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Cellai I, Comeglio P, Filippi S, Martinelli S, Villanelli F, Amore F, Rapizzi E, Maseroli E, Cipriani S, Raddi C, Guarnieri G, Sarchielli E, Danza G, Morelli A, Rastrelli G, Maggi M, Vignozzi L. The regulatory effect of sex steroids on the RhoA/ROCK pathway in the rat distal vagina. J Sex Med 2023; 20:1-13. [PMID: 36897236 DOI: 10.1093/jsxmed/qdac009] [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: 01/18/2022] [Revised: 08/18/2022] [Accepted: 09/21/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Sex steroids have been demonstrated as important modulators of vaginal function. The RhoA/ROCK calcium-sensitizing pathway plays a role in genital smooth muscle contractile mechanism, but its regulation has never been elucidated. AIM This study investigated the sex steroid regulation of the vaginal smooth muscle RhoA/ROCK pathway using a validated animal model. METHODS Ovariectomized (OVX) Sprague-Dawley rats were treated with 17β-estradiol (E2), testosterone (T), and T with letrozole (T + L) and compared with intact animals. Contractility studies were performed to test the effect of the ROCK inhibitor Y-27632 and the nitric oxide (NO) synthase inhibitor L-NAME. In vaginal tissues, ROCK1 immunolocalization was investigated; mRNA expression was analyzed by semiquantitative reverse transcriptase-polymerase chain reaction; and RhoA membrane translocation was evaluated by Western blot. Finally, rat vaginal smooth muscle cells (rvSMCs) were isolated from the distal vagina of intact and OVX animals, and quantification of the RhoA inhibitory protein RhoGDI was performed after stimulation with NO donor sodium nitroprusside, with or without administration of the soluble guanylate cyclase inhibitor ODQ or PRKG1 inhibitor KT5823. OUTCOMES Androgens are critical in inhibiting the RhoA/ROCK pathway of the smooth muscle compartment in the distal vagina. RESULTS ROCK1 was immunolocalized in the smooth muscle bundles and blood vessel wall of the vagina, with weak positivity detected in the epithelium. Y-27632 induced a dose-dependent relaxation of noradrenaline precontracted vaginal strips, decreased by OVX and restored by E2, while T and T + L decreased it below the OVX level. In Western blot analysis, when compared with control, OVX significantly induced RhoA activation, as revealed by its membrane translocation, with T reverting it at a level significantly lower than in controls. This effect was not exerted by E2. Abolishing NO formation via L-NAME increased Y-27632 responsiveness in the OVX + T group; L-NAME had partial effects in controls while not modulating Y-27632 responsiveness in the OVX and OVX + E2 groups. Finally, stimulation of rvSMCs from control animals with sodium nitroprusside significantly increased RhoGDI protein expression, counteracted by ODQ and partially by KT5823 incubation; no effect was observed in rvSMCs from OVX rats. CLINICAL IMPLICATIONS Androgens, by inhibiting the RhoA/ROCK pathway, could positively contribute to vaginal smooth muscle relaxation, favoring sexual intercourse. STRENGTHS AND LIMITATIONS This study describes the role of androgens in maintaining vaginal well-being. The absence of a sham-operated animal group and the use of the only intact animal as control represented a limitation to the study.
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Affiliation(s)
- Ilaria Cellai
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Paolo Comeglio
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Sandra Filippi
- Interdepartmental Laboratory of Functional and Cellular Pharmacology of Reproduction, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence 50139, Italy
| | - Serena Martinelli
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Fabio Villanelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Francesca Amore
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Elena Rapizzi
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Sarah Cipriani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Chiara Raddi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Giulia Guarnieri
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence 50139, Italy
| | - Erica Sarchielli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence 50139, Italy
| | - Giovanna Danza
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Annamaria Morelli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence 50139, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy.,INBB (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence 50139, Italy.,INBB (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy
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Cellai I, Filippi S, Comeglio P, Cipriani S, Maseroli E, Di Stasi V, Todisco T, Marchiani S, Tamburrino L, Villanelli F, Vezzani S, Corno C, Fambrini M, Guarnieri G, Sarchielli E, Morelli A, Rastrelli G, Maggi M, Vignozzi L. Testosterone positively regulates vagina NO-induced relaxation: an experimental study in rats. J Endocrinol Invest 2022; 45:1161-1172. [PMID: 35072927 PMCID: PMC9098587 DOI: 10.1007/s40618-022-01743-4] [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: 07/12/2021] [Accepted: 12/01/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Female sexual response involves a complex interplay between neurophysiological mechanisms and the nitric oxide (NO)-mediated relaxation of clitoris and vagina. The aim of this study was to evaluate sex steroids regulation of the relaxant pathway in vagina, using a validated animal model. METHODS Subgroups of OVX Sprague-Dawley rats were treated with 17β-estradiol, testosterone, or testosterone and letrozole, and compared with a group of intact animals. Masson's trichrome staining was performed for morphological evaluation of the distal vaginal wall, in vitro contractility studies investigated the effect of OVX and in vivo treatments on vaginal smooth muscle activity. RNA from vaginal tissue was analyzed by semi-quantitative RT-PCR. RESULTS Immunohistochemical analysis showed that OVX induced epithelial and smooth muscle structural atrophy, testosterone and testo + letrozole increased the muscle bundles content and organization without affecting the epithelium while 17β-estradiol mediated the opposite effects. In vitro contractility studies were performed on noradrenaline pre-contracted vaginal strips from each experimental group. Acetylcholine (0.001-10 µM) stimulation induced a concentration-dependent relaxation, significantly reduced by NO-synthase inhibitor L-NAME and by guanylate cyclase inhibitor ODQ. OVX resulted in a decreased responsiveness to acetylcholine, restored by testosterone, with or without letrozole, but not by 17β-estradiol. OVX sensitivity to the NO-donor SNP was higher than in the control. Vardenafil, a PDE5 inhibitor, enhanced SNP effect in OVX + testosterone as well as in control, as supported by RNA expression analysis. CONCLUSIONS Our study demonstrates that testosterone improves the NO-mediated smooth muscle vaginal cells relaxation confirming its role in maintaining the integrity of muscular relaxant machinery.
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Affiliation(s)
- I Cellai
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Filippi
- Interdepartmental Laboratory of Functional and Cellular Pharmacology of Reproduction, Department of Neurosciences, Drug Research and Child Health (NEUROFARBA), University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - P Comeglio
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Cipriani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - V Di Stasi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - T Todisco
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Marchiani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - L Tamburrino
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - F Villanelli
- Endocrinology Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - S Vezzani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - C Corno
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - M Fambrini
- Division of Obstetrics and Gynecology, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - G Guarnieri
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - E Sarchielli
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - A Morelli
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - M Maggi
- Endocrinology Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Viale delle Medaglie d'Oro 305, 00136, Rome, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Excellence Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy.
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Viale delle Medaglie d'Oro 305, 00136, Rome, Italy.
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Huntington AJ, Udayasuryan B, Du P, Verbridge SS, Abramowitch SD, Vita RD. Smooth Muscle Organization and Nerves in the Rat Vagina: A First Look Using Tissue Clearing and Immunolabeling. Ann Biomed Eng 2022; 50:440-451. [PMID: 35182248 DOI: 10.1007/s10439-022-02928-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/06/2022] [Indexed: 12/28/2022]
Abstract
Smooth muscle fibers within the vagina, as well as the nerve fibers that contribute to their control mechanisms, are important for the maintenance and alteration of vaginal length and tone. Vaginal smooth muscle (VaSM) is typically described as being arranged into two distinct concentric layers: an inner circular muscular layer and an outer longitudinal muscular layer. However, the distribution of VaSM oriented in the longitudinal direction (LD) and circumferential direction (CD) has never been quantified. In this study, tissue clearing and immunohistochemistry were performed so that the VaSM, and surrounding nerves, within whole rat vaginas ([Formula: see text]) could be imaged without tissue sectioning, preserving the three-dimensional architecture of the organs. Using these methods, the vagina was viewed through the full thickness of the muscularis layer, from the distal to the proximal regions. The VaSM orientation in the proximal and distal regions and the VaSM content along the LD and CD were quantified. Additionally, a qualitative assessment of vaginal nerves was performed. When compared using a permuted version of the Watson [Formula: see text] test, the orientation of VaSM in the proximal and distal regions were found to be significantly different in 4 of the 6 imaged rat vaginas ([Formula: see text]). While the distal vagina contained a similar amount of VaSM oriented within [Formula: see text] of the LD and within [Formula: see text] of the CD, the proximal vagina contained significantly more VaSM oriented towards the LD than towards the CD. Nerve fibers were found to be wavy, running both parallel and perpendicular to vascular and non-vascular smooth muscle within the vagina. Micro-structural analyses, like the one conducted here, are necessary to understand the physiological function and pathological changes of the vagina.
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Affiliation(s)
- Alyssa J Huntington
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, 330A Kelly Hall, 325 Stanger Street, Blacksburg, 24061, VA, USA
| | - Barath Udayasuryan
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 330 Kelly Hall, 325 Stanger Street, Blacksburg, 24061, VA, USA
| | - Pang Du
- Department of Statistics, Virginia Tech, 417A Hutcheson Hall, 250 Drillfield Drive, Blacksburg, 24061, VA, USA
| | - Scott S Verbridge
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 330 Kelly Hall, 325 Stanger Street, Blacksburg, 24061, VA, USA
| | - Steven D Abramowitch
- Translational Biomechanics Lab, Department of Bioengineering, University of Pittsburgh, Benedum Hall, 3700 O'Hara Street, Pittsburgh, 15213, PA, USA
| | - Raffaella De Vita
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, 330A Kelly Hall, 325 Stanger Street, Blacksburg, 24061, VA, USA.
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Huntington A, Abramowitch SD, Moalli PA, De Vita R. Strains induced in the vagina by smooth muscle contractions. Acta Biomater 2021; 129:178-187. [PMID: 34033971 DOI: 10.1016/j.actbio.2021.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/26/2022]
Abstract
The ability of the vagina to contract gives rise to a set of active mechanical properties that contribute to the complex function of this organ in-vivo. Regional differences in the morphology of the vagina have been long recognized, but the large heterogeneous deformations that the vagina experiences during contractions have never been quantified. Furthermore, there is no consensus regarding differences in contractility along the two primary anatomical directions of the vagina: the longitudinal direction (LD) and the circumferential direction (CD). In this study, square vaginal specimens from healthy virgin rats (n=15) were subjected to isometric planar biaxial tests at four equi-biaxial stretches of 1.0, 1.1, 1.2, and 1.3. Contractions were induced at each stretch by a high concentration potassium solution. The digital image correlation method was used to perform full-field strain measurements during contractions. The vagina was found to undergo significantly higher compressive strains, tensile strains, and contractile forces along the LD than along the CD during contractions. Specifically, when computed over all the applied equi-biaxial stretches, mean (± std. dev.) absolute maximum compressive strains were -(13.43 ± 1.56)% along the LD and -(3.19 ± 0.25)% along the CD, mean absolute maximum tensile strains were (10.92 ± 1.73)% along the LD and (3.62 ± 0.57)% along the CD, and mean maximum contractile forces were 6.24 ± 0.55 mN along the LD and 3.35 ± 0.56 mN along the CD. Moreover, the vaginal tissue appeared to undergo compression in the proximal region and tension in the distal region while kept at constant equi-biaxial stretches. The active mechanical properties of the healthy vagina need to be fully investigated so that detrimental alterations in vaginal contractility, such as those caused by pelvic floor disorders and current treatment strategies, can be prevented. STATEMENT OF SIGNIFICANCE: Contractile forces of the vagina have been measured by several investigators using uniaxial tensile testing methods. Unlike previous studies, in this study planar-biaxial tests of vaginal specimens were performed while the full-field strains of the vagina, as induced by smooth muscle contraction, were measured. The vagina was found to generate significantly larger contractile strains and forces in the longitudinal direction than in the circumferential direction. Knowledge of the contractile mechanics of the healthy vagina is essential to understand the detrimental effects that pelvic organ prolapse and the use of surgical meshes have on the functionality of smooth muscle in the vagina.
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Affiliation(s)
- Alyssa Huntington
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Steven D Abramowitch
- Translational Biomechanics Lab, Department of Bioengineering, University of Pittsburgh, Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Pamela A Moalli
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, 204 Craft Ave, Pittsburgh, PA, 15213, USA
| | - Raffaella De Vita
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, 24061, USA.
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Huntington A, Donaldson K, De Vita R. Contractile Properties of Vaginal Tissue. J Biomech Eng 2020; 142:080801. [PMID: 32203570 PMCID: PMC10854261 DOI: 10.1115/1.4046712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/26/2020] [Indexed: 01/11/2024]
Abstract
The vagina is an important organ of the female reproductive system that has been largely understudied in the field of biomechanics. In recent years, some research has been conducted to evaluate the mechanical properties of the vagina, but much has focused on characterizing the passive mechanical properties. Because vaginal contractions play a central role in sexual function, childbirth, and development and treatment of pelvic floor disorders, the active mechanical properties of the vagina must be also quantified. This review surveys and summarizes published experimental studies on the active properties of the vagina including the differences in such properties determined by anatomic regions and orientations, neural pathways, life events such as pregnancy and menopause, pelvic floor disorders such as prolapse, and surgical mesh treatment. Conflicting experimental findings are presented, illustrating the need for further research on the active properties of the vagina. However, consensus currently exists regarding the negative impact of surgical mesh on vaginal contractility. This review also identifies knowledge gaps and future research opportunities, thus proving a firm foundation for novice and experienced researchers in this emerging area of biomechanics and encouraging more activity on women's sexual and reproductive health research.
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Affiliation(s)
- Alyssa Huntington
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061
| | - Kandace Donaldson
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061
| | - Raffaella De Vita
- STRETCH Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061
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André GI, Firman RC, Simmons LW. The coevolution of male and female genitalia in a mammal: A quantitative genetic insight. Evolution 2020; 74:1558-1567. [PMID: 32490547 DOI: 10.1111/evo.14031] [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: 10/17/2019] [Revised: 04/10/2020] [Accepted: 05/30/2020] [Indexed: 12/28/2022]
Abstract
Male genitalia are among the most phenotypically diverse morphological traits, and sexual selection is widely accepted as being responsible for their evolutionary divergence. Studies of house mice suggest that the shape of the baculum (penis bone) affects male reproductive fitness and experimentally imposed postmating sexual selection has been shown to drive divergence in baculum shape across generations. Much less is known of the morphology of female genitalia and its coevolution with male genitalia. In light of this, we used a paternal half-sibling design to explore patterns of additive genetic variation and covariation underlying baculum shape and female vaginal tract size in house mice (Mus musculus domesticus). We applied a landmark-based morphometrics approach to measure baculum size and shape in males and the length of the vaginal tract and width of the cervix in females. Our results reveal significant additive genetic variation in house mouse baculum morphology and cervix width, as well as evidence for genetic covariation between male and female genital measures. Our data thereby provide novel insight into the potential for the coevolutionary divergence of male and female genital traits in a mammal.
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Affiliation(s)
- Gonçalo I André
- Centre for Evolutionary Biology, School of Biological Sciences (M092), The University of Western Australia, Crawley, 6009, Australia
| | - Renée C Firman
- Centre for Evolutionary Biology, School of Biological Sciences (M092), The University of Western Australia, Crawley, 6009, Australia
| | - Leigh W Simmons
- Centre for Evolutionary Biology, School of Biological Sciences (M092), The University of Western Australia, Crawley, 6009, Australia
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Zhang N, Qin X, Zhang J, Zhang Z, Li Y, Xie Y, Kong D, Du R, Huang X, Xu Y. Bone Marrow Mesenchymal Stem Cells Accelerate the Morphological and Functional Recovery of Neovaginas. Artif Organs 2018; 42:1206-1215. [DOI: 10.1111/aor.13297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/18/2018] [Accepted: 05/24/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Ning Zhang
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Xijing Qin
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Jingkun Zhang
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Zhiqiang Zhang
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Yanan Li
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Yanling Xie
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Desheng Kong
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Runxuan Du
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Xianghua Huang
- Department of Obstetrics and Gynecology; The Second Hospital of Hebei Medical University
| | - Yanfang Xu
- Department of Pharmacology; Hebei Medical University; Shijiazhuang China
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van Helden DF, Kamiya A, Kelsey S, Laver DR, Jobling P, Mitsui R, Hashitani H. Nerve-induced responses of mouse vaginal smooth muscle. Pflugers Arch 2017; 469:1373-1385. [DOI: 10.1007/s00424-017-1995-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 03/30/2017] [Accepted: 05/10/2017] [Indexed: 12/23/2022]
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Estrogen Replacement Regulates Vaginal Innervations in Ovariectomized Adult Virgin Rats: A Histological Study. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7456853. [PMID: 28401161 PMCID: PMC5376441 DOI: 10.1155/2017/7456853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 02/18/2017] [Accepted: 02/22/2017] [Indexed: 11/17/2022]
Abstract
Background. Our previous Gräfenberg spot findings confirmed that the distal-third areas of the anterior vaginal wall bore a significantly greater number of nerves and sexual hormone may have certain degree of influence on these significant differences. However, the role of estrogen in vaginal innervations remains controversial. Methods. To investigate whether hormonal-neural interactions occur in the vagina, sixty rats were randomly divided into six groups: Sham-operated, ovariectomy, and 4 treatment groups. After 2 weeks of treatment, vaginal biopsies were prepared with hematoxylin and eosin and PGP9.5 using immunohistochemistry. Results. The density of small nerve fibers was significantly higher in the distal-half areas of intact vaginal walls than the proximal-half areas (P = 0.001). In contrast, the overall PGP 9.5-ir fiber innervation density was significantly decreased in the OVX rats subjected to surgical menopause. Sustained estrogen administration for 2 weeks resulted in nerve fiber proliferation, with values reaching normal levels in the low-dose estradiol valerate group. Conclusion. Our findings indicate that systemic hormonal therapy with low-dose estradiol valerate is effective and safe for treating deficient vaginal innervation caused by low level of estrogen activity in menopausal women and may aid studies to identify an optimal estradiol dose to provide relief from vaginal discomfort.
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Zhang JK, Du RX, Zhang L, Li YN, Zhang ML, Zhao S, Huang XH, Xu YF. A new material for tissue engineered vagina reconstruction: Acellular porcine vagina matrix. J Biomed Mater Res A 2017; 105:1949-1959. [PMID: 28294563 DOI: 10.1002/jbm.a.36066] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 02/25/2017] [Accepted: 03/07/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Jing-Kun Zhang
- Department of Obstetrics and Gynecology; the Second Hospital of Hebei Medical University; Shijiazhuang Hebei 050000 China
| | - Run-Xuan Du
- Department of Obstetrics and Gynecology; the Second Hospital of Hebei Medical University; Shijiazhuang Hebei 050000 China
| | - Lin Zhang
- Department of Obstetrics and Gynecology; the Second Hospital of Hebei Medical University; Shijiazhuang Hebei 050000 China
| | - Ya-Nan Li
- Department of Obstetrics and Gynecology; the Second Hospital of Hebei Medical University; Shijiazhuang Hebei 050000 China
| | - Ming-Le Zhang
- Department of Obstetrics and Gynecology; the Second Hospital of Hebei Medical University; Shijiazhuang Hebei 050000 China
| | - Shuo Zhao
- School of Mechanical Engineering; Hebei University of Science and Technology; Shijiazhuang Hebei 050018 China
| | - Xiang-Hua Huang
- Department of Obstetrics and Gynecology; the Second Hospital of Hebei Medical University; Shijiazhuang Hebei 050000 China
| | - Yan-Fang Xu
- Department of Pharmacology; Hebei Medical University; Shijiazhuang Hebei 050000 China
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Horvath G, Nemeth J, Brubel R, Opper B, Koppan M, Tamas A, Szereday L, Reglodi D. Occurrence and Functions of PACAP in the Placenta. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/978-3-319-35135-3_23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Cho KJ, Lee KS, Choo MS, Seo JT, Kim JH, Choi JB, Oh SJ, Kim JC. Expressions of vaginal endothelial nitric oxide synthase and phosphodiesterase 5 in female sexual dysfunction: a pilot study. Int Urogynecol J 2016; 28:431-436. [DOI: 10.1007/s00192-016-3159-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 09/07/2016] [Indexed: 10/20/2022]
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Li T, Ma Y, Zhang H, Yan P, Huo L, Hu Y, Chen X, Li T, Zhang M, Liu Z. Differential Regulation of Morphology and Estrogen Receptor-Alpha Expression in the Vagina of Ovariectomized Adult Virgin Rats by Estrogen Replacement: A Histological Study. Int J Endocrinol 2016; 2016:1093512. [PMID: 27642295 PMCID: PMC5013240 DOI: 10.1155/2016/1093512] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/31/2016] [Indexed: 01/15/2023] Open
Abstract
Background. To determine the exact role of estrogen in vaginal tissue morphology and estrogen receptor-alpha (ERα) distribution in the vagina, which remains controversial. Methods. Sixty rats were randomly categorized: sham-operated (sham), ovariectomy (OVX), and four estradiol treatments (estradiol valerate at 0.4, 0.8, 1.6, and 3.2 mg/kg/day) for 2 weeks. Thereafter, vaginal samples were biopsied from the distal- and proximal-half portions. The percentage of ERα-immunoreactive cells and the ERα score were quantified using immunohistochemistry to assess changes in ERα expression and distribution. Results. OVX induced significant vaginal atrophy and organic index. Estrogen-replacement therapy (ERT) reversed vaginal atrophy. The vaginal distal-half areas showed lower ERα% than the proximal-half areas. The ERα% increased sharply 4 weeks after OVX, especially in the epithelial layer (P = 0.023). ERT elicited different degrees of reductions in tissues after the 2-week treatment, but the ERα% in only the epithelium recovered in parallel with that in the sham group (P = 0.001). The OVX group showed higher ERα histological scores than the sham group, and the distal-half area changed more evidently than the proximal-half area. ERα expression was nearly unchanged after ERT (P > 0.05). Conclusions. ERT is effective for treating obesity and vulvovaginal atrophy caused by hypoestrogenism and advancing age in menopausal women but cannot recover the distribution and expression of ERα.
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Affiliation(s)
- Ting Li
- Department of Obstetrics and Gynecology, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Yuanyuan Ma
- Animal Center Laboratory, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Hong Zhang
- Department of Pathology, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Ping Yan
- Department of Nuclear Medicine, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Lili Huo
- Department of Obstetrics and Gynecology, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Yongyan Hu
- Animal Center Laboratory, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Xi Chen
- Department of Obstetrics and Gynecology, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Ting Li
- Department of Pathology, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
| | - Miao Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
- *Miao Zhang:
| | - Zhaohui Liu
- Department of Obstetrics and Gynecology, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China
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Marson L, Giamberardino MA, Costantini R, Czakanski P, Wesselmann U. Animal Models for the Study of Female Sexual Dysfunction. Sex Med Rev 2015; 1:108-122. [PMID: 27784584 DOI: 10.1002/smrj.14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Significant progress has been made in elucidating the physiological and pharmacological mechanisms of female sexual function through preclinical animal research. The continued development of animal models is vital for the understanding and treatment of the many diverse disorders that occur in women. AIM To provide an updated review of the experimental models evaluating female sexual function that may be useful for clinical translation. METHODS Review of English written, peer-reviewed literature, primarily from 2000 to 2012, that described studies on female sexual behavior related to motivation, arousal, physiological monitoring of genital function and urogenital pain. MAIN OUTCOMES MEASURES Analysis of supporting evidence for the suitability of the animal model to provide measurable indices related to desire, arousal, reward, orgasm, and pelvic pain. RESULTS The development of female animal models has provided important insights in the peripheral and central processes regulating sexual function. Behavioral models of sexual desire, motivation, and reward are well developed. Central arousal and orgasmic responses are less well understood, compared with the physiological changes associated with genital arousal. Models of nociception are useful for replicating symptoms and identifying the neurobiological pathways involved. While in some cases translation to women correlates with the findings in animals, the requirement of circulating hormones for sexual receptivity in rodents and the multifactorial nature of women's sexual function requires better designed studies and careful analysis. The current models have studied sexual dysfunction or pelvic pain in isolation; combining these aspects would help to elucidate interactions of the pathophysiology of pain and sexual dysfunction. CONCLUSIONS Basic research in animals has been vital for understanding the anatomy, neurobiology, and physiological mechanisms underlying sexual function and urogenital pain. These models are important for understanding the etiology of female sexual function and for future development of pharmacological treatments for sexual dysfunctions with or without pain. Marson L, Giamberardino MA, Costantini R, Czakanski P, and Wesselmann U. Animal models for the study of female sexual dysfunction. Sex Med Rev 2013;1:108-122.
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Affiliation(s)
- Lesley Marson
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | | | - Peter Czakanski
- University of Alabama at Birmingham-Departments of Anesthesiology and Obstetrics & Gynecology, Birmingham, AL, USA
| | - Ursula Wesselmann
- University of Alabama at Birmingham-Departments of Anesthesiology and Neurology, Birmingham, AL, USA
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Baldassarre M, Alvisi S, Berra M, Martelli V, Farina A, Righi A, Meriggiola MC. Changes in vaginal physiology of menopausal women with type 2 diabetes. J Sex Med 2015; 12:1346-55. [PMID: 25974321 DOI: 10.1111/jsm.12906] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Metabolic disorders, such as type 2 diabetes, have been associated with an increased risk of development of female sexual dysfunction (FSD). In experimental studies, vascular, neuronal, and hormonal responsiveness alteration at vaginal level were proposed as contributors to the onset of FSD in women with diabetes; however, conclusive data on humans are still lacking. AIMS The study aimed to assess changes in vascularization, sex steroid receptors, nitric oxide synthase, and aquaporin-2 (AQP2) expression occurring at vaginal level in women with diabetes. METHODS Vaginal biopsies were obtained from 21 postmenopausal women, 10 of whom were diagnosed as having type 2 diabetes mellitus. CD31, estrogen receptor-α (ERα) and androgen receptor (AR) expression and localization were analyzed by immunostaining. Expression of endothelial (eNOS) and neuronal (nNOS) nitric oxide synthase isoforms and AQP2 were also assessed in vaginal samples. MAIN OUTCOMES MEASURES Changes in vaginal vascularization, sex steroids receptor, eNOS, nNOS and AQP2 expression. RESULTS Vaginal samples from women with diabetes showed an increased microvessel density in the lamina propria, which were morphologically disrupted suggesting an angiogenic compensatory mechanism. While no differences were seen in ERα, AR expression was significantly reduced in the vaginal epithelium and lamina propria of women with diabetes. Similarly, the gene and protein expressions of both nNOS and eNOS were significantly reduced in patients with diabetes, while AQP2 mRNAs level did not significantly differ between the two groups. CONCLUSION Diabetes greatly impacts vaginal physiology, being associated with alterations of the vaginal lamina propria vascular network, nitrergic signaling, and AR expression. These alterations may contribute to the increased risk of FSD development in women with diabetes.
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Affiliation(s)
- Maurizio Baldassarre
- Center for Applied Biomedical Research (CRBA), Department of Surgical and Medical Sciences, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Stefania Alvisi
- Gynecology and Physiopathology of Human Reproduction, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Marta Berra
- Gynecology and Physiopathology of Human Reproduction, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Valentina Martelli
- Gynecology and Physiopathology of Human Reproduction, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Antonio Farina
- Gynecology and Physiopathology of Human Reproduction, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Alberto Righi
- Department of Pathology, Rizzoli Orthopedics Institute, Bologna, Italy
| | - Maria Cristina Meriggiola
- Center for Applied Biomedical Research (CRBA), Department of Surgical and Medical Sciences, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy.,Gynecology and Physiopathology of Human Reproduction, University of Bologna and S. Orsola-Malpighi Hospital, Bologna, Italy
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16
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Mónica Brauer M, Smith PG. Estrogen and female reproductive tract innervation: cellular and molecular mechanisms of autonomic neuroplasticity. Auton Neurosci 2014; 187:1-17. [PMID: 25530517 DOI: 10.1016/j.autneu.2014.11.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 02/08/2023]
Abstract
The female reproductive tract undergoes remarkable functional and structural changes associated with cycling, conception and pregnancy, and it is likely advantageous to both individual and species to alter relationships between reproductive tissues and innervation. For several decades, it has been appreciated that the mammalian uterus undergoes massive sympathetic axon depletion in late pregnancy, possibly representing an adaptation to promote smooth muscle quiescence and sustained blood flow. Innervation to other structures such as cervix and vagina also undergo pregnancy-related changes in innervation that may facilitate parturition. These tissues provide highly tractable models for examining cellular and molecular mechanisms underlying peripheral nervous system plasticity. Studies show that estrogen elicits rapid degeneration of sympathetic terminal axons in myometrium, which regenerate under low-estrogen conditions. Degeneration is mediated by the target tissue: under estrogen's influence, the myometrium produces proteins repulsive to sympathetic axons including BDNF, neurotrimin, semaphorins, and pro-NGF, and extracellular matrix components are remodeled. Interestingly, nerve depletion does not involve diminished levels of classical sympathetic neurotrophins that promote axon growth. Estrogen also affects sympathetic neuron neurotrophin receptor expression in ways that appear to favor pro-degenerative effects of the target tissue. In contrast to the uterus, estrogen depletes vaginal autonomic and nociceptive axons, with the latter driven in part by estrogen-induced suppression of BMP4 synthesis. These findings illustrate that hormonally mediated physiological plasticity is a highly complex phenomenon involving multiple, predominantly repulsive target-derived factors acting in concert to achieve rapid and selective reductions in innervation.
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Affiliation(s)
- M Mónica Brauer
- Laboratory of Cell Biology, Instituto de Investigaciones Biológicas Clemente Estable, Montevideo 11600, Uruguay.
| | - Peter G Smith
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS 66160, United States; Institute for Neurological Discoveries, University of Kansas Medical Center, Kansas City, KS 66160, United States.
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Liao Z, Smith PG. Persistent genital hyperinnervation following progesterone administration to adolescent female rats. Biol Reprod 2014; 91:144. [PMID: 25359899 DOI: 10.1095/biolreprod.114.121103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Provoked vestibulodynia, a female pelvic pain syndrome affecting substantial numbers of women, is characterized by genital hypersensitivity and sensory hyperinnervation. Previous studies have shown that the risk of developing provoked vestibulodynia is markedly elevated following adolescent use of oral contraceptives with high progesterone content. We hypothesized that progesterone, a steroid hormone with known neurotropic properties, may alter genital innervation through direct or indirect actions. Female Sprague Dawley rats received progesterone (20 mg/kg subcutaneously) from Days 20-27; tissue was removed for analysis in some rats on Day 28, while others were ovariectomized on Day 43 and infused for 7 days with vehicle or 17beta estradiol. Progesterone resulted in overall increases in vaginal innervation at both Day 28 and 50 due to proliferation of peptidergic sensory and sympathetic (but not parasympathetic) axons. Estradiol reduced innervation in progesterone-treated and untreated groups. To assess the mechanisms of sensory hyperinnervation, we cultured dissociated dorsal root ganglion neurons and found that progesterone increases neurite outgrowth by small unmyelinated (but not myelinated) sensory neurons, it was receptor mediated, and it was nonadditive with NGF. Pretreatment of ganglion with progesterone also increased neurite outgrowth in response to vaginal target explants. However, pretreatment of vaginal target with progesterone did not improve outgrowth. We conclude that adolescent progesterone exposure may contribute to provoked vestibulodynia by eliciting persistent genital hyperinnervation via a direct effect on unmyelinated sensory nociceptor neurons and that estradiol, a well-documented therapeutic, may alleviate symptoms in part by reducing progesterone-induced sensory hyperinnervation.
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Affiliation(s)
- Zhaohui Liao
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Peter G Smith
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas Institute for Neurological Discoveries, University of Kansas Medical Center, Kansas City, Kansas Kansas Intellectual and Developmental Disabilities Research Center, University of Kansas Medical Center, Kansas City, Kansas
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Gravina FS, van Helden DF, Kerr KP, de Oliveira RB, Jobling P. Phasic contractions of the mouse vagina and cervix at different phases of the estrus cycle and during late pregnancy. PLoS One 2014; 9:e111307. [PMID: 25337931 PMCID: PMC4206458 DOI: 10.1371/journal.pone.0111307] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 09/30/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/AIMS The pacemaker mechanisms activating phasic contractions of vaginal and cervical smooth muscle remain poorly understood. Here, we investigate properties of pacemaking in vaginal and cervical tissues by determining whether: 1) functional pacemaking is dependent on the phase of the estrus cycle or pregnancy; 2) pacemaking involves Ca2+ release from sarcoplasmic/endoplasmic reticulum Ca2+-ATPase (SERCA) -dependent intracellular Ca2+ stores; and 3) c-Kit and/or vimentin immunoreactive ICs have a role in pacemaking. METHODOLOGY/PRINCIPAL FINDINGS Vaginal and cervical contractions were measured in vitro, as was the distribution of c-Kit and vimentin positive interstitial cells (ICs). Cervical smooth muscle was spontaneously active in estrus and metestrus but quiescent during proestrus and diestrus. Vaginal smooth muscle was normally quiescent but exhibited phasic contractions in the presence of oxytocin or the K+ channel blocker tetraethylammonium (TEA) chloride. Spontaneous contractions in the cervix and TEA-induced phasic contractions in the vagina persisted in the presence of cyclopiazonic acid (CPA), a blocker of the SERCA that refills intracellular SR Ca2+ stores, but were inhibited in low Ca2+ solution or in the presence of nifedipine, an inhibitor of L-type Ca2+channels. ICs were found in small numbers in the mouse cervix but not in the vagina. CONCLUSIONS/SIGNIFICANCE Cervical smooth muscle strips taken from mice in estrus, metestrus or late pregnancy were generally spontaneously active. Vaginal smooth muscle strips were normally quiescent but could be induced to exhibit phasic contractions independent on phase of the estrus cycle or late pregnancy. Spontaneous cervical or TEA-induced vaginal phasic contractions were not mediated by ICs or intracellular Ca2+ stores. Given that vaginal smooth muscle is normally quiescent then it is likely that increases in hormones such as oxytocin, as might occur through sexual stimulation, enhance the effectiveness of such pacemaking until phasic contractile activity emerges.
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Affiliation(s)
- Fernanda S. Gravina
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Dirk F. van Helden
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Karen P. Kerr
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Ramatis B. de Oliveira
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Phillip Jobling
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
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Catalpol Induces Neuroprotection and Prevents Memory Dysfunction through the Cholinergic System and BDNF. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:134852. [PMID: 24194776 PMCID: PMC3782139 DOI: 10.1155/2013/134852] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 06/19/2013] [Accepted: 07/25/2013] [Indexed: 01/26/2023]
Abstract
To investigate the role and mechanism of catalpol on neuroprotective effects and memory enhancing effects simultaneously, neuroprotective effects of catalpol were assessed by neurological deficits score, TTC staining, and cerebral blood flow detecting. Morris water maze was employed to investigate its effects on learning and memory and then clarify its possible mechanisms relating the central cholinergic system and BDNF. Edaravone and oxiracetam were used for positive control drugs based on its different action. Results showed that catalpol and edaravone significantly facilitated neurological function recovery, reduced infarction volume, and increased cerebral blood flow in stroke mice. Catalpol and oxiracetam decreased the escape latency significantly and increased the numbers of crossing platform obviously. The levels of ACh, ChAT, and BDNF in catalpol group were increased in a dose-dependent manner, and AChE declined with a U-shaped dose-response curve. Moreover, the levels of muscarinic AChR subtypes M1 and M2 in hippocampus were considerably raised by catalpol. These results demonstrated that catalpol may be useful for neuroprotection and memory enhancement, and the mechanism may be related to the central cholinergic system.
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Pelletier G, Ouellet J, Martel C, Labrie F. Androgenic Action of Dehydroepiandrosterone (DHEA) on Nerve Density in the Ovariectomized Rat Vagina. J Sex Med 2013; 10:1908-14. [DOI: 10.1111/jsm.12219] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bone morphogenetic protein 4 mediates estrogen-regulated sensory axon plasticity in the adult female reproductive tract. J Neurosci 2013; 33:1050-61a. [PMID: 23325243 DOI: 10.1523/jneurosci.1704-12.2013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Peripheral axons are structurally plastic even in the adult, and altered axon density is implicated in many disorders and pain syndromes. However, mechanisms responsible for peripheral axon remodeling are poorly understood. Physiological plasticity is characteristic of the female reproductive tract: vaginal sensory innervation density is low under high estrogen conditions, such as term pregnancy, whereas density is high in low-estrogen conditions, such as menopause. We exploited this system in rats to identify factors responsible for adult peripheral neuroplasticity. Calcitonin gene-related peptide-immunoreactive sensory innervation is distributed primarily within the vaginal submucosa. Submucosal smooth muscle cells express bone morphogenetic protein 4 (BMP4). With low estrogen, BMP4 expression was elevated, indicating negative regulation by this hormone. Vaginal smooth muscle cells induced robust neurite outgrowth by cocultured dorsal root ganglion neurons, which was prevented by neutralizing BMP4 with noggin or anti-BMP4. Estrogen also prevented axon outgrowth, and this was reversed by exogenous BMP4. Nuclear accumulation of phosphorylated Smad1, a primary transcription factor for BMP4 signaling, was high in vagina-projecting sensory neurons after ovariectomy and reduced by estrogen. BMP4 regulation of innervation was confirmed in vivo using lentiviral transduction to overexpress BMP4 in an estrogen-independent manner. Submucosal regions with high virally induced BMP4 expression had high innervation density despite elevated estrogen. These findings show that BMP4, an important factor in early nervous system development and regeneration after injury, is a critical mediator of adult physiological plasticity as well. Altered BMP4 expression may therefore contribute to sensory hyperinnervation, a hallmark of several pain disorders, including vulvodynia.
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Basha ME, Chang S, Burrows LJ, Lassmann J, Wein AJ, Moreland RS, Chacko S. Effect of estrogen on molecular and functional characteristics of the rodent vaginal muscularis. J Sex Med 2013; 10:1219-30. [PMID: 23438289 DOI: 10.1111/jsm.12088] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Vaginal atrophy is a consequence of menopause; however, little is known concerning the effect of a decrease in systemic estrogen on vaginal smooth muscle structure and function. As the incidence of pelvic floor disorders increases with age, it is important to determine if estrogen regulates the molecular composition and contractility of the vaginal muscularis. AIM The goal of this study was to determine the effect of estrogen on molecular and functional characteristics of the vaginal muscularis utilizing a rodent model of surgical menopause. METHODS Three- to 4-month old Sprague-Dawley rats underwent sham laparotomy (Sham, N = 18) or ovariectomy (Ovx, N = 39). Two weeks following surgery, animals received a subcutaneous osmotic pump containing vehicle (Sham, Ovx) or 17β-estradiol (Ovx). Animals were euthanized 1 week later, and the proximal vagina was collected for analysis of contractile protein expression and in vitro studies of contractility. Measurements were analyzed using a one-way analysis of variance followed by Tukey's post hoc analysis (α = 0.05). MAIN OUTCOME MEASURES Protein and mRNA transcript expression levels of contractile proteins, in vitro measurements of vaginal contractility. RESULTS Ovariectomy decreased the expression of carboxyl-terminal myosin heavy chain isoform (SM1) and h-caldesmon and reduced the amplitude of contraction of the vaginal muscularis in response to KCl. Estradiol replacement reversed these changes. No differences were detected in the % vaginal muscularis, mRNA transcript expression of amino-terminal MHC isoforms, l-caldesmon expression, and maximal velocity of shortening. CONCLUSION Systemic estrogen replacement restores functional and molecular characteristics of the vaginal muscularis of ovariectomized rats. Our results indicate that menopause is associated with changes in the vaginal muscularis, which may contribute to the increased incidence of pelvic floor disorders with age.
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Affiliation(s)
- Maureen E Basha
- Department of Human Science, School of Nursing and Health Studies, Georgetown University, Washington, DC 20057, USA.
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Skoczylas LC, Jallah Z, Sugino Y, Stein SE, Feola A, Yoshimura N, Moalli P. Regional differences in rat vaginal smooth muscle contractility and morphology. Reprod Sci 2013; 20:382-90. [PMID: 23298869 DOI: 10.1177/1933719112472733] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The objective of this study was to define the regional differences in rat vaginal smooth muscle contractility and morphology. We evaluated circumferential segments from the proximal, middle, and distal rat vagina (n = 21) in vitro. Contractile responses to carbachol, phenylephrine, potassium chloride, and electrical field stimulation (EFS) were measured. Immunohistochemical analyses were also performed. The dose-response curves for carbachol- and phenylephrine-dependent contractions were different in the distal (P = .05, P = .04) compared to the proximal/middle regions. Adjusted for region-dependent changes in contractility, the distal vagina generated lower force in response to carbachol and higher force in response to phenylephrine. There was less force with increasing EFS frequency in the distal (P = .03), compared to the proximal/middle regions. Cholinergic versus adrenergic nerves were more frequent in the proximal region (P = .03). In summary, the results indicate that functional and morphological differences in smooth muscle and nerve fibers of the distal versus proximal/middle regions of the vagina exist.
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Affiliation(s)
- Laura C Skoczylas
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Pelletier G, Ouellet J, Martel C, Labrie F. Effects of Ovariectomy and Dehydroepiandrosterone (DHEA) on Vaginal Wall Thickness and Innervation. J Sex Med 2012; 9:2525-33. [DOI: 10.1111/j.1743-6109.2012.02895.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Systemic and topical hormone therapies reduce vaginal innervation density in postmenopausal women. Menopause 2012; 19:630-5. [PMID: 22205148 DOI: 10.1097/gme.0b013e31823b8983] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Menopause is often accompanied by vaginal discomfort including burning, itching, dryness, and spontaneous or provoked pain. Although the direct effects of estrogen withdrawal on vaginal cells are implicated, surgical menopause in rodents causes autonomic and sensory nerves to proliferate, suggesting that indirect effects mediated by changes in vaginal innervation may contribute. We assessed whether postmenopausal women display hormone-dependent changes in vaginal innervation. METHODS Vaginal biopsies from 20 postmenopausal women undergoing surgery for stress urinary incontinence and pelvic organ prolapse were fixed and immunostained for the pan-neuronal marker protein gene product 9.5, sympathetic marker tyrosine hydroxylase, parasympathetic marker vasoactive intestinal polypeptide, and sensory nociceptor marker calcitonin gene-related peptide. Innervation density was measured as an apparent percentage of the section area occupied by immunofluorescent axons. Specimens were grouped according to whether participants received systemic hormone therapy (HT), topical (vaginal) HT, or no HT. RESULTS Women not receiving HT showed relatively high levels of total innervation, with most axons expressing tyrosine hydroxylase or vasoactive intestinal polypeptide immunoreactivity. In women receiving systemic HT, overall innervation was reduced, as were presumptive parasympathetic, sympathetic, and sensory axon populations. Topical HT elicited more dramatic reductions in innervation than in systemic HT. CONCLUSIONS Hormone therapy reduces autonomic and sensory vaginal innervation density, which may, in part, contribute to relief from vaginal discomfort. Moreover, topical therapy is more effective than systemic therapy, which may help explain the greater improvement reported with topical compared with systemic HT.
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Abstract
Changes in reproductive status place varied functional demands on the vagina. These include receptivity to male intromission and sperm transport in estrus, barrier functions during early pregnancy, and providing a conduit for fetal passage at parturition. Peripheral innervation regulates vaginal function, which in turn may be influenced by circulating reproductive hormones. We assessed vaginal innervation in diestrus and estrus (before and after the estrous cycle surge in estrogen), and in the early (low estrogen) and late (high estrogen) stages in pregnancy. In vaginal sections from cycling rats, axons immunoreactive for the pan-neuronal marker protein gene product 9.5 (PGP 9.5) showed a small reduction at estrus relative to diestrus, but this difference did not persist after correcting for changes in target size. No changes were detected in axons immunoreactive for tyrosine hydroxylase (sympathetic), vesicular acetylcholine transporter (parasympathetic), or calcitonin gene-related peptide and transient receptor potential vanilloid type 1 (TRPV-1; sensory nociceptors). In rats at 10 days of pregnancy, innervation was similar to that observed in cycling rats. However, at 21 days of pregnancy, axons immunoreactive for PGP 9.5 and each of the subpopulation-selective markers were significantly reduced both when expressed as percentage of sectional area or after correcting for changes in target size. Because peripheral nerves regulate vaginal smooth muscle tone, blood flow, and pain sensitivity, reductions in innervation may represent important adaptive mechanisms facilitating parturition.
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Affiliation(s)
- Zhaohui Liao
- Institute for Neurological Disorders, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Feola A, Moalli P, Alperin M, Duerr R, Gandley RE, Abramowitch S. Impact of pregnancy and vaginal delivery on the passive and active mechanics of the rat vagina. Ann Biomed Eng 2010; 39:549-58. [PMID: 20824342 DOI: 10.1007/s10439-010-0153-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 08/21/2010] [Indexed: 12/18/2022]
Abstract
Remodeling of vaginal extracellular matrix and smooth muscle likely plays a critical role in reducing the risk of maternal injury during vaginal delivery by altering the mechanical properties to increase distension and reduce stress. Long-Evans rats were divided into five groups to examine the passive mechanical and active contractile properties throughout pregnancy and postpartum: virgin (n=17), mid-pregnant (Day 14-16, n=12), late-pregnant (Day 20-22, n=14), immediate postpartum (0-2 h after delivery, n=14), and 4 week postpartum (n=15). Longitudinal sections of vaginal tissue were loaded to failure uniaxially for passive mechanical or active contractile properties were examined. For passive mechanics, the tangent modulus decreased 45% by mid-pregnancy and immediately postpartum (p<0.001). The ultimate strain continuously increased up to 43% higher than virgin animals (p=0.007) in the immediate postpartum group. For active mechanics, the maximal contractile force was 36-56% lower through immediate postpartum animals, and was significantly more sensitive to K+ throughout pregnancy and postpartum (p=0.003). The changes observed in the passive and active properties of the rat vagina are consistent with what would be expected from a tissue that is remodeling to maximize its ability to distend at the time of vaginal delivery to facilitate passage of the fetus with minimal injury.
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Affiliation(s)
- Andrew Feola
- Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
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Traish AM, Botchevar E, Kim NN. Biochemical Factors Modulating Female Genital Sexual Arousal Physiology. J Sex Med 2010; 7:2925-46. [DOI: 10.1111/j.1743-6109.2010.01903.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Giuliano F, Pfaus J, Balasubramanian S, Hedlund P, Hisasue SI, Marson L, Wallen K. Experimental Models for the Study of Female and Male Sexual Function. J Sex Med 2010; 7:2970-95. [DOI: 10.1111/j.1743-6109.2010.01960.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Vaudry D, Falluel-Morel A, Bourgault S, Basille M, Burel D, Wurtz O, Fournier A, Chow BKC, Hashimoto H, Galas L, Vaudry H. Pituitary Adenylate Cyclase-Activating Polypeptide and Its Receptors: 20 Years after the Discovery. Pharmacol Rev 2009; 61:283-357. [DOI: 10.1124/pr.109.001370] [Citation(s) in RCA: 829] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Basha M, Labelle EF, Northington GM, Wang T, Wein AJ, Chacko S. Functional significance of muscarinic receptor expression within the proximal and distal rat vagina. Am J Physiol Regul Integr Comp Physiol 2009; 297:R1486-93. [PMID: 19741053 DOI: 10.1152/ajpregu.90516.2008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Information regarding the role of cholinergic nerves in mediating vaginal smooth muscle contraction is sparse, and in vitro studies of the effects of muscarinic agonists on vaginal smooth muscle are discrepant. The goal of this study was to determine the expression of muscarinic receptors in the vaginal wall of the rat. In addition, we sought to determine the effect of the muscarinic receptor agonist carbachol on contractility and inositol phosphate production of the proximal and distal rat vaginal muscularis. RT-PCR analysis indicated that both M(2) and M(3) receptor transcripts were expressed within the proximal and distal rat vagina. Carbachol dose-dependently (10(-7)-10(-4) M) contracted the rat vaginal muscularis with a greater maximal contractile response in the proximal vagina (P < 0.01) compared with the distal vagina. The contractile responses of the rat vaginal muscularis to carbachol were dose dependently inhibited by the M(3) antagonist para-fluoro-hexahydrosiladefenidol, and a pK(B) of 7.78 and 7.95 was calculated for the proximal and distal vagina, respectively. Inositol phosphate production was significantly increased in both regions of the vagina following 20-min exposure to 50 muM carbachol with higher levels detected in the proximal vagina compared with the distal (P < 0.05). Preliminary experiments indicated the presence of M(2) and M(3) receptors in the human vaginal muscularis as well as contraction of human vaginal muscularis to carbachol, indicating that our animal studies are relevant to human tissue. Our results provide strong evidence for the functional significance of M(3) receptor expression in the vaginal muscularis.
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Affiliation(s)
- Maureen Basha
- Department of Pharmacology and Physiology, Drexel University College of Medicine; Philadelphia, USA
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Cushman TT, Kim N, Hoyt R, Traish AM. Estradiol ameliorates diabetes-induced changes in vaginal structure of db/db mouse model. J Sex Med 2009; 6:2467-79. [PMID: 19453883 DOI: 10.1111/j.1743-6109.2009.01316.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Women with diabetes experience diminished genital arousal, reduced vaginal lubrication, vaginal atrophy, dyspareunia, and increased infections. Limited studies are available investigating the effects of diabetic complications on the vagina. AIMS The goals of this study were to investigate type 2 diabetes-induced changes in vaginal structure, and to determine if estradiol treatment ameliorates these changes. METHODS Eight-week-old female diabetic (db/db) mice (strain BKS*Cg-m+/+Lepr(db)/J) and age-matched control normoglycemic female littermates were used to investigate the effects of type 2 diabetes on vaginal tissue structural integrity. Diabetic animals were divided into two subgroups: diabetic treated with vehicle only and diabetic treated with pellets containing estradiol. At 16 weeks, the animals were sacrificed, and the vaginal tissues were excised and analyzed by histological and immunohistochemical methods to assess diabetes-induced changes in vaginal tissue and the extent by which these parameters are restored by estradiol treatment. MAIN OUTCOME MEASURES The effects of type 2 diabetes and estradiol supplementation were investigated on vaginal histoarchitecture. RESULTS Diabetic animals exhibited high blood glucose levels (>600 mg/dL), increased body weight (43.0 +/- 6.0 g vs. 24.4 +/- 2.0 g), and reduced plasma estradiol levels (65.5 +/- 6.6 pg/mL vs. 80.77 +/- 13.2 pg/mL) when compared to control animals. Diabetes resulted in significant thinning of the epithelium (P <or= 0.05), marked decrease in the muscularis area (P </= 0.05), distinct truncation of elastic fibers, and significant reduction of the nitrergic immunoreactive nerve fibers (P <or= 0.05). Treatment of diabetic animals with estradiol restored epithelial thickness (P <or= 0.05), muscularis area (P <or= 0.05), and elastic fiber distribution, and partially restored the density of nitrergic nerve fibers. CONCLUSIONS The data in this study demonstrate that type 2 diabetes disrupts vaginal structural integrity and that estradiol supplementation ameliorates the diabetes-induced vaginal pathology.
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Affiliation(s)
- Tulay T Cushman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
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Traish AM, Cushman T, Hoyt R, Kim NN. Diabetes Attenuates Female Genital Sexual Arousal Response via Disruption of Estrogen Action. Korean J Urol 2009. [DOI: 10.4111/kju.2009.50.3.211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Abdulmaged M. Traish
- Department of Biochemistry and Urology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Tulay Cushman
- Departments of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Richard Hoyt
- Departments of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Noel N Kim
- Department of Urology, Boston University School of Medicine, Boston, MA 02118, USA
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Musicki B, Liu T, Lagoda GA, Bivalacqua TJ, Strong TD, Burnett AL. Endothelial nitric oxide synthase regulation in female genital tract structures. J Sex Med 2008; 6 Suppl 3:247-53. [PMID: 19138376 DOI: 10.1111/j.1743-6109.2008.01122.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Female sexual arousal disorder (FSAD) is a major component of female sexual dysfunctions, affecting 25-70% of women. The mechanisms of FSAD are poorly understood. Estrogen contributes to the control of genital blood flow during the sexual response. Vascular effects of estrogen are mostly attributed to its regulation of endothelial nitric oxide (NO) production. However, the role of endothelial NO synthase (eNOS) and the mechanisms that regulate eNOS in female genital tract structures are largely unknown. AIM To review available evidence of the mechanisms of eNOS regulation in female genital tract structures. METHODS This article reviews the literature that relates to the role of NO and eNOS in female sexual arousal and its modulation by estrogen. MAIN OUTCOME MEASURES Association between female sexual arousal, NO, and eNOS. RESULTS The NO/cyclic guanosine monophosphate pathway is believed to have a primary role in the regulation of clitoral and vaginal blood flow, and smooth muscle relaxation during sexual arousal. Estrogen is critical for maintaining vaginal and clitoral blood flow and vaginal transudate production. Estrogen regulates eNOS by genomic mechanisms, involving augmented mRNA transcription and protein synthesis, and by non-genomic mechanisms, which occur without alterations in gene expression. However, limited studies have evaluated the physiological role of endothelial NO and the molecular mechanisms of eNOS regulation in the female genital tract. CONCLUSIONS The effects of estrogen on increasing genital blood flow and smooth muscle relaxation have been attributed mostly to regulation of eNOS. However, the exact mechanisms of eNOS regulation in female genital tract structures and the molecular basis for the eNOS defect with aging and vascular diseases warrant further investigation.
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Affiliation(s)
- Biljana Musicki
- Department of Urology, The Johns Hopkins University, Baltimore, MD 21287, USA.
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Activation of Somatosensory Afferents Elicit Changes in Vaginal Blood Flow and the Urethrogenital Reflex Via Autonomic Efferents. J Urol 2008; 180:1167-72. [DOI: 10.1016/j.juro.2008.04.139] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Indexed: 01/04/2023]
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Hong X, Huang L, Song Y. Role of vasoactive intestinal peptide and pituitary adenylate cyclase activating polypeptide in the vaginal wall of women with stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J 2008; 19:1151-7. [PMID: 18351280 DOI: 10.1007/s00192-008-0585-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 02/02/2008] [Indexed: 12/22/2022]
Abstract
Pelvic floor connective tissue degeneration is closely associated with retrogradation of its dominating nerve fibers. We hypothesized that some neuropeptides from pelvic floor tissue might be involved in the pathological progress of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in women. Thirty premenopausal and 31 postmenopausal patients participated in the study. The morphological appearance in the vaginal tissue was examined. The vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase activating polypeptide-38 (PACAP) immunoreactivities (ir-VIP, ir-PACAP) were tested by immunohistochemistry and radioimmunoassay. We found that the VIP and PACAP immunostainings were weaker and sparser, and ir-VIP and ir-PACAP levels were significantly decreased in the anterior vaginal wall in the premenopausal and postmenopausal SUI or POP patients. Ir-VIP and ir-PACAP levels were reversely correlated with the age and menopausal status in the SUI or POP patients. Our data suggest that VIP and PACAP may participate in the pathophysiological process of SUI and POP.
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Affiliation(s)
- Xinru Hong
- Department of Obstetrics and Gynecology, Fuzhou General Hospital, Fuzhou, Fujian 350025, People's Republic of China.
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Pauls R, Mutema G, Segal J, Silva WA, Kleeman S, Dryfhout V, Karram M. ORIGINAL RESEARCH—BASIC SCIENCE: A Prospective Study Examining the Anatomic Distribution of Nerve Density in the Human Vagina. J Sex Med 2006; 3:979-987. [PMID: 17100930 DOI: 10.1111/j.1743-6109.2006.00325.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Women possess sufficient vaginal innervation such that tactile stimulation of the vagina can lead to orgasm. However, there are few anatomic studies that have characterized the distribution of nerves throughout the human vagina. AIM The aim of this prospective study was to better characterize the anatomic distribution of nerves in the adult human vagina. A secondary aim was to assess whether vaginal innervation correlates with the subject's demographic information and sexual function. METHODS Full-thickness biopsies of anterior and posterior vagina (proximal and distal), cuff, and cervix were taken during surgery in a standardized manner. Specimens were prepared with hematoxylin and eosin, and S100 protein immunoperoxidase. The total number of nerves in each specimen was quantified. Enrolled patients completed a validated sexual function questionnaire (Female Sexual Function Index, FSFI) preoperatively. MAIN OUTCOME MEASURES A description of vaginal innervation by location and an assessment of vaginal innervation in association with the subject's demographic information and sexual function. RESULTS Twenty-one patients completed this study, yielding 110 biopsy specimens. Vaginal innervation was somewhat regular, with no site consistently demonstrating the highest nerve density. Nerves were located throughout the vagina, including apex and cervix. No significant differences were noted in vaginal innervation based on various demographic factors, including age, vaginal maturation index, stage of prolapse, number of vaginal deliveries, or previous hysterectomy. There were no correlations between vaginal nerve quantity and FSFI domain and overall scores. Fifty-seven percent of the subjects had female sexual dysfunction; when compared to those without dysfunction, there were no significant differences in total or site-specific nerves. CONCLUSIONS In a prospective study, vaginal nerves were located regularly throughout the anterior and posterior vagina, proximally and distally, including apex and cervix. There was no vaginal location with increased nerve density. Vaginal innervation was not associated with demographic information or sexual function.
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Affiliation(s)
- Rachel Pauls
- Division of Urogynecology and Reconstructive Pelvic Surgery, Good Samaritan Hospital, Cincinnati, OH.
| | - George Mutema
- Department of Pathology, Good Samaritan Hospital, Cincinnati, OH
| | - Jeffrey Segal
- Saint Barnabas Medical Center-Center for Urogynecology, Livingston, NJ
| | - W Andre Silva
- Pacific Northwest Urogynecology-Urogynecology, Federal Way, WA
| | - Steven Kleeman
- Division of Urogynecology and Reconstructive Pelvic Surgery, Good Samaritan Hospital, Cincinnati, OH
| | - Vicki Dryfhout
- Hatton Institute for Research and Education, Good Samaritan Hospital, Cincinnati, OH, USA
| | - Mickey Karram
- Division of Urogynecology and Reconstructive Pelvic Surgery, Good Samaritan Hospital, Cincinnati, OH
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Kim NN, Stankovic M, Cushman TT, Goldstein I, Munarriz R, Traish AM. Streptozotocin-induced diabetes in the rat is associated with changes in vaginal hemodynamics, morphology and biochemical markers. BMC PHYSIOLOGY 2006; 6:4. [PMID: 16734901 PMCID: PMC1481539 DOI: 10.1186/1472-6793-6-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Accepted: 05/30/2006] [Indexed: 12/26/2022]
Abstract
Background Diabetes is associated with declining sexual function in women. However, the effects of diabetes on genital tissue structure, innervation and function remains poorly characterized. In control and streptozotocin-treated female rats, we investigated the effects of diabetes on vaginal blood flow, tissue morphology, and expression of arginase I, endothelial nitric oxide synthase (eNOS) and cGMP-dependent protein kinase (PKG), key enzymes that regulate smooth muscle relaxation. We further related these changes with estrogen receptor alpha (ERα) and androgen receptor (AR) expression. Results In addition to significantly elevated blood glucose levels, diabetic rats had decreased mean body weight, lower levels of plasma estradiol, and higher plasma testosterone concentration, compared to age-matched controls. Eight weeks after administration of buffer (control) or 65 mg/kg of streptozotocin (diabetic), the vaginal blood flow response to pelvic nerve stimulation was significantly reduced in diabetic rats. Histological examination of vaginal tissue from diabetic animals showed reduced epithelial thickness and atrophy of the muscularis layer. Diabetic animals also had reduced vaginal levels of eNOS and arginase I, but elevated levels of PKG, as assessed by Western blot analyses. These alterations were accompanied by a reduction in both ERα and AR in nuclear extracts of vaginal tissue from diabetic animals. Conclusion In ovariectomized (estrogen deficient) animals, previous reports from our lab and others have documented changes in blood flow, tissue structure, ERα, arginase I and eNOS that parallel those observed in diabetic rats. We hypothesize that diabetes may lead to multiple disruptions in sex steroid hormone synthesis, metabolism and action. These pathological events may cause dramatic changes in tissue structure and key enzymes that regulate cell growth and smooth muscle contractility, ultimately affecting the genital response during sexual arousal.
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Affiliation(s)
- Noel N Kim
- Institute for Sexual Medicine, Department of Urology, Boston University School of Medicine, Boston, USA
| | - Miljan Stankovic
- Institute for Sexual Medicine, Department of Urology, Boston University School of Medicine, Boston, USA
| | - Tulay T Cushman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, USA
| | - Irwin Goldstein
- Institute for Sexual Medicine, Department of Urology, Boston University School of Medicine, Boston, USA
| | - Ricardo Munarriz
- Institute for Sexual Medicine, Department of Urology, Boston University School of Medicine, Boston, USA
| | - Abdulmaged M Traish
- Institute for Sexual Medicine, Department of Urology, Boston University School of Medicine, Boston, USA
- Department of Biochemistry, Boston University School of Medicine, Boston, USA
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Onol FF, Ercan F, Tarcan T. The effect of ovariectomy on rat vaginal tissue contractility and histomorphology. J Sex Med 2006; 3:233-41. [PMID: 16490016 DOI: 10.1111/j.1743-6109.2006.00216.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Ovarian hormones have an important role in age-related genital arousal disorders; however, our knowledge regarding possible vaginal wall morphology and contractility changes in low-hormonal states is limited. AIMS To investigate morphological and functional alterations in the vaginal tissue in a rat ovariectomy model and to show the differences between proximal and distal vagina. METHODS Six weeks following ovariectomy, vaginal tissues were examined under light and electron microscopy. Circularly cut distal and proximal tissues were studied in the organ bath under isometric tension and compared with age-matched controls. Contractile responses to electrical field stimulation (EFS), phenylephrine, carbachol, and the effects of alpha-1 and alpha-2 blockade on EFS-induced contractility were investigated. Relaxation responses to EFS and vardenafil were investigated in precontracted strips. MAIN OUTCOME MEASURES Differences between control and ovariectomy groups in terms of vaginal tissue contractility and histomorphological properties. RESULTS Distal vagina showed different epithelial characteristics and a better-developed muscularis compared with proximal vagina. Ovariectomy caused thinning of the epithelium, severe degeneration in epithelial architecture, and smooth muscle atrophy. Contraction and relaxation responses of distal strips were significantly lower in ovariectomized rats. Contractile responses to neuropharmacological stimulation were insignificant in proximal strips of both groups. EFS-induced contractions in distal strips diminished significantly after alpha-1 and alpha-2 adrenergic blockade. EFS caused frequency-dependent relaxation responses in precontracted distal strips, which were significantly decreased after nitric oxide synthase inhibition. CONCLUSIONS Ovariectomy causes significant alteration in rat vaginal tissue morphology and contractility. Contraction and relaxation responses of distal vagina are significantly greater compared with morphologically distinct proximal vagina. Alpha-1 and alpha-2 receptors are the main mediators of contraction in distal rat vaginal tissue whereas nitric oxide pathway may have at least a partial role in relaxation. Main mediators of the rat vaginal tissue relaxation and the effect of ovariectomy on this regulation are yet to be defined.
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Affiliation(s)
- F Fatih Onol
- Department of Urology, Maramara University School of Medicine, Istanbul, Turkey
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Basha M, Chang S, Smolock EM, Moreland RS, Wein AJ, Chacko S. Regional differences in myosin heavy chain isoform expression and maximal shortening velocity of the rat vaginal wall smooth muscle. Am J Physiol Regul Integr Comp Physiol 2006; 291:R1076-84. [PMID: 16690774 DOI: 10.1152/ajpregu.00118.2006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Contractility of the proximal and distal vaginal wall smooth muscle may play distinct roles in the female sexual response and pelvic support. The goal of this study was to determine whether differences in contractile characteristics of smooth muscle from these regions reside in differences in the expression of isoforms of myosin, the molecular motor for muscle contraction. Adult female Sprague-Dawley rats were killed on the day of estrus, and the vagina was dissected into proximal and distal segments. The Vmax at peak force was greater for tissue strips of the proximal vagina compared with that of distal (P < 0.01), although, at steady state, the Vmax for the muscle strips from the two regions was not different. Furthermore, at steady state, muscle stress was higher (P < 0.001) for distal vaginal strips (n = 5). Consistent with the high Vmax for the proximal vaginal strips, RT-PCR results revealed a higher %SM-B (P < 0.001) in the proximal vagina. A greater expression of SM-B protein (P < 0.001) was also detected by Western blotting (n = 4). Interestingly, there was no regional difference noted in SM-1/SM-2 isoforms (n = 6). The proximal vagina had a higher expression of myosin heavy chain protein (P < 0.01) and a greater percentage of smooth muscle bundles (P < 0.001). The results of this study are the first demonstration of a regional heterogeneity in Vmax and myosin isoform distribution in the vagina wall smooth muscle and confirm that the proximal vaginal smooth muscle exhibits phasic contractile characteristics compared with the distal vaginal smooth muscle, which is tonic.
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Affiliation(s)
- Maureen Basha
- Division of Urology, University of Pennsylvania, PA, USA
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Giraldi A, Marson L, Nappi R, Pfaus J, Traish AM, Vardi Y, Goldstein I. Physiology of female sexual function: animal models. J Sex Med 2006; 1:237-53. [PMID: 16422954 DOI: 10.1111/j.1743-6109.04037.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Data concerning the physiology of desire, arousal, and orgasm in women are limited because of ethical constraints. Aim. To gain knowledge of physiology of female sexual function through animal models. METHODS To provide state-of-the-art knowledge concerning female sexual function in animal models, representing the opinions of seven experts from five countries developed in a consensus process over a 2-year period. MAIN OUTCOME MEASURE Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. RESULTS Sexual desire may be considered as the presence of desire for, and fantasy about, sexual activity. Desire in animals can be inferred from certain appetitive behaviors that occur during copulation and from certain unconditioned copulatory measures. Proceptive behaviors are dependent in part on estrogen, progesterone, and drugs that bind to D1 dopamine receptors, adrenergic receptors, oxytocin receptors, opioid receptors, or gamma-amino butyric acid receptors. Peripheral arousal states are dependent on regulation of genital smooth muscle tone. Multiple neurotransmitters/mediators are involved including adrenergic, and nonadrenergic, noncholinergic agents such as vasoactive intestinal polypeptide, nitric oxide, neuropeptide Y, calcitonin gene-related peptide, and substance P. Sex steroid hormones, estrogens and androgens, are critical for structure and function of genital tissues including modulation of genital blood flow, lubrication, neurotransmitter function, smooth muscle contractility, mucification, and sex steroid receptor expression in genital tissues. Orgasm may be investigated by urethrogenital (UG) reflex, in which genital stimulation results in rhythmic contractions of striated perineal muscles and contractions of vagina, anus, and uterine smooth muscle. The UG reflex is generated by a multisegmental spinal pattern generator involving the coordination of sympathetic, parasympathetic, and somatic efferents innervating the genital organs. Serotonin and dopamine may modulate UG reflex activity. CONCLUSIONS More research is needed in animal models in the physiology of female sexual function.
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Pessina MA, Hoyt RF, Goldstein I, Traish AM. Differential effects of estradiol, progesterone, and testosterone on vaginal structural integrity. Endocrinology 2006; 147:61-9. [PMID: 16210369 DOI: 10.1210/en.2005-0870] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Ovarian steroids are known to be important in maintaining vaginal tissue, and evidence is mounting that imbalances in the hormonal milieu contribute to vaginal pathophysiology. To date, limited data are available on the effects of hormone deprivation and replacement on vaginal tissue morphology and vaginal innervation. The goal of this study was to assess the dynamic changes in vaginal tissue structure in response to sex steroid hormone deprivation and administration. Female Sprague-Dawley rats were either kept intact (controls) or ovariectomized. Ovariectomized animals were treated with vehicle, estradiol, testosterone, progesterone, or a combination of estradiol plus testosterone or progesterone. Histological techniques, including stereological analysis and immunohistochemistry for localization of neuronal markers, were used. Ovariectomy produced a significant decrease in epithelial height that was restored with estradiol replacement. Interestingly, a subphysiological dose of estradiol resulted in hyperplasia of the vaginal epithelium and nonvascular smooth muscle. Neither testosterone nor progesterone had a significant effect on epithelial height or muscularis thickness. However, testosterone treatment resulted in a significant increase in small adrenergic nerve fibers. Addition of either testosterone or progesterone to estradiol mitigated but did not abolish the effects of estradiol alone. This study demonstrates that estradiol and testosterone have differential effects on vaginal tissue parameters and that ovarian hormones are critical for the maintenance of genital tissue structure. Present observations also suggest that combined replacement regimens may be required for an optimal physiological response.
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Affiliation(s)
- Monica A Pessina
- Department of Anatomy and Neurobiology, Institute for Sexual Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, USA
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Uckert S, Ehlers V, Nüser V, Oelke M, Kauffels W, Scheller F, Jonas U. In vitro functional responses of isolated human vaginal tissue to selective phosphodiesterase inhibitors. World J Urol 2005; 23:398-404. [PMID: 16273419 DOI: 10.1007/s00345-005-0014-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Accepted: 09/16/2005] [Indexed: 12/27/2022] Open
Abstract
Only little is known as to the significance of the cyclic nucleotide-mediated signal transduction in the control of the function of human vaginal smooth musculature. Recently, the presence of the phosphodiesterase (PDE) isoenzymes 4 (cAMP-PDE) and 5 (cGMP-PDE) in the human vagina was reported. Thus, it was the aim of the study to elucidate the effects of some PDE inhibitors on the tension induced by endothelin 1 (ET-1), as well as on levels of cGMP and cAMP in isolated human vaginal wall tissue. Using the organ bath technique, the ability of norepinephrine (NE), carbachol, serotonin (5-HT), oxytocin and ET-1 to contract isolated vaginal wall muscle strips was evaluated. In another set-up, the effects of the PDE4 inhibitor rolipram and PDE5 inhibitors sildenafil and vardenafil (1 nM-10 microM) on the tension induced by 0.1 microM ET-1 of human vaginal wall tissue strips were investigated. In order to measure drug effects on tissue levels of cGMP and cAMP, vaginal tissue was exposed to different concentrations (0.1, 1 and 10 microM) of the compounds and the accumulation of cyclic nucleotides was determined. The adenylyl cyclase stimulating agents forskolin and nitric oxide donor sodium nitroprusside (SNP) (0.01, 0.1 and 1 microM) were used as reference compounds. While NE, carbachol and oxytocin failed to contract the vaginal tissue, ET-1 and, to a certain degree, 5-HT elicited contractile responses of the isolated strip preparations. The tension induced by 0.1 microM ET-1 was dose-dependently reversed by the drugs. The rank order of efficacy was sildenafil > forskolin > rolipram >or= vardenafil > SNP. Rmax values ranged from 24% (SNP) to 50% (sildenafil). With sildenafil being the only exception, none of the compounds reached an EC50 value. The relaxing effects of the drugs were paralleled by a fourfold to tenfold increase in tissue levels of cGMP and/or cAMP. Our results demonstrate that PDE inhibitors can relax human vaginal tissue and increase levels of cyclic nucleoside monophosphates. The findings with regard to the PDE5 inhibitors may indicate that the NO-cGMP pathway is, to a certain degree, involved in the control of vaginal smooth muscle tone. This might be of significance with regard to the pharmacological treatment of disorders connected with female sexual arousal and the ability to achieve orgasm.
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Affiliation(s)
- Stefan Uckert
- Department of Urology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Aygen E, Camci C, Durmus AS, Dogru O, Topuz O, Ayten R, Ayar A. Inhibitory effects of sildenafil citrate on the tonus of isolated dog internal anal sphincter. Dis Colon Rectum 2005; 48:1615-9. [PMID: 15937621 DOI: 10.1007/s10350-005-0064-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Although the exact pathogenesis of anal fissure is not known, hypertonicity of the internal anal sphincter might be involved in its pathogenesis as main event. To gain information about possible usefulness of the novel, smooth-muscle-relaxing drug, sildenafil, in chronic anal fissure, we investigated the effect of sildenafil citrate on acetylcholine-induced contractility of internal anal sphincter isolated from dogs. METHODS Internal anal sphincter strips were taken from German shepherd dogs and suspended in a tissue bath filled with Krebs solution at 37 degrees C (pH 7.4) continuously bubbled with 95 percent oxygen and 5 percent carbon dioxide, and isometric contractions were recorded. Contractions were evoked by 10 muM acetylcholine, and the effects of different concentrations of sildenafil citrate (0.1, 0.3, and 1 mM) on the isometric tension of each internal anal sphincter strip were examined. The statistical significance was analyzed by one-way analysis of variance. RESULTS Pretreatment with sildenafil citrate (0.1 mM) attenuated contractile response to acetylcholine (n = 3), which were significantly weak compared with the maximum contractile response to the acetylcholine alone (610 +/- 110 mg vs. 2,825.17 +/- 416 mg; n = 12; P < 0.05). Sildenafil citrate also significantly inhibited the acetylcholine-induced contractions in a dose-dependent manner when applied after. CONCLUSIONS This experimental in vitro study showed that sildenafil citrate relaxes acetylcholine stimulated contractions of isolated dog internal anal sphincter. This may be of importance for raising the possibility that sildenafil cit-rate may have future potential in the treatment of chronic anal fissure. Further studies are needed for a conclusive decision on possible usefulness of sildenafil citrate in patients with chronic anal fissure.
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Affiliation(s)
- Erhan Aygen
- Department of Surgery, Firat University School of Medicine, Elazig, Turkey
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Jin GP, Lin XQ. Voltammetric behavior and determination of estrogens at carbamylcholine modified paraffin-impregnated graphite electrode. Electrochim Acta 2005. [DOI: 10.1016/j.electacta.2005.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Traish AM, Kim N, Munarriz R, Goldstein I. Female genital sexual arousal: biochemical mediators and potential mechanisms of dysfunction. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.ddmec.2004.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ting AY, Blacklock AD, Smith PG. Estrogen Regulates Vaginal Sensory and Autonomic Nerve Density in the Rat1. Biol Reprod 2004; 71:1397-404. [PMID: 15189832 DOI: 10.1095/biolreprod.104.030023] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Vaginal function is strongly influenced by reproductive hormone status. Vaginal dysfunction during menopause is generally assumed to occur because of diminished estrogen-mediated trophic support of vaginal target cells. However, peripheral neurons possess estrogen receptors and are potentially responsive to gonadal steroid hormones. In the present study, we investigated whether sensory and autonomic innervation of the vagina varies among rats during the estrus phase of the estrous cycle, following chronic ovariectomy, and after sustained estrogen replacement. Relative to rats in estrus, ovariectomized rats showed a 59% elevation in nerve density, as determined using the panneuronal marker PGP 9.5. This increase persisted even after correcting for differences in vaginal tissue size, indicating true axonal proliferation after ovariectomy rather than changes secondary to altered volume. Increased total innervation after ovariectomy was attributable to increased densities of sympathetic nerves immunostained for tyrosine hydroxylase (70%), cholinergic parasympathetic nerves immunoreactive for vesicular acetylcholine transporter (93%), and calcitonin gene-related peptide-immunoreactive sensory nociceptor nerves (84%). Myelinated primary sensory innervation revealed by RT-97 immunoreactivity did not appear to be affected. Sustained 17beta-estradiol administration reduced innervation density to an extent comparable to that of estrus, implying that estrogen is the hormone mediating vaginal neuroplasticity. These findings indicate that some aspects of vaginal dysfunction during menopause may be attributable to changes in innervation. Increased sympathetic innervation may augment vasoconstriction and promote vaginal dryness, while sensory nociceptor axon proliferation may contribute to symptoms of pain, burning, and itching associated with menopause and some forms of vulvodynia.
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Affiliation(s)
- Alison Y Ting
- Department of Molecular and Integrative Physiology, Kansas University Medical Center, Kansas City, Kansas 66160, USA
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Kim NN, Christianson DW, Traish AM. Role of arginase in the male and female sexual arousal response. J Nutr 2004; 134:2873S-2879S; discussion 2895S. [PMID: 15465804 DOI: 10.1093/jn/134.10.2873s] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The NO-cGMP pathway plays a key role in the male and female genital sexual arousal response. Nitric oxide synthase (NOS) utilizes L-arginine and oxygen as substrates to produce nitric oxide (NO) and citrulline. Arginase is a metalloenzyme that catalyzes the hydrolysis of L-arginine to produce L-ornithine and urea. It is proposed that arginase competes for L-arginine and reduces NOS activity in genital tissues, thus modulating sexual function. Using 2 transition state analogue inhibitors of arginase, 2(S)-Amino-6-boronohexanoic acid (ABH) and S-(2-boronoethyl)-L-cysteine (BEC), we have characterized arginase activity in penile and vaginal tissue. Neither of these inhibitors has activity against NOS. Thus, ABH and BEC are useful compounds for examining the role of arginase in genital tissue physiology, without directly influencing NOS activity. We present data to suggest that arginase may regulate NO production by competing for endogenous pools of L-arginine. In this fashion, arginase is an indirect regulator of penile and vaginal blood flow and specific arginase inhibitors may improve genital blood flow during sexual arousal. As evidenced by the upregulation of arginase in specific disease states, its distribution in the vagina, and its modulation by sex steroid hormones, this enzyme may also participate in numerous other physiological and pathophysiological processes, such as tissue growth, fibrosis, and immune function.
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Affiliation(s)
- Noel N Kim
- Department of Urology and Institute for Sexual Medicine, Boston University School of Medicine, Boston, MA 02118, USA
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Kim SW, Jeong SJ, Munarriz R, Kim NN, Goldstein I, Traish AM. Role of the nitric oxide-cyclic GMP pathway in regulation of vaginal blood flow. Int J Impot Res 2004; 15:355-61. [PMID: 14562137 DOI: 10.1038/sj.ijir.3901038] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The regulatory role of nitric oxide (NO) in vaginal perfusion remains unclear. We used specific inhibitors of enzymes in the NO-cyclic GMP (NO-cGMP) pathway and investigated their effects on vaginal blood flow in the rabbit. NO synthase (NOS) activity was similar in both the proximal and distal rabbit vagina; whereas, arginase activity was 3.4-fold higher in the distal vagina. Intravenous administration of the NOS inhibitor L-NAME resulted in a 66% reduction in genital tissue oxyhemoglobin and a 53% reduction in vaginal blood flow. This attenuation occurred despite a 20-30% increase in systemic arterial pressure. The arginase inhibitor ABH caused a 2.1-fold increase in genital tissue oxyhemoglobin and 34% increase in vaginal blood flow. The guanylate cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3,-a]quinoxalin-1-one and the phosphodiesterase type 5 inhibitor sildenafil caused in a 37% reduction and a 44% increase in vaginal blood flow, respectively. These observations suggest that the NO-cGMP pathway is an important regulator of vaginal hemodynamics.
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Affiliation(s)
- S W Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
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Kim SW, Jeong SJ, Munarriz R, Kim NN, Goldstein I, Traish AM. An in vivo rat model to investigate female vaginal arousal response. J Urol 2004; 171:1357-61. [PMID: 14767348 DOI: 10.1097/01.ju.0000109868.19569.d7] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE We established a rat model to investigate the female vaginal arousal response and the role of the nitric oxide (NO) pathway on vaginal blood flow in vivo. MATERIALS AND METHODS Vaginal blood flow changes induced by pelvic nerve stimulation (PNS) in female Sprague-Dawley rats were determined by laser Doppler flowmetry. Frequency response data were determined in each animal. In addition, changes in vaginal blood flow were measured after intravenous administration of the NO synthase inhibitor L-NAME (NG-nitro-L-arginine methyl ester) or the phosphodiesterase type 5 inhibitor sildenafil in response to PNS at submaximal frequency. Changes in blood flow were evaluated by comparing the area under the curve of each response. RESULTS Reproducible frequency dependent increases in vaginal blood flow were observed in response to PNS. Administration of L-NAME (a NO synthase inhibitor) resulted in significant attenuation (25.6% to 18.2% vs control at 30 minutes, p <0.00001) of the PNS induced increase in vaginal blood flow. In contrast, sildenafil administration significantly increased PNS induced vaginal blood flow (166.9% +/- 25.8% vs control at 30 minutes, p <0.00001). CONCLUSIONS Our data suggest that the rat is a useful and reliable animal model for investigating the vaginal arousal response. In addition, we used this model to demonstrate the important role of the NO-cyclic guanosine monophosphate pathway in vaginal arousal.
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Affiliation(s)
- Soo Woong Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
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