OVERACTIVITY AND STRUCTURAL CHANGES IN THE CHRONICALLY ISCHEMIC BLADDER:

Mirodenafil prevents bladder dysfunction induced by chronic bladder ischemia in rats

Purpose:

To investigate the protective effect of mirodenafil on bladder function in a rat model of chronic bladder ischemia (CBI).

Methods:

Twenty-four Sprague-Dawley rats were randomized to three groups: untreated, sham-operated rats (control group); untreated, CBI model rats (CBI group); and CBI rats treated daily with 4 mg/kg mirodenafil (CBI+mirodenafil group). The CBI and CBI+mirodenafil groups underwent endothelial injury to the iliac arteries and were fed a 2% cholesterol diet after injury. Four weeks after surgery, the CBI+mirodenafil group started daily treatment with mirodenafil for four weeks. Eight weeks after surgery, continuous in vivo cystometry and in vivo organ bath studies of detrusor muscle strips were performed.

Results:

in vivo cystometry revealed that the rats in the CBI group had a significantly higher micturition frequency, lower bladder capacity, and lower compliance than the rats in the control and CBI+mirodenafil groups. The detrusor muscle strip study showed that the magnitude of the carbachol-induced contractile response was significantly lower in the CBI group compared to either the control or CBI+mirodenafil group. Addition of daily mirodenafil after induction of CBI decreased the contractile response, compared to untreated CBI rats. CBI induced submucosal fibrosis and degenerative changes in bladder walls, which was reversed by the addition of mirodenafil.

Conclusions:

Daily treatment with mirodenafil showed protective effects against bladder dysfunction resulting from CBI in rats.

Functional and molecular identification of pH-sensitive K+ channels in murine urinary bladder smooth muscle

OBJECTIVE

To examine the role of pH-sensitive K(+) channels in setting the resting membrane potential in murine bladder smooth muscle, as bladder contractility is influenced by the resting membrane potential, which is mainly regulated by background K(+) conductances.

MATERIALS AND METHODS

Using conventional microelectrode recordings, isometric tension measurements, patch-clamp recordings, reverse transcription-polymerase chain reaction (RT-PCR), Western blotting and immunohistochemistry, we assessed bladder smooth muscle cells and tissues.

RESULTS

Acidic pH (pH 6.5) depolarized the resting membrane potential of murine bladder smooth muscles and increased muscle tone and contractility. The pH-induced changes were not abolished by neuronal blockers or classical K(+)-channel antagonists. Lidocaine (1 mM) and bupivacaine (100 microm) mimicked the effects of acidifying the external solution, and in the presence of lidocaine no further increase in contractility was induced by reducing the pH to 6.5. Voltage-clamp experiments on freshly dispersed bladder myocytes showed that pH 6.5 decreased the outward current. Pre-treatment of bladder myocytes with the classical K(+) antagonists tetraethylammonium (10 mm), 4-aminopyridine (5 mM), glibenclamide (10 microm) or apamin (300 nM) did not inhibit the effects of low pH on outward current. However, treatment with lidocaine (1 mM) abolished the effects of acidic pH on outward current. RT-PCR showed the expression of the acid-sensitive K(+) channel (TASK)-1 and TASK-2 gene transcripts in murine bladder, and immunohistochemistry and Western blot analysis showed TASK-1 and TASK-2 channel expression and distribution in smooth muscle tissues and cells.

CONCLUSION

TASK channels are expressed in bladder smooth muscle and contribute to the basal K(+) conductances responsible for resting membrane potential.

Detrusor glycogen reflects the functional history of bladders with partial outlet obstruction

OBJECTIVE

To assess the relationship between glycogen content in bladder detrusor tissue and historical bladder function in a guinea-pig model of partial bladder outlet obstruction (PBOO).

MATERIALS AND METHODS

In male immature guinea pigs PBOO was created with a silver ring around the proximal urethra; a control group had a sham operation for comparison. Longitudinal individual urodynamic data were obtained weekly, so that guinea pigs were killed at different levels of bladder dysfunction. Bladder sections were stained with periodic acid-Schiff (PAS) to assess overall morphology and glycogen granule density, scored from 0 (no glycogen) to 3. Glycogen scores were related to both the end-stage and historical extremes of bladder function values.

RESULTS

Glycogen granules were seen only in the detrusor; as their number increased their location expanded from only close to the serosa (glycogen score 1), through the detrusor (score 2) up to the urothelium (score 3). A glycogen score of 0 correlated with normal values for all urodynamic variables. Compared with a glycogen score of 0 a score of 1 correlated with significant (P < 0.05) changes in end-stage compliance (decrease) and contractility (increase) and significantly higher historical values for contractility, pressure and number of unstable contractions (NUC). In the group with a glycogen score of 2 there were significant changes in both the end-stage values and historical extremes for compliance, pressure, contractility and NUC (all P < 0.05). In the group with a glycogen score of 3 all these changes were even more dramatic, except for the end-stage contractility, for which the increase was not significant. From glycogen score 0 to score 3 all changes increased in magnitude.

CONCLUSION

A high glycogen content reflects a history of abnormal urodynamic function. This finding exemplifies the added value of structural analysis to urodynamic studies. Further studies are needed to relate bladder structure to the potential for functional recovery.

Effects of a vitamin D(3) analogue in a rat model of bladder outlet obstruction

OBJECTIVES

To explore the effect of the vitamin D3 analogue, BXL-628, on some of the consequences of bladder outlet obstruction (BOO), e.g. hypertrophy and loss of contractile function, as vitamin D3 and BXL-628 inhibit prostate and bladder cell growth in vitro, and there are receptors for vitamin D in rat and human bladder.

MATERIAL AND METHODS

In female rats, BOO was produced by a standardized method; one group received daily BXL-628 (150 microg/kg per day) and the remaining rats received vehicle. Sham-operated rats received BXL-628 or vehicle. After 2 weeks, the conscious rats were assessed by cystometry. Plasma calcium levels were determined and in vitro contractility assessed at the end of the experiments.

RESULTS

There was a significant increase in bladder weight, micturition interval and volume, and in bladder capacity in both the obstructed groups compared to sham controls, but no difference between the obstructed groups. On plotting the micturition pressure against bladder weight within the obstructed groups, there was a clear correlation in the vehicle-treated group, indicating a decrease in contractile function with increasing bladder weight. There was no such correlation in the treatment group. In vitro, there was a strong correlation of increasing bladder weights vs decrease in response to KCl and electrical-field stimulation in strips from obstructed vehicle-treated rats, but no correlation in those from drug-treated rats. Treatment increased the plasma calcium level by 12%.

CONCLUSIONS

The vitamin D(3) analogue used did not prevent bladder hypertrophy, but appeared to reduce some of the negative functional changes of the bladder smooth muscle, which occurs with BOO-induced increases in bladder weight.

Assessment of microheterogeneity of blood flow in the rat urinary bladder by high-resolution digital radiography

OBJECTIVES

To assess high-resolution digital radiography for measuring blood flow and thus examine the microheterogeneity of bladder microcirculation in a rat model.

MATERIALS AND METHODS

Microheterogeneity of blood flow in both mucosa and detrusor muscle of eight anaesthetized rats was investigated using an imaging technique with very high spatial resolution (0.1 x 0.1 mm(2)) using digital radiography combined with the deposition of (3)H-labelled desmethylimipramine. The spatial pattern of blood flow was quantified by the coefficient of variation of the regional flow (CV = sd/mean). RESULTS Muscle blood flow was less than mucous blood flow (muscle : mucosa, 2.9 : 5) in the empty bladder. In the muscle layer the blood flow distribution was more heterogeneous than that in the mucosa, with a mean (sd) CV in muscle and mucosa of 0.33 (0.033) and 0.16 (0.019), respectively (P < 0.001) at the capillary level.

CONCLUSION

There was a heterogeneous distribution of blood flow in the microcirculation to capillary vessels in the muscular layer, possibly reflecting a difference in dynamic blood flow of regional perfusion of the emptied bladder.