DIRECT DETECTION OF NITRIC OXIDE IN RAT URINARY BLADDER DURING ISCHEMIA-REPERFUSION

Real-Time Monitoring of Blood Flow and Intravesical Pressure in the Rat Bladder

OBJECTIVES

Because there is little information available about blood flow in the voiding cycle of the bladder, we performed a study in which we simultaneously monitored blood flow and intravesical pressure during the micturition cycle in a rat model.

METHODS

Approximately 300 g male Wistar rats were used in this study. Cystometric studies were performed according to our previous report, and simultaneously blood flow was monitored.

RESULTS

Before the micturition reflex occurred, a significant increase in bladder blood flow was observed, and this increased blood flow continued during the micturition reflex. Under the maximum contraction pressure, blood flow rapidly decreased (within 10% compared to the max level). This low level of blood flow continued for more than half a minute.

CONCLUSION

Our data indicated that the blood flow in the bladder was dynamically changed during voiding. This technique may represent a strong tool to investigate bladder function under drug administrations and/or pathophysiological conditions.

Interactions between inducible nitric oxide synthase and cyclooxygenase-2 in response to ischaemia-reperfusion of rabbit bladder

OBJECTIVE

To investigate the interactions between inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in response to ischaemia-reperfusion (I/R) of rabbit bladder.

MATERIALS AND METHODS

Rabbit bladders were exposed to 2 h of ischaemia by bilaterally clamping the major arteries entering the bladder and then a subsequent 36 h of reperfusion (I/R) with or without intraperitoneal administration of a selective iNOS inhibitor n-(3-(amynomethyl)benzyl)acetamidine (1400W) or a selective COX-2 inhibitor NS-398 given 1 h before killing. The bladder tissues were processed for isometric tension experiments, enzymatic NOS activitiy, tissue contents of nitrite/nitrate (NO(X) ), cyclic guanosine monophosphate (cGMP) and COX activity determined by prostaglandin E(2) (PGE(2) ) production.

RESULTS

iNOS and constitutive NOS (cNOS) activities, NO(X) and PGE(2) contents in the bladder tissues at 36 h after reperfusion were significantly higher than those in the sham group with no significant increase in cGMP. Treatment with 1400W abrogated the increases in iNOS activity and NO(X) as well as PGE(2) without changing cNOS activity. In the tension experiments, a NOS substrate, l-arginine, induced detrusor contraction only in the I/R group, which was inhibited by 1400W or NS-398 but not by a selective soluble guanylate cyclase inhibitor 1H-[1,2,4] oxadiazole[4,3-a]quinoxalin-1-one (ODQ). 8-Br-cGMP induced detrusor relaxation in the sham and I/R groups. Also, l-arginine increased NO(X) and PGE(2) in the bladder tissues only in the I/R group, which were inhibited by pretreatment with 1400W. While, l-arginine increased cGMP contents in the I/R group and this increase was suppressed by ODQ but not by 1400W.

CONCLUSION

These results show that NO derived from an up-regulation of iNOS after I/R increases COX-2-derived PG via a cGMP-independent mechanism. NO-mediated activation of COX-2 may be an important mechanism for the modulation of bladder function after I/R injury.

Nitric oxide/cyclic guanosine monophosphate signalling mediates an inhibitory action on sensory pathways of the micturition reflex in the rat

BACKGROUND

Overactive bladder can be associated with a hyperexcitability of bladder afferent C-fibres. Several studies have suggested that nitric oxide (NO) or its downstream signalling could modulate the micturition reflex (MR) by reducing the excitability of bladder afferents.

OBJECTIVES

To evaluate the role of the NO/cyclic guanosine monophosphate (cGMP) signalling pathway on the MR in a model of bladder hyperactivity (BHA) associated with C-fibre activation in the rat.

DESIGN, SETTING, AND PARTICIPANTS

Adult female Sprague Dawley rats were used.

MEASUREMENTS

Cystometry was performed in anaesthetised rats. The effects of 0.1 mg/kg of sodium nitroprusside (SNP), an NO donor; 10 mg/kg of 8Br-cGMP, a cGMP analogue; 3 mg/kg of sildenafil and 1 mg/kg of vardenafil, two phosphodiesterase type 5 inhibitors (PDE5-I); 10 mg/ml of L-N(G)-nitroarginine methyl ester (L-NAME), an NO synthase inhibitor; and 1 mg/kg of LY-83583, a guanylate cyclase inhibitor, were investigated on BHA during intravesical capsaicin (30 micromol/l) instillation. All drugs were delivered intravenously except for L-NAME, which was intravesically administered.

RESULTS AND LIMITATIONS

SNP, 8Br-cGMP, and PDE5-I increased the intercontraction interval (ICI), while SNP and PDE5-I increased the micturition pressure threshold (MPT). L-NAME and LY-83583 decreased MPT, and L-NAME decreased ICI. 8Br-cGMP decreased the maximum intravesical pressure (MP), contrary to L-NAME and LY-83583. SNP and PDE5-I had no effect on MP. SNP increased the voided volume (VV). PDE5-I and 8Br-cGMP also increased VV, although not significantly. In contrast, L-NAME tended to decrease VV. Although 8Br-cGMP decreased the baseline intravesical pressure, LY-83583 increased it. Neither SNP nor PDE5-I nor L-NAME had any effect on baseline pressure.

CONCLUSIONS

Compounds activating the NO/cGMP pathway inhibited BHA, whereas compounds inhibiting the NO/cGMP pathway increased it. These results indicate that the NO/cGMP signalling pathway is involved in the regulation of the MR, with an action that seems more predominant on the sensory rather on the motor component of the MR in a rat model of BHA associated with C-fibre afferent activation.

Antioxidant levels in the pig urinary bladder: distribution within the bladder wall and in the urothelium derived from different bladder regions

This study was designed to determine the antioxidant levels in the urinary bladder wall layers as well as urothelium derived from different bladder regions. Samples of the urothelium, lamina propria, muscularis, and serosa were prepared from the pig's urinary bladder body, while samples used for regional mapping of the urothelium were prepared from trigone, ventral and dorsal middle bladder body, and apex region. Activities of superoxide dismutase, glutathione peroxidase, glutathione reductase, and catalase were determined. Concentrations of ascorbic acid and glutathione were also measured. Antioxidant activities, i.e. concentrations of superoxide dismutase, glutathione peroxidase, glutathione reductase and glutathione, were shown to be highest in the urothelium and progressively lower towards the serosa. Regional mapping of the urothelium singled out apex as the region with the lowest antioxidant activities, i.e. concentrations of glutathione peroxidase, ascorbic acid, and glutathione. The fact that antioxidants are concentrated in the urothelium implies that urothelium functions as a barrier against reactive species. The urothelium derived from the apex is the region with the lowest antioxidant levels and is therefore probably the region most liable to development of oxidative damage.

Effects ofl-arginine andl-NAME on chronic partial bladder outlet obstruction in rabbit

Nitric oxide (NO) is synthesized from l-arginine by nitric oxide synthase (NOS). NOS can be inhibited by NG-nitro-l-arginine methyl ester (l-NAME) and stimulated by supplementing the diet with l-arginine. The aim of this study was to investigate the influence of NOS activity on the response of rabbits to chronic partial bladder outlet obstruction (PBOO). Surgical PBOOs (2 and 8 wk) were performed on male New Zealand White rabbits. Before obstruction, one-third of the animals were premedicated for 7 days with l-NAME and another third with l-arginine. The results are summarized as follows. First, bladder weight after 8-wk PBOO was significantly lower in animals treated with l-arginine compared with both untreated and rabbits treated with l-NAME. Second, contractile function decreased progressively with PBOO duration. However, after 8 wk of PBOO, the l-arginine group had significantly greater contractile function compared with the no-treatment group, and the l-NAME group had significantly lower contractile function compared with the no-treatment group. Third, at 8 wk following PBOO, the level of protein oxidation and nitration was lowest for the l-arginine group and highest in the l-NAME group. These studies clearly demonstrated that increasing blood flow by stimulating NOS significantly protected the bladder from PBOO dysfunctions, whereas inhibiting blood flow by l-NAME enhanced the dysfunctions mediated by PBOO.

Beneficial effect of preconditioning on ischemia–reperfusion injury in the rat bladder in vivo

We investigated the effect of preconditioning on ischemia-reperfusion injury in the rat bladder. Rat abdominal aorta was clamped with a small clip to induce ischemia-reperfusion injury in the bladder. Twelve-week-old male SD rats were divided into three groups; sham-operated control (Cont), 30 min ischemia-60 min reperfusion (IR) and three times of 5 min ischemia and then 30 min ischemia-60 min reperfusion (PC) groups. The bladder functions were estimated by cystometric and functional studies. Contractile response curves to increasing concentrations of carbachol were constructed in the absence and presence of various concentrations of subtype selective muscarinic antagonists, i.e. atropine (non-selective), pirenzepine (M1 selective), methoctramine (M2 selective), and 4-DAMP (M1/M3 selective). We also measured tissue levels of malonaldehyde (MDA) and examined possible histological changes in these rats' bladders. Preconditioning partially prevented the reduction of bladder dysfunction induced by ischemia-reperfusion. Estimation of the pA2 values for atropine, pirenzepine, methoctramine, and 4-DAMP indicates that the carbachol-induced contractile response in bladder dome is mediated through the M3 receptor subtype in all groups. The MDA concentration in the IR group was significantly larger than that of the control group, and preconditioning significantly reduced MDA production in the bladder. In histological studies, the ischemia-reperfusion with or without preconditioning caused infiltration of leukocytes and rupture of microcirculation in the regions of submucosa and smooth muscle without a corresponding sloughing of mucosal cells. Our data indicate that preconditioning has a beneficial effect on ischemia-reperfusion injury in the rat bladder.

The role of free radicals and nitric oxide in the ischemia–reperfusion injury mediated by acute bladder outlet obstruction

Free-radical generation and nitric oxide (NO) generation were detected in the rat bladder following acute bladder outlet obstruction (BOO), and the results were compared with those for vascular ischemia and reperfusion (I-R). Forty male Sprague Dawley rats were used. In the acute BOO plus I-R group (group 1), rats were catheterized with a 3-Fr catheter and an inflated balloon was positioned at the bladder neck. The bladder was overdistended after administration of Ringer solution and furosemide (12 mg/kg, each) for 60 min, and was then drained to allow reperfusion for 30 min. In the acute BOO plus nerve stimulation group (group 2), the pelvic nerve was stimulated in the distended bladder for 60 min (5 s every 5 min, 10 V/0.1 ms, 20 Hz). Pelvic nerve stimulation was performed in nonobstructed animals in group 3. In the I-R group (group 4), the distal aorta was occluded for 60 min followed by reperfusion for 30 min. Sham-operated animals served as the control group (group 5). At the end of the protocols, the levels of hydroxyl and superoxide radicals and NO levels were measured in the bladder tissues with luminol- and lucigenin-enhanced chemiluminescence methods. The results were compared by a one-way analysis of variance test. The levels of hydroxyl radicals were not significantly different between the study groups. In contrast, superoxide radicals and NO levels were significantly increased in both group 1 and group 4 compared with those in control animals (P<0.05 for all comparisons). Superoxide radical generation in group 2 was comparable to the levels in group 1 (P>0.05), whereas NO levels were substantially lower than in group 1 (P=0.06). In summary, vascular I-R causes significant oxidative damage to the bladder. Acute BOO with overdistension of the bladder mimics the effects of true vascular I-R injury. The NO pathway has possibly a major role in I-R-induced bladder damage. Prolonged BOO may therefore significantly enhance the oxidative damage to the bladder and further accentuate the effects of generalized atherosclerotic processes in the elderly adult.

Preventive effects of cyclohexenonic long-chain fatty alcohol on diabetic cystopathy in the rat

In this study, we investigated the preventive effect of n-hexacosanol on diabetes-induced bladder dysfunction in the rat. Diabetes was induced in 8-week-old male Sprague-Dawley rats by administering an injection of streptozotocin (50 mg/kg, i.p.). The rats were randomly divided into 4 groups (age-matched control rats, diabetic rats without treatment with n-hexacosanol, and diabetic rats treated with n-hexacosanol (2 and 8 mg/kg, i.p. every day)) and maintained for 4 weeks. The serum glucose and serum insulin levels were determined, and the functions of bladder were estimated by voiding behavior, cystometric, and functional studies to carbachol and KCl. Furthermore, we examined possible diabetic induced histological changes in these rats. Treatment with n-hexacosanol did not alter diabetic status including body mass, bladder mass, and serum glucose and serum insulin levels, but significantly improved the maximum contraction pressure of the detrusor and residual urine volume in cystometric studies and Emax values to carbachol in functional studies in a dose-dependent manner. Diabetes induced bladder smooth muscle hypertrophy, which tended to be ameliorated by treatment with n-hexacosanol in a dose-dependent manner. Treatment with n-hexacosanol did not alter the diabetic status, but significantly improved diabetic cystopathy in a dose-dependent manner.

Altered Nitric Oxide Synthase, Arginase and Ornithine Decarboxylase Activities, and Polyamine Synthesis in Response to Ischemia of the Rabbit Detrusor

PURPOSE

Little is known about L-arginine catabolism following ischemia in the bladder. We examined the changes in nitric oxide synthase, arginase and ornithine decarboxylase activity, polyamine biosynthesis and the ability to produce nitric oxide following ischemia of the rabbit bladder.

MATERIALS AND METHODS

Bladder ischemia was created by ligation of a unilateral bladder artery. At various time points, that is 1, 4, 8, 24, 48 and 72 hours following ligation, the bladders were excised and harvested for determinations.

RESULTS

Constitutive nitric oxide synthase, inducible nitric oxide synthase arginase and ornithine decarboxylase activities increased with time, peaking at 48 hours without significant differences between the ligated and nonligated sides in the whole layer. Arginase and ornithine decarboxylase increased mainly in the muscularis following ischemia. Also, putrescine in the muscularis was significantly higher than in the mucosa 48 hours following ischemia. Baseline nitrite/nitrate production in the whole detrusor on the ligated side at 24 hours was significantly lower than that in the normal detrusor. However, nor-hydroxyarginine as an arginase inhibitor and L-arginine increased nitrite/nitrate production in the ischemic detrusor without changing in the normal detrusor. This increasing effect of nor-hydroxyarginine was abolished by nitroarginine methylester as a nitric oxide synthase inhibitor.

CONCLUSIONS

Enzymes related to L-arginine catabolism were involved in the early events of ischemic bladder. Arginase may have 2 independent roles, that is 1) activation of arginase/ornithine decarboxylase/polyamines pathways in the muscle injury and remodeling following ischemia, and 2) endogenous negative regulation of nitric oxide production by limiting the L-arginine substrate for nitric oxide synthase.

Acute alterations in biochemistry, morphology and contractility of rat isolated urinary bladder via increased intra-abdominal pressure

OBJECTIVE

To determine the acute effects of increased intra-abdominal pressure (IAP) on the biochemistry, morphology and contractility of the rat isolated urinary bladder using an experimental laparoscopy model.

METHODS

We divided 24 adult female Sprague-Dawley rats into three groups. The control group (group I) was not subjected to increased IAP. In groups II and III, IAPs of 10 and 20 mm Hg, respectively, were established by carbon dioxide pneumoperitoneum for 60 min. Thirty minutes after desufflation, the rat urinary bladder dome was removed for in vitro pharmacological investigation, measurement of malondialdehyde (MDA) levels and histopathological examination. Statistical comparisons between groups were performed.

RESULTS

Tissue MDA levels in groups II and III were significantly higher than in the control group. In group II, only the lamina propria was significantly damaged. However, the epithelium, lamina propria, and serosa were significantly damaged in group III. Acetylcholine potentiated contractions in both IAP groups. Increased responses to electrical field stimulation in the IAP groups were significant only in group II.

CONCLUSIONS

In this experimental model, 10 and 20 mm Hg of IAP induced by pneumoperitoneum increased MDA levels and caused important changes in the morphology and contractile response of the urinary bladder.

General administration of cyclohexenonic long-chain fatty alcohol ameliorates hyperreactivity of STZ-induced diabetic rat aorta

Diabetic neuropathy, a major complication of diabetes mellitus, is associated with the development of vascular dysfunction and autonomic neuropathy. We studied the effects of cyclohexenonic long-chain fatty alcohol (FA) on streptozotocin-diabetic hyperreactivity in the rat aorta smooth muscle. The rats were divided randomly into four groups and were maintained for 4 weeks: age-matched control rats, diabetic rats without treatment with FA, and diabetic rats treated with FA (2 and 8 mg/kg, i.p. everyday). The serum glucose and insulin levels were determined, and the contractile responses of the aorta induced by a thromboxane A2 agonist, U46619 and KCl were investigated. Treatment with FA did not alter rats' diabetic status, i.e., body weight, thickness of the aorta, serum glucose levels, and serum insulin levels, but significantly improved the diabetic-induced hyperreactivity of the rat aorta in a dose-dependent manner. Removal of endothelium did not change contractile force between groups. In histological examinations, thinning of smooth muscle bundle in the wall of aorta was observed in the diabetic rat, which was not significantly improved by treatment with FA. Our data indicate that FA can prevent hyperreactivity in the diabetic aorta.

Effect of partial outlet obstruction on nitrotyrosine content and distribution within the rabbit bladder

PURPOSE

Evidence indicates that free radicals are etiological factors in obstructive bladder disease. However, it is not clear which species of reactive oxygen or nitrogen species mediate the damage. The current studies were designed to determine if partial outlet obstruction in rabbits results in the generation of nitrotyrosine (NT).

MATERIALS AND METHODS

Sixteen rabbits were separated into four groups of four. The rabbits in groups 1 and 2 underwent sham operation while rabbits in groups 3 and 4 underwent partial outlet obstruction. The rabbits in groups 1 and 3 were evaluated after 1 week of obstruction and the rabbits in groups 2 and 4 were evaluated after 2 weeks of obstruction. A separate group of four controls were evaluated simultaneously with the sham and obstructed rabbits. Four rabbits from each group were evaluated after 1 and 2 weeks of obstruction. Four control rabbits were also evaluated. Isolated strips were evaluated for contractile responses and NT content of the mucosa and muscle were quantitated by Western blot analysis.

RESULTS

(1) The mucosa contains both 42 and 62 kD proteins exhibiting a strong nitrotyrosine signal; the muscle presents a signal only at 62 kD. (2) The sham operations had no effect on nitrotyrosine distribution or content. (3) The nitrotyrosine of both mucosal proteins and the muscle protein are increased in the 1 week obstructed bladder; whereas, only the 62 kD signal is increased in the two week obstructed bladder mucosa. (4) The contractile response to FS are reduced to a significantly greater degree than the responses to carbachol, KCl, or ATP.

CONCLUSIONS

These studies clearly demonstrated that partial outlet obstruction in rabbits results in significant increases in nitrotyrosine within the bladder and may contribute to the contractile dysfunctions mediated by partial outlet obstruction.

Effect of cyclohexenonic long-chain fatty alcohol on rat overactive bladder induced by bladder neck obstruction

We attempted to clarify the preventive effects of cyclohexenonic long-chain fatty alcohol on detrusor overactivity induced by mild bladder neck obstruction. Bladder neck obstruction was created by partial ligation of the urethra. Female Sprague-Dawley rats were divided into three groups: those with bladder neck obstruction treated without long-chain fatty alcohol, those with bladder neck obstruction with long-chain fatty alcohol (8 mg/kg, i.p., every day) and the sham-operated control group (A, B, and C groups, respectively). Six weeks after the induction of bladder neck obstruction, voiding behavior was observed in the metabolic cage, and a cystometrogram was performed in the experimental animals. Furthermore, Hematoxylin and Eosin, Azan-Mallory, and Bodian stainings were performed in these bladders. Bladder weight, voiding behaviors and a cystometry indicated that rats in the A group showed detrusor overactivity, which was improved by treatment with long-chain fatty alcohol. The proportion of connective tissue and the density of bundles of neurofibers in the bladder of the A group was significantly less than that in the other bladders. Mild bladder neck obstruction induces detrusor overactivity, which is improved by treatment with long-chain fatty alcohol.

Effect of vaginal distension on blood flow and hypoxia of urogenital organs of the female rat

Vaginal delivery of children causes traumatic injury to tissues of the pelvic floor and is correlated with stress urinary incontinence; however, the exact mechanism of organ and tissue injury leading to incontinence development is unknown. The purpose of this project was to test the hypothesis that vaginal distension results in decreased blood flow to, and hypoxia of, the urogenital organs responsible for continence, which would suggest an ischemic and/or reperfusion mechanism of injury. Thirteen female rats underwent vaginal distension for 1 h. Thirteen age-matched rats were sham-distended controls. Blood flow to the bladder, urethra, and vagina were determined using a microsphere technique. Hypoxia of these organs was determined by immunohistochemistry. Blood flow to all three organs was significantly decreased just before release of vaginal distension. Bladder blood flow decreased further immediately after release of vaginal distension and continued to be significantly decreased 15 min after the release. Blood flow to both the urethra and vagina tripled immediately after release, inducing a rapid return to normal values. Vaginal distension resulted in extensive smooth muscle hypoxia of the bladder, as well as extensive hypoxia of the vaginal epithelium and urethral hypoxia. Bladders from sham-distended rats demonstrated urothelial hypoxia as well as focal hypoxic areas of the detrusor muscle. We have clearly demonstrated that vaginal distension results in decreased blood flow to, and hypoxia of, the bladder, urethra, and vagina, supportive of hypoxic injury as a possible mechanism of injury leading to stress urinary incontinence.

Expression of HSP 70 and its mRNAS during ischemia-reperfusion in the rat bladder

HSP 70 is an important protein that repairs damaged tissue after injury. In the present study, we investigated the expression of HSP 70 and its mRNAs during ischemia-reperfusion in the rat bladder. Rat abdominal aorta was clamped with a small clip to induce ischemia-reperfusion injury in the bladder dome. Male Wistar rats, 8 weeks old, were divided into six groups: controls, 30-min ischemia, 30-min ischemia and 30-, 60-minute, 1- and 7-day reperfusion, groups A, B, C, D, E, and F, respectively. In functional studies, contractile responses to carbachol were measured in these groups. The expression of HSP 70-1/2 mRNAs was quantified using a real-time PCR method, and that of HSP 70 proteins was measured using ELISA in the bladders. In the functional study, Emax values of carbachol to bladders in the A, B, C, D, E and F groups were 9.3 +/- 1.3, 7.9 +/- 1.7, 4.3 +/- 0.8, 4.2 +/- 0.7, 4.5 +/- 0.6, and 8.1 +/- 1.2 g/mm2, respectively. In the control group, the expression of HSP 70-1/2 mRNA was detected, and the expression of HSP 70-1 mRNAs was significantly higher than that of HSP 70-2 mRNAs in each group. The expression of HSP 70-1 mRNA increased in groups B and C, but decreased in groups D, E, and F. The expression of HSP 70-2 mRNA in group C was significantly higher than that of groups A, D, E, and F. The expression of HSP 70-1/2 mRNAs after 1 day or 1 week of reperfusion was similar to control levels. The expression of HSP 70 proteins was increased shortly after the expression of their mRNAs. The expression of HSP 70 after 1 day or 1 week of reperfusion was almost identical to control levels. Our data indicate that contractile responses of the bladder were decreased by ischemia reperfusion, and that expression of HSP 70 and its mRNAs appeared to increase after a short period of the insult.

Melatonin treatment protects against sepsis-induced functional and biochemical changes in rat ileum and urinary bladder

Sepsis is commonly associated with enhanced generation of reactive oxygen metabolites, which lead to multiple organ dysfunction. The aim of this study was to examine the role of melatonin, a potent antioxidant, in protecting the intestinal and bladder tissues against damage in a rat model of sepsis. Sepsis was induced by cecal ligation and perforation (CLP) in Wistar Albino rats. Sham operated (control) and CLP group received saline or melatonin (10 mg/kg, ip) 30 minutes prior to and 6 hours after the operation. Sixteen hours after the surgery, rats were decapitated and the intestinal and urinary bladder tissues were used for contractility studies, or stored for the measurement of malondialdehyde (MDA) content -an index of lipid peroxidation-, glutathione (GSH) levels -a key antioxidant- and myeloperoxidase (MPO) activity- an index of neutrophil infiltration-. Ileal and bladder MDA levels in the CLP group were significantly increased (p < 0.001) with concomitant decreases in GSH levels (p < 0.01 - p < 0.001) when compared to the control group. Similarly, MPO activity was significantly increased (p < 0.001) in both ileum and bladder tissues. On the other hand, melatonin treatment significantly reversed (p < 0.001) the elevations in MDA and MPO levels, while reduced GSH levels were increased back to the control levels (p < 0.01 - p < 0.001). In the CLP group, the contractility of the ileal and bladder tissues decreased significantly compared with controls. Melatonin treatment of the CLP group restored these responses. In this study, CLP induced dysfunction of the ileal and bladder tissue of rats was reversed by melatonin treatment. Moreover, melatonin, as an antioxidant, abolished the elevation in lipid peroxidation products and myeloperoxidase activity, and reduction in the endogenous antioxidant glutathione and thus protected the tissues against sepsis-induced oxidative damage.

Expression of heat shock protein 70 and its mRNAs during ischemia–reperfusion in the rat prostate

We investigated the expression of heat shock protein (HSP) 70 and its mRNAs during ischemia-reperfusion in the rat prostate. Eight-week-old rats were divided into six groups: a control group, a 30-min ischemia group, and 30-min ischemia+30-min, 60-min, 1-day, and 1-week reperfusion groups (groups A, B, C, D, E, and F, respectively). In vivo real-time blood flow and HSP 70-1 and 70-2 mRNAs and proteins in the prostate were measured using laser Doppler flow meter, real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) methods, respectively. Clamping of the aorta decreased blood flow to 10% of the basal level. The expressions of HSP 70-1/2 mRNAs increased in groups B, C, and D, and decreased in groups E and F. The expression of HSP 70 proteins was increased after a short interval of increase in their mRNAs. Our data indicated that the expressions of HSP 70 proteins and their mRNAs are dramatically changed during ischemia-reperfusion in the rat prostate.

Nerve-mediated bladder contraction is impaired by cytokines: involvement of inducible nitric oxide synthase

We investigated the possible involvement of inducible nitric oxide synthase (iNOS) in the effect of cytokines on neuromuscular function in isolated rat bladder strips. Bladder strips were incubated in cell culture medium for 24 h with or without tumour necrosis factor-alpha (TNF-alpha)+interleukin-1beta. Mechanical activity in response to electrical field stimulation and carbachol was recorded in organ baths. Both the electrical field stimulation- and carbachol-induced contractions were reduced by the incubation. The electrical field stimulation-induced contraction was significantly further impaired after prolonged exposure to TNF-alpha+interleukin-1beta. This impairment was restored by dexamethasone, the iNOS inhibitor aminoguanidine and partially by brain-derived neurotrophic factor (BDNF). In contrast, carbachol-induced contractions were not affected by cytokines. iNOS protein expression was detected in cytokine-incubated bladder strips by immunohistochemistry and Western blot analysis. The results demonstrated that TNF-alpha+interleukin-1beta impaired nerve-mediated bladder contractions. Aminoguanidine, and to some extent BDNF, exerted neuroprotective effects.

Melatonin treatment protects against ischemia/reperfusion-induced functional and biochemical changes in rat urinary bladder

Reactive oxygen metabolites play important roles in ischemia/reperfusion (I/R) injury in several systems. The aim of this study was to investigate the role of melatonin against I/R injury of the rat urinary bladder. The abdominal aorta was clamped to induce ischemia for 30 min, then the animals were subjected to 60 min of reperfusion. Melatonin (10 mg/kg, i.p.) or the vehicle (control 1% alcohol i.p.) was administered before I/R. After decapitation, the bladder was removed and the tissue was either used for functional studies or stored for measurement of products of lipid peroxidation (LP), glutathione (GSH) levels and myeloperoxidase activity (MPO). Bladder strips were suspended in oxygenated Tyrode's buffer at 37 degrees C and isometric contractions to carbachol (CCh; 10(-8)-10(-4) m) were recorded. In the I/R group, the contractile responses of the bladder strips were lower than those of the control group (P < 0.01-0.001) and were reversed by treatment with melatonin (P < 0.05-0.001). LP which was higher in I/R group compared with control (27.68 +/- 1.69 and 10.59 +/- 1.27 nmol/g, respectively; P < 0.001) was partially reversed by melatonin (19.01 +/- 1.85 nmol/g; P < 0.01). Similarly, GSH showed a decrease in the I/R group compared with controls (0.27 +/- 0.03 and 0.43 +/- 0.04 micromol/g, respectively; P < 0.05) and melatonin prevented this effect completely (0.45 +/- 0.04 micromol/g; P < 0.05). MPO activity in the I/R group (4.19 +/- 0.08 U/g) was significantly higher than that of the control group (1.41 +/- 0.08 U/g; P < 0.001) and melatonin treatment reduced MPO levels compared with I/R alone (3.16 +/- 0.07; P < 0.001). Melatonin almost completely reversed the low contractile responses of rat urinary bladder strips to CCh and prevented oxidative tissue damage following I/R.

Inducible nitric oxide synthase promotes pathophysiological consequences of experimental bladder outlet obstruction

PURPOSE

Bladder outlet obstruction leads to histological and functional changes in the bladder over time. We investigated the role of inducible nitric oxide synthase (iNOS) in the progression of pathological changes of the bladder secondary to outlet obstruction in a rat and a mouse model.

MATERIALS AND METHODS

To assess expression of iNOS in the bladder, polymerase chain reaction amplification of mRNA was done. Rats were subjected to sham operation or partial bladder outlet obstruction. They were given the iNOS inhibitor aminoguanidine in drinking water or unmodified water. After 2 weeks, awake cystometric evaluation was performed, the bladders were harvested and the degree of fibrosis was assessed. In another series of experiments mice deficient in the iNOS gene (iNOS -/-) were compared to WT mice for cystometric as well as histological changes in the bladder following partial bladder outlet obstruction or sham operation.

RESULTS

Partial bladder outlet obstruction induced the expression of iNOS mRNA in the mouse bladder. iNOS -/- mice showed a significantly smaller increase in bladder volume at 3 weeks compared with WT. Pharmacological inhibition of iNOS activity significantly attenuated the increase in bladder size and the number of spontaneous bladder contractions in obstructed rats at 2 weeks. Furthermore, genetic and pharmacological decreases in iNOS led to significantly less fibrosis of the bladder after partial bladder outlet obstruction in mice and rats, respectively.

CONCLUSIONS

Pharmacological or genetic decreases in iNOS resulted in amelioration of functional and fibrotic changes in the bladder after partial bladder outlet obstruction, suggesting that NO contributes to the pathophysiology of bladder outlet obstruction.

N(G)-nitro-L-arginine methylester, a nitric oxide synthase inhibitor, diminishes apoptosis induced by ischemia-reperfusion in the rat bladder

AIMS

To evaluated the effects of N(G)-nitro-L-arginine methylester (L-NAME), a nitric oxide synthase (NOS) inhibitor, on apoptosis induced by ischemia-reperfusion injury in the rat through a muscle bath and TUNEL staining.

METHODS

The rat abdominal aorta was clamped to induce ischemia-reperfusion (I-R) injury in the rat bladder dome with or without L-NAME (30 mg/kg, i.p. 30 minutes before the ischemia) according to our previous reports [Saito et al., 1998 Life Sci. 62:PL149-56; Saito and Miyagawa, 1999 J. Urol. 162:1490-5]. Some rats were exposed to 30 minutes of ischemia only, whereas others also received 30 minutes, 3 days, or 7 days of reperfusion after the ischemia. Muscle bath studies with carbachol and 100 mM KCl were performed to confirm the bladder function. TUNEL and hematoxylin and eosin staining were performed in the experimental rat bladders to detect apoptosis.

RESULTS

The contractile responses of the rat bladder dome after 30 minutes of ischemia differed slightly, not significantly, from those of controls. Reperfusion (30 minutes) produced significant reductions in the contractile responses to carbachol and KCl in the rat bladders. The treatment with L-NAME significantly reduced the extent of reperfusion injury, as judged by pharmacologic experiments. At 3 and 7 days after the induction of ischemia-reperfusion, the contractile responses were improved compared with the 30-minute reperfusion group. For each duration group, treatment with L-NAME significantly increased the contractile responses compared with the I-R group without L-NAME. Ischemia-reperfusion induced apoptosis, and the peak in TUNEL-positive cells was observed 3 days after the insult. Pretreatment with L-NAME reduced the induction of apoptosis.

CONCLUSION

Our data indicated treatment with L-NAME can reduce apoptosis induced by ischemia-reperfusion in the bladder.

Microcirculation of the urinary bladder in a rat model of ischemia-reperfusion-induced cystitis

OBJECTIVES

To determine the microcirculatory disturbances in a rat model of ischemia-reperfusion-induced cystitis using intravital fluorescence videomicroscopy.

METHODS

Twenty male Sprague-Dawley rats were used for the experiments. In 10 animals, warm ischemia of the bladder was induced for 60 minutes. After 30 minutes of reperfusion, microvascular macromolecular leakage, leukocyte-endothelial cell interactions, venular red blood cell velocity, functional capillary density, and the arteriolar and venular diameters were determined by intravital videomicroscopy. In addition, the intravesical pressure and macrohemodynamic parameters were assessed during the experiments. Sham-operated animals served as the controls (n = 10).

RESULTS

After ischemia-reperfusion, the numbers of rolling and firmly adherent leukocytes in the postcapillary venules were significantly increased. Venular red blood cell velocity and functional capillary density, as well as the arteriolar and venular diameters, were significantly decreased. The macromolecular leakage had increased in both arterioles and venules.

CONCLUSIONS

After ischemia-reperfusion, inflammatory reactions and microcirculatory failure were observed in the urinary bladder. This study targeted the microcirculatory consequences of cystitis using intravital videomicroscopy. Because the parameters investigated are relevant not only for ischemia-reperfusion of the urinary bladder but also for cystitis caused by other stimuli, this model represents a novel tool in the field of inflammation research in urology.

Activity and expression of nitric oxide synthase in the hypertrophied rat bladder and the effect of nitric oxide on bladder smooth muscle growth

PURPOSE

We investigated the expression and activity of nitric oxide synthase (NOS) and the localization of cyclic guanosine monophosphate (cGMP) in hypertrophied rat bladder. We also examined whether nitric oxide (NO) has a growth inhibitory effect in bladder smooth muscle cells.

MATERIALS AND METHODS

The urethra was partly ligated and the bladder was removed 3 days, 3 or 6 weeks after obstruction. NOS activity was determined as the conversion of L-[14C]citrulline from L-[14C]arginine (Amersham Life Science, Solna, Sweden). Neuronal NOS (nNOS) expression was studied with Western blot analysis and immunohistochemistry. The expression of inducible NOS (iNOS) and cGMP was evaluated by immunohistochemistry. The effect of NO on isolated bladder smooth muscle cell growth was assessed as protein and DNA synthesis by [3H]-leucine and [3H]-thymidine (NEN Life Science Products, Zaventem, Belgium) incorporation, respectively.

RESULTS

Ca independent iNOS activity increased after short-term obstruction. Immunohistochemical studies in obstructed bladders demonstrated iNOS expression primarily in urothelial and inflammatory cells. Ca dependent nNOS activity decreased after obstruction, as confirmed by Western blot analysis. The cGMP immunoreactive cells were mainly found within the serosal layer of obstructed bladders. The NO donor DETA-NONOate (Alexis Biochemicals, Lausen, Switzerland) (300 microM.) reduced [3H]-leucine and [ H]-thymidine incorporation by a mean of 29% +/- 2% and 95% +/- 2%, respectively, in cultured bladder smooth muscle cells.

CONCLUSIONS

Bladder obstruction caused a small increase in iNOS activity and a decrease in nNOS activity. NO was found to have a growth inhibitory effect in bladder smooth muscle cells, suggesting that changes in NOS activity may influence the progress of bladder hypertrophy.

Preventive effect of long-chain fatty alcohol on ischemia--reperfusion injury in the rat bladder

We attempted in the present study to clarify the preventive effects of cyclohexenonic long-chain fatty alcohol on ischemia-reperfusion injury in the rat bladder. Rat bladders were exposed to 30 min of ischemia and a subsequent 30 min of reperfusion with or without several doses of cyclohexenonic long-chain fatty alcohol (0.5, 2, 8 mg/kg). Muscle-bath studies were performed, and malonaldehyde concentrations were measured in the bladder. Bladder dysfunction and lipid peroxidation caused by ischemia-reperfusion were prevented by cyclohexenonic long-chain fatty alcohol in a dose-dependent manner. Our data indicate that cyclohexenonic long-chain fatty alcohol can prevent the production of free radicals and ischemia-reperfusion injury in the bladder.

The aging bladder--a significant but underestimated role in the development of lower urinary tract symptoms

There are three major areas in which bladder dysfunction causes considerable losses in quality of life: detrusor instability, impaired detrusor function and detrusor reaction on bladder outlet obstruction. Considerable changes in detrusor morphology, detrusor innervation and bladder metabolism are seen with aging and obstruction. This causes dysfunction and lower urinary tract symptoms. The relation between aging per se and external influence on the detrusor from diseases in the nervous system, in the vascular supply and in the lower urinary tract itself is poorly understood. To improve our ability to prevent and treat these conditions we need more insight in these pathophysiological conditions.