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Kim JH, Yang HJ, Lee HJ, Song YS. Decreased Angiopoietin Expression in Underactive Bladder Induced by Long-term Bladder Outlet Obstruction. Int Neurourol J 2023; 27:271-279. [PMID: 38171327 PMCID: PMC10762367 DOI: 10.5213/inj.2346296.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE Ischemia of the bladder can occur if neovascular formation cannot keep pace with hypoxia induced by chronic bladder outlet obstruction (BOO). The aim of this study was to examine changes in angiogenesis growth factor expression generated by chronic BOO in a rat model of underactive bladder. METHODS Twenty female Sprague-Dawley rats aged 6 weeks were assigned to 4 groups (5 rats per group). Group 1 was the control. Group 2 underwent sham surgery. The rats in groups 3 and 4 underwent BOO and were followed up for 1 week and 8 weeks. Cystometry was carried out together with bladder tissue analysis at 1 week and 8 weeks postoperatively. Real-time polymerase chain reaction (PCR) assays were conducted to determine the expression level of angiogenesis-related growth factors. A hypoxia signaling pathway PCR array was additionally carried out. RESULTS The group that underwent BOO for 8 weeks showed abnormal bladder function, with a diminished intercontraction interval, decreased maximal voiding pressure, and higher volume of residual urine (P<0.05). Hypoxia-inducible factor-1 alpha expression was elevated in this group. The expression levels of vascular endothelial growth factor (VEGF) and VEGF receptor messenger RNA (mRNA) in the BOO group were comparable to those in the control group. However, angiotensin/tie receptor mRNA expression levels increased at 1 week after BOO, but decreased at 8 weeks after BOO. In animals that underwent BOO, fewer blood vessels exhibited positive immunofluorescent staining for von Willebrand factor. Alterations were also seen in the hypoxia signaling pathway PCR array. CONCLUSION In a rat model of underactive bladder caused by surgical BOO, reduced angiopoietin expression was demonstrated. This observation might underlie visceral ischemia and fibrosis associated with the procedure. The findings of this study might offer an improved understanding of the disease processes underlying BOO and facilitate selection of the appropriate time to repair the organ in this condition.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Hee Jo Yang
- Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea
| | - Hong Jun Lee
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
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Choi BH, Cho TJ, Lee T, Park CS. Hypoxia-inducible factor-1α-mediated SERPINE-1 expression in ischemic urinary bladder. Mol Cell Toxicol 2023. [DOI: 10.1007/s13273-023-00334-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Ramsay S, Zagorodnyuk V. Role of circadian rhythms and melatonin in bladder function in heath and diseases. Auton Neurosci 2023; 246:103083. [PMID: 36871511 DOI: 10.1016/j.autneu.2023.103083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
The circadian system modulates all visceral organ physiological processes including urine storage and voiding. The "master clock" of the circadian system lies within suprachiasmatic nucleus of the hypothalamus while "peripheral clocks" are found in most peripheral tissue and organs, including the urinary bladder. Disruptions of circadian rhythms can cause organ malfunction and disorder or exacerbate pre-existing ones. It has been suggested that nocturia, which develops mostly in the elderly, could be a circadian-related disorder of the bladder. In the bladder, many types of gap junctions and ion channels in the detrusor, urothelium and sensory nerves are likely under strict local peripheral circadian control. The pineal hormone, melatonin, is a circadian rhythm synchroniser capable of controlling a variety of physiological processes in the body. Melatonin predominantly acts via the melatonin 1 and melatonin 2 G-protein coupled receptors expressed in the central nervous system, and many peripheral organs and tissues. Melatonin could be beneficial in the treatment of nocturia and other common bladder disorders. The ameliorating action of melatonin on bladder function is likely due to multiple mechanisms which include central effects on voiding and peripheral effects on the detrusor and bladder afferents. More studies are warranted to determine the precise mechanisms of circadian rhythm coordination of the bladder function and melatonin influences on the bladder in health and diseases.
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Affiliation(s)
- Stewart Ramsay
- Discipline of Human Physiology, Flinders Health & Medical Research Institute, College of Medicine and Public Health, Flinders University, South Australia, Australia
| | - Vladimir Zagorodnyuk
- Discipline of Human Physiology, Flinders Health & Medical Research Institute, College of Medicine and Public Health, Flinders University, South Australia, Australia.
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Maximum Voided Volume Is a Better Clinical Parameter for Bladder Capacity Than Maximum Cystometric Capacity in Patients With Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: A Prospective Cohort Study. Int Neurourol J 2022; 26:317-324. [PMID: 36599340 PMCID: PMC9816439 DOI: 10.5213/inj.2244158.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Bladder capacity is an important parameter in the diagnosis of lower urinary tract dysfunction. We aimed to determine whether the maximum bladder capacity (MCC) measured during a urodynamic study was affected by involuntary detrusor contraction (IDC) in patients with Lower Urinary Tract Symptoms (LUTS)/Benign Prostatic Hyperplasia (BPH). METHODS Between March 2020 and April 2021, we obtained maximum voided volume (MVV) from a 3-day frequency-volume chart, MCC during filling cystometry, and maximum anesthetic bladder capacity (MABC) during holmium laser enucleation of the prostate under spinal or general anesthesia in 139 men with LUTS/BPH aged >50 years. Patients were divided according to the presence of IDC during filling cystometry. We assumed that the MABC is close to the true value of the MCC, as it is measured under the condition of minimizing neural influence over the bladder. RESULTS There was no difference in demographic and clinical characteristics between the non-IDC (n=20) and IDC groups (n=119) (mean age, 71.5±7.4) (P>0.05). The non-IDC group had greater bladder volume to feel the first sensation, first desire, and strong desire than the IDC group (P<0.001). In all patients, MABC and MVV were correlated (r=0.41, P<0.001); however, there was no correlation between MCC and MABC (r=0.19, P=0.02). There was no significant difference in MABC between the non-IDC and IDC groups (P=0.19), but MVV and MCC were significantly greater in the non-IDC group (P<0.001). There was no significant difference between MABC and MVV (MABC-MVV, P=0.54; MVV/MABC, P=0.07), but there was a significant difference between MABC and MCC between the non-IDC and IDC groups (MABC-MCC, P<0.001; MCC/MABC, P<0.001). CONCLUSION Maximum bladder capacity from a urodynamic study does not represent true bladder capacity because of involuntary contractions.
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Kim JH, Yang HJ, Lee HJ, Song YS. Enhanced Hypoxia-Associated Genes in Impaired Contractility From Bladder Outlet Obstruction. J Korean Med Sci 2022; 37:e84. [PMID: 35289143 PMCID: PMC8921211 DOI: 10.3346/jkms.2022.37.e84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/14/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Hypoxia damages the bladder wall and contributes to the initiation of bladder dysfunction. The change of hypoxia is not well known in impaired bladder contractility caused by long-term bladder outlet obstruction (BOO). We aimed to find out whether hypoxia of bladder tissue is present and what signaling mechanisms are involved in the decompensated bladder in BOO. METHODS Twenty 6-week-old female Sprague-Dawley rats were divided into 2 groups, 10 rats each: group 1, sham operation; group 2, BOO for 8 weeks. Eight weeks after the onset of BOO, we did cystometric evaluation and processed polymerase chain reaction (PCR) array for hypoxia pathway using bladder tissues. The PCR array consists of 84 genes known to be involved in the hypoxic response, cell differentiation, and metabolism. We did quantitative PCR (qPCR) and immunohistochemical staining of bladder tissue for hypoxia. RESULTS Eight genes were at least 2-fold upregulated and 3 genes were at least 2-fold downregulated in BOO group, compared with the sham operation group. The up-regulated genes (fold change) belonging to the hypoxia-inducible factor (HIF) 1 interactor included Cdkn2a (11.0), and the down-regulated genes belonging to HIF and co-transcription factors included Hif3a (-39.6) and Per1 (-5.1) by BOO. Genes influenced each other by means of TGFβ1, TNF, and TP53. CONCLUSION Hypoxia genes were increased in impaired contractility because of long-term BOO. The gene expression profiles could explain the molecular mechanisms of hypoxia in impaired contractility because of long-term BOO.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Hee Jo Yang
- Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea
| | - Hong J Lee
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea.
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
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Kim JH, Yang HJ, Choi SS, Kim SU, Lee HJ, Song YS. Improved bladder contractility after transplantation of human mesenchymal stem cells overexpressing hepatocyte growth factor into underactive bladder from bladder outlet obstruction models of rats. PLoS One 2021; 16:e0261402. [PMID: 34936660 PMCID: PMC8694482 DOI: 10.1371/journal.pone.0261402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/01/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction An underactive bladder can lead to difficulty in voiding that causes incomplete emptying of the bladder, suggesting the need for a new strategy to increase bladder contractility in such patients. This study was performed to investigate whether human mesenchymal stem cells (hMSCs) were capable of restoring bladder contractility in rats with underactive bladder due to bladder outlet obstruction (BOO) and enhancing their effects by overexpressing hepatocyte growth factor (HGF) in hMSCs. Materials and methods The hMSCs were transplanted into the bladder wall of rats. Fifty female Sprague-Dawley rats at six weeks of age were divided into five groups: group 1: control; group 2: sham intervention; group 3: eight-week BOO; group 4: BOO rats transplanted with hMSCs; and group 5: BOO rats transplanted with hMSCs overexpressing HGF. Two weeks after the onset of BOO in groups 4 and 5, hMSCs were injected into the bladder wall. Cystometry evaluation was followed by Masson’s trichrome staining of bladder tissues. Realtime PCR and immunohistochemical staining were performed to determine for hypoxia, apoptosis, and angiogenesis. Results Collagen deposition of bladder increased in BOO but decreased after transplantation of hMSCs. The increased inter-contraction interval and residual urine volume after BOO was reversed after hMSCs transplantation. The decreased maximal voiding pressure after BOO was restored by hMSCs treatment. The mRNA expression of bladder collagen1 and TGF-β1 increased in BOO but decreased after hMSCs transplantation. The decrease in vWF-positive cells in the bladder following BOO was increased after hMSCs transplantation. Caspase 3 and TUNEL-positive apoptosis of bladder cells increased in BOO but decreased after transplantation of hMSCs. These effects were enhanced by overexpressing HGF in hMSCs. Conclusion Transplantation of hMSCs into bladder wall increased the number of micro-vessels, decreased collagen deposition and apoptosis of detrusor muscle, and improved bladder underactivity. The effects were enhanced by overexpressing HGF in hMSCs. Our findings suggest that the restoration of underactive bladder using hMSCs may be used to rectify micturition disorders in patients following resolution of BOO. Further studies are needed before hMSCs can be used in clinical applications.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Hee Jo Yang
- Department of Urology, Soonchunhyang University School of Medicine, Cheonan, Republic of Korea
| | - Sung Sik Choi
- Medical Science Research Institute, Chungbuk National University, Cheong Ju, Republic of Korea
| | - Seung U. Kim
- Division of Neurology, Department of Medicine, UBC Hospital, University of British Columbia, Vancouver, Canada
| | - Hong J. Lee
- Medical Science Research Institute, Chungbuk National University, Cheong Ju, Republic of Korea
- * E-mail: (HJL); (YSS)
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
- * E-mail: (HJL); (YSS)
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Predisposing factors of persistent storage symptoms after holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia and their correlations to the symptom recovery period. J INCL PHENOM MACRO 2021. [DOI: 10.1007/s10847-021-01051-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Tumor Necrosis Factor-α Initiates miRNA-mRNA Signaling Cascades in Obstruction-Induced Bladder Dysfunction. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 188:1847-1864. [DOI: 10.1016/j.ajpath.2018.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/03/2018] [Accepted: 05/03/2018] [Indexed: 02/08/2023]
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Lo TS, Chua S, Uy-Patrimonio MC, Kao CC, Lin CH. Clinical outcomes of detrusor underactivity in female with advanced pelvic organ prolapse following vaginal pelvic reconstructive surgery. Neurourol Urodyn 2018; 37:2242-2248. [PMID: 29664135 DOI: 10.1002/nau.23576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 03/07/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Keelung Medical Center; Keelung Taiwan Republic of China
- Department of Obstetrics and Gynecology, Division of Urogynecology, Chang Gung Memorial Hospital; Linkou Medical Center; Taoyuan, Linkou Taiwan Republic of China
- Chang Gung University; School of Medicine; Taoyuan Taiwan Republic of China
| | - Sandy Chua
- Fellow, Department of Obstetrics and Gynecology; Division of Urogynecology; Chang Gung Memorial Hospital; Linkou Medical Center; Taoyuan Taiwan Republic of China
- Department of Obstetrics and Gynecology; Cebu Velez General Hospital; Cebu City Philippines
| | - Ma. Clarissa Uy-Patrimonio
- Fellow, Department of Obstetrics and Gynecology; Division of Urogynecology; Chang Gung Memorial Hospital; Linkou Medical Center; Taoyuan Taiwan Republic of China
- Department of Obstetrics and Gynecology; Dr. Pablo O. Torre Memorial Hospital; Bacolod City Philippines
| | - Chuan C. Kao
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Keelung Medical Center; Keelung Taiwan Republic of China
| | - Chih H. Lin
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Keelung Medical Center; Keelung Taiwan Republic of China
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10
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Mesenchymal stem cells inhibit hypoxia-induced inflammatory and fibrotic pathways in bladder smooth muscle cells. World J Urol 2018; 36:1157-1165. [DOI: 10.1007/s00345-018-2247-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 02/20/2018] [Indexed: 12/18/2022] Open
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Aizawa N, Igawa Y. Pathophysiology of the underactive bladder. Investig Clin Urol 2017; 58:S82-S89. [PMID: 29279880 PMCID: PMC5740034 DOI: 10.4111/icu.2017.58.s2.s82] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/22/2017] [Indexed: 01/05/2023] Open
Abstract
Underactive bladder (UAB), which has been described as a symptom complex suggestive of detrusor underactivity, is usually characterized by prolonged urination time with or without a sensation of incomplete bladder emptying, usually with hesitancy, reduced sensation on filling, and slow stream often with storage symptoms. Several causes such as aging, bladder outlet obstruction, diabetes mellitus, neurologic disorders, and nervous injury to the spinal cord, cauda equine, and peripheral pelvic nerve have been assumed to be responsible for the development of UAB. Several contributing factors have been suggested in the pathophysiology of UAB, including myogenic failure, efferent and/or afferent dysfunctions, and central nervous system dysfunction. In this review article, we have described relationships between individual contributing factors and the pathophysiology of UAB based on previous reports. However, many pathophysiological uncertainties still remain, which require more investigations using appropriate animal models.
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Affiliation(s)
- Naoki Aizawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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12
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Kaya E, Kibar Y, Yılmaz S, Ebiloglu T, Ozcan A, Seyrek M, Yıldız O, Ulusoy KG. The histopathological and pharmacodynamic effects of intradetrusor decorin injected in a rabbit partial bladder outlet obstruction model. Int Urol Nephrol 2017; 49:607-614. [PMID: 28138904 DOI: 10.1007/s11255-017-1518-x] [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: 12/02/2016] [Accepted: 01/17/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate whether or not the bladder function can be protected by supporting the detrusor with decorin levels during the fibrotic process. METHODS Forty-two male rabbits were divided into three main groups, partial bladder outlet obstruction (pBOO) group, pBOO + intradetrusor decorin-injected (IDI) group and control group. Both pBOO and pBOO + IDI groups were divided into three subgroups according to the killing schedule. Histopathological, immunohistochemical and pharmacodynamics studies were performed for the evaluation of fibrotic process and tissue characteristics. RESULTS Histopathological evaluation revealed statistically significant high fibrosis levels for both pBOO and pBOO + IDI groups when compared with control. Strikingly the antifibrotic effect of decorin was significant on 2nd, 4th and 8th week and increased as time passed. Immunohistochemical analysis was revealed high expressions of anti-TGF-β1 and decorin levels in all pBOO + IDI groups. Pharmacodynamical results were also revealed better contraction responses in favor of 2nd, 4th and 8th week groups of pBOO + IDI groups, when compared with pBOO groups. In addition, the contraction responses against the depolarizer agent KCl were increased in the three decorin-administrated groups. CONCLUSION Our study demonstrates the antifibrotic effects of decorin on bladder fibrosis. Strikingly, this antifibrotic effect is shown in histopathological, immunohistochemical and pharmacodynamics studies. Although further studies are warranted to make more decisive inferences regarding its clinical use, our study has the proper pride to be the first step of this time course.
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Affiliation(s)
- Engin Kaya
- Gulhane Military Medical Academy, Ankara, Turkey.
| | - Yusuf Kibar
- Gulhane Military Medical Academy, Ankara, Turkey
| | | | | | - Ayhan Ozcan
- Gulhane Military Medical Academy, Ankara, Turkey
| | - Melik Seyrek
- Gulhane Military Medical Academy, Ankara, Turkey
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Gheinani AH, Kiss B, Moltzahn F, Keller I, Bruggmann R, Rehrauer H, Fournier CA, Burkhard FC, Monastyrskaya K. Characterization of miRNA-regulated networks, hubs of signaling, and biomarkers in obstruction-induced bladder dysfunction. JCI Insight 2017; 2:e89560. [PMID: 28138557 DOI: 10.1172/jci.insight.89560] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Bladder outlet obstruction (BOO) induces significant organ remodeling, leading to lower urinary tract symptoms accompanied by urodynamic changes in bladder function. Here, we report mRNA and miRNA transcriptome sequencing of bladder samples from human patients with different urodynamically defined states of BOO. Patients' miRNA and mRNA expression profiles correlated with urodynamic findings. Validation of RNA sequencing results in an independent patient cohort identified combinations of 3 mRNAs (NRXN3, BMP7, UPK1A) and 3 miRNAs (miR-103a-3p, miR-10a-5p, miR-199a-3p) sufficient to discriminate between bladder functional states. All BOO patients shared cytokine and immune response pathways, TGF-β and NO signaling pathways, and hypertrophic PI3K/AKT signaling pathways. AP-1 and NFkB were dominant transcription factors, and TNF-α was the top upstream regulator. Integrated miRNA-mRNA expression analysis identified pathways and molecules targeted by differentially expressed miRNAs. Molecular changes in BOO suggest an increasing involvement of miRNAs in the control of bladder function from the overactive to underactive/acontractile states.
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Affiliation(s)
- Ali Hashemi Gheinani
- Urology Research Laboratory, Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Bernhard Kiss
- Department of Urology, University Hospital, Bern, Switzerland
| | - Felix Moltzahn
- Department of Urology, University Hospital, Bern, Switzerland
| | - Irene Keller
- Interfaculty Bioinformatics Unit, University of Bern, Bern, Switzerland
| | - Rémy Bruggmann
- Interfaculty Bioinformatics Unit, University of Bern, Bern, Switzerland
| | | | | | | | - Katia Monastyrskaya
- Urology Research Laboratory, Department of Clinical Research, University of Bern, Bern, Switzerland.,Department of Urology, University Hospital, Bern, Switzerland
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Hur WS, Kim JC, Kim HS, Koh JS, Kim SH, Kim HW, Cho SY, Cho KJ. Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia. Investig Clin Urol 2016; 57:431-436. [PMID: 27847917 PMCID: PMC5109790 DOI: 10.4111/icu.2016.57.6.431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/04/2016] [Indexed: 11/20/2022] Open
Abstract
Purpose To investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH). Materials and Methods We retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups. Results In total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement. Conclusions A preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.
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Affiliation(s)
- Won Sok Hur
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joon Chul Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyo Sin Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun Sung Koh
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Hoon Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Woo Kim
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Su Yeon Cho
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kang Jun Cho
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Hypoxia-increased expression of genes involved in inflammation, dedifferentiation, pro-fibrosis, and extracellular matrix remodeling of human bladder smooth muscle cells. In Vitro Cell Dev Biol Anim 2016; 53:58-66. [PMID: 27632054 DOI: 10.1007/s11626-016-0085-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/03/2016] [Indexed: 10/21/2022]
Abstract
Partial bladder outlet obstruction (pBOO) is characterized by exaggerated stretch, hydrodynamic pressure, and inflammation which cause significant damage and fibrosis to the bladder wall. Several studies have implicated hypoxia in its pathophysiology. However, the isolated progressive effects of hypoxia on bladder cells are not yet defined. Sub-confluent normal human bladder smooth muscle cells (hbSMC) were cultured in 3% O2 tension for 2, 24, 48, and 72 h. RNA, cellular proteins, and secreted proteins were used for gene expression analysis, immunoblotting, and ELISA, respectively. Transcription of hypoxia-inducible factor (HIF)1α and HIF2α were transiently induced after 2 h of hypoxia (p < 0.05), whereas HIF3 was upregulated after 72 h (p < 0.005). HIF1 and HIF3α proteins were significantly induced after 2 and 72 h, respectively. VEGF mRNA increased significantly after 24 and 72 h (p < 0.005). The inflammatory cytokines, TGFB (protein and mRNA), IL 1β, 1L6, and TNFα (mRNA) demonstrated a time-dependent increased expression. Furthermore, the anti-inflammatory cytokine IL-10 was downregulated after 72 h (p < 0.05). Evidence of smooth muscle cell dedifferentiation included increased αSMA, vimentin, and desmin. Evidence of pro-fibrotic changes included increased CTGF, SMAD 2, and SMAD 3 as well as collagens 1, 2, 3, and 4, fibronectin, aggrecan, and TIMP 1 transcripts (p < 0.05). Total collagen proteins also increased time-dependently (p < 0.05). Together, these results show that exposure of hbSMC to low oxygen tension results in intense hypoxic cascade, including inflammation, de-differentiation, pro-fibrotic changes, and increased extracellular matrix expression. This elucidates mechanisms of hypoxia-driven bladder deterioration in bladder cells, which is important in tailoring in vivo experiments and may ultimately translate into improved clinical outcomes.
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Verratti V, Paulesu L, Pietrangelo T, Doria C, Di Giulio C, Aloisi AM. The influence of altitude hypoxia on uroflowmetry parameters in women. Am J Physiol Renal Physiol 2016; 311:F562-6. [DOI: 10.1152/ajprenal.00284.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 06/24/2016] [Indexed: 12/31/2022] Open
Abstract
There is scientific evidence to suggest a correlation between hypoxia and the physiology of micturition. During a Himalayan Scientific and Mountaineering Expedition, we performed tests to investigate the functional interactions between altitude hypoxia and uroflowmetry parameters in women. The tests were carried out in seven women (36.3 ± 7.1 yr) from normoxic [1,340 meters above sea level (m a.s.l.)] to hypoxic conditions (up to 5,050 m a.s.l.) and during the return descent. The following measures were determined: uroflowmetry parameters and saturation of peripheral oxygen (SpO2). As expected, SpO2 decreased from 97.7 to 77.8% with increasing altitude. Micturition flow time, flow volume, and voiding time increased with altitude ( P < 0.04 for all), indicating a negative correlation with SpO2. In conclusion, in young adult women, micturition physiological parameters were affected during adaptation to hypoxia; the correlation with SpO2 strongly suggests a role of hypoxia in these changes. These data could help to support the design of new strategies for both prevention and medical treatment. An example of the latter might be hyperbaric oxygen therapy, which in some studies has proved able to reduce the symptoms in patients with hypoxic bladder.
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Affiliation(s)
- Vittore Verratti
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Chieti-Pescara, Italy
| | - Luana Paulesu
- Department of Life Sciences, University of Siena, Siena, Italy; and
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Chieti-Pescara, Italy
| | - Christian Doria
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Chieti-Pescara, Italy
| | - Camillo Di Giulio
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Chieti-Pescara, Italy
| | - Anna Maria Aloisi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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Abstract
In this review, we have looked at three important areas in understanding male lower urinary tract symptoms. These are improvement in terminology, detrusor underactivity, and nocturia. Benign prostatic hyperplasia leading to bladder outlet obstruction has been covered in a previous review.
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Affiliation(s)
- Arman A Kahokehr
- Department of Urology, Wellington Hospital, Wellington, New Zealand
| | - Peter J Gilling
- Head of School, Bay of Plenty Clinical School, Tauranga, New Zealand
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Non-uniform changes in membrane receptors in the rat urinary bladder following outlet obstruction. Eur J Pharmacol 2015; 762:82-8. [PMID: 26004535 DOI: 10.1016/j.ejphar.2015.05.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/15/2015] [Accepted: 05/11/2015] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to investigate the expression and distribution of membrane receptors after bladder outlet obstruction (BOO). Partial bladder outlet obstruction (BOO) was induced in female rats and bladders were harvested after either 10 days or 6 weeks of BOO. The expression of different receptors was surveyed by microarrays and corroborated by immunohistochemistry and western blotting. A microarray experiment identified 10 membrane receptors that were differentially expressed compared to sham-operated rats including both upregulated and downregulated receptors. Four of these were selected for functional experiments on the basis of magnitude of change and relevance to bladder physiology. At 6 weeks of BOO, maximal contraction was reduced for neuromedin B and vasopressin (AVP), consistent with reductions of receptor mRNA levels. Glycine receptor-induced contraction on the other hand was increased and receptor mRNA expression was accordingly upregulated. Maximal relaxation by the β3-adrenergic receptor agonist CL316243 was reduced as was the receptor mRNA level. Immunohistochemistry supported reduced expression of neuromedin B receptors, V1a receptors and β3-adrenergic receptors, but glycine receptor expression appeared unchanged. Western blotting confirmed repression of V1a receptors and induction of glycine receptors in BOO. mRNA for vasopressin was detectable in the bladder, suggesting local AVP production. We conclude that changes in receptor expression following bladder outlet obstruction are non-uniform. Some receptors are upregulated, conferring increased responsiveness to agonist, whereas others are downregulated, leading to decreased agonist-induced responses. This study might help to select pharmacological agents that are effective in modulating lower urinary tract symptoms in BOO.
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Ischemia in Pelvic Organs as an Independent Pathogenic Factor in the Development of Benign Prostatic Hyperplasia and Urinary Bladder Dysfunction. Bull Exp Biol Med 2015; 158:718-22. [DOI: 10.1007/s10517-015-2845-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Indexed: 11/29/2022]
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20
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Osman NI, Chapple CR. Contemporary concepts in the aetiopathogenesis of detrusor underactivity. Nat Rev Urol 2014; 11:639-48. [PMID: 25330789 DOI: 10.1038/nrurol.2014.286] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Detrusor underactivity (DUA) is a poorly understood, yet common, bladder dysfunction, referred to as underactive bladder, which is observed in both men and women undergoing urodynamic studies. Despite its prevalence, no effective therapeutic approaches exist for DUA. Exactly how the contractile function of the detrusor muscle changes with ageing is unclear. Data from physiological studies in animal and human bladders are contradictory, as are the results of the limited number of clinical studies assessing changes in urodynamic parameters with ageing. The prevalence of DUA in different patient groups suggests that multiple aetiologies are involved in DUA pathogenesis. Traditional concepts focused on either efferent innervation or myogenic dysfunction. By contrast, contemporary views emphasize the importance of the neural control mechanisms, particularly the afferent system, which can fail to potentiate detrusor contraction, leading to premature termination of the voiding reflex. In conclusion, the contemporary understanding of the aetiology and pathophysiology of DUA is limited. Further elucidation of the underlying mechanisms is needed to enable the development of new and effective treatment approaches.
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Affiliation(s)
- Nadir I Osman
- Department of Urology, Royal Hallamshire Hospital, Glossop Road, Sheffield, South Yorkshire S10 2JF, UK
| | - Christopher R Chapple
- Department of Urology, Royal Hallamshire Hospital, Glossop Road, Sheffield, South Yorkshire S10 2JF, UK
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21
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Drake MJ, Williams J, Bijos DA. Voiding dysfunction due to detrusor underactivity: an overview. Nat Rev Urol 2014; 11:454-64. [PMID: 25002201 DOI: 10.1038/nrurol.2014.156] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Detrusor underactivity (DUA) is defined as a voiding contraction of reduced strength and/or duration, which prolongs urination and/or prevents complete emptying of the bladder within a 'normal' period of time. This issue is associated with voiding and postmicturition urinary symptoms, and can predispose to urinary infections and acute urinary retention. The aetiology of DUA is influenced by multiple factors, including ageing, bladder outlet obstruction, neurological disease, and autonomic denervation. The true prevalence of this condition remains unknown, as most data come from referral populations. Urodynamic testing is used to diagnose the condition, either by assessing the relationship between bladder pressures and urinary flow, or by interrupting voiding to measure detrusor pressure change under isovolumetric conditions. Current treatments for DUA have poor efficacy and tolerability, and often fail to improve quality of life; muscarinic receptor agonists, in particular, have limited efficacy and frequent adverse effects. Bladder emptying might be achieved through Valsalva straining, and intermittent or indwelling catheterization, although sacral nerve stimulation can reduce dependency on catheterization. Novel stem-cell-based therapies have been attempted; however, new drugs that increase contractility are currently largely conceptual, and the complex pathophysiology of DUA, difficulty achieving organ specificity of treatment, the limited availability of animal models, and the subjective nature of current outcome measures must be addressed to facilitate the development of such agents.
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Affiliation(s)
- Marcus J Drake
- Urology Department, University of Bristol and Bristol Urological Institute, Southmead Hospital, Bristol, Avon BS10 5NB, UK
| | - Jonathan Williams
- Urology Department, University of Bristol and Bristol Urological Institute, Southmead Hospital, Bristol, Avon BS10 5NB, UK
| | - Dominika A Bijos
- Urology Department, University of Bristol and Bristol Urological Institute, Southmead Hospital, Bristol, Avon BS10 5NB, UK
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van Koeveringe GA, Rademakers KLJ, Birder LA, Korstanje C, Daneshgari F, Ruggieri MR, Igawa Y, Fry C, Wagg A. Detrusor underactivity: Pathophysiological considerations, models and proposals for future research. ICI-RS 2013. Neurourol Urodyn 2014; 33:591-6. [PMID: 24839258 DOI: 10.1002/nau.22590] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 02/20/2014] [Indexed: 12/19/2022]
Abstract
AIMS Detrusor underactivity, resulting in either prolonged or inefficient voiding, is a common clinical problem for which treatment options are currently limited. The aim of this report is to summarize current understanding of the clinical observation and its underlying pathophysiological entities. METHODS This report results from presentations and subsequent discussion at the International Consultation on Incontinence Research Society (ICI-RS) in Bristol, 2013. RESULTS AND CONCLUSIONS The recommendations made by the ICI-RS panel include: Development of study tools based on a system's pathophysiological approach, correlation of in vitro and in vivo data in experimental animals and humans, and development of more comprehensive translational animal models. In addition, there is a need for longitudinal patient data to define risk groups and for the development of screening tools. In the near-future these recommendations should lead to a better understanding of detrusor underactivity and its pathophysiological background. Neurourol. Urodynam. 33:591-596, 2014. © 2014 Wiley Periodicals, Inc.
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Effect of hydrogen peroxide on contractility and citrate synthase activity of the rabbit urinary bladder in the presence and absence of resveratrol and a whole-grape suspension. Mol Cell Biochem 2014; 391:233-9. [DOI: 10.1007/s11010-014-2007-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 02/21/2014] [Indexed: 10/25/2022]
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24
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WADA N, MATSUMOTO S, KITA M, HASHIZUME K, KAKIZAKI H. Improvement of Overactive Bladder Symptoms and Bladder Ischemia with Dutasteride in Patients with Benign Prostatic Enlargement. Low Urin Tract Symptoms 2014; 7:37-41. [DOI: 10.1111/luts.12047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 12/01/2013] [Accepted: 12/09/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Naoki WADA
- Department of Renal and Urologic Surgery; Asahikawa Medical University; Asahikawa Japan
| | - Seiji MATSUMOTO
- Department of Renal and Urologic Surgery; Asahikawa Medical University; Asahikawa Japan
| | - Masafumi KITA
- Department of Renal and Urologic Surgery; Asahikawa Medical University; Asahikawa Japan
| | - Kazumi HASHIZUME
- Department of Renal and Urologic Surgery; Asahikawa Medical University; Asahikawa Japan
| | - Hidehiro KAKIZAKI
- Department of Renal and Urologic Surgery; Asahikawa Medical University; Asahikawa Japan
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Choi BH, Jin LH, Kim KH, Kang SA, Kang JH, Yoon SM, Park CS, Lee T. Cystometric parameters and the activity of signaling proteins in association with the compensation or decompensation of bladder function in an animal experimental model of partial bladder outlet obstruction. Int J Mol Med 2013; 32:1435-41. [PMID: 24085268 DOI: 10.3892/ijmm.2013.1515] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 09/19/2013] [Indexed: 11/06/2022] Open
Abstract
We conducted this study to determine whether the degree of detrusor contractility is associated with the compensation or decompensation of bladder function depending on the residual volume (RV) during the first two weeks after the onset of partial bladder outlet obstruction (BOO). Moreover, we also examined whether the degree of the phosphorylation and expression of signaling proteins [AMP-activated kinase (AMPK), extracellular signal‑regulated protein kinases 1 and 2 (ERK1/2) and protein kinase C (PKC)] is associated with the prevalence of compensation or decompensation of bladder function. Twenty-seven female Sprague-Dawley (SD) rats were randomly assigned to either the sham-operated group (n=7) or the group with partial bladder outlet obstruction (BOO) (n=20). We then measured cystometric parameters from three reproducible micturition cycles and averaged the results for a comparison between the two groups. Based on a cut-off value of a mean RV% of 25%, we subdivided our experimental animals into two subgroups: the subgroup with bladder compensation (mean RV%, <25%) and the subgroup with bladder decompensation (mean RV%, >25%). Our results indicated that the degree of detrusor overactivity (DO) was associated with the compensation or decompensation of bladder function depending on the RV during the first two weeks after the onset of BOO in an animal experimental model of partial BOO. Moreover, we also demonstrate that AMPK and ERK1/2 are involved in the compensation or decompensation of bladder function. Furthermore, our results suggest that PKC is not involved in two-phase bladder contraction. Alterations in the activities of signaling proteins, such as AMPK and ERK1/2 may prove to be helpful in the treatment of patients with voiding difficulty.
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Affiliation(s)
- Bo-Hwa Choi
- Department of Pharmacology, Inha University College of Medicine by BK 21 Project, Incheon, Republic of Korea
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Soler R, Andersson KE, Chancellor MB, Chapple CR, de Groat WC, Drake MJ, Gratzke C, Lee R, Cruz F. Future direction in pharmacotherapy for non-neurogenic male lower urinary tract symptoms. Eur Urol 2013; 64:610-21. [PMID: 23711541 DOI: 10.1016/j.eururo.2013.04.042] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/29/2013] [Indexed: 01/26/2023]
Abstract
BACKGROUND The pathophysiology of male lower urinary tract symptoms (LUTS) is highly complex and multifactorial. The shift in perception that LUTS are not sex or organ specific has not been followed by significant innovations regarding the available drug classes. OBJECTIVE To review pathophysiologic mechanisms and clinical and experimental data related to the development of new pharmacologic treatments for male LUTS. EVIDENCE ACQUISITION The PubMed database was used to identify articles describing experimental and clinical studies of pathophysiologic mechanisms contributing to male LUTS and, supported by them, new pharmacotherapies with clinical or experimental evidence in the field. EVIDENCE SYNTHESIS Several pathologic processes (eg, androgen signaling, inflammation, and metabolic factors) and targets (eg, the urothelium, prostate, interstitial cells, detrusor, neurotransmitters, neuromodulators, and receptors) have been implicated in male LUTS. Some newly introduced drugs, such as phosphodiesterase type 5 inhibitors and β3-adrenergic agonists, have just started broad use in clinical practice. Drugs with potential benefit, such as vitamin D3 receptor analogs, gonadotropin-releasing hormone antagonists, cannabinoids, and drugs injected into the prostate, have been evaluated in experimental studies and have progressed to clinical trials. However, safety and efficacy data for these drugs are still scarce. Some compounds with interesting profiles have only been tested in experimental settings (eg, transient receptor potential channel blockers, Rho-kinase inhibitors, purinergic receptor blockers, and endothelin-converting enzyme inhibitors). CONCLUSIONS New pathophysiologic mechanisms of male LUTS are described that lead to the continuous development of new pharmacotherapies. To date, few drugs have been added to the current armamentarium, and several are in various phases of clinical or experimental investigation.
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Affiliation(s)
- Roberto Soler
- Division of Urology, Federal University of São Paulo and Hospital Israelita Albert Einstein, São Paulo, Brazil
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27
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Callaghan CM, Schuler C, Leggett RE, Levin RM. Effect of severity and duration of bladder outlet obstruction on catalase and superoxide dismutase activity. Int J Urol 2013; 20:1130-5. [PMID: 23418991 DOI: 10.1111/iju.12115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 01/16/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To study the effects of partial bladder outlet obstruction on the cell's anti-oxidant defense mechanisms, superoxide dismutase and catalase, in order to elucidate how the bladder responds to oxidative stress. METHODS Four groups of eight rabbits were subjected to partial bladder outlet obstruction for 4, 8 and 12 weeks. Eight sham rabbits were used as the control group. The bladders were removed under anesthesia, and the muscle and mucosa were separated, frozen and stored at -80°C for analysis. Superoxide dismutase and catalase assays were carried out on these tissues. The groups were also categorized by severity (mild, intermediate and severe) of decompensation, as well as duration. RESULTS When separated by duration, catalase activity of the mucosa was significantly higher in the control and the 12-weeks obstructed rabbits. This activity was lower than the control in the 4- and 8-weeks obstructed rabbits. When separated by severity, catalase activity of the mucosa was significantly higher and severely decompensated than the muscle in the controls. When separated by duration or severity, superoxide dismutase activity of the muscle was significantly lower than controls for all obstructed rabbits. The activities of both superoxide dismutase and catalase were significantly reduced in the severely decompensated bladder smooth muscle, but not in the 12-weeks obstructed bladder smooth muscle. CONCLUSIONS Partial bladder outlet obstruction has significant effects on the activity of both superoxide dismutase and catalase in the bladder, with variations that are dependent on the severity and duration of the obstruction.
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Affiliation(s)
- Connor M Callaghan
- Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, New York, USA; Department of Research, Stratton VA Medical Center, Albany, New York, USA
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28
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Yang L, Liu R, Wang X, He D. Imbalance between matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) contributes to bladder compliance changes in rabbits with partial bladder outlet obstruction (PBOO). BJU Int 2013; 112:E391-7. [PMID: 23305285 DOI: 10.1111/j.1464-410x.2012.11740.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Lin Yang
- The First Affiliated Hospital of the Medical College of Xi'an Jiaotong University; Xi'an; Shaanxi; China
| | - Runming Liu
- The First Affiliated Hospital of the Medical College of Xi'an Jiaotong University; Xi'an; Shaanxi; China
| | - Xinyang Wang
- The First Affiliated Hospital of the Medical College of Xi'an Jiaotong University; Xi'an; Shaanxi; China
| | - Dalin He
- The First Affiliated Hospital of the Medical College of Xi'an Jiaotong University; Xi'an; Shaanxi; China
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29
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Matsumoto S. Editorial Comment to Partial outlet obstruction in rabbits: Duration versus severity. Int J Urol 2012; 20:114-5. [DOI: 10.1111/j.1442-2042.2012.03199.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Seiji Matsumoto
- Department of Renal and Urologic Surgery; Asahikawa Medical University; Asahikawa; Hokkaido; Japan
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30
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Assessment of Intramural Blood Flow and Neurogenic Control in Intact and Hypertrophic Urinary Bladder with Harmonic Analysis of Bioimpedance in Rats. Bull Exp Biol Med 2012; 153:436-40. [DOI: 10.1007/s10517-012-1734-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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31
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Kang YJ, Jin LH, Park CS, Shin HY, Yoon SM, Lee T. Early sequential changes in bladder function after partial bladder outlet obstruction in awake sprague-dawley rats: focus on the decompensated bladder. Korean J Urol 2011; 52:835-41. [PMID: 22216396 PMCID: PMC3246516 DOI: 10.4111/kju.2011.52.12.835] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Accepted: 10/11/2011] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We investigated bladder function, with special focus on initial functional changes, by objective report of decompensated bladder according to the percentage of residual urine volume to bladder capacity in awake, obstructed rats. MATERIALS AND METHODS Thirty rats were randomly subjected to sham operations (n=10) or partial bladder outlet obstruction (BOO, n=20). Cystometric investigations were performed without anesthesia 1 or 2 weeks after BOO surgery. To reduce the influence of confounding factors in awake cystometry, we used simultaneous recordings of intravesical and intraabdominal pressures. Decompensated bladder was defined as the bladder with more than 20% of residual volume compared with bladder capacity. RESULTS Compared with that in sham animals, basal pressure was elevated in both BOO groups. Threshold pressure was higher in the 2 week BOO (p<0.01) group. Compliance was decreased in the 1 week BOO group (p<0.01) and increased in the 2 week BOO group (p<0.001). Bladder capacity was not increased in the 1 week BOO group, but was increased in the 2 week BOO group (p<0.01). Decompensation was found in 62.5% of the 1 week BOO group and in 33.3% of the 2 week BOO group. CONCLUSIONS From the earlier phase, the bladders exhibited serial changes in pressure and volume parameters, and decompensated bladders defined by the percentage of residual volume to bladder capacity could be seen. During the later phase, there was an increasing tendency of compensated bladders, accompanied by the bladders being enlarged and more compliant.
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Affiliation(s)
- Yong-Jin Kang
- Department of Urology, Inha University College of Medicine by BK 21 Project, Incheon, Korea
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32
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Fitzpatrick B, Schuler C, Leggett RE, Levin RM. Calcium effects on superoxide dismutase and catalase of the rabbit urinary bladder muscle and mucosa. Urol Int 2011; 88:107-11. [PMID: 22094966 DOI: 10.1159/000333144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 09/13/2011] [Indexed: 11/19/2022]
Abstract
PURPOSE Superoxide dismutase (SOD) and catalase are two important antioxidant mechanisms that work together to reduce free radical damage. Intracellular free calcium in smooth muscle can change rapidly and many enzymes can be affected. The sensitivity of SOD and catalase activity to calcium was determined in both rabbit bladder smooth muscle and mucosa. MATERIALS AND METHODS Calcium sensitivity was analyzed by determining SOD and catalase activity in muscle and mucosa at the following calcium concentrations: 0 (in the presence of 1 mM EGTA), 1 and 5 mM CaCl(2). RESULTS SOD: EGTA resulted in increased SOD activity of bladder smooth muscle, whereas both 1 and 5 mM calcium significantly decreased SOD activity. EGTA had no effect on SOD activity of the mucosa whereas 1 and 5 mM calcium decreased SOD activity of the muscle. Catalase: 1 mM calcium resulted in decreased catalase activity of the muscle and no change in the activity of the mucosa, whereas 5 mM calcium resulted in increased catalase activity of the mucosa but no change in the activity of the muscle. DISCUSSION Mucosa showed more SOD and catalase activity than the muscle. Both SOD and catalase showed differing sensitivities to EGTA and calcium.
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Kibar Y, Irkilata HC, Yaman H, Onguru O, Coguplugil AE, Ergin G, Seyrek M, Yildiz O, Dayanc M. The effect of intravesical acetylsalicylic acid instillation on tissue prostaglandin levels after partial bladder outlet obstruction in rabbits. Neurourol Urodyn 2011; 30:1646-51. [PMID: 21826721 DOI: 10.1002/nau.21153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 04/20/2011] [Indexed: 11/10/2022]
Abstract
AIMS To examine whether obstruction changes the expression of prostaglandins (PGs) in bladder, intravesical low-dose aspirin could be used as a new route of drug administration, this way of administration influences PGs' expression, and contractile function of the bladder is protected after treatment. METHODS Eighteen rabbits were divided into three groups. Sham-operated group (group 1) included 6 rabbits. Twelve rabbits were partially obstructed for 70 days. Six of these 12 rabbits not receiving any treatment constituted obstructed group (group 2). The remaining six rabbits received 2 mg/kg/day aspirin (group 3). One rabbit in each group was evaluated on 1st, 7th, 14th, 28th, 42nd, and 70th days following obstructive surgery. After scarification, the percentage of collagenous area and concentrations of PGE2 and PGF2-alpha were measured. Contractile responses to field stimulation (EFS), carbachol, and potassium chloride (KCl) were determined. RESULTS Wet tissue PGE2 and PGF2-alpha levels were higher in obstructed group than the other groups. Aspirin decreased the percentage of collagenous area in group 3 compared to the group 2, but this difference was not statistically significant. The strips from aspirin groups resulted in better contractile response to cholinergic stimulation with KCl, but this difference was not statistically significant between the obstructed and aspirin groups. Similarly, carbachol did not elicit significantly greater concentration-dependent contraction in strips from obstructed group compared to those from aspirin groups. Maximum responses to EFS were not significant in aspirin group compared to those from obstructed group. CONCLUSIONS Intravesical aspirin may have protective effect on partially obstructed bladder.
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Affiliation(s)
- Yusuf Kibar
- Department of Urology, Gulhane Military Medical Academy, Ankara, Turkey.
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The effect of antioxidants on the response of the rabbit urinary bladder to in vitro ischemia/reperfusion. Mol Cell Biochem 2011; 355:65-73. [DOI: 10.1007/s11010-011-0839-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 04/15/2011] [Indexed: 10/18/2022]
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Woo LL, Tanaka ST, Anumanthan G, Pope JC, Thomas JC, Adams MC, Brock JW, Bhowmick NA. Mesenchymal stem cell recruitment and improved bladder function after bladder outlet obstruction: preliminary data. J Urol 2011; 185:1132-8. [PMID: 21255803 DOI: 10.1016/j.juro.2010.10.033] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Indexed: 12/15/2022]
Abstract
PURPOSE Mesenchymal stem cells have various therapeutic benefits in various organ injury models. Bladder outlet obstruction causes smooth muscle hypertrophy and fibrosis, leading to lowered compliance, increased storage pressures and renal injury. Decreased blood flow and hypoxia may contribute to obstruction related bladder decompensation. We used a mouse model to determine whether mesenchymal stem cell recruitment occurred after bladder outlet obstruction and whether this was associated with changes in bladder hypoxia, histology and function. We also identified potential chemokines involved in mesenchymal stem cell recruitment. MATERIALS AND METHODS A total of 20 female mice underwent bladder outlet obstruction. Three days later 2 million green fluorescent protein labeled mesenchymal stem cells were intravenously administered. After 4 weeks urodynamic and histological evaluation was performed. Quantitative reverse transcriptase-polymerase chain reaction was done to determine relative expression of the chemokines CCL2, CCL20, CCL25, CXCL9 and CXCL16. We simultaneously studied mice with bladder outlet obstruction only without mesenchymal stem cell injection and a control group. RESULTS In 10 of 15 surviving mesenchymal stem cell injected mice mesenchymal stem cells were identified in the detrusor, and decreased hypoxia, hypertrophy and fibrosis was seen. Nine of 10 mice with mesenchymal stem cell engraftment had improved compliance compared to those without engraftment (mean±SD 9.6±5.1 vs 3.9±2.6 μl/cm H2O, p=0.012). Polymerase chain reaction revealed a 2-fold increase in CCL2 expression but there were no significant changes in other chemokine levels. CONCLUSIONS Mesenchymal stem cell recruitment to the bladder after bladder outlet obstruction appears to be associated with increased blood flow and decreased tissue hypoxia, which may contribute to improvement in histopathological and functional parameters. Mesenchymal stem cell recruitment may be related to CCL2 over expression. Additional studies in larger samples are needed but these initial results suggest a potential role for mesenchymal stem cell based therapy for bladder outlet obstruction related bladder injury.
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Affiliation(s)
- Lynn L Woo
- Division of Pediatric Urology, Vanderbilt University Medical Center, Monroe Carell, Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee 37232-9820, USA
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Venugopal V, Leggett RE, Schuler C, Levin RM. Effect of hydrogen peroxide on rabbit urinary bladder citrate synthase activity in the presence and absence of a grape suspension. Int Braz J Urol 2010; 36:749-57; discussion 757-8. [PMID: 21176282 DOI: 10.1590/s1677-55382010000600014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2010] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The etiology of obstructive bladder dysfunction includes free radical damage to mitochondria. Feeding rabbits a standardized grape suspension protects the ability of the bladder to contract and empty in part by preventing mitochondrial damage, thus maintaining smooth muscle and mucosal metabolism. The objective of the current study is to determine the direct effect of this grape suspension on the response of mitochondria to the oxidative effects of hydrogen peroxide. MATERIALS AND METHODS Six male rabbits were anesthetized with sodium pentobarbital and the bladders excised. Four full thickness strips were obtained for contractile studies and the balance separated into smooth muscle and mucosa compartments by blunt dissection. The effect of hydrogen peroxide on the contractile response to field stimulation was quantitated. Each tissue was homogenized and the effects of increasing concentrations of hydrogen peroxide in the presence and absence of grape suspension on citrate synthase activity was determined. RESULTS Citrate synthase activity was significantly higher in the mucosa than in the muscle. The grape suspension had no effect on control citrate synthase activity. However, the grape suspension provided significant protection of both smooth muscle and mucosal citrate synthase activity. CONCLUSIONS These studies support the conclusion that the grape suspension provides direct protection of mitochondrial function.
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Affiliation(s)
- Vijay Venugopal
- Albany College of Pharmacy and Health Sciences, Albany, New York 12208, USA
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Mizuno H, Yamamoto T, Okutsu H, Ohtake A, Sasamata M, Matsukawa Y, Funahashi Y, Kato M, Hattori R, Gotoh M. Effect of tamsulosin on bladder microcirculation in a rat ischemia-reperfusion model, evaluated by pencil lens charge-coupled device microscopy system. Urology 2010; 76:1266.e1-5. [PMID: 21056274 DOI: 10.1016/j.urology.2010.06.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 06/12/2010] [Accepted: 06/19/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To investigate the effect of tamsulosin hydrochloride on bladder microcirculation in a rat ischemia-reperfusion model using a pencil lens charge-coupled device microscopy system (PLCMS). METHODS Changes in blood flow through a submucosal capillary of the rat bladder were measured during bladder filling using the PLCMS. One week after starting infusion of either physiological saline or tamsulosin, blood flow in the bladder was halted by bladder overdistention via an infusion of physiological saline. The bladder was then emptied to be reperfused with blood. Changes in blood flow through a submucosal capillary of the bladder during ischemia and reperfusion were measured using a PLCMS, and the data obtained for the control group and tamsulosin group were compared. RESULTS As the bladder was distended, the velocity of red blood cell flow in a submucosal capillary of the bladder slowed and stopped altogether when the bladder became overdistended. In the control group, capillary blood flow improved over time after release from overdistention but failed to return to the baseline level, demonstrating that reperfusion injury to bladder microcirculation was caused by bladder overdistention and emptying. In the tamsulosin group, capillary blood flow rapidly returned to baseline after release from overdistention. CONCLUSIONS Using a PLCMS, bladder microcirculation was able to be visualized and quantitatively assessed by measuring the velocity of blood flow in a submucosal capillary of the bladder. Findings from the present study suggest that tamsulosin hydrochloride exerts a protective effect on blood flow in ischemia-reperfusion injury of the bladder.
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Affiliation(s)
- Hideki Mizuno
- Department of Urology, Nagoya University, Graduate School of Medicine, Nagoya, Japan.
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The effect of in vitro ischemia/reperfusion on contraction, free fatty acid content, phospholipid content, and malondialdehyde levels of the rabbit urinary bladder. Mol Cell Biochem 2010; 346:179-86. [DOI: 10.1007/s11010-010-0603-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 09/18/2010] [Indexed: 12/17/2022]
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Partial Bladder Outlet Obstruction: Bladder Dysfunction and Related Issues in Animal Studies. UROLOGICAL SCIENCE 2010. [DOI: 10.1016/s1879-5226(10)60015-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Abstract
From the earliest studies with epithelial cells implanted into detrusor muscle to later experiments on smooth muscle in defined collagen gels, cell niche and extracellular matrix (ECM) have been clearly shown to orchestrate cellular behavior and fate whether quiescent, migratory, or proliferative. Normal matrix can revert transformed cells to quiescence, and damaged matrix can trigger malignancy or dedifferentiation. ECM influence in disease, development, healing and regeneration has been demonstrated in many other fields of study, but a thorough examination of the roles of ECM in bladder cell activity has not yet been undertaken. Structural ECM proteins, in concert with adhesive proteins, provide crucial structural support to the bladder. Both structural and nonstructural components of the bladder have major effects on smooth muscle function, through effects on matrix rigidity and signaling through ECM receptors. While many ECM components and receptors identified in the bladder have specific known functions in the vascular smooth musculature, their function in the bladder is often less well defined. In cancer and obstructive disease, the ECM has a critical role in pathogenesis. The challenge in these settings will be to find therapies that prevent hyperproliferation and encourage proper differentiation, through an understanding of matrix effects on cell biology and susceptibility to therapeutics.
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HYDERY T, SCHULER C, LEGGETT RE, LEVIN RM. Treatment of Obstructive Bladder Dysfunction in Rabbits with Coenzyme Q10 and Alpha Lipoic Acid. Low Urin Tract Symptoms 2009. [DOI: 10.1111/j.1757-5672.2009.00053.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Levin R, Chichester P, Levin S, Buttyan R. Role of angiogenesis in bladder response to partial outlet obstruction. ACTA ACUST UNITED AC 2009:37-47. [PMID: 15545195 DOI: 10.1080/03008880410015156] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Benign prostatic hyperplasia (BPH) is a disease that has its etiology in the abnormal growth of the adult human prostate gland that accompanies the aging process in men. The symptomatic presentation of this disease, however, is related largely to degenerative changes in the bladder that occur as a result of the increasing urethral resistance and partial bladder outlet obstruction (PBOO) caused by the growing prostate gland. BPH is characterized by bladder hypertrophy, significant decreases in urinary flow and compliance, presence of residual urine after voiding, voiding urgency and incontinence (). Obstructed bladder dysfunction secondary to BPH is a slow, progressive disease that is so strongly associated with human aging that it is an expected occurrence of the male aging process. Although the symptoms of BPH are usually not life threatening, they effect an extremely negative quality of life for men who suffer from them. However, many men delay seeking medical treatment for early BPH since bladder function can remain relatively normal as the hypertrophying bladder initially compensates for the progressive increase in urethral resistance caused by prostatic obstruction. The limited changes in micturition pressure and flow characteristics that occur during compensated function are not usually disabling enough to motivate seeking medical attention, which, often, is not sought until the symptoms become typical of advanced disease. Recent advances in detection methods enable identification of patients with significant BPH during compensation before the bladder becomes dysfunctional (decompensated). A more complete understanding of the disease processes that underlie the loss of bladder function associated with BPH might enable the development of treatments that better protect these early-stage BPH patients from the more debilitating aspects of the disease. This review updates the understanding of obstructive bladder dysfunction via the use of animal models.
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Affiliation(s)
- Robert Levin
- Division of Basic and Pharmaceutical Sciences, Albany College of Pharmacy, NY 12208, USA.
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Ercolani M, Sahota A, Schuler C, Yang M, Evan AP, Reimer D, Barone JG, Tischfield JA, Levin RM. Bladder outlet obstruction in male cystinuria mice. Int Urol Nephrol 2009; 42:57-63. [PMID: 19484501 DOI: 10.1007/s11255-009-9597-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Accepted: 05/19/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cystinuria is the most common inherited cause of urinary tract stones in children. It can lead to obstructive uropathy, which is a major cause of renal failure. Genetic studies have identified two genes, SLC3A1 and SLC7A9, to be directly involved in cystine stone formation. Slc3a1 knockout male mice develop cystine stones in the bladder and, to a lesser extent, in the kidney. Slc3a1 knockout female mice also develop cystinuria, but they do not form stones. The specific aim of this study was to characterize bladder function in cystinuria mice. METHODS Eight control (4 male, 4 female) and 16 Slc3a1 knockout (9 male, 7 female) mice of mixed strain background (C57B/129, age 4-5 months) were evaluated. Each mouse was anesthetized and the bladder dome catheterized for cystometry. Immediately following cystometry, the bladder was excised, weighed, and separated into three full thickness strips for contractile studies. RESULTS Bladders from cystinuria male mice had significantly increased weight, all of them had stones, decreased compliance, and decreased contractile responses to field stimulation, ATP, carbachol, and KCl. Compared with controls, female knockout mice showed normal bladder weight, decreased voiding pressure, slightly decreased compliance, and slightly decreased contractile responses. CONCLUSIONS These studies clearly demonstrate that the bladder stones that developed in the male cystinuria mice resulted in a partial outlet obstruction. Although the female cystinuria mice did not have bladder stones, bladder function was mildly impaired; presumably by the presence of cystine crystals.
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Affiliation(s)
- Mathew Ercolani
- Department of Surgery, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA
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Lin WY, Mannikarottu A, Li S, Juan YS, Schuler C, Javed Z, Blaivas J, Levin RM. Correlation of in vivo bladder blood flow measurements with tissue hypoxia. World J Urol 2009; 29:165-70. [DOI: 10.1007/s00345-008-0369-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 12/29/2008] [Indexed: 11/30/2022] Open
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Siflinger-Birnboim A, Levin RM, Hass MA. Partial outlet obstruction of the rabbit urinary bladder induces selective protein oxidation. Neurourol Urodyn 2008; 27:532-9. [DOI: 10.1002/nau.20557] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kalorin CM, Mannikarottu A, Neumann P, Leggett R, Weisbrot J, Johnson A, Kogan BA, Levin RM. Protein oxidation as a novel biomarker of bladder decompensation. BJU Int 2008; 102:495-9. [PMID: 18341622 DOI: 10.1111/j.1464-410x.2008.07567.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yang L, He DL, Wang S, Cheng HP, Wang XY. Effect of long-term partial bladder outlet obstruction on caldesmon isoforms and their correlation with contractile function. Acta Pharmacol Sin 2008; 29:600-5. [PMID: 18430369 DOI: 10.1111/j.1745-7254.2008.00784.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIM In the present study, we investigate the expression of caldesmon (CAD) isoforms in rabbit detrusor smooth muscles (DSM) during the progression of partial bladder outlet obstruction and relate them with the time course of obstruction. METHODS Detrusor samples were obtained from the bladders of rabbits with partial bladder outlet obstruction and sham-operated control rabbits after 1, 2, 4, and 8 weeks of obstruction. Contractile responses to field stimulation and carbachol were determined in the isolated bladder strips. Western blotting was used to determine the relative levels of CaD isoform expression at the protein levels. RESULTS The contractile responses decreased progressively over the course of obstruction. The expression of l-CaD increased significantly to approximately the same extent as the 1-4-week obstructed groups and further in the 8-week obstructed group. The expression of h-CaD increased in all of the obstructed bladders, but at significantly higher levels in the 1-2-week obstructed bladders compared to the control and 4-8-week obstructed bladders. CONCLUSIONS The changes in the isoforms of CaD may be part of the molecular mechanism for bladder compensation following partial bladder outlet obstruction. The overexpression of l-CaD and the h-CaD/l-CaD ratio could be markers for the status of DSM remodeling and dysfunction.
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Affiliation(s)
- Lin Yang
- Institute of Urology, Xi'an Hospital of Medical Collage of Xi' an Jiaotong University, Xioan 710061, China
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Yamada S, Takeuchi C, Oyunzul L, Ito Y. Bladder angiotensin-II receptors: characterization and alteration in bladder outlet obstruction. Eur Urol 2008; 55:482-9. [PMID: 18378069 DOI: 10.1016/j.eururo.2008.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 03/11/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND It is assumed that angiotensin II (AngII) is significantly implicated in the pathogenesis of urinary dysfunction because of bladder outlet obstruction (BOO). OBJECTIVE The current study was undertaken to characterize AngII receptors in the rat bladder in relation to BOO. MEASUREMENTS Bladder AngII receptors were measured by a sensitive binding assay using a specific antagonist radioligand, [(125)I]-Sar(1)-Ile(8)-AngII, in bladder outlet-obstructed rats with and without repeated oral administration of telmisartan. RESULTS AND LIMITATIONS [(125)I]-Sar(1)-Ile(8)-AngII bound specifically to the rat bladder homogenates with high affinity. This specific binding of [(125)I]-Sar(1)-Ile(8)-AngII was concentration-dependently displaced by the type 1 subtype (AT(1))-selective antagonists. These findings revealed the significant existence of pharmacologically relevant AngII (AT(1)) receptors in the bladder with relatively high density. Oral administration of telmisartan in rats has been shown to bind to the bladder AngII receptors. Bladder weight was about three times greater in bladder outlet-obstructed rats than in sham rats. Maximal number of binding sites (B(max)) for [(125)I]-Sar(1)-Ile(8)-AngII binding in the bladder was significantly (48%) decreased in the bladder-outlet rats when compared with sham rats, suggesting the down regulation of pharmacologically relevant AngII receptor sites. Notably, repeated oral administration of telmisartan (3mg/kg/d, 14 d) in rats completely prevented the development of a BOO-induced decrease in B(max) for bladder [(125)I]-Sar(1)-Ile(8)-AngII binding. Telmisartan treatment also effectively attenuated the increase in the bladder-wet weight caused by urinary outlet obstruction. CONCLUSIONS Bladder AngII may be at least partly associated with the pathogenesis of urinary dysfunction occurring subsequent to BOO through stimulation of the AT(1) receptor subtype.
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Affiliation(s)
- Shizuo Yamada
- Department of Pharmacokinetics and Pharmacodynamics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan.
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Lin WY, Guven A, Juan YS, Neuman P, Whitbeck C, Chichester P, Kogan B, Levin RM, Mannikarottu A. Free radical damage as a biomarker of bladder dysfunction after partial outlet obstruction and reversal. BJU Int 2008; 101:621-6. [DOI: 10.1111/j.1464-410x.2007.07389.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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