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Yang Y, Zhang H, Lu Q, Liu X, Fan Y, Zhu J, Sun B, Zhao J, Dong X, Li L. Suppression of adenosine A 2a receptors alleviates bladder overactivity and hyperalgesia in cyclophosphamide-induced cystitis by inhibiting TRPV1. Biochem Pharmacol 2020; 183:114340. [PMID: 33189675 DOI: 10.1016/j.bcp.2020.114340] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 01/09/2023]
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a type of chronic bladder inflammation characterized by increased voiding frequency, urgency and pelvic pain. The sensitization of bladder afferents is widely regarded as one of the pathophysiological changes in the development of IC/BPS. There is evidence that adenosine A2a receptors are involved in regulating the sensitization of sensory afferents. However, the effect of adenosine A2a receptors on cystitis remains unknown. In the present study, a rat model of chronic cystitis was established by intraperitoneal injection with cyclophosphamide (CYP). Cystometry and behavioral tests were performed to investigate bladder micturition function and nociceptive pain. The rats with chronic cystitis showed symptoms of bladder overactivity, characterized by an increase in bladder voiding frequency and voiding pressure. CYP treatment significantly increased the expression of the A2a receptor in bladder afferent fibers and dorsal root ganglion (DRG) neurons. The A2a receptor antagonist ZM241385 prevented bladder overactivity and hyperalgesia elicited by CYP-induced cystitis. In addition, the A2a receptor and TRPV1 were coexpressed on DRG neurons. The TRPV1 antagonist capsazepine blocked bladder overactivity induced by the A2a receptor agonist CGS21680. In contrast, ZM241385 significantly inhibited the capsaicin-induced increase in intracellular calcium concentration in DRG neurons. These results suggest that suppression of adenosine A2a receptors in bladder afferents alleviates bladder overactivity and hyperalgesia elicited by CYP-induced cystitis in rats by inhibiting TRPV1, indicating that the adenosine A2a receptor in bladder afferents is a potential therapeutic target for the treatment of IC/BPS.
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Affiliation(s)
- Yang Yang
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Hengshuai Zhang
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Qudong Lu
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Xin Liu
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Yi Fan
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Jingzhen Zhu
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Bishao Sun
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Jiang Zhao
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Xingyou Dong
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China.
| | - Longkun Li
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China.
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Kadota T, Kakuta N, Horikawa YT, Tsutsumi R, Oyama T, Tanaka K, Tsutsumi YM. Plasma substance P concentrations in patients undergoing general anesthesia: an objective marker associated with postoperative nausea and vomiting. JA Clin Rep 2016; 2:9. [PMID: 29497664 PMCID: PMC5818727 DOI: 10.1186/s40981-016-0034-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/11/2016] [Indexed: 11/10/2022] Open
Abstract
Background This study investigated plasma concentrations of substance P (SP) in patients undergoing general anesthesia (GA) and postoperative nausea and vomiting (PONV). This prospective, observational, cohort study included 23 patients who underwent scheduled surgery under general anesthesia. Blood was collected from the radial artery at predetermined time points (15-30 mins prior anesthesia, 15-30 mins after surgery/GA, and 24 h after surgery). PONV, SP concentrations, risk factors, and analgesics used were measured. Findings Nine of 23 patients experienced PONV. In patients without PONV, SP concentrations significantly decreased (P < 0.0001) at the end of surgery/GA, compared to baseline, and recovered at 24 h after surgery/GA (452.9 ± 146.2 vs. 666.9 ± 176.5 vs. 580.7 ± 168.6 pg/mL, respectively), whereas SP levels were unchanged during surgery/GA and increased at 24 hours after surgery (P = 0.020) in patients with PONV (726.1 ± 167.8 vs. 655.8 ± 168.0 vs. 779.7 ± 220.7 pg/mL, respectively). Conclusions These finding suggest that SP levels may be utilized as an objective marker for PONV.
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Affiliation(s)
- Takako Kadota
- Department of Anesthesiology, Tokushima Univeristy, 3-18-15 Kuramoto, Tokushima, 770-8503 Japan
| | - Nami Kakuta
- Department of Anesthesiology, Tokushima Univeristy, 3-18-15 Kuramoto, Tokushima, 770-8503 Japan
| | - Yousuke T Horikawa
- Department of Anesthesiology, Tokushima Univeristy, 3-18-15 Kuramoto, Tokushima, 770-8503 Japan.,Department of Pediatrics, Sharp Rees-Stealy Medical Group, San Diego, 92101 USA
| | - Rie Tsutsumi
- Department of Nutrition, Tokushima University, 3-18-15 Kuramoto, Tokushima, 770-8503 Japan
| | - Takuro Oyama
- Department of Anesthesiology, Tokushima Univeristy, 3-18-15 Kuramoto, Tokushima, 770-8503 Japan
| | - Katsuya Tanaka
- Department of Anesthesiology, Tokushima Univeristy, 3-18-15 Kuramoto, Tokushima, 770-8503 Japan
| | - Yasuo M Tsutsumi
- Department of Anesthesiology, Tokushima Univeristy, 3-18-15 Kuramoto, Tokushima, 770-8503 Japan
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Bossowska A, Lepiarczyk E, Mazur U, Janikiewicz P, Markiewicz W. Botulinum toxin type A induces changes in the chemical coding of substance P-immunoreactive dorsal root ganglia sensory neurons supplying the porcine urinary bladder. Toxins (Basel) 2015; 7:4797-816. [PMID: 26580655 PMCID: PMC4663534 DOI: 10.3390/toxins7114797] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/10/2015] [Accepted: 11/06/2015] [Indexed: 12/24/2022] Open
Abstract
Botulinum toxin (BTX) is a potent neurotoxin which blocks acetylcholine release from nerve terminals, and therefore leads to cessation of somatic motor and/or parasympathetic transmission. Recently it has been found that BTX also interferes with sensory transmission, thus, the present study was aimed at investigating the neurochemical characterization of substance P-immunoreactive (SP-IR) bladder-projecting sensory neurons (BPSN) after the toxin treatment. Investigated neurons were visualized with retrograde tracing method and their chemical profile was disclosed with double-labelling immunohistochemistry using antibodies against SP, calcitonin gene-related peptide (CGRP), pituitary adenylate cyclase activating polypeptide (PACAP), neuronal nitric oxide synthase (nNOS), galanin (GAL), calbindin (CB), and somatostatin (SOM). In the control group (n = 6), 45% of the total population of BPSN were SP-IR. Nearly half of these neurons co-expressed PACAP or CGRP (45% and 35%, respectively), while co-localization of SP with GAL, nNOS, SOM or CB was found less frequently (3.7%, 1.8%, 1.2%, and 0.7%, respectively). In BTX-treated pigs (n = 6), toxin-injections caused a decrease in the number of SP-IR cells containing CGRP, SOM or CB (16.2%, 0.5%, and 0%, respectively) and a distinct increase in these nerve cells immunopositive to GAL (27.2%). The present study demonstrates that BTX significantly modifies the chemical phenotypes of SP-IR BPSN.
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Affiliation(s)
- Agnieszka Bossowska
- Department of Human Physiology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Warszawska 30, Olsztyn 10-082, Poland.
| | - Ewa Lepiarczyk
- Department of Human Physiology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Warszawska 30, Olsztyn 10-082, Poland.
| | - Urszula Mazur
- Department of Human Physiology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Warszawska 30, Olsztyn 10-082, Poland.
| | - Paweł Janikiewicz
- Department of Human Physiology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Warszawska 30, Olsztyn 10-082, Poland.
| | - Włodzimierz Markiewicz
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, Olsztyn 10-719, Poland.
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Ogawa T, Ishizuka O, Ueda T, Tyagi P, Chancellor MB, Yoshimura N. Current and emerging drugs for interstitial cystitis/bladder pain syndrome (IC/BPS). Expert Opin Emerg Drugs 2015; 20:555-70. [DOI: 10.1517/14728214.2015.1105216] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Yoshimura N, Oguchi T, Yokoyama H, Funahashi Y, Yoshikawa S, Sugino Y, Kawamorita N, Kashyap MP, Chancellor MB, Tyagi P, Ogawa T. Bladder afferent hyperexcitability in bladder pain syndrome/interstitial cystitis. Int J Urol 2015; 21 Suppl 1:18-25. [PMID: 24807488 DOI: 10.1111/iju.12308] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 08/27/2013] [Indexed: 12/30/2022]
Abstract
Bladder pain syndrome/interstitial cystitis is a disease with lower urinary tract symptoms, such as bladder pain and urinary frequency, which results in seriously impaired quality of life of patients. The extreme pain and urinary frequency are often difficult to treat. Although the etiology of bladder pain syndrome/interstitial cystitis is still not known, there is increasing evidence showing that afferent hyperexcitability as a result of neurogenic bladder inflammation and urothelial dysfunction is important to the pathophysiological basis of symptom development. Further investigation of the pathophysiology will lead to the effective treatment of patients with bladder pain syndrome/interstitial cystitis.
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Affiliation(s)
- Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Cassinello F, Prieto I, del Olmo M, Rivas S, Strichartz GR. Cancer surgery: how may anesthesia influence outcome? J Clin Anesth 2015; 27:262-72. [PMID: 25769963 DOI: 10.1016/j.jclinane.2015.02.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/12/2014] [Accepted: 02/17/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To review the published literature regarding the effects of anesthesia on cancer surgery to prevent tumor cell proliferation/migration or induce apoptosis. BACKGROUND Surgery is the main treatment for potentially curable solid tumors, but most cancer-related deaths in patients who have received previous surgical treatment are caused by metastatic disease. There is increasing evidence that anesthetic technique has the potential to affect long-term outcome after cancer surgery. METHODS This work reviews the English published literature that was obtained by performing a search of the PubMed database up to January 2014. We selected articles that provided evidence or reviewed the possible actions of anesthetics on cancer cells or the influence of anesthesia in recurrence/outcome. RESULTS Inhaled anesthetics induce immunosuppression and activate inflammatory cascade activation, whereas propofol has a protective action. Opioids might promote cancer recurrence and metastasis. In vitro and in vivo studies have demonstrated that local anesthetics inhibit proliferation and migration of cancer cells and induce apoptosis. CONCLUSIONS Anesthesiologists should follow current best clinical practice and include all strategies that effectively decrease pain and attenuate stress. Regional anesthesia and multimodal analgesia, adding anti-inflammatory drugs, play an unquestionable role in the control of perioperative pain and may improve recurrence-free survival.
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Affiliation(s)
| | - Isabel Prieto
- IDC-Salud Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain.
| | - Mercedes del Olmo
- IDC-Salud Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Sonia Rivas
- IDC-Salud Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Gary R Strichartz
- Pain Research Center, Department of Anesthesia. Harvard Medical School, Brigham and Women's Hospital, Boston, 02115 MA, USA
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DeBerry JJ, Schwartz ES, Davis BM. TRPA1 mediates bladder hyperalgesia in a mouse model of cystitis. Pain 2014; 155:1280-1287. [PMID: 24704367 DOI: 10.1016/j.pain.2014.03.023] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/13/2014] [Accepted: 03/27/2014] [Indexed: 01/07/2023]
Abstract
Urinary bladder pain is a primary symptom associated with interstitial cystitis/painful bladder syndrome. We used systemic injections of cyclophosphamide (CYP), an alkylating antineoplastic agent, to induce cystitis and examine the roles of 2 channels previously demonstrated to be required for inflammatory visceral hyperalgesia: transient receptor potential vanilloid-1 (TRPV1) and ankyrin-1 (TRPA1). Injection of CYP (100 mg/kg, i.p.) every other day for 5 days was accompanied by bladder edema and urothelial ulceration, but without significant plasma extravasation or infiltration of neutrophils. Toluidine blue staining showed a significant increase in the number of degranulated bladder mast cells after CYP treatment. Despite this mild pathology, CYP-treated mice exhibited bladder hyperalgesia 1 day after the final injection that persisted 7 days later. Although many previous studies of visceral hyperalgesia have reported changes in dorsal root ganglion neuron TRPV1 expression and/or function, we found no change in bladder afferent TRPV1 expression or sensitivity on the basis of the percentage of bladder afferents responsive to capsaicin, including at submaximal concentrations. In contrast, the percentage of bladder afferents expressing functional TRPA1 protein (i.e., those responsive to mustard oil) increased ∼2.5-fold 1 day after CYP treatment, and remained significantly elevated 7 days later. Moreover, bladder hyperalgesia was reversed by acute treatment with the TRPA1 antagonist HC-030031 (300 mg/kg, i.p.). Our results indicate that CYP-induced bladder hyperalgesia can be induced without robust inflammation or changes in primary afferent TRPV1. However, significant changes were observed in TRPA1 expression, and blockade of TRPA1 alleviated CYP-induced bladder hyperalgesia.
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Affiliation(s)
- Jennifer J DeBerry
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15261, USA Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA 15261, USA Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15261, USA Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA 15261, USA
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Yamauchi H, Akino H, Ito H, Aoki Y, Nomura T, Yokoyama O. Urinary Prostaglandin E2 Was Increased in Patients With Suprapontine Brain Diseases, and Associated With Overactive Bladder Syndrome. Urology 2010; 76:1267.e13-9. [DOI: 10.1016/j.urology.2010.06.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 06/07/2010] [Accepted: 06/09/2010] [Indexed: 11/29/2022]
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Kalsi V, Apostolidis A, Gonzales G, Elneil S, Dasgupta P, Fowler CJ. Early Effect on the Overactive Bladder Symptoms following Botulinum Neurotoxin Type A Injections for Detrusor Overactivity. Eur Urol 2008; 54:181-7. [DOI: 10.1016/j.eururo.2007.12.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2007] [Accepted: 12/14/2007] [Indexed: 10/22/2022]
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Apostolidis A, Dasgupta P, Fowler CJ. Proposed mechanism for the efficacy of injected botulinum toxin in the treatment of human detrusor overactivity. Eur Urol 2006; 49:644-50. [PMID: 16426734 DOI: 10.1016/j.eururo.2005.12.010] [Citation(s) in RCA: 251] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 12/04/2005] [Accepted: 12/05/2005] [Indexed: 02/06/2023]
Abstract
BACKGROUND Treatment of human bladder overactivity with intradetrusor Botulinum-A neurotoxin (BoNT/A) injections temporarily blocks the presynaptic release of acetylcholine from the parasympathetic innervation and produces a paralysis of the detrusor smooth muscle. The efficacy of the treatment exceeds that expected from simple detrusor muscle paralysis, however, and its effect of reducing urgency is greatly welcomed by patients. OBJECTIVES To examine whether BoNT/A has a complex effect on sensory mechanisms by inhibiting vesicular release of multiple excitatory neurotransmitters by urothelial and suburothelial nerves and reducing axonal expression of SNARE-complex dependent proteins. METHODS A literature review. CONCLUSIONS We propose that a primary peripheral effect of BoNT/A is the inhibition of release of acetylcholine, ATP, substance P, and reduction in the axonal expression of the capsaicin and purinergic receptors. This may be followed by central desensitization through a decrease in central uptake of substance P and neurotrophic factors. The summation of these effects is a profound and long-lasting inhibition of those afferent and efferent mechanisms that are thought to be the pathophysiological basis for DO.
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Affiliation(s)
- Apostolos Apostolidis
- Department of Uro-Neurology, the National Hospital for Neurology and Neurosurgery, London, UK
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