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Schmidt P, Perniss A, Bodenbenner-Tuerich M, Wiegand S, Briand L, Deckmann K. Tas1R3 Dependent and Independent Recognition of Sugars in the Urethra and the Role of Tuft Cells in this Process. Adv Biol (Weinh) 2024; 8:e2400117. [PMID: 38548667 DOI: 10.1002/adbi.202400117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Indexed: 06/16/2024]
Abstract
Increased sugar concentrations on mucosal surfaces display risk factors for infections. This study aims to clarify sugar monitoring in the urethra. Urethral tuft cells (UTC) are known sentinels monitoring the urethral lumen for potentially harmful substances and initiating protective mechanisms. Next-generation sequencing (NGS), RT-PCR, and immunohistochemistry show expression of the taste receptor Tas1R3 in murine UTC, a crucial component of the classical sweet detection pathway. Isolated UTC respond to various sugars with an increase of intracellular [Ca2+]. The Tas1R3 inhibitor gurmarin and Tas1R3 deletion reduces these responses. Utilizing mice lacking UTC, glibenclamide, a K+-ATP channel antagonist, and phlorizin, a SGLT1 inhibitor, reveal an additional Tas1R3 independent sweet detection pathway. Inhibition of both pathways abrogates the sugar responses. Rat cystometry shows that intraurethral application of sucrose and glucose increases detrusor muscle activity Tas1R3 dependently. Sugar monitoring in the urethra occurs via two distinct pathways. A Tas1R3 dependent pathway, exclusive to UTC, and a Tas1R3 independent sweet detection pathway, which can be found both in UTC and in other urethral epithelial cells.
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Affiliation(s)
- Patricia Schmidt
- Institute for Anatomy and Cell Biology, Justus-Liebig-University Giessen, 35385, Giessen, Germany
- Leibniz Institute on Aging-Fritz Lipmann Institute, 07745, Jena, Germany
| | - Alexander Perniss
- Institute for Anatomy and Cell Biology, Justus-Liebig-University Giessen, 35385, Giessen, Germany
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital and Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | | | - Silke Wiegand
- Institute for Anatomy and Cell Biology, Justus-Liebig-University Giessen, 35385, Giessen, Germany
| | - Loic Briand
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, F-21000, France
| | - Klaus Deckmann
- Institute for Anatomy and Cell Biology, Justus-Liebig-University Giessen, 35385, Giessen, Germany
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2
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Burns RT, Arnold PJ, Song L, Moss KL, Powell CR. An analysis of urodynamic parameters in diabetic and nondiabetic women. Neurourol Urodyn 2024. [PMID: 38808694 DOI: 10.1002/nau.25510] [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: 04/04/2024] [Revised: 05/02/2024] [Accepted: 05/17/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES Diabetes is highly prevalent worldwide, with an estimated 536 million living with diabetes in 2021, and that number projected to increase to 783 million by 2045. Diabetic bladder dysfunction is thought to affect up to 60%-90% of individuals with diabetes and can significantly impact quality of life. Despite the prevalence of diabetic bladder dysfunction, the exact pathophysiological mechanism, and resulting clinical presentation, remains debated. Our objective was to compare urodynamic parameters between diabetic and nondiabetic women, assessing the impact of various markers of diabetes severity on bladder function. METHODS A retrospective chart review was conducted on female patients aged 18 and above who underwent urodynamic studies at a single tertiary care university hospital system from 2014 to 2020. Patients were categorized based on diabetes status, and diabetes severity including duration of disease, hemoglobin A1c levels, insulin dependence, and markers of end-organ dysfunction. Urodynamic variables, including compliance, bladder voided efficiency, bladder contractility index, postvoid residual, maximum flow rate, capacity, voided volume, and detrusor overactivity, were assessed by two independent reviewers. Statistical analyses were performed to assess the impact of diabetes and diabetic severity on urodynamic parameters. RESULTS A total of 652 female patients were included in the study, of which, 152 (23.3%) had diabetes, with an average duration of diagnosis of 82.3 months. Diabetic women were older and had higher body mass index compared to nondiabetic women. Diabetic retinopathy and neuropathy were present in 18% and 54.6% of diabetic patients, respectively. Significant differences in urodynamic parameters were observed between diabetic and nondiabetic women, with diabetic women showing higher rates of detrusor overactivity (p = 0.01), particularly associated with increasing BMI (p = 0.03). However, classic markers of diabetes severity including duration, as well as markers of end-organ damage, showed mixed associations with urodynamic changes. CONCLUSIONS Despite the prevalence of diabetic bladder dysfunction and its impact on patient quality of life, the exact mechanisms and clinical presentation remain elusive. Our study highlights the significant differences in urodynamic parameters between diabetic and nondiabetic women, emphasizing the need for further research into the relationship between diabetes and diabetic bladder dysfunction.
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Affiliation(s)
- Ramzy T Burns
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Peter J Arnold
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Leo Song
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kevin L Moss
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Charles R Powell
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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3
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Bea S, Lee H, Park S, Cho YM, Choi WS, Bykov K, Shin JY. Concomitant Use of Sodium-Glucose Cotransporter 2 Inhibitors and Overactive Bladder Drugs and the Risk of Urinary Tract Infection. Clin Pharmacol Ther 2024; 115:1132-1140. [PMID: 38284421 PMCID: PMC11023771 DOI: 10.1002/cpt.3182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/05/2024] [Indexed: 01/30/2024]
Abstract
Concomitant use of sodium glucose cotransporter-2 inhibitors (SGLT-2i) and overactive bladder (OAB) drugs potentially poses a risk of urinary tract infections (UTIs) due to the urinary retention of highly concentrated glucose in the urine. Thus, this study aimed to investigate the risk of UTIs among patients who initiated SGLT-2i treatment while taking OAB drugs. This population-based cohort study included new-users of SGLT-2i or comparator antidiabetics (dipeptidyl peptidase-4 inhibitor (DPP-4i); glucagon-like peptide-1 receptor agonist (GLP-1RA)) with OAB drugs between 2014 and 2020 using claim data from Korea. Primary outcome was a composite UTI event composite end point comprising pyelonephritis, cystitis, and urethritis, using both inpatient and outpatient diagnoses. Propensity score fine stratification was used to adjust for potential confounding factors. Weighted hazard ratios (HR) were calculated using the Cox proportional hazards model. In the first cohort, 796 and 9,181 new-users of SGLT-2i and DPP-4i with OAB drugs were identified, respectively. This study found a similar risk of UTIs in concomitant users of SGLT-2i and DPP-4i (weighted HR 1.08, 95% confidence interval: 0.88-1.32) with OAB drugs. In the second cohort, 2,387 and 280 new-users of SGLT-2i and GLP-1RA with OAB drugs were identified, respectively. Initiation of SGLT-2i while on OAB treatment was not associated with increased risk of UTI (0.89, 0.50-1.60), compared with initiation of GLP-1RA. These results show that the concomitant use of SGLT-2i with OAB drugs was not associated with an increased risk of UTI compared with the concomitant use of DPP-4i or GLP-1RA with OAB drugs.
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Affiliation(s)
- Sungho Bea
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Hyesung Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Sohee Park
- Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom
| | - Young Min Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Ansan Hospital, Ansan, South Korea
| | - Katsiaryna Bykov
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
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Oliveira AL, de Oliveira MG, Mónica FZ, Antunes E. Methylglyoxal and Advanced Glycation End Products (AGEs): Targets for the Prevention and Treatment of Diabetes-Associated Bladder Dysfunction? Biomedicines 2024; 12:939. [PMID: 38790901 PMCID: PMC11118115 DOI: 10.3390/biomedicines12050939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/26/2024] Open
Abstract
Methylglyoxal (MGO) is a highly reactive α-dicarbonyl compound formed endogenously from 3-carbon glycolytic intermediates. Methylglyoxal accumulated in plasma and urine of hyperglycemic and diabetic individuals acts as a potent peptide glycation molecule, giving rise to advanced glycation end products (AGEs) like arginine-derived hydroimidazolone (MG-H1) and carboxyethyl-lysine (CEL). Methylglyoxal-derived AGEs exert their effects mostly via activation of RAGE, a cell surface receptor that initiates multiple intracellular signaling pathways, favoring a pro-oxidant environment through NADPH oxidase activation and generation of high levels of reactive oxygen species (ROS). Diabetic bladder dysfunction is a bothersome urological complication in patients with poorly controlled diabetes mellitus and may comprise overactive bladder, urge incontinence, poor emptying, dribbling, incomplete emptying of the bladder, and urinary retention. Preclinical models of type 1 and type 2 diabetes have further confirmed the relationship between diabetes and voiding dysfunction. Interestingly, healthy mice supplemented with MGO for prolonged periods exhibit in vivo and in vitro bladder dysfunction, which is accompanied by increased AGE formation and RAGE expression, as well as by ROS overproduction in bladder tissues. Drugs reported to scavenge MGO and to inactivate AGEs like metformin, polyphenols, and alagebrium (ALT-711) have shown favorable outcomes on bladder dysfunction in diabetic obese leptin-deficient and MGO-exposed mice. Therefore, MGO, AGEs, and RAGE levels may be critically involved in the pathogenesis of bladder dysfunction in diabetic individuals. However, there are no clinical trials designed to test drugs that selectively inhibit the MGO-AGEs-RAGE signaling, aiming to reduce the manifestations of diabetes-associated bladder dysfunction. This review summarizes the current literature on the role of MGO-AGEs-RAGE-ROS axis in diabetes-associated bladder dysfunction. Drugs that directly inactivate MGO and ameliorate bladder dysfunction are also reviewed here.
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Affiliation(s)
| | | | | | - Edson Antunes
- Department of Translational Medicine, Pharmacology Area, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas 13084-971, SP, Brazil; (A.L.O.); (M.G.d.O.); (F.Z.M.)
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5
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Khan J, Shaw S. Risk of multiple lower and upper urinary tract problems among male older adults with type-2 diabetes: a population-based study. Aging Male 2023; 26:2208658. [PMID: 37256730 DOI: 10.1080/13685538.2023.2208658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
AIM This study explores the risk of diabetes-associated lower and upper urinary tract diseases among male older adults aged 45 and above in India. METHODS Longitudinal Ageing Study in India (LASI), 2017-2018 data was used in this study. The prevalence of various urinary tract problems and diabetes among male older adults was estimated by background characteristics using bivariate cross-tabulation. In addition, multivariate logistic regression was applied to examine the likelihood of urological disorders associated with diabetes. RESULT The prevalence of incontinence was highest among male older adults with diabetes, followed by kidney stones, benign prostatic hyperplasia, and chronic renal failure. Multivariate logistic regression estimation showed that men diagnosed with diabetes were 80% more likely to experience chronic renal failure, 78% more likely to suffer from incontinence, and 37% more likely to suffer from kidney stones than those without diabetes when controlling for various socio-demographic, behavioral, and co-morbidity status of the older adults. CONCLUSIONS The study findings suggest that diabetes is associated with multiple urinary complications among male older adults in India and needs more careful investigation of the phenomenon. Independent risk factors such as changes in lifestyle with regular monitoring and diagnosis may help to prevent the progression of diabetes and reduce the risk of diabetes-associated lower and upper urinary tract diseases among male older adults.
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Affiliation(s)
- Junaid Khan
- International Institute for Population Sciences, Mumbai, India
| | - Subhojit Shaw
- International Institute for Population Sciences, Mumbai, India
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Sirmakesyan S, Hajj A, Hamouda A, Cammisotto P, Campeau L. Synthesis and secretion of Nerve Growth Factor is regulated by Nitric Oxide in bladder cells in vitro under a hyperglycemic environment. Nitric Oxide 2023; 140-141:30-40. [PMID: 37699453 DOI: 10.1016/j.niox.2023.09.002] [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: 07/14/2023] [Revised: 08/23/2023] [Accepted: 09/09/2023] [Indexed: 09/14/2023]
Abstract
Urine samples of female patients with overactive bladder (OAB) are characterized by low levels of nerve growth factor (NGF) and elevated concentrations of nitric oxide (NO) compared to healthy controls. We therefore examined how NO might regulate NGF synthesis using rat bladder smooth muscle (SMCs) and urothelial (UROs) cells in culture. In UROs, incubation in hyperglycemic conditions to mimic insulin insensitivity present in the OAB cohort increased secretion of NO and concomitantly decreased NGF, except when the NO synthase inhibitor, l-NAME (1 mM) was present. Sodium nitroprusside (SNP) (300 μM, 24 h), a NO generator, decreased NGF levels and decreased cyclic GMP (cGMP) content, a process validated by the cGMP synthase inhibitor ODQ (100 μM). Alternatively, SNP increased mRNA of both NGF and matrix metalloproteinase-9 (MMP-9). MMP-9 knockout of UROs by Crispr-Cas9 potently decreased the effect of SNP on NGF, implying a dependent role of NO on MMP-9. On the other hand, matrix metalloproteinase-7 (MMP-7) activity was increased by SNP, which taken together with increase in NGF mRNA, suggests a compensatory mechanism. In SMCs, hyperglycemic conditions had the same effect on extracellular content of NO and NGF than in UROs. SNP also decreased NGF secretion but increased cGMP content. Stable permeable analogs of cGMP 8-(4-Chlorophenylthio)-cGMP (1 mM) and N2,2'-O-Dibutyryl-cGMP (3 mM) inhibited NGF release. NGF and MMP-9 mRNA expression was unchanged by SNP. Deletion of MMP-9 in SMCs by Crispr-Cas9 did not alter the effect of SNP. Finally, SNP decreased MMP-7 activity, diminishing the conversion of proNGF to NGF. These results demonstrate that enhanced NO secretion triggered by high glucose decreases NGF secretion through pathways unique for each cell type that involve cGMP and proteases MMP-7 and MMP-9. These results might help to explain our observations from the urine from patients with OAB associated with metabolic syndrome.
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Affiliation(s)
| | - Aya Hajj
- Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
| | - Aalya Hamouda
- Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
| | | | - Lysanne Campeau
- Lady Davis Institute for Medical Research, Montreal, Quebec, Canada; Urology Department, Jewish General Hospital, Montreal, Quebec, Canada.
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7
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Du H, Xu F, Liu J, Zhang J, Qin Y, Xu Y, Li N. Long-term aspirin administration suppresses inflammation in diabetic cystopathy. Aging (Albany NY) 2023; 15:9128-9143. [PMID: 37702622 PMCID: PMC10522387 DOI: 10.18632/aging.205021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
Diabetic cystopathy (DCP) is one of the most common and troublesome urologic complications of diabetes mellitus, characterized by chronic low-grade inflammatory response. However, the correlation between inflammation and disease progression remains ambiguous and effective drugs interventions remain deficient. Herein, during 12-week study, 48 male Sprague-Dawley rats were randomly assigned to four groups: negative control (NC), NC treated with aspirin (NC+Aspirin), DCP, and DCP treated with aspirin (DCP+Aspirin). Type 1 diabetes mellitus was established by intraperitoneal injection of streptozotocin (65 mg/kg). After 2 weeks modeling, the rats in treatment groups received daily oral aspirin (100 mg/kg/d). After 10 weeks of treatment, aspirin ameliorated pathological weight loss and bladder weight increase in diabetic rats, accompanied by a 16.5% decrease in blood glucose concentrations. H&E, Masson, immunohistochemistry and transmission electron microscopy revealed that a dilated bladder with thickened detrusor smooth muscle (DSM) layer, inflammatory infiltration, fibrosis and ultrastructural damage were observed in diabetic rats, which were obviously ameliorated by aspirin. The dynamic investigations at 4, 7 and 10 weeks revealed inflammation gradually increased as the disease progresses. After 10 weeks of treatment, the expression of TNF-α, IL-1β, IL-6, and NF-κB has been decreased to 78%, 39.7%, 44.1%, 33.3% at mRNA level and 67.6%, 76.7%, 71.4%, 67.1% at protein level, respectively (DCP+Aspirin vs. DCP, p < 0.01). Aspirin partially restored the increased expression of inflammatory mediators in bladder DSM of diabetic rats. The study provided insight into long-term medication therapies, indicating that aspirin might serve as a potential strategy for DCP treatment.
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Affiliation(s)
- Huifang Du
- Department of Urology, Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Feihong Xu
- Department of Urology, Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Jingxuan Liu
- Department of Urology, Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Jiakui Zhang
- Department of Urology, Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Yinhua Qin
- Department of Anatomy, Army Medical University (Third Military Medical University), Chongqing, China
| | - Youqian Xu
- Department of Anatomy, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ning Li
- Department of Urology, Fourth Affiliated Hospital, China Medical University, Shenyang, China
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8
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Chilaka C, Toozs-Hobson P, Chilaka V. Pelvic floor dysfunction and obesity. Best Pract Res Clin Obstet Gynaecol 2023; 90:102389. [PMID: 37541114 DOI: 10.1016/j.bpobgyn.2023.102389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 08/06/2023]
Abstract
Obesity is a growing condition within the society and more patients, who have underlying obesity, are presenting with lower urinary tract symptoms (LUTS) and pelvic floor dysfunction (PFD). The effect of obesity on general health has been well documented, and its impact on the cardiovascular, endocrine, and musculoskeletal systems has been extensively studied. There is now a growing body of evidence on the effects of obesity on the female urogenital system. It seems to influence the prevalence, presentation, assessment, management, and outcome of various types of LUTS and PFD. A holistic approach is needed to assess and manage these patients. A clear understanding of the functions of the pelvic floor and the way it can be affected by obesity is essential in providing holistic care to this group. A frank discussion about patient weight is required in the clinics handling PFD. A multimodal approach to weight loss would help improve PFD symptoms and progression. Patients with obesity should still be offered standard treatment options for all PFDs and should not be forced to lose weight as a prerequisite before starting treatment. However, they should also be made aware of the impediments that being overweight adds to their care and their expectations should be managed accordingly.
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Affiliation(s)
| | | | - Victor Chilaka
- Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar.
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Meile S, Du J, Staubli S, Grossmann S, Koliwer-Brandl H, Piffaretti P, Leitner L, Matter CI, Baggenstos J, Hunold L, Milek S, Guebeli C, Kozomara-Hocke M, Neumeier V, Botteon A, Klumpp J, Marschall J, McCallin S, Zbinden R, Kessler TM, Loessner MJ, Dunne M, Kilcher S. Engineered reporter phages for detection of Escherichia coli, Enterococcus, and Klebsiella in urine. Nat Commun 2023; 14:4336. [PMID: 37474554 PMCID: PMC10359277 DOI: 10.1038/s41467-023-39863-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/03/2023] [Indexed: 07/22/2023] Open
Abstract
The rapid detection and species-level differentiation of bacterial pathogens facilitates antibiotic stewardship and improves disease management. Here, we develop a rapid bacteriophage-based diagnostic assay to detect the most prevalent pathogens causing urinary tract infections: Escherichia coli, Enterococcus spp., and Klebsiella spp. For each uropathogen, two virulent phages were genetically engineered to express a nanoluciferase reporter gene upon host infection. Using 206 patient urine samples, reporter phage-induced bioluminescence was quantified to identify bacteriuria and the assay was benchmarked against conventional urinalysis. Overall, E. coli, Enterococcus spp., and Klebsiella spp. were each detected with high sensitivity (68%, 78%, 87%), specificity (99%, 99%, 99%), and accuracy (90%, 94%, 98%) at a resolution of ≥103 CFU/ml within 5 h. We further demonstrate how bioluminescence in urine can be used to predict phage antibacterial activity, demonstrating the future potential of reporter phages as companion diagnostics that guide patient-phage matching prior to therapeutic phage application.
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Affiliation(s)
- Susanne Meile
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland
| | - Jiemin Du
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland
| | - Samuel Staubli
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland
| | | | | | | | - Lorenz Leitner
- Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | | | - Laura Hunold
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland
| | - Sonja Milek
- Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | | | - Vera Neumeier
- Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Angela Botteon
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland
| | - Jochen Klumpp
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland
| | - Jonas Marschall
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, US
| | - Shawna McCallin
- Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Thomas M Kessler
- Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Matthew Dunne
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland.
| | - Samuel Kilcher
- Institute of Food Nutrition and Health, ETH, Zurich, Switzerland.
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10
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Hughes FM, Allkanjari A, Odom MR, Mulcrone JE, Jin H, Purves JT. Male Akita mice develop signs of bladder underactivity independent of NLRP3 as a result of a decrease in neurotransmitter release from efferent neurons. Am J Physiol Renal Physiol 2023; 325:F61-F72. [PMID: 37167271 PMCID: PMC10292983 DOI: 10.1152/ajprenal.00284.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/26/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023] Open
Abstract
Diabetic bladder dysfunction (DBD) is a prevalent diabetic complication that is recalcitrant to glucose control. Using the Akita mouse model (type 1) bred to be NLR family pyrin domain containing 3 (NLRP3)+/+ or NLRP3-/-, we have previously found that females (mild hyperglycemia) progress from an overactive to underactive bladder phenotype and that this progression was dependent on NLRP3-induced inflammation. Here, we examined DBD in the male Akita mouse (severe hyperglycemia) and found by urodynamics only a compensated underactive-like phenotype (increased void volume and decreased frequency but unchanged efficiency). Surprisingly, this phenotype was still present in the NLRP3-/- strain and so was not dependent on NLRP3 inflammasome-induced inflammation. To examine the cause of the compensated underactive-like phenotype, we assessed overall nerve bundle density and afferent nerve bundles (Aδ-fibers). Both were decreased in density during diabetes, but denervation was absent in the diabetic NLRP3-/- strain so it was deemed unlikely to cause the underactive-like symptoms. Changes in bladder smooth muscle contractility to cell depolarization and receptor activation were also not responsible as KCl (depolarizing agent), carbachol (muscarinic agonist), and α,β-methylene-ATP (purinergic agonist) elicited equivalent contractions in denuded bladder strips in all groups. However, electrical field stimulation revealed a diabetes-induced decrease in contractility that was not blocked in the NLRP3-/- strain, suggesting that the bladder compensated underactive-like phenotype in the male Akita mouse is likely through a decrease in efferent neurotransmitter release.NEW & NOTEWORTHY In this study, we show that diabetic bladder dysfunction (the most common diabetic complication) manifests through different mechanisms that may be related to severity of hyperglycemia and/or sex. Male Akita mice, which have severe hyperglycemia, develop bladder underactivity as a result of a decrease in efferent neurotransmitter release that is independent of inflammation. This contrasts with females, who have milder hyperglycemia, where diabetic bladder dysfunction progresses from overactivity to underactivity in an inflammation-dependent manner.
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Affiliation(s)
- Francis M Hughes
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Armand Allkanjari
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Michael R Odom
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Jack E Mulcrone
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Huixia Jin
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States
| | - J Todd Purves
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States
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11
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Yamada S, Shibagaki Y, Tominaga N. Distended Bladder beyond the Umbilicus: Asymptomatic Diabetic Cystopathy. Intern Med 2023; 62:671-672. [PMID: 35831102 PMCID: PMC10017228 DOI: 10.2169/internalmedicine.0063-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Shohei Yamada
- Division of Nephrology and Hypertension, Kawasaki Municipal Tama Hospital, Japan
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Naoto Tominaga
- Division of Nephrology and Hypertension, Kawasaki Municipal Tama Hospital, Japan
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
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12
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Celik S, Bal MD, Kelleci M. Comparison of sexual functions in women with and without type 1 diabetes. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:216-221. [PMID: 36790230 PMCID: PMC9983465 DOI: 10.1590/1806-9282.20220293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 02/12/2023]
Abstract
OBJECTIVE This study aimed to investigate female sexual function in patients with type 1 diabetes by comparing female sexual function index scores between women with and without type 1 diabetes. METHODS A total of 62 women with type 1 diabetes and 69 age-matched women without diabetes but with similar backgrounds were enrolled in the patient and control groups, respectively. All participants were sexually active and had no systemic diseases other than diabetes in the patient group. RESULTS The frequency of female sexual dysfunction was significantly higher, and the mean female sexual function index score was significantly lower in women with diabetes compared to the control group (p=0.01). There was a significant relationship between sexual dysfunction and duration of diabetes, glycosylated hemoglobin test, and body mass index (p<0.05). CONCLUSION This study demonstrates that female sexual dysfunction is more common among women with type 1 diabetes than among women without type 1 diabetes. Patients with type 1 diabetes should be evaluated in terms of sexual health. Health professionals should give more attention to and provide guidance regarding sexual function in women with type 1 diabetes.
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Affiliation(s)
- Selda Celik
- University of Health Sciences, Hamidiye Faculty of Nursing - Istanbul, Turkey
| | - Meltem Demirgöz Bal
- Marmara University, Health Sciences Faculty, Midwifery Department - Istanbul, Turkey
| | - Meral Kelleci
- Cumhuriyet University, Faculty of Health Sciences, Nursing Department - Sivas, Turkey
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Hughes FM, Odom MR, Cervantes A, Purves J. Inflammation triggered by the NLRP3 inflammasome is a critical driver of diabetic bladder dysfunction. Front Physiol 2022; 13:920487. [PMID: 36505062 PMCID: PMC9733912 DOI: 10.3389/fphys.2022.920487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
Diabetes is a rapidly expanding epidemic projected to affect as many as 1 in 3 Americans by 2050. This disease is characterized by devastating complications brought about high glucose and metabolic derangement. The most common of these complications is diabetic bladder dysfunction (DBD) and estimates suggest that 50-80% of patients experience this disorder. Unfortunately, the Epidemiology of Diabetes Interventions and Complications Study suggests that strict glucose control does not decrease ones risk for incontinence, although it does decrease the risk of other complications such as retinopathy, nephropathy and neuropathy. Thus, there is a significant unmet need to better understand DBD in order to develop targeted therapies to alleviate patient suffering. Recently, the research community has come to understand that diabetes produces a systemic state of low-level inflammation known as meta-inflammation and attention has focused on a role for the sterile inflammation-inducing structure known as the NLRP3 inflammasome. In this review, we will examine the evidence that NLRP3 plays a central role in inducing DBD and driving its progression towards an underactive phenotype.
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Affiliation(s)
- Francis M. Hughes
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC, United States
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14
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Martonosi ÁR, Pázmány P, Kiss S, Zsákai A, Szabó L. INvesTigating the Abnormality of detrusor ConTractility by uroflowmetry in diabetic children (INTACT Trial): protocol of a prospective, observational study. BMJ Open 2022; 12:e062198. [PMID: 36375985 PMCID: PMC9664277 DOI: 10.1136/bmjopen-2022-062198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Bladder emptying abnormalities and cardiovascular autonomic dysfunction are manifestations of autonomic dysfunction in people with diabetes mellitus (DM), which are major causes of morbidity and mortality. Since they can reduce the quality of life, they are urgent to be addressed before resulting in complications. As uroflowmetry might determine autonomic neuropathy earlier than cardiovascular autonomic dysfunction symptoms occur, our aim is to detect early abnormalities in bladder muscle function in children with DM. We investigate the diagnostic accuracy of uroflowmetry. As a secondary aim, we compare the prevalence of uroflowmetry abnormalities to the appearance of measures of cardiovascular autonomic neuropathy. Finally, as an ancillary study, we examine the association of uroflowmetry with the appearance of peripheral neuropathy. These three aims, we feel, will put our results regarding uroflowmetry into an overall context of nerve disease early in the course of type 1 DM. To our knowledge, such an approach has heretofore not been performed. METHODS AND ANALYSIS This will be a prospective, observational, single-centre clinical study. Patients with DM fulfilling the inclusion criteria and healthy controls will have uroflowmetry examination, cardiovascular autonomic dysfunction tests (heart rate response to deep breathing, to Valsalva manoeuvre, blood pressure and heart rate response to standing up, and to sustained handgrip) and nerve conduction test. The autonomic nervous system function will be examined by the reproducible and standardised cardiovascular reflex tests described by Ewing et al. During the examination, electrocardiogram (ECG) and blood pressure values will be recorded continuously. Heart rate response to deep inspiration will be executed to investigate the parasympathetic nervous system. Peripheral neuropathy will be evaluated by nerve conduction test. After a pilot period, when the first 50 diabetic and 50 healthy children will be assessed, sample size calculation will be carried out. The primary objective of this trial is to evaluate the diagnostic accuracy (sensitivity, specificity, positive and negative predictive value) of uroflowmetry. To do so, we compare uroflowmetry to the gold standard neuropathy tests, which are cardiovascular autonomic dysfunction tests (heart rate response to deep breathing, to Valsalva manoeuvre, blood pressure and heart rate response to standing up and to sustained handgrip). ETHICS AND DISSEMINATION Ethics approval was obtained from the Scientific and Research Ethics Committee of the Heim Pál National Paediatric Institute in Budapest, Hungary (registration number KUT-37/2021). Results will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT05247840.
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Affiliation(s)
- Ágnes Rita Martonosi
- Internal Medicine and Pulmonology Department, Heim Pál National Paediatric Institute, Budapest, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Piroska Pázmány
- Internal Medicine and Pulmonology Department, Heim Pál National Paediatric Institute, Budapest, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Szabolcs Kiss
- Internal Medicine and Pulmonology Department, Heim Pál National Paediatric Institute, Budapest, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Annamária Zsákai
- Department of Biological Anthropology, Eotvos Lorand University, Budapest, Hungary
| | - László Szabó
- Internal Medicine and Pulmonology Department, Heim Pál National Paediatric Institute, Budapest, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
- Family Care Methodology Department, Institute of Health Science, Semmelweis University, Budapest, Hungary
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15
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de Silva NL, Athukorala T, Gamage JL, Katulanda G, de Silva P, Sumanatilleke M, Somasundaram N. Sexual dysfunction among men with diabetes; a cross-sectional study at a specialised diabetes clinic in Sri Lanka. BMC Endocr Disord 2022; 22:206. [PMID: 35978307 PMCID: PMC9382620 DOI: 10.1186/s12902-022-01108-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many publications report the prevalence, there is limited data on its associations, impact, and health-seeking behaviour. The objectives were to assess the prevalence of male sexual dysfunction, its associations, impact and treatment-seeking among men with diabetes in a selected tertiary care Diabetes Clinic. METHODS A cross-sectional study was conducted at the Diabetes Clinic, National Hospital of Sri Lanka, from January to September 2020. Men with diabetes aged 18 to 70 years undergoing annual assessment were recruited consecutively. Socio-demographic and clinical information were collected using an interviewer-administered questionnaire. Erectile dysfunction (ED), premature ejaculation, mental health and quality of life were assessed using validated self-administered questionnaires. Cardiovascular autonomic reflex tests and total testosterone levels were performed. Penile colour Doppler ultrasonography was performed on consenting participants with erectile dysfunction. Associations were assessed using the chi-square test or Fisher's exact for dichotomous variables and independent sample t-test for continuous variables. RESULTS Two hundred and twelve participants were recruited with a mean age of 54.1 (SD = 10.1) years. Erectile dysfunction was present in 168 (79.2%), (mild: 45, mild-moderate: 56, moderate: 26, severe: 41). Premature ejaculation was present in 26 (18.7%). Libido was low among 16%. Sexual dysfunction was not revealed to a health provider by 85.6% despite 60.5% experiencing psychological and/or relationship effects. Out of 18 who sought treatment, only 4 achieved a good response. Mean age (55.4 ± 9.5 vs 48.7 ± 10.6 years, p < 0.001) and duration of diabetes (10.9 ± 7.6 vs 5.8 ± 4.6 years, p < 0.001) were higher while eGFR was lower (73.9 ± 27.7 vs 100.51 ± 28.08 years, p < 0.008) among those with ED compared to those without. Diabetic retinopathy (4% vs 42%, p < 0.001), peripheral neuropathy (17.9% vs 38.4%, p = 0.041) and lower limb arterial disease (0% vs 12.2%, p = 0.04) were associated with ED. Arterial insufficiency was seen among 50% of the participants who underwent penile colour Doppler ultrasonography. CONCLUSIONS Male sexual dysfunction is a pervasive yet underappreciated problem in diabetes care despite its effect on the individual. Patient and disease characteristics would guide the identification of high-risk individuals for targeted screening in clinical practice.
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Affiliation(s)
- Nipun Lakshitha de Silva
- Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo, Sri Lanka.
- Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
| | - Tharaka Athukorala
- Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | | - Gaya Katulanda
- Department of Chemical Pathology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Prasad de Silva
- Department of Radiology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | | - Noel Somasundaram
- Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
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16
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Song QX, Sun Y, Deng K, Mei JY, Chermansky CJ, Damaser MS. Potential role of oxidative stress in the pathogenesis of diabetic bladder dysfunction. Nat Rev Urol 2022; 19:581-596. [PMID: 35974244 DOI: 10.1038/s41585-022-00621-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/09/2022]
Abstract
Diabetes mellitus is a chronic metabolic disease, posing a considerable threat to global public health. Treating systemic comorbidities has been one of the greatest clinical challenges in the management of diabetes. Diabetic bladder dysfunction, characterized by detrusor overactivity during the early stage of the disease and detrusor underactivity during the late stage, is a common urological complication of diabetes. Oxidative stress is thought to trigger hyperglycaemia-dependent tissue damage in multiple organs; thus, a growing body of literature has suggested a possible link between functional changes in urothelium, muscle and the corresponding innervations. Improved understanding of the mechanisms of oxidative stress could lead to the development of novel therapeutics to restore the redox equilibrium and scavenge excessive free radicals to normalize bladder function in patients with diabetes.
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Affiliation(s)
- Qi-Xiang Song
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Sun
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Kangli Deng
- Department of Urology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin-Yi Mei
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | | | - Margot S Damaser
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. .,Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. .,Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
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17
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Xu F, Du H, Hou J, Liu J, Li N. Anti-inflammation properties of resveratrol in the detrusor smooth muscle of the diabetic rat. Int Urol Nephrol 2022; 54:2833-2843. [PMID: 35943662 DOI: 10.1007/s11255-022-03334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/22/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE In this paper, we aimed to prove that resveratrol can inhibit inflammation in the detrusor smooth muscle of diabetic rats, which may provide a new direction for diabetic cystopathy (DCP) treatment. METHODS We induced a Sprague-Dawley (SD) rat model of type 1 diabetes by intraperitoneal injections of streptozotocin (STZ). Then, we separated the SD rats into four groups: (1) an excipient-treated control group; (2) a resveratrol-treated control group; (3) an excipient-treated streptozotocin (STZ)-injected group; and (4) a resveratrol-treated STZ-injected group. We administered the resveratrol or excipient by intragastric administration. After 12 weeks of diabetes induction, we measured the blood-sugar concentrations and bladder weights, and we took the bladder tissues of each group of rats for hematoxylin-eosin staining to observe the histological changes. We used real-time quantitative polymerase chain reaction (qPCR) and Western blotting to analyze the expression levels of tumor necrosis factor-alpha (TNF-α), nuclear factor kappa B (NF-κB), interleukin (IL)-6, and IL-1β. RESULTS The bodyweights of the diabetic rats were appreciably reduced, while the bladder weights and blood-glucose concentrations were substantially increased. Oral resveratrol could not improve the changes in the bodyweights and blood-glucose concentrations, but it had a certain effect on the bladder weights. In a macroscopic evaluation, the bladder walls of the STZ-induced diabetes rats were thickened, and, from the H&E staining, we could see that the bladder tissues of the diabetic rats had inflammatory cell infiltration, edema, and the capillary congestion of the mucosa and lamina propria. After resveratrol treatment, the bladder-wall thickening was reduced, and the tissue damage and inflammation were significantly ameliorated. We could associate all these changes with markedly heightened expressions of TNF-α, IL-1β, IL-6, and NF-κB in the detrusor smooth muscle (DSM) tissues of the diabetic rats. Oral treatment with resveratrol alleviated the expressivity of the inflammatory cytokines in the DSM tissues. CONCLUSIONS Resveratrol treatment ameliorated the histological changes in the bladder and inhibited the expressions of DSM-tissue inflammatory factors in diabetes rats. Resveratrol may provide a new direction of research for the treatment of diabetic cystopathy.
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Affiliation(s)
- Feihong Xu
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China
| | - Huifang Du
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China
| | - Jun Hou
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China
| | - Jingxuan Liu
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China
| | - Ning Li
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China.
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18
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Shidid S, Bluth MH, Smith-Norowitz TA. The Role of Inflammasomes in Mediating Urological Disease: A Short Literature Review. J Inflamm Res 2022; 15:4359-4365. [PMID: 35937918 PMCID: PMC9354909 DOI: 10.2147/jir.s370451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/23/2022] [Indexed: 11/23/2022] Open
Abstract
Inflammasome dysfunction may be responsible for underlying inflammatory diseases, which include renal and urological pathologies. Five inflammasomes have been described, including nucleotide-binding domain leucine-rich repeat (NLR), NL pyrin domain containing receptor 1(NLPR1), NLRP3, NLR and caspase recruitment domain containing receptor 4 (NLRC4), and the AIM2-like receptor. The purpose of this study was to review literature sources regarding how innate immunity and inflammasomes contribute to urologic disease and infection. A literature search of PubMed/MEDLINE, EMBASE and Google Scholar articles. Articles were selected for review if their content included (1) inflammasomes and (2) urology in the adult population. The initiation of specific cytokine cascades, which include IL-1β and IL-18, appear responsible for a repertoire of urologic pathologies. Inflammation mediates a wide range of uropathies (urologic disorders and infections) which are found in the bladder, prostate, or kidney and inflammasomes appear to be particularly responsible for urological and renal pathologies. Understanding the role of inflammasomes in urologic disorders can help improve treatment and overall quality of life in patients with these disorders.
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Affiliation(s)
- Sarah Shidid
- Department of Pediatrics, Division of Infectious Diseases, State University of New York Downstate Medical Center, New York, NY, 11203, USA
- Correspondence: Sarah Shidid, Department of Pediatrics, Division of Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn, New York, NY, 11203, USA, Tel +1718 270-1295, Fax +1718 270-3289, Email
| | - Martin H Bluth
- Department of Pathology, Maimonides Medical Center, New York, NY, 11219, USA
| | - Tamar A Smith-Norowitz
- Department of Pediatrics, Division of Infectious Diseases, State University of New York Downstate Medical Center, New York, NY, 11203, USA
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Association of Proteus mirabilis and Providencia stuartii Infections with Diabetes. Medicina (B Aires) 2022; 58:medicina58020271. [PMID: 35208593 PMCID: PMC8880118 DOI: 10.3390/medicina58020271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 01/13/2023] Open
Abstract
Background and Objectives: Proteus and Providencia are related genera of opportunistic pathogens belonging to the Morganellaceae family, often a cause of infections in the immunocompromised hosts, such as diabetic patients. Their clinical significance has increased due to their intrinsic resistance to polymyxins, which is often associated with acquired resistance mechanisms. In this study we evaluated the infections caused by Proteus mirabilis and Providencia stuartii in two groups of patients, with diabetes (group 1) and without diabetes (group 2) admitted to the intensive care unit and surgical wards. The infections were investigated in terms of infection type, risk factors, clinical course, predictive factors for unfavourable outcomes and antibiotic resistance profile. Materials and Methods: An observational, retrospective, cross-sectional study was conducted, comprising all patients infected with these pathogens. Bacterial identification and antibiotic sensitivity testing were performed using the Vitek2C automated system. Results: Comparison of the two groups showed that the statistically significant common infectious risk factors were found less frequently among diabetic patients when compared with non-diabetic patients, and that antimicrobial resistance was significantly lower in the diabetic patient group. However, survival rates did not differ between the two groups, drawing attention to the implications of diabetes as comorbidity. Additionally, with regard to the antibiotic resistance profile, 38.89% of P. stuartii strains isolated from diabetic patients belonged to the difficult-to-treat (DTR) phenotype, contributing to the severity of these infections compared with those caused by P. mirabilis, of which 32% were wild type strains and 0% were DTR phenotype. The DTR/extended spectrum beta-lactamase producing P. stuartii isolates more than doubled the risk of mortality, while the presence of nasogastric nutrition tripled the risk. Conclusions: P. stuartii infections that occurred in diabetic patients proved to be more difficult to treat, the majority of them being healthcare-associated bacteremias.
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Wang J, Dai L, Yue X, Shen C, Li T, Long L, Zhi Y, Wang Y, Shen G, Shi C, Liu Y, Fang Q, Li W. IR-61 Improves Voiding Function via Mitochondrial Protection in Diabetic Rats. Front Pharmacol 2021; 12:608637. [PMID: 33935703 PMCID: PMC8080033 DOI: 10.3389/fphar.2021.608637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/26/2021] [Indexed: 12/26/2022] Open
Abstract
Diabetic bladder dysfunction (DBD) afflicts nearly half of diabetic patients, but effective treatment is lacking. In this study, IR-61, a novel heptamethine cyanine dye with potential antioxidant effects, was investigated to determine whether it can alleviate DBD. Rats were intraperitoneally injected with IR-61 or vehicle after diabetes was induced with streptozotocin. Before evaluating the effects of IR-61 in improving DBD by filling cystometry, we detected its distribution in tissues and subcellular organelles by confocal fluorescence imaging. Near infrared (NIR) imaging showed that IR-61 could accumulate at high levels in the bladders of diabetic rats, and confocal images demonstrated that it was mainly taken up by bladder smooth muscle cells (BSMCs) and localized in mitochondria. Then, filling cystometry illustrated that IR-61 significantly improved the bladder function of diabetic rats. The histomorphometry results showed that IR-61 effectively mitigated the pathological changes in bladder smooth muscle (BSM) in diabetic rats. Furthermore, IR-61 remarkably reduced the number of apoptotic BSMCs and the unfavorable expression of proteins related to the mitochondrial apoptotic pathway (Bcl-2, BAX, Cytochrome C, and cleaved Caspase-9) in diabetic rats. Moreover, the frozen section staining and transmission electron microscopy results proved that IR-61 significantly reduced the reactive oxygen species (ROS) levels and prevented the mitochondrial mass and morphology damage in the BSM of diabetic rats. In addition, IR-61 upregulated the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and its associated antioxidant proteins in the BSM of diabetic rats. Together, these results indicate that IR-61 can improve the voiding function of rats with DBD by protecting the mitochondria of BSMCs from oxidative stress, which is possibly mediated through the activation of the Nrf2 pathway.
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Affiliation(s)
- Jianwu Wang
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
| | - Linyong Dai
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
| | - Xiaofeng Yue
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
| | - Chongxing Shen
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
| | - Tong Li
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
| | - Lei Long
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Rocket Force Medicine, Third Military Medical University, Chongqing, China
| | - Yi Zhi
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
| | - Yawei Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Rocket Force Medicine, Third Military Medical University, Chongqing, China
| | - Gufang Shen
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Rocket Force Medicine, Third Military Medical University, Chongqing, China
| | - Chunmeng Shi
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Rocket Force Medicine, Third Military Medical University, Chongqing, China
| | - Yunsheng Liu
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Rocket Force Medicine, Third Military Medical University, Chongqing, China
| | - Qiang Fang
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
| | - Weibing Li
- Department of Urology, The Third Affiliated Hospital (Gener Hospital) of Chongqing Medical University, Chongqing, China
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21
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Xue J, Liu Y, Zhang S, Ding L, Shen B, Shao Y, Wei Z. Caffeine improves bladder function in diabetic rats via a neuroprotective effect. Exp Ther Med 2021; 21:501. [PMID: 33791010 PMCID: PMC8005692 DOI: 10.3892/etm.2021.9932] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/18/2021] [Indexed: 12/16/2022] Open
Abstract
Diabetic cystopathy (DCP) is one of the most common complications of diabetes mellitus (DM). A previous study reported that caffeine may improve bladder dysfunction in rats with DM. The aim of the present study was to investigate the mechanisms behind the capacity for caffeine to improve bladder function in rats with DM. Sprague Dawley rats were divided into four groups: control, caffeine, DM and DM plus caffeine treatment (DM + caffeine). Bladder function was measured by urodynamic analyses. The levels of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP) in the bladder tissue were detected by ELISA. Apoptosis in the dorsal root ganglion (DRG) was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay. The expression levels of B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), caspase-3, cleaved caspase-3, caspase-9 and cleaved caspase-9 proteins in the DRG were detected by western blotting. Following treatment with caffeine, the urination time and micturition interval of rats with DM were improved, the bladder wet weight was decreased, and the maximum voiding pressure was increased. Relative to that in the DM group, the expression levels of NGF, BDNF and CGRP in the bladder tissue of DM + caffeine rats increased; cellular apoptosis in the DRG of DM + caffeine rates decreased; and the expression levels of Bcl-2, Bax, cleaved caspase-3 and cleaved caspase-9 proteins in the DRG of DM + caffeine rats were restored to a certain extent. In conclusion, caffeine promotes bladder function in rats with DM through a protective effect on DRG.
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Affiliation(s)
- Jun Xue
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China
| | - Yadong Liu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China
| | - Sichong Zhang
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China
| | - Liucheng Ding
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China
| | - Baixin Shen
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China
| | - Yunpeng Shao
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China
| | - Zhongqing Wei
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China
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22
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Mitidieri E, Vanacore D, Turnaturi C, Sorrentino R, d’Emmanuele di Villa Bianca R. Uterine Dysfunction in Diabetic Mice: The Role of Hydrogen Sulfide. Antioxidants (Basel) 2020; 9:antiox9100917. [PMID: 32993056 PMCID: PMC7599872 DOI: 10.3390/antiox9100917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
It is well-known that the physiological uterine peristalsis, related to several phases of reproductive functions, plays a pivotal role in fertility and female reproductive health. Here, we have addressed the role of hydrogen sulfide (H2S) signaling in changes of uterine contractions driven by diabetes in non-obese diabetic (NOD) mice, a murine model of type-1 diabetes mellitus. The isolated uterus of NOD mice showed a significant reduction in spontaneous motility coupled to a generalized hypo-contractility to uterotonic agents. The levels of cyclic nucleotides, cAMP and cGMP, notoriously involved in the regulation of uterus homeostasis, were significantly elevated in NOD mouse uteri. This increase was well-correlated with the higher levels of H2S, a non-specific endogenous inhibitor of phosphodiesterases. The exposure of isolated uterus to L-cysteine (L-Cys), but not to sodium hydrogen sulfide, the exogenous source of H2S, showed a weak tocolytic effect in the uterus of NOD mice. Western blot analysis revealed a reorganization of the enzymatic expression with an upregulation of 3-mercaptopyruvate-sulfurtransferase (3-MST) coupled to a reduction in both cystathionine-β-synthase (CBS) and cystathionine-γ-lyase (CSE) expression. In conclusion, the increased levels of cyclic nucleotides dysregulate the uterus peristalsis and contractility in diabetic mice through an increase in basal H2S synthesis suggesting a role of 3-MST.
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Affiliation(s)
- Emma Mitidieri
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
| | - Domenico Vanacore
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
| | - Carlotta Turnaturi
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
| | - Raffaella Sorrentino
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples, Federico II, Via Pansini, 5, 80131 Naples, Italy
- Interdepartmental Centre for Sexual Medicine, University of Naples, Federico II, Via Pansini 5, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-678437
| | - Roberta d’Emmanuele di Villa Bianca
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
- Interdepartmental Centre for Sexual Medicine, University of Naples, Federico II, Via Pansini 5, 80131 Naples, Italy
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Shin JH, Ryu CM, Ju H, Yu HY, Song S, Hong KS, Chung HM, Park J, Shin DM, Choo MS. Therapeutic Efficacy of Human Embryonic Stem Cell-Derived Multipotent Stem/Stromal Cells in Diabetic Detrusor Underactivity: A Preclinical Study. J Clin Med 2020; 9:jcm9092853. [PMID: 32899334 PMCID: PMC7563486 DOI: 10.3390/jcm9092853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/31/2020] [Indexed: 01/23/2023] Open
Abstract
Mesenchymal stem/stromal cell (MSC) therapy is a promising approach for treatment of as yet incurable detrusor underactivity (DUA), which is characterized by decreased detrusor contraction strength and/or duration, leading to prolonged bladder emptying. In the present study, we demonstrated the therapeutic potential of human embryonic stem cell (ESC)-derived multipotent MSCs (M-MSCs) in a diabetic rat model of DUA. Diabetes mellitus (DM) was induced by intraperitoneal injection of streptozotocin (STZ) (50 mg/kg) into 8-week-old female Sprague-Dawley rats. Three weeks later, various doses of M-MSCs (0.25, 0.5, and 1 × 106 cells) or an equivalent volume of PBS were injected into the outer layer of the bladder. Awake cystometry, organ bath, histological, and gene expression analyses were evaluated 1 week (short-term) or 2 and 4 weeks (long-term) after M-MSC transplantation. STZ-induced diabetic rats developed DUA, including phenotypes with significantly longer micturition intervals, increased residual urine amounts and bladder capacity, decreased micturition pressure on awake cystometry, and contractile responses to various stimuli in organ bath studies. Muscle degeneration, mast cell infiltration, fibrosis, and apoptosis were present in the bladders of DM animals. A single local transplantation of M-MSCs ameliorated DUA bladder pathology, including functional changes and histological evaluation, and caused few adverse outcomes. Immunostaining and gene expression analysis revealed that the transplanted M-MSCs supported myogenic restoration primarily by engrafting into bladder tissue via pericytes, and subsequently exerting paracrine effects to prevent apoptotic cell death in bladder tissue. The therapeutic efficacy of M-MSCs was superior to that of human umbilical cord-derived MSCs at the early time point (1 week). However, the difference in efficacy between M-MSCs and human umbilical cord-derived MSCs was statistically insignificant at the later time points (2 and 4 weeks). Collectively, the present study provides the first evidence for improved therapeutic efficacy of a human ESC derivative in a preclinical model of DM-associated DUA.
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Affiliation(s)
- Jung Hyun Shin
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.H.S.); (J.P.)
| | - Chae-Min Ryu
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Hyein Ju
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Hwan Yeul Yu
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Sujin Song
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
| | - Ki-Sung Hong
- Department of Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (K.-S.H.); (H.-M.C.)
| | - Hyung-Min Chung
- Department of Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (K.-S.H.); (H.-M.C.)
| | - Juhyun Park
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.H.S.); (J.P.)
| | - Dong-Myung Shin
- Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (C.-M.R.); (H.J.); (H.Y.Y.); (S.S.)
- Correspondence: (D.-M.S.); (M.-S.C.); Tel.: +82-2-3010-2086 (D.-M.S.); +82-2-3010-3735 (M.-S.C.); Fax: +82-2-3010-8493 (D.-M.S.); +82-2-477-8928 (M.-S.C.)
| | - Myung-Soo Choo
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.H.S.); (J.P.)
- Correspondence: (D.-M.S.); (M.-S.C.); Tel.: +82-2-3010-2086 (D.-M.S.); +82-2-3010-3735 (M.-S.C.); Fax: +82-2-3010-8493 (D.-M.S.); +82-2-477-8928 (M.-S.C.)
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Penckofer S, Limeira R, Joyce C, Grzesiak M, Thomas-White K, Wolfe AJ. Characteristics of the microbiota in the urine of women with type 2 diabetes. J Diabetes Complications 2020; 34:107561. [PMID: 32184058 PMCID: PMC7329247 DOI: 10.1016/j.jdiacomp.2020.107561] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/17/2020] [Accepted: 02/20/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE The urinary microbiota in women with type 2 diabetes (T2DM) can have bacterial uropathogens which are more virulent. The primary objective was to describe and compare the characteristics of the microbiota in voided urine of women with and without T2DM. METHODS Two cohorts of women: those with T2DM (n = 87) and those without T2DM (n = 49) were studied. Demographic data, hemoglobin A1c (HbA1c), fasting serum glucose, and voided urine were collected. To determine the characteristics of the microbiota in the urine, 16S rRNA gene sequencing was used. RESULTS The genus Lactobacillus was more often present in women with T2DM (75.9%, n = 66) than in the controls (59.2%, n = 30) (p = 0.042), as was the family Enterobacteriaceae (12.6% T2DM versus 2.0% control, p = 0.055). There was evidence of an association between HbA1c and the relative abundance of the various bacteria in the total cohort. The relative abundance of Lactobacillus was positively associated (ρ = 0.19, 95% CI: 0.02, 0.34), while Corynebacterium (ρ = -0.26, 95% CI: -0.41, -0.10) and Prevotella (ρ = -0.23, 95% CI: -0.38, -0.06) were inversely associated with HbA1c. CONCLUSIONS Enterobacteriaceae (e.g. E. coli) predispose women to urinary tract infections and since T2DM increases this risk, further study is needed. The species of Lactobacillus and its impact needs exploration.
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Affiliation(s)
- Sue Penckofer
- Loyola University Chicago, Health Sciences Campus, Maywood, IL, United States of America.
| | - Robert Limeira
- Loyola University Chicago, Health Sciences Campus, Maywood, IL, United States of America
| | - Cara Joyce
- Loyola University Chicago, Health Sciences Campus, Maywood, IL, United States of America
| | | | - Krystal Thomas-White
- Loyola University Chicago, Health Sciences Campus, Maywood, IL, United States of America
| | - Alan J Wolfe
- Loyola University Chicago, Health Sciences Campus, Maywood, IL, United States of America
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Nocturia in Women With Type 2 Diabetes Mellitus: A Cross-sectional, Correlation Study. J Wound Ostomy Continence Nurs 2020; 47:265-272. [PMID: 32195774 DOI: 10.1097/won.0000000000000635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE The first aim of this study was to compare nighttime voiding frequency (nocturia), serum hemoglobin A1c level, peripheral neuropathy score, and global sleep quality score in younger (>40 to <65 years) versus older (≥65 years) women with type 2 diabetes mellitus (DM). Additional aims were to identify factors associated with clinically relevant nocturia (≥2 episodes/night) and to analyze relationships between nocturia frequency, glycemic control, peripheral neuropathy, and sleep quality in these women. DESIGN Cross-sectional study. SETTING AND SUBJECTS Participants were 118 women older than 40 years and with type 2 DM. Their mean age was 65.25 (SD = 9.66) years; the mean duration since diagnosis of type 2 DM was 10.96 (SD = 7.66) years. The study setting was 2 metabolism and endocrinology outpatient departments located in Taipei City and Taoyuan, Taiwan. METHODS Data were collected using a questionnaire that queried sociodemographic information, lower urinary tract symptoms, and sleep quality. We also assessed peripheral neuropathy and lower extremity edema and obtained pertinent information from participants' medical records. Independent t tests, multivariate logistic regression analyses, Spearman's rank correlation coefficients, and one-way analysis of variance were used to address the 3 study aims. RESULTS Analyses found that older women (aged ≥65 years) had a significantly higher nighttime voiding frequency, a higher peripheral neuropathy score, and a higher sleep quality score than younger (>40 to <65 years) women. Multivariate logistic regression analyses identified 4 factors associated with clinically relevant nocturia advanced age, elevated hemoglobin A1c level, suspected peripheral neuropathy, and lower extremity edema. Significant correlation coefficients were found between nighttime voiding frequency and serum hemoglobin A1c levels, peripheral neuropathy scores, and sleep quality scores. Analyses also found that women with a greater nocturia frequency had higher hemoglobin A1c levels, peripheral neuropathy scores, and sleep quality scores. CONCLUSIONS Healthcare professionals should screen for nocturia in women with type 2 DM and provide appropriate management for those experiencing nocturia.
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Asefa A, Nigussie T, Henok A, Mamo Y. Prevalence of sexual dysfunction and related factors among diabetes mellitus patients in Southwest Ethiopia. BMC Endocr Disord 2019; 19:141. [PMID: 31852461 PMCID: PMC6921479 DOI: 10.1186/s12902-019-0473-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 12/10/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diabetes mellitus causes multiple medical, psychological and sexual problems in both men and women. Sexual dysfunction is one of those problems that lead to a strong social and psychological problem which adversely affect marital relation and treatment outcome. The issue has not been well studied in Ethiopia; therefore, this study aimed to evaluate the prevalence and factors related to sexual dysfunction in adult patients with diabetes mellitus. METHODS Facility-based cross-sectional study was conducted among adults with diabetes mellitus on follow-up at diabetic clinics of Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to select 423 study participants, and data were collected through interviewer-administered questionnaire and patients' medical chart review. Changes in Sexual Functioning Questionnaire-fourteen items (CSFQ-14) was used to measure sexual dysfunction. Descriptive statistics and binary logistic regression analyses were performed. Two tail tests at α of less 0.05 were used as a level of significance. RESULTS A total of 398 diabetic patients were interviewed, with a 94% response rate. The prevalence of sexual dysfunction was 53.3%. Age of above 41 years (AOR: 3.98, 95% CI 2.32-6.85), lack of formal education (AOR: 3.20, 95% CI 1.60-6.39), divorced or widowed (AOR: 5.28, 95% CI 2.35-11.86), type 2 DM (AOR: 4.52, 95% CI 2.17-9.42), depression (AOR: 4.05, 95% CI 2.32-7.10), complications or co-morbidity (AOR: 2.05, 95% CI 1.18-3.58), and not doing physical activity (AOR: 1.62, 95% CI; 1.47-1.77) were significantly associated with sexual dysfunction among diabetes patients. CONCLUSIONS The prevalence of sexual dysfunction was as high as reports from other studies. Therefore, health care providers should include the issue of sexual health in their routine discussions with adult diabetes mellitus patients. Presence of depression, not doing physical activity and having complications or co-morbidity are modifiable factors associated with sexual dysfunction; therefore, they should be attended during care addressing sexual dysfunction.
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Affiliation(s)
- Adane Asefa
- Department of Public Health, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Tadesse Nigussie
- Department of Public Health, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Andualem Henok
- Department of Public Health, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Yitagesu Mamo
- Department of Pharmacy, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
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The impact of catheter‐based bladder drainage method on urinary tract infection risk in spinal cord injury and neurogenic bladder: A systematic review. Neurourol Urodyn 2019; 39:854-862. [DOI: 10.1002/nau.24253] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/26/2019] [Indexed: 01/08/2023]
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28
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Elrashidy RA, Liu G. Long-term diabetes causes molecular alterations related to fibrosis and apoptosis in rat urinary bladder. Exp Mol Pathol 2019; 111:104304. [PMID: 31479659 DOI: 10.1016/j.yexmp.2019.104304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/23/2019] [Accepted: 08/30/2019] [Indexed: 02/05/2023]
Abstract
Diabetes induces time-dependent alterations in urinary bladders. Long-term diabetes causes an underactive bladder. However, the fundamental mechanisms are still elusive. This study aimed to examine the histological changes and the potential molecular pathways affected by long-term diabetes in the rat bladder. Diabetes was induced in 8-week-old male Lewis rats by streptozotocin, while age-matched control rats received citrate buffer only. Forty-four weeks after diabetes induction, bladders were harvested for histological and molecular analyses. The expressions of proteins related to fibrosis, apoptosis and oxidative stress as well as the cellular signaling pathway in the bladder were examined by immunoblotting. Histological examinations illustrated diabetes caused detrusor hypertrophy and fibrotic changes in the bladder. Immunoblotting analysis demonstrated higher collagen I but lower elastin expression in the bladder in diabetic rats. These were accompanied by an increase in the expression of transforming growth factor-beta1, along with the downregulation of matrix metalloptoteinase-1, and upregulation of tissue inhibitor of metalloproteinase-1. Diabetic rats showed an increase in nitrotyrosine, but decrease in nuclear factor erythroid-related factor 2 (Nrf2) levels in the bladder. Enhanced apoptotic signaling was observed, characterized by increased expression of Bcl-2-associated X protein (Bax), decreased expression of Bcl-2, in the diabetic bladder. The nerve growth factor level was decreased in the diabetic bladder. A significant suppression in the protein expressions of phosphorylated extracellular signal-regulated kinases 1/2 was found in diabetic bladders. This study demonstrated that long-term diabetes caused molecular changes that could promote fibrosis and apoptosis in the bladder. Oxidative stress may be involved in this context.
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Affiliation(s)
- Rania A Elrashidy
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA; Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
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Jiao N, Chen Y, Zhu Y, Wang W, Liu M, Ding W, Lv G, Lu J, Yu B, Xu H. Protective effects of catalpol on diabetes mellitus-induced male reproductive damage via suppression of the AGEs/RAGE/Nox4 signaling pathway. Life Sci 2019; 256:116736. [PMID: 31398417 DOI: 10.1016/j.lfs.2019.116736] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 12/20/2022]
Abstract
AIMS Diabetes mellitus (DM)-induced reproductive damage is an important cause of infertility for male DM patients, we herein evaluated the effects of catalpol on diabetic reproductive damage through the suppression of the AGEs/RAGE/Nox4 signaling pathway. METHODS KK-Ay diabetic reproductive damage mice were administered with catalpol for 8 weeks, the testis/body weight ratio, testicular histopathology, the levels of endogenous hormone and the activity of testicular marker enzymes were determined. In vitro, the GC-2 cell injury model was induced by advanced glycation end-products (AGEs) and pretreated with catalpol. Cell viability, apoptosis, and oxidative stress markers were detected and the mechanism based on the AGEs/RAGE/Nox4 pathway was explored. KEY FINDINGS Catalpol showed remarkable capacity on protecting diabetic reproductive damage by improving the histomorphology of the testes, increasing the testis/body weight ratio and activity of acid phosphatase (ACP), lactate dehydrogenase (LDH), gamma-glutamyl transferase (γ-GT). The reduced testosterone (T), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in DM mice were also reversed with catalpol intervention. Moreover, catalpol showed markedly effects of anti-oxidative in vivo and in vitro, which significantly down-regulated reactive oxygen species (ROS) levels and restored superoxide dismutase (SOD) activity, meanwhile decreased GC-2 cell apoptosis and Bax/Bcl-2 ratio. Moreover, the over-expression of receptors for AGEs (RAGE), NADPH oxidase type 4 (Nox4) and phosphorylation of nuclear transcription factor-κB p65 (NF-κB p65) were suppressed by catalpol. SIGNIFICANCE Catalpol could alleviate DM-induced male reproductive damage by inhibiting oxidative stress-induced apoptosis and inflammation mediated by AGEs/RAGE/Nox4 signaling pathway.
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Affiliation(s)
- Ni Jiao
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China; Affiliated Hospital of Nanjing University of TCM, Nanjing 210029, China
| | - Yuping Chen
- Department of Basic Medical Science, Jiangsu Vocational College of Medicine, Yanchen 224005, China; Nursing Department, Chemistry and Life Science College, Nanjing University Jinling College, Nanjing 210089, China
| | - Yihui Zhu
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Wei Wang
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Mengxue Liu
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Wangli Ding
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Gaohong Lv
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jinfu Lu
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Bin Yu
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Huiqin Xu
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing 210023, China.
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Wang Z, Gao Z, Wang A, Jia L, Zhang X, Fang M, Yi K, Li Q, Hu H. Comparative oral and intravenous pharmacokinetics of phlorizin in rats having type 2 diabetes and in normal rats based on phase II metabolism. Food Funct 2019; 10:1582-1594. [PMID: 30806398 DOI: 10.1039/c8fo02242a] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Phlorizin (PHZ), a type of dihydrochalcone widely found in Rosaceae such as apples, is the first compound discovered as a sodium-glucose cotransporter (SGLT) inhibitor. It has been confirmed to improve the symptoms of diabetes and diabetic complications effectively. Like other flavonoids, the bioavailability challenge of PHZ is the wide phase I and II metabolism in the digestive tract. In this study, we investigated the pharmacokinetics and contribution of phase II metabolism after the oral and intravenous administrations of PHZ in rats having type 2 diabetes (T2D) and in normal rats. The phase II metabolism characteristics of PHZ were investigated by treating plasma samples with β-glucuronidase/sulfatase. The contribution ratio of phase II metabolism of PHZ ranged from 41.9% to 69.0% after intravenous injection with three doses of PHZ in normal rats. Compared with the observations for normal rats, AUC0-t and Cmax of PHZ significantly increased and T1/2 of PHZ significantly decreased in T2D rats. PHZ was converted into phloretin (PHT) through an enzyme-catalyzed hydrolysis reaction, and PHT was further transformed into conjugates with glycose after both oral and intravenous administrations. Moreover, it was found that the bioavailability of PHZ was about 5% in T2D rats, which was significantly higher than that in normal rats (0%). In conclusion, compared with the observations for normal rats, the pharmacokinetic characteristics of PHZ significantly changed in T2D rats through oral and intravenous administrations. The bioavailability of PHZ significantly increased in T2D rats. Besides, the phase II metabolites of PHT were the major existing forms in blood after oral and intravenous administrations. Our results indicated that the phase II metabolism characteristics of PHZ should be considered when PHZ is applied for the treatment of diabetes as a drug or functional food.
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Affiliation(s)
- Zhanguo Wang
- Chengdu Holistic Integrative Medicine Collaborative Innovation Research Center, Aba Tibetan and Qiang Medicine Quality Evaluation Innovation Research Laboratory, School of Medicine and Nursing, Chengdu University, Longquan, Chengdu 610106, China
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Wittig L, Carlson KV, Andrews JM, Crump RT, Baverstock RJ. Diabetic Bladder Dysfunction:A Review. Urology 2019; 123:1-6. [DOI: 10.1016/j.urology.2018.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/27/2018] [Accepted: 10/02/2018] [Indexed: 12/11/2022]
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Ding H, Zhang P, Li N, Liu Y, Wang P. The phosphodiesterase type 4 inhibitor roflumilast suppresses inflammation to improve diabetic bladder dysfunction rats. Int Urol Nephrol 2018; 51:253-260. [PMID: 30474782 DOI: 10.1007/s11255-018-2038-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/19/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To demonstrate that phosphodiesterase type 4 (PDE4) inhibitors could potentially treat diabetic bladder dysfunction (DBD) through modulation of the systemic inflammatory response. METHODS In this 6-week study, 60 female Sprague-Dawley rats were divided into three groups: (i) vehicle-treated control rats; (ii) vehicle-treated streptozocin (STZ)-injected rats; and (iii) roflumilast-treated STZ-injected rats. Oral roflumilast (5 mg/kg/day) was administered during the last 4 weeks of STZ injection to induce diabetes in the test group. At 6 weeks, a urodynamic study was performed in each group. The expression of nuclear factor kappa B (NF-κB), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-1β in detrusor smooth muscle (DSM) was analyzed using quantitative reverse transcription-polymerase chain reaction and Western blotting. RESULTS A significant decrease in bodyweight and significant increases in bladder weight and blood glucose level were observed in the diabetic rats and were not ameliorated by roflumilast treatment. Cystometry showed the increased bladder capacity, voiding volume, residual urine volume, and voiding interval in the diabetic rats and the prevention of these changes by roflumilast. These changes were accompanied by significantly enhanced expression of NF-κB, TNF-α, IL-6, and IL-1β in DSM tissue from diabetic rats. Furthermore, roflumilast attenuated the expression of inflammatory factors in DSM tissue. CONCLUSIONS Oral treatment with roflumilast in diabetic rats improves bladder function and inhibits the expression of inflammatory factors in DSM tissue, indicating that PDE4 is a potential therapeutic target for DBD.
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Affiliation(s)
- Honglin Ding
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China.,Department of Urology, Affiliated Hospital, Chifeng University, 42 Wangfu Street, Chifeng, Neimeng, China
| | - Peng Zhang
- Department of General Surgery, Shenyang 242 Hospital, 3 Leshan Road, Shenyang, Liaoning, China
| | - Ning Li
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China.
| | - Yili Liu
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China
| | - Ping Wang
- Department of Urology, Fourth Affiliated Hospital, China Medical University, 4 Chongshan East Road, Shenyang, Liaoning, China
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33
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Wittig L, Andrews JM, Crump RT, Carlson KV, Baverstock RJ. Investigating the effect of early bladder management in patients with chronic kidney disease and diabetes: Lessons learned from a failed pilot study. Can Urol Assoc J 2018; 12:301-302. [PMID: 30333077 DOI: 10.5489/cuaj.5304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Luc Wittig
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
| | - J Matthew Andrews
- Division of Urology, Department of Surgery, Memorial University, St. John's, NL, Canada
| | - R Trafford Crump
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
| | - Kevin V Carlson
- Vesia [Alberta Bladder Centre]; Division of Urology, Department of Surgery, University of Calgary, Calgary AB, Canada
| | - Richard J Baverstock
- Vesia [Alberta Bladder Centre]; Division of Urology, Department of Surgery, University of Calgary, Calgary AB, Canada
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Wang JY, Liao L, Liu M, Sumarsono B, Cong M. Epidemiology of lower urinary tract symptoms in a cross-sectional, population-based study: The status in China. Medicine (Baltimore) 2018; 97:e11554. [PMID: 30142751 PMCID: PMC6112902 DOI: 10.1097/md.0000000000011554] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lower urinary tract symptoms (LUTS) are reported to affect over half of all adults, and they are associated with significantly impaired quality of life (QOL). We performed a population-based study to evaluate the overall prevalence and impact of LUTS including overactive bladder (OAB) in adults aged ≥40 years in China.Adults aged ≥40 years were eligible to participate in this internet-based survey, provided that they had the ability to access the internet, to use a computer and to read the local language. The survey contained questions relating to International Continence Society (ICS) symptom definitions, the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS). The primary study objective was to determine the prevalence of LUTS using the ICS 2002 symptom definition.Among the 4136 respondents, 2080 (50.3%) were men and 1347 (32.6%) were aged ≥60 years. LUTS prevalence according to ICS criteria was 60.3% in men and 57.7% in women. All 3 ICS symptom groups (voiding, storage, and postmicturition) were present in 22.8% of women and 24.2% of men, making this the most common combination of ICS symptom groups. The most bothersome symptoms were terminal dribble and nocturia. According to IPSS scores, 32.9% of participants had at least moderate symptoms. The prevalence of OAB was 23.9%. The presence of LUTS-particularly all 3 ICS symptom groups-was associated with reduced sexual QOL in women, reduced satisfaction with erectile function in men, higher anxiety and depression scores, and reduced health-related QOL (physical health and mental health domains). The overall percentage of participants with LUTS visiting healthcare professionals for urinary symptoms was 38%.In conclusion, LUTS affect the majority of adults aged ≥40 years in China, and prevalence increases with increasing age. LUTS are associated with impaired QOL and mental health, but fewer than half of individuals in China with LUTS seek healthcare for their symptoms. There is therefore a need to improve awareness and treatment of the condition.ClinicalTrials.gov identifier: NCT02618421.
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Affiliation(s)
| | - Limin Liao
- Department of Urology, China Rehabilitation Research Center, Capital Medical University, Beijing, China
| | - Ming Liu
- Department of Urology, Beijing Hospital
| | | | - Min Cong
- Astellas Pharma China, Inc., Beijing, China
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Daneshgari F, Liu G, Hanna-Mitchell AT. Path of translational discovery of urological complications of obesity and diabetes. Am J Physiol Renal Physiol 2017; 312:F887-F896. [PMID: 28052873 DOI: 10.1152/ajprenal.00489.2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/15/2016] [Accepted: 01/01/2017] [Indexed: 01/07/2023] Open
Abstract
Diabetes mellitus (DM) is a prevalent chronic disease. Type 1 DM (T1DM) is a metabolic disorder that is characterized by hyperglycemia in the context of absolute lack of insulin, whereas type 2 DM (T2DM) is due to insulin resistance-related relative insulin deficiency. In comparison with T1DM, T2DM is more complex. The natural history of T2DM in most patients typically involves a course of obesity to impaired glucose tolerance, to insulin resistance, to hyperinsulinemia, to hyperglycemia, and finally to insulin deficiency. Obesity is a risk factor of T2DM. Diabetes causes some serious microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, angiopathy and stroke. Urological complications of obesity and diabetes (UCOD) affect quality of life, but are not well investigated. The urological complications in T1DM and T2DM are different. In addition, obesity itself affects the lower urinary tract. The aim of this perspective is to review the available data, combined with the experience of our research teams, who have spent a good part of last decade on studies of association between DM and lower urinary tract symptoms (LUTS) with the aim of bringing more focus to the future scientific exploration of UCOD. We focus on the most commonly seen urological complications, urinary incontinence, bladder dysfunction, and LUTS, in obesity and diabetes. Knowledge of these associations will lead to a better understanding of the pathophysiology underlying UCOD and hopefully assist urologists in the clinical management of obese or diabetic patients with LUTS.
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Affiliation(s)
- Firouz Daneshgari
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Ann T Hanna-Mitchell
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
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Denys MA, Anding R, Tubaro A, Abrams P, Everaert K. Lower urinary tract symptoms and metabolic disorders: ICI-RS 2014. Neurourol Urodyn 2016; 35:278-82. [PMID: 26872568 DOI: 10.1002/nau.22765] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 02/23/2015] [Indexed: 12/12/2022]
Abstract
AIMS To investigate the link between lower urinary tract symptoms (LUTS) and metabolic disorders. MATERIALS AND METHODS This report results from presentations and subsequent discussions about LUTS and metabolic disorders at the International Consultation on Incontinence Research Society (ICI-RS) in Bristol, 2014. RESULTS There are common pathophysiological determinants for the onset of LUTS and the metabolic syndrome (MetS). Both conditions are multifactorial, related to disorders in circadian rhythms and share common risk factors. As in men with erectile dysfunction, these potentially modifiable lifestyle factors may be novel targets to prevent and treat LUTS. The link between LUTS and metabolic disorders is discussed by using sleep, urine production and bladder function as underlying mechanisms that need to be further explored during future research. CONCLUSION Recent findings indicate a bidirectional relationship between LUTS and the MetS. Future research has to explore underlying mechanisms to explain this relationship, in order to develop new preventive and therapeutic recommendations, such as weight loss and increasing physical activity. The second stage is to determine the effect of these new treatment approaches on the severity of LUTS and each of the components of the MetS.
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Affiliation(s)
| | - Ralf Anding
- Department of Neuro-Urology, University Hospital, Bonn, Germany
| | - Andrea Tubaro
- Department of Urology Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Paul Abrams
- Department of Urology, Bristol Urological Institute, Bristol, United Kingdom
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
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Ma R, Weng H, Liang J. Screening of lipase inhibitors in Folium Mori with lipase-linked magnetic microspheres by high-performance liquid chromatography and evaluation in diabetic mice. J Sep Sci 2016; 39:4474-4483. [DOI: 10.1002/jssc.201600924] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 09/23/2016] [Accepted: 09/23/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Rui Ma
- Department of Pharmaceutical Analysis, School of Pharmacy; Fudan University; Shanghai P.R. China
| | - Hongbo Weng
- Department of Pharmacology, School of Pharmacy; Fudan University; Shanghai P.R. China
| | - Jianying Liang
- Department of Pharmaceutical Analysis, School of Pharmacy; Fudan University; Shanghai P.R. China
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Caporarello N, Salmeri M, Scalia M, Motta C, Parrino C, Frittitta L, Olivieri M, Cristaldi M, Avola R, Bramanti V, Toscano MA, Anfuso CD, Lupo G. Cytosolic and Calcium-Independent Phospholipases A2 Activation and Prostaglandins E2 Are Associated with Escherichia coli-Induced Reduction of Insulin Secretion in INS-1E Cells. PLoS One 2016; 11:e0159874. [PMID: 27631977 PMCID: PMC5024995 DOI: 10.1371/journal.pone.0159874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/02/2016] [Indexed: 01/01/2023] Open
Abstract
It is suspected that microbial infections take part in the pathogenesis of diabetes mellitus type 1 (T1DM). Glucose-induced insulin secretion is accompanied by the release of free arachidonic acid (AA) mainly by cytosolic- and calcium independent phospholipases A2 (cPLA2 and iPLA2). Insulinoma cell line (INS-1E) was infected with E. coli isolated from the blood culture of a patient with sepsis. Invasion assay, Scanning Electron Microscopy and Transmission Electron Microscopy demonstrated the capacity of E. coli to enter cells, which was reduced by PLA2 inhibitors. Glucose-induced insulin secretion was significantly increased after acute infection (8h) but significantly decreased after chronic infection (72h). PLA2 activities, cPLA2, iPLA2, phospho-cPLA2, and COX-2 expressions were increased after acute and, even more, after chronic E. coli infection. The silencing of the two isoforms of PLA2s, with specific cPLA2- or iPLA2-siRNAs, reduced insulin secretion after acute infection and determined a rise in insulin release after chronic infection. Prostaglandins E2 (PGE2) production was significantly elevated in INS-1E after long-term E. coli infection and the restored insulin secretion in presence of L798106, a specific EP3 antagonist, and NS-398, a COX-2 inhibitor, and the reduction of insulin secretion in presence of sulprostone, a specific EP3 agonist, revealed their involvement in the effects triggered by bacterial infection. The results obtained demonstrated that cPLA2 and iPLA2 play a key role in insulin secretion process after E. coli infection. The high concentration of AA released is transformed into PGE2, which could be responsible for the reduced insulin secretion.
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Affiliation(s)
- Nunzia Caporarello
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Mario Salmeri
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Marina Scalia
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Carla Motta
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Cristina Parrino
- Dept. of Clinical and Experimental Medicine, School of Medicine, University of Catania, Catania, Italy
| | - Lucia Frittitta
- Dept. of Clinical and Experimental Medicine, School of Medicine, University of Catania, Catania, Italy
| | - Melania Olivieri
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Martina Cristaldi
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Roberto Avola
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Vincenzo Bramanti
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Maria Antonietta Toscano
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Carmelina Daniela Anfuso
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Gabriella Lupo
- Dept. of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
- * E-mail:
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Pecoits-Filho R, Abensur H, Betônico CCR, Machado AD, Parente EB, Queiroz M, Salles JEN, Titan S, Vencio S. Interactions between kidney disease and diabetes: dangerous liaisons. Diabetol Metab Syndr 2016; 8:50. [PMID: 27471550 PMCID: PMC4964290 DOI: 10.1186/s13098-016-0159-z] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/10/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (DM) globally affects 18-20 % of adults over the age of 65 years. Diabetic kidney disease (DKD) is one of the most frequent and dangerous complications of DM2, affecting about one-third of the patients with DM2. In addition to the pancreas, adipocytes, liver, and intestines, the kidneys also play an important role in glycemic control, particularly due to renal contribution to gluconeogenesis and tubular reabsorption of glucose. METHODS In this review article, based on a report of discussions from an interdisciplinary group of experts in the areas of endocrinology, diabetology and nephrology, we detail the relationship between diabetes and kidney disease, addressing the care in the diagnosis, the difficulties in achieving glycemic control and possible treatments that can be applied according to the different degrees of impairment. DISCUSSION Glucose homeostasis is extremely altered in patients with DKD, who are exposed to a high risk of both hyperglycemia and hypoglycemia. Both high and low glycemic levels are associated with increased morbidity and shortened survival in this group of patients. Factors that are associated with an increased risk of hypoglycemia in DKD patients include decreased renal gluconeogenesis, deranged metabolic pathways (including altered metabolism of medications) and decreased insulin clearance. On the other hand, decrease glucose filtration and excretion, and inflammation-induce insulin resistance are predisposing factors to hyperglycemic episodes. CONCLUSION Appropriate glycaemic monitoring and control tailored for diabetic patients is required to avoid hypoglycaemia and other glycaemic disarrays in patients with DM2 and kidney disease. Understanding the renal physiology and pathophysiology of DKD has become essential to all specialties treating diabetic patients. Disseminating this knowledge and detailing the evidence will be important to initiate breakthrough research and to encourage proper treatment of this group of patients.
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Affiliation(s)
- Roberto Pecoits-Filho
- School of Medicine, Pontificia Universidade Católica do Paraná, Imaculada Conceição, 1155, Curitiba, PR 80215-901 Brazil
| | - Hugo Abensur
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carolina C. R. Betônico
- Hospital Regional de Presidente Prudente, Universidade do Oeste Paulista, Presidente Prudente, São Paulo, Brazil
| | | | | | - Márcia Queiroz
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Silvia Titan
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Sergio Vencio
- Institute of Pharmaceutical Sciences, Goiania, Brazil
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Kushner P. Benefits/risks of sodium-glucose co-transporter 2 inhibitor canagliflozin in women for the treatment of Type 2 diabetes. WOMEN'S HEALTH (LONDON, ENGLAND) 2016; 12:379-88. [PMID: 26928259 PMCID: PMC5384506 DOI: 10.2217/whe-2016-0001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 01/02/2023]
Abstract
Sodium-glucose co-transporter 2 (SGLT2) inhibitors, such as canagliflozin, are used in patients with Type 2 diabetes mellitus (T2DM). In clinical studies, canagliflozin significantly reduced A1C, bodyweight and blood pressure, and was generally well tolerated with no increased risk of hypoglycemia. Most common adverse effects observed were genital mycotic infections and urinary tract infections, and increased urination. Approximately 10% of women treated with canagliflozin experienced a genital mycotic infection compared with 3% treated with placebo; those with a prior history were at greater risk. Approximately 9% of women treated with canagliflozin reported a urinary tract infection compared with 7% treated with placebo. Most adverse events were considered mild to moderate in intensity and responded to standard therapy. Treatment with canagliflozin was effective and generally well tolerated in both women (and men) with T2DM.
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Hsieh TH, Lin YT, Chen SC, Peng CW. Chronic pudendal neuromodulation using an implantable microstimulator improves voiding function in diabetic rats. J Neural Eng 2016; 13:046001. [PMID: 27187108 DOI: 10.1088/1741-2560/13/4/046001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective Few studies have investigated the feasibility of using chronic pudendal neuromodulation for improving voiding function in patients with diabetes who are also experiencing urinary retention. The present study investigated the effects of chronic electrical stimulation (ES) of the sensory branch of the pudendal nerve on voiding function in diabetic rats. Approach A custom-made implantable microstimulation system was designed and manufactured for chronic implantation in normal control (NC) and diabetic rats. After three or six weeks of pudendal neuromodulation, the intravesical pressure, external urethral sphincter electromyograms (EUS-EMGs), and urine flow rate (UFR) of all rats were simultaneously recorded to assess the effects of chronic pudendal ES on voiding function. Morphological changes in pudendal axons were assessed through hematoxylin and eosin (H&E) staining. Significance This study demonstrated the feasibility of using chronic pudendal neuromodulation for improving voiding function in diabetic rats. These results may facilitate the development of an advanced neural prosthesis for restoring bladder function in clinical settings.
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Affiliation(s)
- Tsung-Hsun Hsieh
- Graduate Institute of Neural Regenerative Medicine, Taipei Medical University, Taipei, Taiwan. Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
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Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study. Int J Impot Res 2016; 28:143-7. [PMID: 27169492 DOI: 10.1038/ijir.2016.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/25/2015] [Accepted: 10/26/2015] [Indexed: 01/27/2023]
Abstract
Chronic inflammation may cause endothelial dysfunction and atherosclerosis, resulting in subsequent erectile dysfunction (ED). We examined the relationship between chronic osteomyelitis, which is a chronic inflammatory disease, and ED. A retrospective cohort study was conducted using data from the National Health Insurance Research Database. After excluding patients <40 years of age, 677 male patients newly diagnosed with chronic osteomyelitis (COM) from 1 January 2000 to 31 December 2011 were identified for the study. The non-osteomyelitis comparison cohort consisted of 2706 male participants. The incidence of ED was 2.66-fold higher in the COM cohort than in the non-osteomyelitis cohort (4.01 vs 1.51 per 10 000 person-years). After adjusting for age and comorbidities of coronary heart disease, hypertension, hyperlipidemia, depression, stroke, diabetes, peripheral vascular disease, chronic kidney disease, chronic obstructive pulmonary disease and asthma, the patients with COM had a 2.82-fold risk of ED (95% confidence interval=1.44-5.56). The incidence of ED increased with that of comorbidities in both cohorts. The highest hazard ratio was in patients between 40 and 59 years of age who had COM. Our data showed, for the first time, that COM is a possible risk factor for the development of ED.
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Probucol Improves Erectile Function by Restoring Endothelial Function and Preventing Cavernous Fibrosis in Streptozotocin-induced Diabetic Rats. Urology 2016; 91:241.e9-241.e16. [DOI: 10.1016/j.urology.2016.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/11/2016] [Accepted: 02/03/2016] [Indexed: 01/06/2023]
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Sayyid RK, Fleshner NE. Diabetes Mellitus Type 2: A Driving Force for Urological Complications. Trends Endocrinol Metab 2016; 27:249-261. [PMID: 26969242 DOI: 10.1016/j.tem.2016.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/12/2016] [Accepted: 02/17/2016] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a growing epidemic associated with many adverse complications. Urological complications of diabetes mellitus in men are gaining recognition. Previously unknown associations between T2DM and risk for prostate cancer, bladder cancer, renal cell carcinomas, urinary tract infections, nephrolithiasis, penile lesions, androgen deficiency, and erectile dysfunction have been discovered. Significantly, metformin could play a role in the management of urological malignancies, and therapies used for management of these cancers could in return lead to increased risk for diabetes. In this review, we aim to bridge the gap between T2DM and urological complications by discussing the latest findings in these fields, with the ultimate goal being improved patient care on both fronts.
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Affiliation(s)
- Rashid K Sayyid
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, M5G 2M9, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, M5G 2M9, Toronto, Ontario, Canada.
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Powell CR. Not all neurogenic bladders are the same: a proposal for a new neurogenic bladder classification system. Transl Androl Urol 2016; 5:12-21. [PMID: 26904408 PMCID: PMC4739982 DOI: 10.3978/j.issn.2223-4683.2016.01.02] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Neurogenic bladder (NGB) has long been defined as a clinical entity that describes a heterogeneous collection of syndromes. The common theme is a bladder disorder concomitant with a neurologic disorder. This definition does not give the clinician much information about the bladder disorder, nor how to treat it, or even what the natural history of the disorder is likely to be. It may be time for a new classification scheme to better define the bladder defect and prognosis, as well as inform treatment. We propose a classification system based on seven categories, each having a neurologic defect in a distinct anatomic location. This is termed SALE (Stratify by Anatomic Location and Etiology). In addition, the presence or absence of bowel dysfunction and autonomic dysreflexia will be reported. In the future, as more definite prognostic information can be gleaned from biomarkers, we anticipate adding urinary nerve growth factor (NGF) and urinary brain-derived neurotrophic factor (BDNF) levels to the definition. We expect the SALE system to efficiently describe a patient suffering from NGB and simultaneously inform the most appropriate treatment, follow-up regimen, and long-term prognosis.
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Affiliation(s)
- Charles R Powell
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Giant bladder (10,500 mL in volume) in the ED. Am J Emerg Med 2016; 34:1327.e1-2. [PMID: 26786514 DOI: 10.1016/j.ajem.2015.12.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/14/2015] [Indexed: 01/01/2023] Open
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Malkan UY, Gunes G, Corakci A. Rational diagnoses of diabetes: the comparison of 1,5-anhydroglucitol with other glycemic markers. SPRINGERPLUS 2015; 4:587. [PMID: 26543722 PMCID: PMC4628038 DOI: 10.1186/s40064-015-1389-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 09/29/2015] [Indexed: 12/16/2022]
Abstract
Diabetes mellitus (DM) is a frequently encountered disease with important morbidity and mortality. The aim of this study is to document the importance of 1,5-anhydroglucitol (1,5-AG) for the diagnosis of prediabetes and DM, as well as to compare the 1,5-AG with other glycemic markers in order to understand which one is the better diagnostic tool. Between April 2012 and December 2012, 128 participants enrolled in the study. Participants were split into five groups that are IFG, IGT, IFG+IGT, diabetic and control groups by their OGTT results. The diagnostic value of markers was compared by ROC (receiver operating characteristic) method. The mean serum 1,5-AG levels in the diabetic group (33.38 nmol/ml) were lower than, IFG (59.83 nmol/ml), IGT (54.44 nmol/ml), IFG+IGT (51.98 nmol/ml) and control groups (73.24 nmol/ml). When analyzed in the total study population serum 1,5-AG levels did not differ by gender significantly. When analyzed in the total study population, 1,5-AG correlates inversely with age significantly (p = 0.036). In subgroup analysis, in the control group, serum 1,5-AG level was also inversely correlated with age (p = 0.087). The best marker for the diagnosis of prediabetes and DM was fasting plasma glucose (FPG). 1,5-AG was not found to be effective for the diagnosis of DM. This study, contributes to our knowledge of the efficiency and cut-off values of 1,5-AG for the diagnosis of prediabetes and DM. In future, there is a need for larger studies with more standardized and commonly used measurement methods for 1,5-AG, in order to evaluate the efficiency of 1,5-AG for the diagnosis of prediabetes and DM.
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Affiliation(s)
- Umit Yavuz Malkan
- Department of Internal Medicine, School of Medicine, Ufuk University, Ankara, Turkey
| | - Gursel Gunes
- Department of Internal Medicine, School of Medicine, Ufuk University, Ankara, Turkey
| | - Ahmet Corakci
- Department of Endocrinology, School of Medicine, Ufuk University, Ankara, Turkey
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Kadow BT, Tyagi P, Chermansky CJ. Neurogenic Causes of Detrusor Underactivity. CURRENT BLADDER DYSFUNCTION REPORTS 2015; 10:325-331. [PMID: 26715948 DOI: 10.1007/s11884-015-0331-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Detrusor underactivity (DU) is a poorly understood dysfunction of the lower urinary tract which arises from multiple etiologies. Symptoms of DU are non-specific, and a pressure-flow urodynamic study is necessary to differentiate DU from other conditions such as overactive bladder (OAB) or bladder outlet obstruction (BOO). The prevalence of DU ranges from 10-48%, and DU is most prevalent in elderly males. The pathophysiology underlying DU can be from both neurogenic and non-neurogenic causes. In this article, we review the neurogenic causes of detrusor underactivity, including diabetic bladder dysfunction, spinal cord injury, multiple sclerosis, Parkinson's disease, cerebrovascular accident, traumatic brain injury, and Fowler's syndrome. As knowledge about the underlying causes of DU advances, there have been several potential therapeutic approaches proposed to help those who suffer from this condition.
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Affiliation(s)
- Brian T Kadow
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S
| | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S
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Bourafa N, Loucif L, Boutefnouchet N, Rolain JM. Enterococcus hirae, an unusual pathogen in humans causing urinary tract infection in a patient with benign prostatic hyperplasia: first case report in Algeria. New Microbes New Infect 2015; 8:7-9. [PMID: 26543562 PMCID: PMC4590716 DOI: 10.1016/j.nmni.2015.08.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 08/10/2015] [Indexed: 12/17/2022] Open
Abstract
Enterococcus hirae is a zoonotic pathogen rarely isolated from human infections. This case is the first description of E. hirae causing urinary tract infection in a diabetic man with benign prostatic hyperplasia from Algeria. The clinical isolate was identified by MALDI-TOF MS and displayed a multisensitivity antibiotic profile.
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Affiliation(s)
- N Bourafa
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France ; Laboratoire de microbiologie et biochimie appliquée, Département de biochimie, Université Badji mokhtar Annaba, Algeria ; Département de biologie, Faculté des sciences de la nature et de la vie, Université Mohamed Cherif Messaadia-Souk-ahras, Algeria
| | - L Loucif
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France ; Laboratoire de Biotechnologie des Molécules Bioactives et de la Physiopathologie Cellulaire (LBMBPC), Université El Hadj Lakhdar, Batna, Algeria
| | - N Boutefnouchet
- Laboratoire de microbiologie et biochimie appliquée, Département de biochimie, Université Badji mokhtar Annaba, Algeria
| | - J-M Rolain
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
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Chen S, Zhu Y, Liu Z, Gao Z, Li B, Zhang D, Zhang Z, Jiang X, Liu Z, Meng L, Yang Y, Shi B. Grape Seed Proanthocyanidin Extract Ameliorates Diabetic Bladder Dysfunction via the Activation of the Nrf2 Pathway. PLoS One 2015; 10:e0126457. [PMID: 25974036 PMCID: PMC4431834 DOI: 10.1371/journal.pone.0126457] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/03/2015] [Indexed: 01/11/2023] Open
Abstract
Diabetes Mellitus (DM)-induced bladder dysfunction is predominantly due to the long-term oxidative stress caused by hyperglycemia. Grape seed proanthocyanidin extract (GSPE) has been reported to possess a broad spectrum of pharmacological and therapeutic properties against oxidative stress. However, its protective effects against diabetic bladder dysfunction have not been clarified. This study focuses on the effects of GSPE on bladder dysfunction in diabetic rats induced by streptozotocin. After 8 weeks of GSPE administration, the bladder function of the diabetic rats was improved significantly, as indicated by both urodynamics analysis and histopathological manifestation. Moreover, the disordered activities of antioxidant enzymes (SOD and GSH-Px) and abnormal oxidative stress levels were partly reversed by treatment with GSPE. Furthermore, the level of apoptosis in the bladder caused by DM was decreased following the administration of GSPE according to the Terminal Deoxynucleotidyl Transferase (TdT)-mediated dUTP Nick-End Labeling (TUNEL) assay. Additionally, GSPE affected the expression of apoptosis-related proteins such as Bax, Bcl-2 and cleaved caspase-3. Furthermore, GSPE showed neuroprotective effects on the bladder of diabetic rats, as shown by the increased expression of nerve growth factor (NGF) and decreased expression of the precursor of nerve growth factor (proNGF). GSPE also activated nuclear erythroid2-related factor2 (Nrf2), which is a key antioxidative transcription factor, with the concomitant elevation of downstream hemeoxygenase-1 (HO-1). These findings suggested that GSPE could ameliorate diabetic bladder dysfunction and decrease the apoptosis of the bladder in diabetic rats, a finding that may be associated with its antioxidant activity and ability to activate the Nrf2 defense pathway.
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Affiliation(s)
- Shouzhen Chen
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Yaofeng Zhu
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Zhifeng Liu
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
- Department of Urology, The Central Hospital of Tai’ an, Longtan Road, Tai’ an, Shandong Province, People’s Republic of China
| | - Zhaoyun Gao
- Department of Urology, People’s Hospital of Yinan County, Lishan Road, Yinan, Shandong Province, People’s Republic of China
| | - Baoying Li
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Dongqing Zhang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Zhaocun Zhang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Xuewen Jiang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Zhengfang Liu
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Lingquan Meng
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Yue Yang
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
| | - Benkang Shi
- Department of Urology, Qilu Hospital of Shandong University, Wenhua Xi Road, Jinan, Shandong Province, People’s Republic of China
- * E-mail:
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