) in diabetic animals normalized spinal MOR number and G protein coupling and rescued spinal fentanyl-induced antinociception. These findings identify for the first time a loss in functional MOR on central terminals of sensory neurons as a contributing factor for the impaired spinal opioid responsiveness during advanced STZ-induced diabetes that can be reversed by NGF. Moreover, they support growing evidence of a distinct regulation of opioid responsiveness during various painful states of disease (eg, arthritis, cancer, neuropathy) and may give novel therapeutic incentives. PERSPECTIVE In diabetic neuropathy a loss in sensory neuron mu-opioid receptor number and coupling contributes to impaired spinal opioid antinociception that can be reversed by NGF. These findings support growing evidence of a distinct regulation of opioid responsiveness during various painful diseases and may give novel therapeutic incentives.
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ZHU SHAOXING, HUANG SHIYONG, SU YIMING, CAI PENG. Growth and expression of rat bone marrow mesenchymal stem cells modified by nerve growth factor in diabetic rat bladders. Mol Med Rep 2013; 7:1791-9. [DOI: 10.3892/mmr.2013.1425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 03/13/2013] [Indexed: 11/05/2022] Open
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Mousa SA, Shaqura M, Khalefa BI, Zöllner C, Schaad L, Schneider J, Shippenberg TS, Richter JF, Hellweg R, Shakibaei M, Schäfer M. Rab7 silencing prevents μ-opioid receptor lysosomal targeting and rescues opioid responsiveness to strengthen diabetic neuropathic pain therapy. Diabetes 2013; 62:1308-19. [PMID: 23230081 PMCID: PMC3609597 DOI: 10.2337/db12-0590] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Painful diabetic neuropathy is poorly controlled by analgesics and requires high doses of opioids, triggering side effects and reducing patient quality of life. This study investigated whether enhanced Rab7-mediated lysosomal targeting of peripheral sensory neuron μ-opioid receptors (MORs) is responsible for diminished opioid responsiveness in rats with streptozotocin-induced diabetes. In diabetic animals, significantly impaired peripheral opioid analgesia was associated with a loss in sensory neuron MOR and a reduction in functional MOR G-protein-coupling. In control animals, MORs were retained mainly on the neuronal cell membrane. In contrast, in diabetic rats, they were colocalized with upregulated Rab7 in LampI-positive perinuclear lysosome compartments. Silencing endogenous Rab7 with intrathecal Rab7-siRNA or, indirectly, by reversing nerve growth factor deprivation in peripheral sensory neurons not only prevented MOR targeting to lysosomes, restoring their plasma membrane density, but also rescued opioid responsiveness toward better pain relief. These findings elucidate in vivo the mechanisms by which enhanced Rab7 lysosomal targeting of MORs leads to a loss in opioid antinociception in diabetic neuropathic pain. This is in contrast to peripheral sensory neuron MOR upregulation and antinociception in inflammatory pain, and provides intriguing evidence that regulation of opioid responsiveness varies as a function of pain pathogenesis.
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Affiliation(s)
- Shaaban A Mousa
- Department of Anaesthesiology and Intensive Care Medicine, Charité University Berlin, Campus Virchow Klinikum and Campus Charite Mitte, Berlin, Germany.
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Hanna-Mitchell AT, Ruiz GW, Daneshgari F, Liu G, Apodaca G, Birder LA. Impact of diabetes mellitus on bladder uroepithelial cells. Am J Physiol Regul Integr Comp Physiol 2012; 304:R84-93. [PMID: 23174855 DOI: 10.1152/ajpregu.00129.2012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Diabetic bladder dysfunction (DBD), a prevalent complication of diabetes mellitus (DM), is characterized by a broad spectrum of symptoms including urinary urgency, frequency, and incontinence. As DBD is commonly diagnosed late, it is important to understand the chronic impact of DM on bladder tissues. While changes in bladder smooth muscle and innervation have been reported in diabetic patients, the impact of DM on the specialized epithelial lining of the urinary bladder, the urothelium (UT), is largely unknown. Quantitative polymerase chain reaction analysis and electron microscopy were used to evaluate UT gene expression and cell morphology 3, 9, and 20 wk following streptozotocin (STZ) induction of DM in female Sprague-Dawley rats compared with age-matched control tissue. Desquamation of superficial (umbrella) cells was noted at 9 wk DM, indicating a possible breach in barrier function. One causative factor may be metabolic burden due to chronic hyperglycemia, suggested by upregulation of the polyol pathway and glucose transport genes in DM UT. While superficial UT repopulation occurred by 20 wk DM, the phenotype was different, with significant upregulation of receptors associated with UT mechanosensation (transient receptor potential vanilloid subfamily member 1; TRPV1) and UT autocrine/paracrine signaling (acetylcholine receptors AChR-M2 and -M3, purinergic receptors P2X(2) and P2X(3)). Compromised barrier function and alterations in UT mechanosensitivity and cell signaling could contribute to bladder instability, hyperactivity, and altered bladder sensation by modulating activity of afferent nerve endings, which appose the urothelium. Our results show that DM impacts urothelial homeostasis and may contribute to the underlying mechanisms of DBD.
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Ha US, Bae WJ, Kim SJ, Yoon BI, Jang H, Hong SH, Lee JY, Hwang SY, Kim SW. Protective effect of cyanidin-3-O-β-D-glucopyranoside fraction from mulberry fruit pigment against oxidative damage in streptozotocin-induced diabetic rat bladder. Neurourol Urodyn 2012; 32:493-9. [PMID: 23129268 DOI: 10.1002/nau.22334] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 09/18/2012] [Indexed: 12/20/2022]
Abstract
AIMS To determine whether cyanidin-3-O-β-D-glucopyranoside (C3G) fraction from mulberry fruit pigment has protective effects against bladder dysfunction on streptozotocin-induced diabetic rats METHODS Sprague-Dawley rats were divided into three groups (n = 12 in each): normal, diabetes (DM), and DM treated with C3G fraction (DM + C3G). The DM and DM + C3G groups received a single injection of streptozotocin (50 mg/kg) intraperitoneally. Four weeks after the induction of diabetes, the DM + C3G group was treated with daily oral C3G (10 mg/kg) dissolved in water, for 8 weeks. After 12 weeks of streptozotocin injections, rats in each group underwent cystometrography and bladders were used for evaluation of apoptosis and oxidative stress. RESULTS The DM group showed a markedly lower maximal intravesical pressure than that observed in the control group, whereas rats in the DM + C3G group showed improved maximum intravesical pressure associated with minimization of apoptosis, and increased levels of Akt and Bad phosphorylation, implying inhibition of pro-apoptotic stimuli. The level of 8-hydroxy-2-deoxyguanosine, a marker of oxidative stress, was significantly greater in the DM group compared to the control group and it was significantly reduced in the C3G treated group. Immunoblotting revealed a significant decrease in the levels of the superoxide dismutase protein and nerve growth factor in the DM group compared with the control group; however, these proteins were upregulated in the DM + C3G group compared with the DM group. CONCLUSIONS The study is the first to suggest that C3G fraction have a potency to protect the bladder under conditions of diabetes-induced oxidative stress.
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Affiliation(s)
- U-Syn Ha
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
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