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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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2
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Xu Z, Elrashidy RA, Li B, Liu G. Oxidative Stress: A Putative Link Between Lower Urinary Tract Symptoms and Aging and Major Chronic Diseases. Front Med (Lausanne) 2022; 9:812967. [PMID: 35360727 PMCID: PMC8960172 DOI: 10.3389/fmed.2022.812967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Aging and major chronic diseases are risk factors for lower urinary tract symptoms (LUTS). On the other hand, oxidative stress (OS) is one of the fundamental mechanisms of aging and the development of chronic diseases. Therefore, OS might be a candidate mechanism linking these two clinical entities. This article aims to summarize the studies on the prevalence of LUTS, the role of OS in aging and chronic diseases, and the potential mechanisms supporting the putative link. A comprehensive literature search was performed to identify recent reports investigating LUTS and OS in major chronic diseases. In addition, studies on the impact of OS on the lower urinary tract, including bladder, urethra, and prostate, were collected and summarized. Many studies showed LUTS are prevalent in aging and major chronic diseases, including obesity, metabolic syndrome, diabetes, cardiovascular disease, hypertension, obstructive sleep apnea, autoimmune diseases, Alzheimer’s disease, and Parkinson’s disease. At the same time, OS is a key component in the pathogenesis of those chronic diseases and conditions. Recent studies also provided evidence that exacerbated OS can cause functional and/or structural changes in the bladder, urethra, and prostate, leading to LUTS. The reviewed data support the concept that OS is involved in multiple risk factors-associated LUTS, although further studies are needed to confirm the causative relationship. The specific ROS/RNS and corresponding reactions/pathways involved in chronic diseases and associated LUTS should be identified in the future and could serve as therapeutic targets.
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Affiliation(s)
- Zhenqun Xu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Rania A. Elrashidy
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Bo Li
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- *Correspondence: Guiming Liu,
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3
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Çakıcı ÖU, Dinçer S. The effect of amino acids on the bladder cycle: a concise review. Amino Acids 2021; 54:13-31. [PMID: 34853916 DOI: 10.1007/s00726-021-03113-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/25/2021] [Indexed: 11/26/2022]
Abstract
The human bladder maintains a cycle of filling, storing, and micturating throughout an individual's lifespan. The cycle relies on the ability of the bladder to expand without increasing the intravesical pressure, which is only possible with the controlled relaxation of well-complaint muscles and the congruously organized construction of the bladder wall. A competent bladder outlet, which functions in a synchronous fashion with the bladder, is also necessary for this cycle to be completed successfully without deterioration. In this paper, we aimed to review the contemporary physiological findings on bladder physiology and examine the effects of amino acids on clinical conditions affecting the bladder, with special emphasis on the available therapeutic evidence and possible future roles of the amino acids in the treatment of the bladder-related disorders.
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Affiliation(s)
- Özer Ural Çakıcı
- Attending Urologist, Private Practice, Ankara, Turkey.
- PhD Candidate in Physiology, Department of Physiology, Gazi University, Ankara, Turkey.
| | - Sibel Dinçer
- Professor in Physiology, Department of Physiology, Gazi University, Ankara, Turkey
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4
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Cullingsworth ZE, Nandanan N, Swavely NR, Frolov K, Vince R, Zee R, Cisu T, Klausner AP, Speich JE. A preliminary study of bilateral color mapping of pig bladder vasculature demonstrates potential for acute hemi-ischemic events. Transl Androl Urol 2021; 10:2410-2417. [PMID: 34295727 PMCID: PMC8261448 DOI: 10.21037/tau-20-1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background Chronic ischemia is a known risk factor for the development of lower urinary tract symptoms (LUTS) and bladder hypocontractility. Less is known, however, about the impact of acute ischemia. Classic teaching suggests that collateral circulation is robust in the bladder and, therefore, loss of a single source of blood flow should have no deleterious effect. This study aims to provide visual evidence that segmental vascular supply is critical for maintaining adequate perfusion to the bladder. Methods Ex vivo pig bladders were cannulated bilaterally in the superior vesical arteries and perfused using contrasting red and green dye. Images were collected at each step of the perfusion dyeing process and these images were analyzed using a custom program to calculate the average hue of each side. Statistical analysis was performed using Student’s t-test. Results The two halves being perfused by separate arteries showed a statistically significant difference when compared (P<0.05) on both the outer wall (n=9) and in the mucosal layer (n=4). On the outside wall, the average normalized hue of the green halves was 27.5°±14.3°, while the average normalized hue of the red halves was −58.7°±3.1°. In the mucosa, the average normalized hue of the green halves was 34.5°±17.4°, while the average normalized hue of the red halves was −51.5°±3.5°. Conclusions This study identified a novel color mapping method to study pig bladder vascular supply. The results demonstrated a lack of collateral blood flow, highlighting the possibly of acute hemi-ischemic event. However, further research in the effect of acute ischemia on bladder function is necessary.
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Affiliation(s)
- Zachary E Cullingsworth
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University School of Engineering, Richmond, Virginia, USA
| | - Naveen Nandanan
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Natalie R Swavely
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Konstantin Frolov
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University School of Engineering, Richmond, Virginia, USA
| | - Randy Vince
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Rebecca Zee
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Theodore Cisu
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Adam P Klausner
- Department of Surgery/Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - John E Speich
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University School of Engineering, Richmond, Virginia, USA
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5
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Nishijima S, Sugaya K, Kadekawa K, Ashitomi K, Ueda T, Yamamoto H. Tadalafil improves bladder dysfunction and object recognition in rats with pelvic venous congestion. Int J Urol 2019; 26:578-585. [PMID: 30801851 DOI: 10.1111/iju.13932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/28/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the effects of tadalafil on bladder function and object recognition ability in rats with alterations in urinary frequency and locomotor activity as a result of pelvic venous congestion. METHODS A total of 48 female rats were divided into three groups (sham, pelvic venous congestion and pelvic venous congestion/tadalafil groups). In the pelvic venous congestion and pelvic venous congestion/tadalafil groups, the bilateral common iliac veins and uterine veins were ligated under anesthesia. Rats in the pelvic venous congestion/tadalafil group received a diet containing tadalafil, and the other rats were fed a normal diet. After 4 weeks, rats underwent analysis of voiding behavior, locomotor activity, a novel object recognition test, continuous cystometry, measurement of plasma monoamines, and measurement of plasma and urinary nitric oxide metabolites. Expression of nitric oxide synthase messenger ribonucleic acid in the bladder wall was also assessed, along with histological examination of the bladder. RESULTS Rats with pelvic venous congestion showed a higher urinary frequency, lower locomotor activity, and lower plasma and urinary nitric oxide levels than sham rats. The bladder wall endothelial nitric oxide synthase messenger ribonucleic acid level was low and object recognition was impaired. Pelvic venous congestion/tadalafil rats showed improvement in locomotor activity, bladder function and object recognition compared with pelvic venous congestion rats, as well as elevation of plasma and urinary nitric oxide, plasma monoamines, and bladder neuronal nitric oxide synthase messenger ribonucleic acid expression. Bladder wall vascularity was greater in pelvic venous congestion/tadalafil rats compared with sham rats. CONCLUSIONS In rats with pelvic venous congestion, tadalafil might improve bladder function and the general condition by increasing blood flow to the bladder and brain, and by increasing dopamine levels.
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Affiliation(s)
| | | | | | | | - Tomoyuki Ueda
- Faculty of Medicine, Institute for Animal Experiments, University of the Ryukyus, Okinawa, Japan
| | - Hideyuki Yamamoto
- Department of Biochemistry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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6
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Sugaya K, Nishijima S, Kadekawa K, Noguchi K, Ashitomi K, Ueda T, Yamamoto H. Pelvic venous congestion induces lower urinary tract dysfunction in rats. Biomed Res 2018; 39:269-277. [PMID: 30531156 DOI: 10.2220/biomedres.39.269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Pelvic venous congestion (PC) is thought to be related to several diseases of the lower urinary tract (LUT). We examined the characteristics of the LUT in rats with PC. To create PC, female rats were anesthetized with isoflurane, and the bilateral common iliac veins and bilateral uterine veins were ligated. At 1-8 weeks after either ligation or sham surgery, we performed cystometry with or without administration of carbazochrome sodium sulfonate hydrate or propiverine hydrochloride, histologic examination of the bladder, blood flow imaging, assessment of locomotor activity, measurement of urinary 8-hydroxydeoxyguanosine (8-OHdG) and nitric oxide metabolites (NOx), and the Evans blue dye extravasation test. PC elevated frequency of urination after 2-6 weeks, and caused a decrease of spontaneous locomotor activity. In addition, there was a decrease of bladder blood flow, an increase of bladder vascular permeability, an increase of urinary 8-OHdG, a decrease of urinary NOx, and mild inflammatory changes of the bladder. In rats with PC, frequency of urination was normalized by administration of propiverine or carbazochrome. Rats with PC may be used as a model of PC associated with high frequency of urination, and this model may be useful when developing treatment for LUT symptoms associated with PC.
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Affiliation(s)
| | | | | | | | | | - Tomoyuki Ueda
- The Institute for Animal Experiments, Faculty of Medicine, University of the Ryukyus
| | - Hideyuki Yamamoto
- Department of Biochemistry, Graduate School of Medicine, University of the Ryukyus
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7
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Yee CH, Yip JSY, Cheng NMY, Kwan CH, Li KM, Teoh JYC, Chiu PKF, Wong JHM, Chan ESY, Chan CK, Hou SSM, Ng CF. The cardiovascular risk factors in men with lower urinary tract symptoms. World J Urol 2018; 37:727-733. [PMID: 30083830 DOI: 10.1007/s00345-018-2432-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/02/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE It has been hypothesized that endothelial dysfunction and pelvic atherosclerosis may contribute to lower urinary tract symptoms (LUTS). We assessed the relationship between cardiovascular risk factors and LUTS severity in male patients presented to urology clinic. METHODS It is a cross-sectional study on patients who presented between 2013 and 2015 with LUTS. A total of 1176 male patients were encountered, and 966 were included for analysis after excluding patients with urinary tract malignancy, urethral stricture, bladder stone and history of urinary tract surgery. Cardiovascular risk factors including components of Framingham risk score, body mass index, uroflowmetry, International Prostate Symptoms Score, fasting blood glucose and serum prostate-specific antigen (PSA) were assessed. Correlation between Framingham risk score, cardiovascular risk factors and severity of LUTS was investigated. RESULTS Multinomial logistic regression analysis showed that severe LUTS significantly associated with Framingham score (P = 0.008) and its components of total cholesterol (OR = 1.318; P = 0.010) and age (OR = 1.032; P = 0.006) compare with mild symptoms. Framingham risk score was found to correlate with storage symptoms (CC = 0.083; P < 0.0001) but not voiding symptoms (CC = - 0.029; P = 0.185). CONCLUSIONS Severity of LUTS and storage symptom significantly increases Framingham risk score, particularly with the components of total cholesterol level and age.
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Affiliation(s)
- Chi-Hang Yee
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| | - Jenny S Y Yip
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Nicole M Y Cheng
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Cheuk-Hang Kwan
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Kai-Man Li
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Jeremy Y C Teoh
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Peter K F Chiu
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Joseph Hon-Ming Wong
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Eddie S Y Chan
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Chi-Kwok Chan
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Simon S M Hou
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Chi-Fai Ng
- Division of Urology, Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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8
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The multiple functions of melatonin in regenerative medicine. Ageing Res Rev 2018; 45:33-52. [PMID: 29630951 DOI: 10.1016/j.arr.2018.04.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 02/07/2023]
Abstract
Melatonin research has been experiencing hyper growth in the last two decades; this relates to its numerous physiological functions including anti-inflammation, oncostasis, circadian and endocrine rhythm regulation, and its potent antioxidant activity. Recently, a large number of studies have focused on the role of melatonin in the regeneration of cells or tissues after their partial loss. In this review, we discuss the recent findings on the molecular involvement of melatonin in the regeneration of various tissues including the nervous system, liver, bone, kidney, bladder, skin, and muscle, among others.
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Liang C, Shaw SS, Lin Y, Lee T. Amniotic fluid stem cells ameliorate bladder dysfunction induced by chronic bladder ischemia in rat. Neurourol Urodyn 2017; 37:123-131. [DOI: 10.1002/nau.23316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/08/2017] [Indexed: 01/26/2023]
Affiliation(s)
- Ching‐Chung Liang
- Female Urology Section, Department of Obstetrics and GynecologyChang Gung Memorial Hospital Linkou MedicalTaoyuanTaiwan
- College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Sheng‐Wen Steven Shaw
- Female Urology Section, Department of Obstetrics and GynecologyChang Gung Memorial Hospital Linkou MedicalTaoyuanTaiwan
- Maternal Fetal Medicine SectionDepartment of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical CenterTaoyuanTaiwan
| | - Yi‐Hao Lin
- Female Urology Section, Department of Obstetrics and GynecologyChang Gung Memorial Hospital Linkou MedicalTaoyuanTaiwan
- College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Tsong‐Hai Lee
- College of MedicineChang Gung UniversityTaoyuanTaiwan
- Stroke Center and Department of NeurologyChang Gung Memorial Hospital Linkou Medical CenterTaoyuanTaiwan
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10
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Hanna-Mitchell AT, Robinson D, Cardozo L, Everaert K, Petkov GV. Do we need to know more about the effects of hormones on lower urinary tract dysfunction? ICI-RS 2014. Neurourol Urodyn 2016; 35:299-303. [PMID: 26872571 DOI: 10.1002/nau.22809] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 05/22/2015] [Indexed: 11/09/2022]
Abstract
This review article reflects the presentations and subsequent discussions during a think tank at the 5th International Consultation on Incontinence Research Society's annual meeting, held in Bristol, UK (September 22-24, 2014). It reviews the current state of knowledge on the role of hormones in lower urinary tract dysfunction (LUTD) and overactive bladder (OAB) and in particular: highlights some specific basic research findings from discussion participants; reviews future research topics; and discusses potential new therapeutic opportunities for LUTD and OAB. The role of the large conductance voltage- and Ca(2+) -activated K(+) (BK) channels, as novel therapeutic targets for OAB was discussed, in particular as recent studies on human detrusor smooth muscle suggest that estradiol exerts a direct non-genomic activation of the BK channels. Recent developments on the roles of sex hormones on diuresis, as well as the roles of melatonin and vitamin D on LUTD were also discussed. It was concluded that further basic science and translational studies are needed to better understand hormonal regulatory mechanisms of the lower urinary tract and the implications for novel treatment options for LUTD and OAB.
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Affiliation(s)
- Ann T Hanna-Mitchell
- Department of Urology, Urology Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Dudley Robinson
- Department of Urogynecology, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Linda Cardozo
- Department of Urogynecology, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Georgi V Petkov
- Department of Drug Discovery and Biomedical Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, South Carolina
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11
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Andersson KE, Boedtkjer DB, Forman A. The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction. Ther Adv Urol 2016; 9:11-27. [PMID: 28042309 DOI: 10.1177/1756287216675778] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The vascular supply to the human bladder is derived mainly from the superior and inferior vesical arteries, the latter being directly connected to the internal iliac artery. Aging is associated with an impairment of blood vessel function and changes may occur in the vasculature at the molecular, cellular and functional level. Pelvic arterial insufficiency may play an important role in the development of bladder dysfunctions such as detrusor overactivity (DO) and the overactive bladder syndrome. Chronic ischemia-related bladder dysfunction may progress to bladder underactivity and it would be desirable to treat not only lower urinary tract symptoms (LUTS) induced by chronic ischemia, but also the progression of the morphological bladder changes. Studies in experimental models in rabbits and rats have shown that pelvic arterial insufficiency may result in significant bladder ischemia with reduced bladder wall oxygen tension. In turn, this will lead to oxidative stress associated with upregulation of oxidative stress-sensitive genes, increased muscarinic receptor activity, ultrastructural damage, and neurodegeneration. The phosphodiesterase type 5 (PDE5) inhibitor tadalafil, the α1-adrenoceptor (AR) blocker silodosin, the β3-AR agonist mirabegron, and the free radical scavenger melatonin, exerted a protecting effect on urodynamic parameters, and on functional and morphological changes of the bladder demonstrable in vitro. Since the agents tested are used clinically for relieving LUTS, the results from the animal models seem to have translational value, and may be of relevance for designing clinical studies to demonstrate if the drugs may prevent progression of ischemia-related functional and morphological bladder changes.
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Affiliation(s)
- Karl-Erik Andersson
- Institute of Clinical Medicine, Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK 8200 Aarhus N, Denmark
| | | | - Axel Forman
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Denmark
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12
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Reiter RJ, Mayo JC, Tan DX, Sainz RM, Alatorre-Jimenez M, Qin L. Melatonin as an antioxidant: under promises but over delivers. J Pineal Res 2016; 61:253-78. [PMID: 27500468 DOI: 10.1111/jpi.12360] [Citation(s) in RCA: 1021] [Impact Index Per Article: 127.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/05/2016] [Indexed: 12/12/2022]
Abstract
Melatonin is uncommonly effective in reducing oxidative stress under a remarkably large number of circumstances. It achieves this action via a variety of means: direct detoxification of reactive oxygen and reactive nitrogen species and indirectly by stimulating antioxidant enzymes while suppressing the activity of pro-oxidant enzymes. In addition to these well-described actions, melatonin also reportedly chelates transition metals, which are involved in the Fenton/Haber-Weiss reactions; in doing so, melatonin reduces the formation of the devastatingly toxic hydroxyl radical resulting in the reduction of oxidative stress. Melatonin's ubiquitous but unequal intracellular distribution, including its high concentrations in mitochondria, likely aid in its capacity to resist oxidative stress and cellular apoptosis. There is credible evidence to suggest that melatonin should be classified as a mitochondria-targeted antioxidant. Melatonin's capacity to prevent oxidative damage and the associated physiological debilitation is well documented in numerous experimental ischemia/reperfusion (hypoxia/reoxygenation) studies especially in the brain (stroke) and in the heart (heart attack). Melatonin, via its antiradical mechanisms, also reduces the toxicity of noxious prescription drugs and of methamphetamine, a drug of abuse. Experimental findings also indicate that melatonin renders treatment-resistant cancers sensitive to various therapeutic agents and may be useful, due to its multiple antioxidant actions, in especially delaying and perhaps treating a variety of age-related diseases and dehumanizing conditions. Melatonin has been effectively used to combat oxidative stress, inflammation and cellular apoptosis and to restore tissue function in a number of human trials; its efficacy supports its more extensive use in a wider variety of human studies. The uncommonly high-safety profile of melatonin also bolsters this conclusion. It is the current feeling of the authors that, in view of the widely diverse beneficial functions that have been reported for melatonin, these may be merely epiphenomena of the more fundamental, yet-to-be identified basic action(s) of this ancient molecule.
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Affiliation(s)
- Russel J Reiter
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA.
| | - Juan C Mayo
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Dun-Xian Tan
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Rosa M Sainz
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Moises Alatorre-Jimenez
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Lilian Qin
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
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13
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Sugaya K, Nishijima S, Kadekawa K, Ashitomi K, Ueda T, Yamamoto H. Naftopidil improves locomotor activity and urinary frequency in rats with pelvic venous congestion. Biomed Res 2016; 37:221-6. [PMID: 27544997 DOI: 10.2220/biomedres.37.221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The α1D/A receptor antagonist, naftopidil, inhibits micturition reflex by acting on various different sites. We examined the effects of naftopidil on bladder activity and changes in the induced urinary frequency using female rats with pelvic venous congestion (PC). Twenty-four female rats were divided into sham, PC, and PC/naftopidil groups. After anesthetizing rats in the PC and PC/naftopidil groups, the bilateral common iliac veins and uterine veins were ligated. Rats in the sham and PC groups were fed a standard diet, while rats in the PC/naftopidil group were fed diets containing 0.04% naftopidil. After 4 weeks of treatment, locomotor activity, urinary nitric oxide metabolites (NOx), continuous cystometry, and plasma monoamine measurements were performed. PC rats exhibited a decrease of locomotor activity, a shorter interval between bladder contractions on continuous cystometry, and decreased urinary NOx and plasma serotonin levels than the sham rats. The PC/naftopidil rats exhibited an increase of locomotor activity, a longer interval between bladder contractions, and increased urinary NOx and plasma serotonin levels. Therefore, naftopidil might improve bladder dysfunction induced by pelvic venous congestion due to several actions in the central nervous system and bladder tissue, as well as acting as an α1 blocker to cause pelvic venous dilation.
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14
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Sugaya K, Nishijima S, Kadekawa K, Ashitomi K, Ueda T, Yamamoto H. Effects of silodosin on bladder activity in rats with frequent urination induced by pelvic venous congestion. Int J Urol 2016; 23:881-887. [DOI: 10.1111/iju.13158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 06/05/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | - Tomoyuki Ueda
- Faculty of Medicine; The Institute for Animal Experiments; University of the Ryukyus; Okinawa Japan
| | - Hideyuki Yamamoto
- Department of Biochemistry; Graduate School of Medicine; University of the Ryukyus; Okinawa Japan
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15
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Thurmond P, Yang JH, Azadzoi KM. LUTS in pelvic ischemia: a new concept in voiding dysfunction. Am J Physiol Renal Physiol 2016; 310:F738-F743. [DOI: 10.1152/ajprenal.00333.2015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/13/2016] [Indexed: 01/27/2023] Open
Abstract
Lower urinary tract symptoms (LUTS) are a group of voiding symptoms affecting both genders as they age. Traditionally, LUTS in men were commonly attributed to bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE). It was later shown that, in approximately one-third to more than one-half of cases, LUTS in men are not associated with BOO. Urodynamic changes in the male bladder and symptom scores in aging men were found to be identical to their age-matched female counterparts. These observations suggested that LUTS in the elderly do not necessarily relate to BOO and may result from local changes in bladder muscle, nerves, and blood vessels. However, aging factors predisposing to bladder dysfunction and LUTS remain unknown. Growing evidence suggests that aging-associated pelvic ischemia may be a primary factor in the development of nonobstructed nonneurogenic overactive bladder and LUTS. First identified in experimental models and later in clinical studies, pelvic ischemia has been shown to compromise the lower urinary tract structure and lead to dysfunction. Structural and functional consequences of bladder and prostate ischemia have been documented in animal models. Clinical studies have shown that bladder and prostate blood flow decreases with aging. The severity of LUTS in elderly patients correlates with the degrees of bladder ischemia. LUTS improvement with α blockers has been associated with increased bladder blood flow. Pelvic ischemia may be an independent factor in nonobstructed nonneurogenic bladder instability and LUTS. Further research into the pathophysiology of LUTS in pelvic ischemia may lead to better management of this problem in the elderly population.
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Affiliation(s)
- Portia Thurmond
- Department of Urology, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts
| | - Jing-Hua Yang
- Department of Urology, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts; and
| | - Kazem M. Azadzoi
- Department of Urology and Department of Pathology, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts
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16
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Fathollahi A, Daneshgari F, Hanna-Mitchell AT. Melatonin and Its Role in Lower Urinary Tract Function: An Article Review. Curr Urol 2015; 8:113-8. [PMID: 26889129 DOI: 10.1159/000365701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 02/20/2015] [Indexed: 01/19/2023] Open
Abstract
This article reviewed the results of studies done on animals that assessed effects of melatonin on bladder function. Melatonin does not change strip relaxation on its own. However, pre-treatment with melatonin decreases contractile responses induced by phenylephrine, acetylcholine, bethanechol and KCl in a dose-dependent manner. The contractile responses induced by the direct calcium channel openers are significantly decreased by melatonin pre-treatment. It also binds to Ca(2+)-activated calmodulin, and prevents it from activating myosin light-chain kinase. It may have direct effects on ion channels which are responsible for regulating bladder contraction. Its other mode of action on bladder occurs via the brain GABAA receptor. Melatonin is an antioxidant. In bladder, treatment with melatonin prevents elevations in malondialdehyde levels, reverses changes in glutathione levels, and decreases myeloperoxidase levels compared with oxidative injury. It can normalize age induced bladder dysfunction through its antioxidant effects, inhibiting smooth muscle contractility directly and restoring impaired contractility via normalization of Ca(2+) handling and sensitizations pathways. It attenuates the severity of cystitis and inflammation. Mast cell proliferation and activation are increased in cystitis, but decrease by melatonin treatment. Also, there is a decrease in expression levels of pro-inflammatory cytokines after melatonin treatment.
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Affiliation(s)
- Ali Fathollahi
- Urology Institute, Case Western Reserve University, Cleveland, OH., USA
| | - Firouz Daneshgari
- Urology Institute, Case Western Reserve University, Cleveland, OH., USA
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17
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Liu G, Elrashidy RA, Xiao N, Kavran M, Huang Y, Tao M, Powell CT, Kim E, Sadeghi G, Mohamed HE, Daneshgari F. Bladder function in mice with inducible smooth muscle-specific deletion of the manganese superoxide dismutase gene. Am J Physiol Cell Physiol 2015; 309:C169-78. [PMID: 25948732 DOI: 10.1152/ajpcell.00046.2015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/02/2015] [Indexed: 11/22/2022]
Abstract
Manganese superoxide dismutase (MnSOD) is considered a critical component of the antioxidant systems that protect against oxidative damage. We are interested in the role of oxidative stress in bladder detrusor smooth muscle (SM) in different disease states. In this study, we generated an inducible, SM-specific Sod2(-/-) mouse model to investigate the effects of MnSOD depletion on the function of the bladder. We crossbred floxed Sod2 (Sod2(lox/lox)) mice with mice containing heterozygous knock-in of a gene encoding a tamoxifen-activated Cre recombinase in the SM22α promoter locus [SM-CreER(T2)(ki)(Cre/+)]. We obtained Sod2(lox/lox),SM-CreER(T2)(ki)(Cre/+) mice and injected 8-wk-old males with 4-hydroxytamoxifen to induce Cre-mediated excision of the floxed Sod2 allele. Twelve weeks later, SM-specific deletion of Sod2 and depletion of MnSOD were confirmed by polymerase chain reaction, immunoblotting, and immunohistochemistry. SM-specific Sod2(-/-) mice exhibited normal growth with no gross abnormalities. A significant increase in nitrotyrosine concentration was found in bladder SM tissue of SM-specific Sod2(-/-) mice compared with both wild-type mice and Sod2(+/+), SM-CreER(T2)(ki)(Cre/+) mice treated with 4-hydroxytamoxifen. Assessment of 24-h micturition in SM-specific Sod2(-/-) mice revealed significantly higher voiding frequency compared with both wild-type and SM-specific Cre controls. Conscious cystometry revealed significantly shorter intercontraction intervals and lower functional bladder capacity in SM-specific Sod2(-/-) mice compared with wild-type mice. This novel model can be used for exploring the mechanistic role of oxidative stress in organs rich in SM in different pathological conditions.
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Affiliation(s)
- Guiming Liu
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Rania A Elrashidy
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Faculty of Pharmacy, Biochemistry Department, Zagazig University, Zagazig, Egypt
| | - Nan Xiao
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China; and
| | - Michael Kavran
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Yexiang Huang
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Urology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Mingfang Tao
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - C Thomas Powell
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Edward Kim
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ghazal Sadeghi
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Hoda E Mohamed
- Faculty of Pharmacy, Biochemistry Department, Zagazig University, Zagazig, Egypt
| | - Firouz Daneshgari
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, Ohio;
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18
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Andersson KE, Nomiya M, Yamaguchi O. Chronic Pelvic Ischemia: Contribution to the Pathogenesis of Lower Urinary Tract Symptoms (LUTS): A New Target for Pharmacological Treatment? Low Urin Tract Symptoms 2014; 7:1-8. [PMID: 26663644 DOI: 10.1111/luts.12084] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 09/30/2014] [Accepted: 10/05/2014] [Indexed: 11/28/2022]
Abstract
The incidence of lower urinary tract symptoms, including overactive bladder (OAB), is continuing to rise, and is associated with a negative impact on quality of life and a heavy economic burden. A major risk factor for OAB is advancing age. The etiology of OAB is multifactorial and appears to involve myogenic, neurogenic, and urotheliogenic factors. In this article, we review the strengthening preclinical evidence supporting the contribution of chronic pelvic ischemia to the pathogenesis of OAB. In animal models, chronic ischemia induced by arterial injury and a high-fat diet upregulates markers of oxidative stress and proinflammatory cytokines in the urothelium and lamina propria, and leads to increased expression of nerve growth factor. These processes result in increased afferent activity and an increased frequency of micturition, reflecting a state of bladder hyperactivity. In severe, prolonged cases, bladder overactivity may develop into underactivity. Antimuscarinic therapies are the mainstay of OAB treatment, but their usefulness is limited by modest efficacy and troublesome side-effects. Our increasing understanding of the contribution of chronic ischemia to OAB is leading toward novel therapeutic options targeting chronic pelvic ischemia and its morphological, functional, and oxidative consequences. Preclinical trials have demonstrated encouraging results with α1 -adrenoreceptor blockade, phosphodiesterase type 5 inhibition, β3 -adrenoreceptor agonism, free radical scavenging, and stem cell therapy, in preventing morphological, biochemical and functional changes induced by chronic bladder ischemia.
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Affiliation(s)
- Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Masanori Nomiya
- Division of Bioengineering and Lower Urinary Tract Diseases Research, Nihon University School of Engineering, Koriyama, Japan
| | - Osamu Yamaguchi
- Division of Bioengineering and Lower Urinary Tract Diseases Research, Nihon University School of Engineering, Koriyama, Japan
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19
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Ito H, Yokoyama O. Metabolic syndrome and lower urinary tract symptoms. World J Clin Urol 2014; 3:330-335. [DOI: 10.5410/wjcu.v3.i3.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 06/21/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
Recently, clinical and epidemiologic data indicating the involvement of metabolic syndrome (MetS) in the pathogenesis and progression of lower urinary tract symptom (LUTS)/benign prostatic hyperplasia (BPH) are reported. This review evaluates the reports on the influence of MetS in the development and progression of LUTS/BPH, and discusses possible clinical implications for the management and treatment of this disease. Recent studies on the epidemiological relationship between MetS and LUTS hypothesize that MetS may be associated with an overactivity of the autonomic nervous system for which hyperinsulinemia, a key element of the MetS, might be responsible. An alternative explanation is that LUTS are associated with chronic ischemia of pelvis resulting from atherosclerotic changes in blood vessels, which leads the production of reactive oxygen species, which can damage the bladder detrusor. Control of autonomic nervous system overactivity and control of chronic bladder ischemia have potential as new targets for LUTS treatment. Studies suggest an association of MetS with LUTS/BPH, although further research is needed to understand how MetS influences LUTS/BPH. MetS should be considered a new domain in basic and clinical research in patients with LUTS/BPH and as a target for treatment.
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20
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Nomiya M, Andersson KE, Yamaguchi O. Chronic bladder ischemia and oxidative stress: New pharmacotherapeutic targets for lower urinary tract symptoms. Int J Urol 2014; 22:40-6. [DOI: 10.1111/iju.12652] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 09/15/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Masanori Nomiya
- Division of Bioengineering and LUTD Research; Nihon University School of Engineering; Koriyama Japan
| | - Karl-Erik Andersson
- Institute for Regenerative Medicine; Wake Forest University School of Medicine; Winston-Salem North Carolina USA
- Aarhus Institute for Advanced Studies; Aarhus University; Aarhus Denmark
| | - Osamu Yamaguchi
- Division of Bioengineering and LUTD Research; Nihon University School of Engineering; Koriyama Japan
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21
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Andersson KE, Nomiya M, Sawada N, Yamaguchi O. Pharmacological treatment of chronic pelvic ischemia. Ther Adv Urol 2014; 6:105-14. [PMID: 24883108 DOI: 10.1177/1756287214526768] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Epidemiological studies have shown that lower urinary tract symptoms, including overactive bladder, commonly occur in both men and women, with an age-related increase in both sexes. Vascular endothelial dysfunction and urological symptoms are common in the metabolic syndrome; they also occur during the human ageing process and are independent risk factors for the development of atherosclerosis and hypertension. Pelvic arterial insufficiency may lead to impaired lower urinary tract perfusion and play an important role in the development of bladder dysfunction such as detrusor overactivity and overactive bladder. It seems reasonable, but has not been definitely established clinically, that chronic ischemia-related bladder dysfunction will progress to bladder underactivity. Studies in experimental models in rabbits and rats have shown that pelvic arterial insufficiency may result in significant bladder ischemia with reduced bladder wall oxygen tension, oxidative stress, increased muscarinic receptor activity, ultrastructural damage, and neurodegeneration. Several types of drug may be able to prevent some of these changes. Even if the α1-adrenoceptor blocker, silodosin, the phosphodiesterase type 5 inhibitor, tadalafil, the β3-α1-adrenoceptor agonist, mirabegron, and the free radical scavenger, melatonin, were unable to prevent the development of neointimal hyperplasia and consequent luminal occlusion in animal models, they all exerted a protecting effect on urodynamic parameters, and on the functional and morphological changes of the bladder demonstrable in vitro. The different mechanisms of action of the drugs suggest that many factors are involved in the pathogenesis of chronic ischemia-induced bladder dysfunction and can be targets for intervention. Since several of the agents tested are used clinically and effectively for relieving lower urinary tract symptoms, the results from animal models of chronic bladder ischemia seem to have translational value. Animal models may be of relevance for designing clinical studies to demonstrate if a certain drug may prevent progression of ischemia-related functional and morphological bladder changes.
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Affiliation(s)
- Karl-Erik Andersson
- AIAS, Aarhus Institute of Advanced Studies, Aarhus University, Høegh-Guldbergs Gade 6B, building 1632, 8000 Aarhus C, Denmark
| | - Masanori Nomiya
- Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan
| | - Norifumi Sawada
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Osamu Yamaguchi
- Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan
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22
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Yamaguchi O, Nomiya M, Andersson KE. Functional consequences of chronic bladder ischemia. Neurourol Urodyn 2013; 33:54-8. [PMID: 24292974 DOI: 10.1002/nau.22517] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 09/30/2013] [Indexed: 01/22/2023]
Abstract
The pathophysiology of lower urinary tract symptoms (LUTS), particularly in the elderly, seems to be multifactorial. One of the factors involved may be chronic ischemia of the bladder caused by bladder outflow obstruction (male) or atherosclerosis (male/female). The mechanisms by which chronic ischemia initiates and causes LUTS and progressive bladder dysfunction, and the time course of the effects, are incompletely known. Bladder ischemia and repeated ischemia/reperfusion during a micturition cycle may produce oxidative stress, leading to denervation of the bladder and the expression of tissue damaging molecules in the bladder wall. This may be responsible for the development of detrusor overactivity progressing to detrusor underactivity and inability to empty the bladder. The extent of bladder dysfunction in chronic bladder ischemia may depend on the degree and duration of ischemia. To prevent chronic bladder ischemia caused by atherosclerosis and to treat its consequences, more pathophysiological knowledge is needed. Several animal models of atherosclerosis-induced chronic bladder ischemia are available and should be useful tools for further research.
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Affiliation(s)
- Osamu Yamaguchi
- Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan
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23
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Nomiya M, Yamaguchi O, Akaihata H, Hata J, Sawada N, Kojima Y, Andersson KE. Progressive vascular damage may lead to bladder underactivity in rats. J Urol 2013; 191:1462-9. [PMID: 24184364 DOI: 10.1016/j.juro.2013.10.097] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE We assessed whether progressive vascular damage causes bladder underactivity in rats. MATERIALS AND METHODS Adult male Sprague Dawley® rats were divided into 4 groups. Controls received a regular diet and tap water. The L-NAME group received a 2% cholesterol diet and L-NAME (3 mg/ml) dissolved in drinking water. The arterial injury group underwent balloon endothelial injury of the common iliac arteries and received a 2% cholesterol diet and tap water after injury. The arterial injury/L-NAME group also received L-NAME dissolved in drinking water. At 8 weeks urodynamics were performed, bladder tissue was harvested for pharmacological studies, and the iliac arteries and bladders were histologically examined. RESULTS Iliac arteries from the injury and injury/L-NAME groups showed neointimal formation and luminal occlusion but arteries from the L-NAME group did not. In the L-NAME and injury groups bladder capacity and voided volume were less than in controls. Conversely, in the injury/L-NAME group these cystometric parameters were significantly greater than in the other groups. Post-void residual volume in the injury/L-NAME group tended to increase compared with the other groups. Contractile responses of bladder strips to various stimuli in the L-NAME, injury and injury/L-NAME groups were significantly less than in controls and the lowest in the injury/L-NAME group. The injury and injury/L-NAME groups showed a significantly increased percent of collagen compared to controls. CONCLUSIONS Pelvic arterial occlusive disease plus vascular endothelial dysfunction may cause progressive vascular damage resulting in bladder dysfunction that develops from bladder hyperactivity to bladder underactivity.
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Affiliation(s)
- Masanori Nomiya
- Department of Urology, Fukushima Medical University of School of Medicine, Fukushima City, Japan.
| | - Osamu Yamaguchi
- Division of Bioengineering and Lower Urinary Tract Dysfunction Research, Nihon University School of Engineering, Koriyama City, Japan
| | - Hidenori Akaihata
- Department of Urology, Fukushima Medical University of School of Medicine, Fukushima City, Japan
| | - Junya Hata
- Department of Urology, Fukushima Medical University of School of Medicine, Fukushima City, Japan
| | - Norifumi Sawada
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University of School of Medicine, Fukushima City, Japan
| | - Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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