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Uvelius B, Andersson KE. Can Urinary Bladder Innervation Be Restored After Outlet Obstruction and Denervation? Int Neurourol J 2024; 28:75-82. [PMID: 38956767 PMCID: PMC11222827 DOI: 10.5213/inj.2448134.067] [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: 03/08/2024] [Accepted: 05/27/2024] [Indexed: 07/04/2024] Open
Abstract
Transurethral resection of the prostate, or other methods to decrease outlet resistance usually leads to relief of symptoms in patients with bladder outlet obstruction (BOO). If symptoms of underactivity persist after normalization of outflow conditions, treatment options are limited. In this review, we hypothesize, based on results from basic research, what might become treatment options for such patients in the future. The primary local treatment will still aim at reducing outlet obstruction. We speculate that local secondary treatment in the future might include transplantation of stem cells or mature bladder ganglion cells into the bladder wall. There has been some success in transplanting ganglion cells into the rat bladder. The ganglion cells will sprout into the surrounding tissue but functional connections between the axons of the transplanted neurons, and the detrusor smooth muscle have so far not been demonstrated. Neurotrophins or neurotrimin might be injected into the bladder wall to increase the sprouting of existing or transplanted neurons. Stem cell transplantation has been performed and improves detrusor function, but it has so far, been difficult to demonstrate transplanted stem cells. BOO, persisting detrusor underactivity, and decreased nerve density are often combined with inflammatory activity of the lower urinary tract. NLR family pyrin domain containing 3 (NLRP3) and its messenger RNA (mRNA) as well as cyclooxygenase-2 (Cox-2) mRNA are increased in obstructed bladders. Systemic treatment with the NLRP3 inhibitor glyburide normalized nerve density in rat bladder, and, to some extent, bladder function. It is unclear whether Cox-2 is involved in the decreased nerve density following obstruction, but Cox-2 mRNA increases 5-fold in obstructed bladder. Future therapy against bladder underactivity remaining following relief of obstruction includes either systemic treatment, perhaps by anti-inflammatory drugs, or local treatment by injection of stem cells, mature ganglion cells, and/or neurotrophins or neurotrimin into the bladder wall.
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Affiliation(s)
- Bengt Uvelius
- Department of Urology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Karl-Erik Andersson
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Wake Forest Institute for Regenerative Medicine, Winston Salem, NC, USA
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2
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Michel MC, Arioglu-Inan E. Function and morphology of the urinary bladder after denervation. Am J Physiol Regul Integr Comp Physiol 2021; 320:R833-R834. [PMID: 33789439 DOI: 10.1152/ajpregu.00093.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Martin C Michel
- Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany
| | - Ebru Arioglu-Inan
- Department of Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
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3
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Hughes FM, Sexton SJ, Ledig PD, Yun CE, Jin H, Purves JT. Bladder decompensation and reduction in nerve density in a rat model of chronic bladder outlet obstruction are attenuated with the NLRP3 inhibitor glyburide. Am J Physiol Renal Physiol 2018; 316:F113-F120. [PMID: 30353742 DOI: 10.1152/ajprenal.00400.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Bladder outlet obstruction (BOO) leads to progressive voiding dysfunction. Acutely, obstruction triggers inflammation that drives bladder dysfunction. Over time, inflammation leads to decreased bladder nerve density and increased fibrosis, responsible for eventual decompensation and irreversibility. We have previously shown that BOO triggers inflammation, reduced bladder nerve density and increased fibrosis via activation of the NLRP3 inflammasome in an acutely obstructed (12-day) rat model. However, as BOO progresses, the bladder may become decompensated with an increase in postvoid residual volume and decreased voiding efficiency. Currently, we have examined rat bladder function and nerve densities after chronic BOO to determine whether NLRP3 plays a role in the decompensation at this stage. Four groups were examined: control, sham-operated, BOO, or BOO+gly (glyburide; an NLRP3 inhibitor). After 42 days, bladder weight, inflammation (Evans blue), urodynamics, and nerve density were measured. BOO greatly enhanced bladder weights and inflammation, while inflammation was prevented by glyburide. Voiding pressures were increased, and flow rates decreased in BOO and BOO+gly groups, demonstrating physical obstruction. No difference in frequency or voided volume was detected. However, postvoid residual volumes were greatly increased in BOO rats while BOO+gly rats were not different than controls. Moreover, there was a dramatic decrease in voiding efficiency in the chronic BOO rats, which was prevented with glyburide treatment. Finally, a reduction in nerve density was apparent with BOO and attenuated with glyburide. Together the results suggest a critical role for NLRP3 in mediating bladder decompensation and nerve density during chronic BOO.
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Affiliation(s)
- Francis M Hughes
- Department of Surgery, Division of Urology, Duke University Medical Center , Durham, North Carolina.,Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Stephanie J Sexton
- Department of Surgery, Division of Urology, Duke University Medical Center , Durham, North Carolina
| | - Patrick D Ledig
- Department of Surgery, Division of Urology, Duke University Medical Center , Durham, North Carolina
| | - Chloe E Yun
- Department of Surgery, Division of Urology, Duke University Medical Center , Durham, North Carolina
| | - Huixia Jin
- Department of Surgery, Division of Urology, Duke University Medical Center , Durham, North Carolina
| | - J Todd Purves
- Department of Surgery, Division of Urology, Duke University Medical Center , Durham, North Carolina.,Department of Bioengineering, Clemson University , Clemson, South Carolina.,Department of Pediatrics, Duke University Medical Center , Durham, North Carolina
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4
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Modulation of lower urinary tract smooth muscle contraction and relaxation by the urothelium. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2018; 391:675-694. [DOI: 10.1007/s00210-018-1510-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/08/2018] [Indexed: 10/14/2022]
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Yoshida S, Noma T, Miyoshi K, Tsukihara H, Orimoto N, Hakozaki A, Sasaki E. Therapeutic effect of TAC-302, a cyclohexenoic fatty alcohol derivative, on bladder denervation-related storage and voiding dysfunctions in rats. Neurourol Urodyn 2018; 37:2106-2113. [PMID: 29635706 DOI: 10.1002/nau.23571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/26/2018] [Indexed: 11/06/2022]
Abstract
AIMS To evaluate the therapeutic effect of TAC-302, a cyclohexenoic fatty alcohol derivative, on bladder denervation-related storage and voiding dysfunctions in rats with bladder outlet obstruction (BOO). METHODS BOO was achieved by partial ligature of the proximal urethra in female rats. Two weeks later, BOO rats were divided into two groups and treated orally with vehicle or 10 mg/kg TAC-302 twice a day for 4 weeks. Urodynamic and immunohistochemical evaluation of the bladder muscle layer was performed. In another study, the BOO rats were treated with intravenous tamsulosin at cystometry. The detrusor contractility in each group was evaluated using the modified Shafer's nomogram. RESULTS Two weeks after BOO, the rats showed significant increases in non-voiding contraction (NVCs) and residual urine volume (RUV) compared to the sham group. Moreover, 6 weeks after BOO, BOO vehicle rats showed significant increases in NVCs and RUV and decreases in detrusor contractility and in the nerve fiber density in the urinary bladder compared to the sham group. BOO-induced denervation of the urinary bladder was partially improved by oral treatment with TAC-302. Oral treatment with TAC-302 significantly reduced the amplitude and frequency of NVCs (P < 0.05) and increased detrusor contractility and tended to reduce RUV compared with the BOO vehicle group. In contrast, the intravenous administration of tamsulosin significantly reduced the frequency of NVCs, but not RUV. CONCLUSIONS TAC-302 improved storage and voiding dysfunctions by improving bladder denervation and detrusor underactivity even when the treatment was started after storage and voiding dysfunctions had already occurred.
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Affiliation(s)
- Shohei Yoshida
- Taiho Pharmaceutical Co. Ltd., Drug Discovery and Development II, Tsukuba, Japan
| | - Takahisa Noma
- Taiho Pharmaceutical Co. Ltd., Drug Discovery and Development II, Tsukuba, Japan
| | - Kazuhisa Miyoshi
- Taiho Pharmaceutical Co. Ltd., Clinical Development II, Tokyo, Japan
| | - Hiroshi Tsukihara
- Taiho Pharmaceutical Co. Ltd., Drug Discovery and Development II, Tsukuba, Japan
| | - Naoki Orimoto
- Taiho Pharmaceutical Co. Ltd., Drug Discovery and Development II, Tsukuba, Japan
| | - Atsushi Hakozaki
- Taiho Pharmaceutical Co. Ltd., Drug Discovery and Development II, Tsukuba, Japan
| | - Eiji Sasaki
- Taiho Pharmaceutical Co. Ltd., Drug Discovery and Development II, Tsukuba, Japan
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6
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Arioglu Inan E, Ellenbroek JH, Michel MC. A systematic review of urinary bladder hypertrophy in experimental diabetes: Part I. Streptozotocin‐induced rat models. Neurourol Urodyn 2018; 37:1212-1219. [DOI: 10.1002/nau.23490] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 12/24/2017] [Indexed: 12/18/2022]
Affiliation(s)
| | - Johanne H. Ellenbroek
- Department of Internal MedicineLeiden University Medical CentreLeidenThe Netherlands
| | - Martin C. Michel
- Department of PharmacologyJohannes Gutenberg UniversityMainzGermany
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Inouye BM, Hughes FM, Sexton SJ, Purves JT. The Emerging Role of Inflammasomes as Central Mediators in Inflammatory Bladder Pathology. Curr Urol 2017; 11:57-72. [PMID: 29593464 DOI: 10.1159/000447196] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 07/09/2017] [Indexed: 12/18/2022] Open
Abstract
Irritative voiding symptoms (e.g. increased frequency and urgency) occur in many common pathologic conditions such as urinary tract infections and bladder outlet obstruction, and these conditions are well-established to have underlying inflammation that directly triggers these symptoms. However, it remains unclear as to how such diverse stimuli individually generate a common inflammatory process. Jürg Tschopp provided substantial insight into this conundrum when, working with extracts from THP-1 cells, he reported the existence of the inflammasome. He described it as a structure that senses multiple diverse signals from intracellular/extracellular sources and pathogens and triggers inflammation by the maturation and release of the pro-inflammatory cytokines interleukin-1β and interleukin-18. Recently, many of these sensors were found in the bladder and the nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3, has been shown to be a central mediator of inflammation in several urological diseases. In this review, we introduce the nucleotide-binding domain, leucine-rich-containing family, pyrin domaincontaining-3 inflammasome, highlight its emerging role in several common urologic conditions, and speculate on the potential involvement of other inflammasomes in bladder pathology.
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Affiliation(s)
- Brian M Inouye
- Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - Francis M Hughes
- Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - Stephanie J Sexton
- Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA
| | - J Todd Purves
- Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC, USA
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8
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Ladi-Seyedian SS, Nabavizadeh B, Sharifi-Rad L, Kajbafzadeh AM. Pharmacological treatments available for the management of underactive bladder in neurological conditions. Expert Rev Clin Pharmacol 2017; 11:193-204. [DOI: 10.1080/17512433.2018.1411801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Seyedeh-Sanam Ladi-Seyedian
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Nabavizadeh
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Lida Sharifi-Rad
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Physical Therapy, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdol-Mohammad Kajbafzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Lütolf R, Hughes FM, Inouye BM, Jin H, McMains JC, Pak ES, Hannan JL, Purves JT. NLRP3/IL-1β mediates denervation during bladder outlet obstruction in rats. Neurourol Urodyn 2017; 37:952-959. [PMID: 28984997 DOI: 10.1002/nau.23419] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 09/06/2017] [Indexed: 12/18/2022]
Abstract
AIMS Denervation of the bladder is a detrimental consequence of bladder outlet obstruction (BOO). We have previously shown that, during BOO, inflammation triggered by the NLRP3 inflammasome in the urothelia mediates physiological bladder dysfunction and downstream fibrosis in rats. The aim of this study was to assess the effect of NLRP3-mediated inflammation on bladder denervation during BOO. METHODS There were five groups of rats: (i) Control (no surgery); (ii) Sham-operated; (iii) BOO rats given vehicle; (iv) BOO rats given the NLRP3 inhibitor glyburide; and (v) BOO rats given the IL-1 receptor antagonist anakinra. BOO was constructed by ligating the urethra over a 1 mm catheter and removing the catheter. Medications were given prior to surgery and once daily for 12 days. Bladder sections were stained for PGP9.5, a pan-neuronal marker. Whole transverse sections were used to identify and count nerves while assessing cross-sectional area. For in vitro studies, pelvic ganglion neurons were isolated and treated with IL-1β. After a 48 h incubation apoptosis, neurite length and branching were assessed. RESULTS In obstructed bladders, the number of nerves decreased while total area increased, indicating a loss of cell number and/or branching. The decrease in nerve density was blocked by glyburide or anakinra, clearly implicating the NLRP3 pathway in denervation. In vitro analysis demonstrated that IL-1β, a product of the inflammasome, induced apoptosis in pelvic ganglion neurons, suggesting one mechanism of BOO-induced denervation is NLRP3/IL-1β triggered apoptosis. CONCLUSIONS The NLRP3/IL-1β-mediated inflammation pathway plays a significant role in denervation during BOO.
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Affiliation(s)
- Robin Lütolf
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Surgery, Department of Urology, Duke University Medical Center, Durham, North Carolina
| | - Francis M Hughes
- Division of Surgery, Department of Urology, Duke University Medical Center, Durham, North Carolina
| | - Brian M Inouye
- Division of Surgery, Department of Urology, Duke University Medical Center, Durham, North Carolina
| | - Huixia Jin
- Division of Surgery, Department of Urology, Duke University Medical Center, Durham, North Carolina
| | - Jennifer C McMains
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Elena S Pak
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Johanna L Hannan
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - J Todd Purves
- Division of Surgery, Department of Urology, Duke University Medical Center, Durham, North Carolina
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10
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Shiina K, Hayashida KI, Ishikawa K, Kawatani M. ATP release from bladder urothelium and serosa in a rat model of partial bladder outlet obstruction. Biomed Res 2017; 37:299-304. [PMID: 27784873 DOI: 10.2220/biomedres.37.299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Overactive bladder is one of the major health problem especially in elderly people. Adenosine triphosphate (ATP) is released from urinary bladder cells and acts as a smooth muscle contraction and sensory signal in micturition but little is known about the role of ATP release in the pathophysiology of overactive bladder. To assess the relationship between ATP and overactive bladder, we used a partial bladder outlet obstruction (pBOO) model in rats. The bladder caused several changes by pBOO: An increase in bladder weight, hypertrophy of sub-urothelium and sub-serosal area, and frequent non-voiding bladder contraction during urine storage. Basal ATP release from urothelium and serosa of pBOO rats was significantly higher than that of normal rats. Distentioninduced ATP release from urothelium of normal and pBOO rats had no significant change. However, distention-induced ATP release from serosa of pBOO rats was higher than that of normal. These findings may identify ATP especially released from serosa as one of causes of non-voiding contractions and overactive bladder symptoms.
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Affiliation(s)
- Kazuhiro Shiina
- Departments of Neurophysiology, Akita University Graduate School of Medicine
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11
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Michel MC, Chess-Williams R, Hegde SS. Are blood vessels a target to treat lower urinary tract dysfunction? Naunyn Schmiedebergs Arch Pharmacol 2015; 388:687-94. [PMID: 26026700 DOI: 10.1007/s00210-015-1137-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 01/12/2023]
Abstract
Bladder dysfunction is common in the general population (Stewart et al. 2010) and even more so among patients seeing a physician for any reason (Goepel et al. 2002). It often manifests as lower urinary tract symptoms (LUTS), a term originally coined to describe voiding and storage symptoms in men with benign prostatic hyperplasia (BPH) but now more universally used to describe any type of voiding and storage symptoms in both sexes. Studies into possible causes of urinary bladder dysfunction have long focused on detrusor smooth muscle cells (Turner and Brading 1999). More recently, it became clear that several other types of cells and organs contribute to regulating detrusor smooth muscle function. These include the urothelium (Andersson and McCloskey 2014; Michel 2015), afferent nerves (Michel and Igawa 2015; Yoshimura et al. 2014b), and the central and autonomic nervous systems (Fowler and Griffiths 2010; Yoshimura et al. 2014a). Alterations in any of these may at least partly be responsible for detrusor dysfunction and, accordingly, be potential targets for the treatment of bladder dysfunction. As highlighted by an article in this issue of Naunyn-Schmiedeberg's Archives of Pharmacology (Bayrak et al. 2015), there is an additional suspect, the bladder vasculature. This article will discuss the currently available experimental and clinical evidence for a role of the vasculature in causing bladder dysfunction, and how existing and emerging treatments may modulate bladder function by acting on blood vessels. Due to a similarity in concept, data on prostate perfusion will also be discussed to some extent.
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Affiliation(s)
- Martin C Michel
- Department of Pharmacology, Johannes Gutenberg Universität, Obere Zahlbacher Str. 67, 55101, Mainz, Germany,
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12
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Michel MC, Igawa Y. Therapeutic targets for overactive bladder other than smooth muscle. Expert Opin Ther Targets 2015; 19:687-705. [DOI: 10.1517/14728222.2015.1009447] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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13
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MICHISHITA M, YANO K, KASAHARA KI, TOMITA KI, MATSUZAKI O. Increased expression of 5-HT2A and 5-HT2B receptors in detrusor muscle after partial bladder outlet obstruction in rats . Biomed Res 2015; 36:187-94. [DOI: 10.2220/biomedres.36.187] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mai MICHISHITA
- Laboratory for Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation
| | - Kazuo YANO
- Laboratory for Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation
| | - Ken-ichi KASAHARA
- Laboratory for Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation
| | - Ken-ichi TOMITA
- Laboratory for Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation
| | - Osamu MATSUZAKI
- Laboratory for Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation
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14
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Michel MC. Therapeutic modulation of urinary bladder function: multiple targets at multiple levels. Annu Rev Pharmacol Toxicol 2014; 55:269-87. [PMID: 25251997 DOI: 10.1146/annurev-pharmtox-010814-124536] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Storage dysfunction of the urinary bladder, specifically overactive bladder syndrome, is a condition that occurs frequently in the general population. Historically, pathophysiological and treatment concepts related to overactive bladder have focused on smooth muscle cells. Although these are the central effector, numerous anatomic structures are involved in their regulation, including the urothelium, afferent and efferent nerves, and the central nervous system. Each of these structures involves receptors for—and the urothelium itself also releases—many mediators. Moreover, hypoperfusion, hypertrophy, and fibrosis can affect bladder function. Established treatments such as muscarinic antagonists, β-adrenoceptor agonists, and onabotulinumtoxinA each work in part through their effects on the urothelium and afferent nerves, as do α1-adrenoceptor antagonists in the treatment of voiding dysfunction associated with benign prostatic hyperplasia; however, none of these treatments are specifically targeted to the urothelium and afferent nerves. It remains to be explored whether future treatments that specifically act at one of these structures will provide a therapeutic advantage.
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Affiliation(s)
- Martin C Michel
- Department of Pharmacology, Johannes Gutenberg University, 55101 Mainz, Germany;
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15
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Iguchi N, Hou A, Koul HK, Wilcox DT. Partial Bladder Outlet Obstruction in Mice May Cause E-Cadherin Repression through Hypoxia Induced Pathway. J Urol 2014; 192:964-72. [DOI: 10.1016/j.juro.2014.03.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 11/16/2022]
Affiliation(s)
- Naoko Iguchi
- Division of Urology, Department of Surgery, University of Colorado School of Medicine and Children's Hospital Colorado (AH, DTW), Aurora, Colorado
| | - Amy Hou
- Division of Urology, Department of Surgery, University of Colorado School of Medicine and Children's Hospital Colorado (AH, DTW), Aurora, Colorado
| | - Hari K. Koul
- Division of Urology, Department of Surgery, University of Colorado School of Medicine and Children's Hospital Colorado (AH, DTW), Aurora, Colorado
| | - Duncan T. Wilcox
- Division of Urology, Department of Surgery, University of Colorado School of Medicine and Children's Hospital Colorado (AH, DTW), Aurora, Colorado
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16
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Arrighi N, Bodei S, Zani D, Michel MC, Simeone C, Cosciani Cunico S, Spano P, Sigala S. Different muscarinic receptor subtypes modulate proliferation of primary human detrusor smooth muscle cells via Akt/PI3K and map kinases. Pharmacol Res 2013; 74:1-6. [PMID: 23628881 DOI: 10.1016/j.phrs.2013.04.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 04/20/2013] [Accepted: 04/22/2013] [Indexed: 11/17/2022]
Abstract
While acetylcholine (ACh) and muscarinic receptors in the bladder are mainly known for their role in the regulation of smooth muscle contractility, in other tissues they are involved in tissue remodelling and promote cell growth and proliferation. In the present study we have used primary cultures of human detrusor smooth muscle cells (HDSMCs), in order to investigate the role of muscarinic receptors in HDSMC proliferation. Samples were obtained as discarded tissue from men >65 years undergoing radical cystectomy for bladder cancer and cut in pieces that were either immediately frozen or placed in culture medium for the cell culture establishment. HDSMCs were isolated from samples, propagated and maintained in culture. [(3)H]-QNB radioligand binding on biopsies revealed the presence of muscarinic receptors, with a Kd of 0.10±0.02nM and a Bmax of 72.8±0.1fmol/mg protein. The relative expression of muscarinic receptor subtypes, based on Q-RT-PCR, was similar in biopsies and HDSMC with a rank order of M2≥M3>M1>M4>M5. The cholinergic agonist carbachol (CCh, 1-100μM) concentration-dependently increased [(3)H]-thymidine incorporation (up to 46±4%). This was concentration-dependently inhibited by the general muscarinic receptor antagonist atropine and by subtype-preferring antagonists with an order of potency of darifenacin >4-DAMP>AF-DX 116. The CCh-induced cell proliferation was blocked by selective PI-3 kinase and ERK activation inhibitors, strongly suggesting that these intracellular pathways mediate, at least in part, the muscarinic receptor-mediated cell proliferation. This work shows that M2 and M3 receptors can mediate not only HDSM contraction but also proliferation; they may also contribute bladder remodelling including detrusor hypertrophy.
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Affiliation(s)
- Nicola Arrighi
- Urology Unit, Istituto Clinico Città di Brescia, Brescia, Italy.
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17
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Sakai T, Kasahara KI, Tomita KI, Ikegaki I, Kuriyama H. 5-Hydroxytryptamine-induced bladder hyperactivity via the 5-HT2A receptor in partial bladder outlet obstruction in rats. Am J Physiol Renal Physiol 2013; 304:F1020-7. [PMID: 23344575 DOI: 10.1152/ajprenal.00365.2012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We investigated the effects of partial bladder outlet obstruction (BOO) on the function and gene expression of 5-hydroxytryptamine (5-HT) receptor subtypes in rat bladder. Isometric contractions of the isolated bladders from sham-operated control and BOO rats were examined. The contractile responses to 5-HT were significantly increased in BOO rat bladder strips, while the responses to KCl, carbachol, or phenylephrine were not different from the control. The 5-HT-induced hypercontraction in BOO rat bladder strips was inhibited by ketanserin, a 5-HT(2A) receptor antagonist. The contractile responses to 5-HT in bladder strips were not affected by urothelium removal from the intact bladder. The gene expression of 5-HT receptor subtypes in the bladders was analyzed by RT-PCR. The mRNA expression of the 5-HT(2A), 5-HT(2B), 5-HT(2C), 5-HT(4), and 5-HT(7) receptors was detected in both the control and BOO rat bladders. Quantitative RT-PCR analysis showed there was a significant increase of 5-HT(2A) receptor mRNA in the BOO rat bladder compared with the control bladder. On the other hand, the gene expression of the 5-HT(4) receptor was not changed in the BOO rat bladder. These results suggest that the increased contractile responses to 5-HT in BOO rat bladder may be partly caused by 5-HT(2A) receptor upregulation in the detrusor smooth muscles.
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Affiliation(s)
- Takumi Sakai
- Laboratory for Development Pharmacology, Pharmaceuticals Research Center, Asahi Kasei Pharma Corporation, Izunokuni-shi, Shizuoka, Japan
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18
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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: 4] [Impact Index Per Article: 0.3] [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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Arrighi N, Bodei S, Lucente A, Michel MC, Zani D, Simeone C, Cunico SC, Spano P, Sigala S. Muscarinic receptors stimulate cell proliferation in the human urothelium-derived cell line UROtsa. Pharmacol Res 2011; 64:420-5. [DOI: 10.1016/j.phrs.2011.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 05/27/2011] [Accepted: 06/13/2011] [Indexed: 01/20/2023]
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Amelink A, Kok DJ, Sterenborg HJCM, Scheepe JR. In vivo measurement of bladder wall oxygen saturation using optical spectroscopy. JOURNAL OF BIOPHOTONICS 2011; 4:715-720. [PMID: 21842487 DOI: 10.1002/jbio.201100043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 08/01/2011] [Accepted: 08/01/2011] [Indexed: 05/31/2023]
Abstract
Current diagnosis, follow-up and treatment of patients suffering from bladder dysfunction are mainly symptom-targeted. A recently recognized cause of continuing bladder function loss is a deteriorated bladder microvasculature. Incorporating this aspect into the clinical diagnostic toolbox may improve treatment results. Recent developments in the field of optical spectroscopy now allow for non-invasive measurement of microvascular blood oxygen saturation in living tissue. We have recently reported pre-clinical data that show that this marker can be successfully measured in an animal bladder. In the animal model the marker differentiated bladders with loss of function from those with normal function. In the present paper, we report on the first in vivo measurement of this marker in the human bladder, as proof of principle, in the muscle of bladders with a normal function.
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Affiliation(s)
- Arjen Amelink
- Center for Optical Diagnostics and Therapy, Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.
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Kim SO, Oh BS, Chang IY, Song SH, Ahn K, Hwang EC, Oh KJ, Kwon D, Park K. Distribution of interstitial cells of Cajal and expression of nitric oxide synthase after experimental bladder outlet obstruction in a rat model of bladder overactivity. Neurourol Urodyn 2011; 30:1639-45. [PMID: 21780165 DOI: 10.1002/nau.21144] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 03/28/2011] [Indexed: 11/08/2022]
Abstract
AIMS Recent studies have showed that interstitial cells (ICs) are widely distributed in the genitourinary tract and have suggested their involvement in spontaneous electrical activity and muscle contraction. Nitric oxide (NO) is thought to play a role in bladder overactivity related with bladder outlet obstruction (BOO). The purposes of this study were to investigate the effect of bladder overactivity induced by BOO on ICs and nitric oxide synthase (NOS) isoforms in rat urinary bladder. METHODS Female Sprague-Dawley rats (230-240 g, n = 40) were divided into two groups: control (group Con, n = 20) and partial BOO (group BOO, n = 20). After 4 weeks, urodynamic studies measuring contraction interval and contraction pressure were done. The cellular localization of cKit immunoreactive ICs and the expression of endothelial NOS (eNOS) and neuronal NOS (nNOS) were determined by Western blot and immunohistochemistry in the rat urinary bladder. RESULTS Filling cystometry studies demonstrated a reduced interval between voiding contractions and an increased voiding pressure in BOO bladders. The contraction interval time (2.9 ± 0.35 min) was significantly decreased in the BOO group compared to the control (6.1 ± 0.05; P < 0.05). The population of ICs was increased in the suburothelial and muscle layers in BOO bladders. ICs had a close contact with each other and neighboring nNOS expressing cells. CONCLUSIONS These results demonstrated an increased population of ICs in the BOO rat model and suggest that the functional change of ICs and NOS isoforms may contribute to the pathophysiology of bladder overactivity induced by BOO.
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Affiliation(s)
- Sun-Ouck Kim
- Department of Urology, Chonnam National University Medical School, Gwangju, South Korea
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Aydin M, Downing K, Villegas G, Zhang X, Chua R, Melman A, DiSanto ME. The sphingosine-1-phosphate pathway is upregulated in response to partial urethral obstruction in male rats and activates RhoA/Rho-kinase signalling. BJU Int 2010; 106:562-71. [DOI: 10.1111/j.1464-410x.2009.09156.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Michel MC, Chapple CR. Basic Mechanisms of Urgency: Preclinical and Clinical Evidence. Eur Urol 2009; 56:298-307. [DOI: 10.1016/j.eururo.2009.05.028] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 05/12/2009] [Indexed: 10/20/2022]
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Barendrecht MM, Frazier EP, Vrydag W, Alewijnse AE, Peters SLM, Michel MC. The effect of bladder outlet obstruction on alpha1- and beta-adrenoceptor expression and function. Neurourol Urodyn 2009; 28:349-55. [PMID: 19034955 DOI: 10.1002/nau.20642] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIMS To explore possible changes in expression and/or function of alpha(1)- and beta-adrenoceptor subtypes as a cause for bladder dysfunction in a rat model of bladder outlet obstruction (BOO). METHODS BOO was induced in rats by partial urethral ligature. Contraction and relaxation experiments were performed with isolated bladder strips from BOO, sham-operated and non-operated (control) rats 7 days after BOO induction. mRNA expression of alpha(1)- and beta-adrenoceptor subtypes was assessed by quantitative real-time PCR. RESULTS Receptor-independent contraction or relaxation did not differ between BOO and sham rats. The alpha(1)-agonists methoxamine and A-61,603 caused only weak contraction without major differences between groups. Against KCl-induced tone, the beta-adrenoceptor agonists noradrenaline and isoprenaline caused similar relaxation in BOO and sham rats, whereas relaxation in response to the beta(3)-selective BRL 37,344 was attenuated. Against passive tension, noradrenaline induced relaxation in sham and control rats; in contrast, noradrenaline induced contraction at low concentrations and relaxation at high concentrations in BOO rats. The contraction component was abolished by the alpha(1)-antagonist prazosin. The mRNA expression of alpha(1D)-adrenoceptors was increased in BOO, whereas none of the other receptor mRNAs were up-regulated. CONCLUSIONS In a rat BOO model, weak contraction responses to alpha(1)-agonists and relaxation responses to beta-agonists are not altered to a major extent. Nevertheless, relaxation responses to the endogenous agonist noradrenaline are turned into alpha(1)-adrenoceptor-mediated contraction responses in BOO, possibly due to an up-regulation of alpha(1D)-adrenoceptors.
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Affiliation(s)
- Maurits M Barendrecht
- Department of Pharmacology and Pharmacotherapy, Academic Medical Center, Amsterdam, The Netherlands
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Wolffenbuttel K, de Jong B, Scheepe J, Kok D. Potential for recovery in bladder function after removing a urethral obstruction. Neurourol Urodyn 2008; 27:782-8. [DOI: 10.1002/nau.20588] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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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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Michel MC, Barendrecht MM. Physiological and pathological regulation of the autonomic control of urinary bladder contractility. Pharmacol Ther 2008; 117:297-312. [DOI: 10.1016/j.pharmthera.2007.12.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Accepted: 12/04/2007] [Indexed: 01/10/2023]
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Barendrecht MM, Oelke M, Laguna MP, Michel MC. Is the use of parasympathomimetics for treating an underactive urinary bladder evidence-based? BJU Int 2007; 99:749-52. [PMID: 17233798 DOI: 10.1111/j.1464-410x.2006.06742.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An underactive urinary bladder (UUB), often occurring after surgery, can lead to urinary retention even in otherwise healthy people. We systematically reviewed published reports to determine whether the use of parasympathomimetic agents is warranted in patients with a UUB. Agents allegedly useful in treating UUB were identified from urology and pharmacology textbooks. A systematic search for randomized clinical trials in patients with UUB using these agents revealed 10 such studies. Controls typically received placebo or no treatment. While three studies reported statistically significant improvements relative to the control group, six did not and one even reported a significant worsening of symptoms. There was no evidence for differences between individual drugs, specific uses of such drugs, or in outcome measures. We conclude that the available studies do not support the use of parasympathomimetics for treating UUB, specifically when frequent and/or serious possible side-effects are taken into account.
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