1
|
Venegoni C, Pederzoli F, Locatelli I, Alchera E, Martinez-Vidal L, Di Coste A, Bandini M, Necchi A, Montorsi F, Salonia A, Moschini M, Jose J, Scarfò F, Lucianò R, Alfano M. Topographic modification of the extracellular matrix precedes the onset of bladder cancer. Matrix Biol Plus 2024; 23:100154. [PMID: 38882394 PMCID: PMC11179621 DOI: 10.1016/j.mbplus.2024.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024] Open
Abstract
Background Non-muscle invasive bladder cancer (NMIBC) patients are affected by a high risk of recurrence. The topography of collagen fibers represents a hallmark of the neoplastic extracellular microenvironment. Objective Assess the topographic change associated with different stages of bladder cancer (from neoplastic lesions to bona fide tumor) and whether those changes favour the development of NMIBC. Design Setting and Participants Seventy-one clinical samples of urothelial carcinoma at different stages were used. Topographic changes preceding tumor onset and progression were evaluated in the rat bladder cancer model induced by nitrosamine (BBN), a bladder-specific carcinogen. The preclinical model of actinic cystitis was also used in combination with BBN. Validated hematoxylin-eosin sections were used to assess the topography of collagen fibrils associated with pre-tumoral steps, NMIBC, and MIBC. Findings Linearization of collagen fibers was higher in Cis and Ta vs. dysplastic urothelium, further increased in T1 and greatest in T2 tumors. In the BBN preclinical model, an increase in the linearization of collagen fibers was established since the beginning of inflammation, such as the onset of atypia of a non-univocal nature and dysplasia, and further increased in the presence of the tumor. Linearization of collagen fibers in the model of actinic cystitis was associated with earlier onset of BBN-induced tumor. Conclusions The topographic modification of the extracellular microenvironment occurs during the inflammatory processes preceding and favoring the onset of bladder cancer. The topographic reconfiguration of the stroma could represent a marker for identifying and treating the non-neoplastic tissue susceptible to tumor recurrence.
Collapse
Affiliation(s)
- Chiara Venegoni
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Filippo Pederzoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Irene Locatelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Elisa Alchera
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Laura Martinez-Vidal
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Alessia Di Coste
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Marco Bandini
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Necchi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Marco Moschini
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Jithin Jose
- FUJIFILM Visualsonics Inc., Amsterdam, the Netherlands
| | | | | | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| |
Collapse
|
2
|
Sun Y, Tsai Y, Wood R, Shen B, Chen J, Zhou Z, Zeng G, Marples B, Kerns S, Chen Y. KDM3B Single-Nucleotide Polymorphisms Impact Radiation Therapy Toxicity Through Circular RNA-Mediated KDM3B Expression and Inflammatory Responses. Int J Radiat Oncol Biol Phys 2024; 119:251-260. [PMID: 38008196 DOI: 10.1016/j.ijrobp.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE Genome-wide association studies have identified single-nucleotide polymorphisms (SNPs) associated with radiation therapy (RT) toxicities in patients with prostate cancer. SNP rs17599026 in intron 21 of KDM3B is significantly associated with the development of late urinary toxicity, specifically in the increase in urinary frequency 2 years after RT compared with pretreatment conditions. The present study aimed to provide mechanistic insights for this association. METHODS AND MATERIALS Using human tissues and cell lines, we examined the protein expression of KDM3B and molecular mechanisms underlying the SNP modulation by variants of KDM3B SNP alleles. In animals with normal and heterozygous expressions of Kdm3b, we examined the relationship between Kdm3b expression and radiation toxicity. RESULTS KDM3B rs17599026 lies in a motif important for circular RNA expression that is responsible for sponging miRNAs to regulate KDM3B expression. Using a murine model with heterozygous deletion of the Kdm3b gene, we found that lower Kdm3b expression is associated with altered pattern of urination after bladder irradiation, which is related to differential degrees of tissue inflammation as measured by analyses of gene expression, lymphocyte infiltration, and noninvasive ultrasound imaging. CONCLUSIONS KDM3B SNPs can impact its expression through regulating noncoding RNA expression. Differential KDM3B expression underlies radiation toxicity through tissue inflammation at the molecular and physiological level. Our study outcome offers a foundation for mechanism-based mitigation for radiation toxicity for prostate cancer survivors.
Collapse
Affiliation(s)
- Yin Sun
- Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
| | - Ying Tsai
- Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Ronald Wood
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Binghui Shen
- Departments of Cancer Genetics and Epigenetics, Beckman Research Institute, City of Hope, Duarte, California
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhen Zhou
- Department of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Guohua Zeng
- Department of Urology and Guangdong Key Laboratory of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong, China
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Sarah Kerns
- Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Yuhchyau Chen
- Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
| |
Collapse
|
3
|
Mota S, Ward EP, Bartolone SN, Chancellor MB, Zwaans BMM. Identification of Molecular Mechanisms in Radiation Cystitis: Insights from RNA Sequencing. Int J Mol Sci 2024; 25:2632. [PMID: 38473879 PMCID: PMC10932361 DOI: 10.3390/ijms25052632] [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: 02/01/2024] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Pelvic cancer survivors who were treated with radiation therapy are at risk for developing (hemorrhagic) radiation cystitis (RC) many years after completion of radiation therapy. Patients with RC suffer from lower urinary tract symptoms, including frequency, nocturia, pelvic pain, and incontinence. In advanced stages, hematuria can occur, potentially escalating to life-threatening levels. Current therapeutic options for RC are limited, partly due to ethical concerns regarding bladder biopsy in patients with fragile bladder tissue. This study aimed to leverage our established preclinical model to elucidate the molecular pathways implicated in radiation-induced tissue changes in the bladder. Female C57Bl/6 mice received a single dose of 40 Gy using CT-guided imaging and a two-beam irradiation approach using the SARRP irradiator. Bladders from irradiated and age-matched littermate controls were harvested at 1 week [n = 5/group] or 6 months [n = 5/group] after irradiation, RNA was harvested, and mRNA sequencing was performed at paired-end 150bp on the Illumina NovaSeq6000 with a target of 30 million reads per sample. Following RNA sequencing, thorough bioinformatics analysis was performed using iPathwayGuide v2012 (ADVAITA Bioinformatics). Findings of the RNA sequencing were validated using qPCR analysis. At 1 week post-irradiation, altered gene expression was detected in genes involved in DNA damage response, apoptosis, and transcriptional regulation. By 6 months post-irradiation, significant changes in gene expression were observed in inflammation, collagen catabolism, and vascular health. Affected pathways included the p53, JAK-STAT, and PI3K-Akt pathways. These findings were validated in vivo in bladder tissues from our preclinical model. This is the first study to determine the molecular changes in the bladder in response to radiation treatment. We have successfully pinpointed several pathways and specific genes that undergo modification, thereby contributing to the progression of radiation cystitis. These insights enhance our understanding of the pathophysiology of radiation cystitis and may ultimately pave the way to the identification of potential new therapeutic targets.
Collapse
Affiliation(s)
- Sabrina Mota
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester Hills, MI 48309, USA
| | - Elijah P. Ward
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
| | - Sarah N. Bartolone
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
| | - Michael B. Chancellor
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester Hills, MI 48309, USA
| | - Bernadette M. M. Zwaans
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester Hills, MI 48309, USA
| |
Collapse
|
4
|
Martinez-Vidal L, Testi C, Pontecorvo E, Pederzoli F, Alchera E, Locatelli I, Venegoni C, Spinelli A, Lucianò R, Salonia A, Podestà A, Ruocco G, Alfano M. Progressive alteration of murine bladder elasticity in actinic cystitis detected by Brillouin microscopy. Sci Rep 2024; 14:484. [PMID: 38177637 PMCID: PMC10766652 DOI: 10.1038/s41598-023-51006-2] [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: 07/13/2023] [Accepted: 12/29/2023] [Indexed: 01/06/2024] Open
Abstract
Bladder mechanical properties are critical for organ function and tissue homeostasis. Therefore, alterations of tissue mechanics are linked to disease onset and progression. This study aims to characterize the tissue elasticity of the murine bladder wall considering its different anatomical components, both in healthy conditions and in actinic cystitis, a state characterized by tissue fibrosis. Here, we exploit Brillouin microscopy, an emerging technique in the mechanobiology field that allows mapping tissue mechanics at the microscale, in non-contact mode and free of labeling. We show that Brillouin imaging of bladder tissues is able to recognize the different anatomical components of the bladder wall, confirmed by histopathological analysis, showing different tissue mechanical properties of the physiological bladder, as well as a significant alteration in the presence of tissue fibrosis. Our results point out the potential use of Brillouin imaging on clinically relevant samples as a complementary technique to histopathological analysis, deciphering complex mechanical alteration of each tissue layer of an organ that strongly relies on mechanical properties to perform its function.
Collapse
Affiliation(s)
- Laura Martinez-Vidal
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, 20132, Milan, Italy.
- Università Vita-Salute San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
| | - Claudia Testi
- Center for Life Nano- and Neuro-Science, Istituto Italiano di Tecnologia, Viale Regina Elena 291, 00161, Roma, Italy.
| | - Emanuele Pontecorvo
- Center for Life Nano- and Neuro-Science, Istituto Italiano di Tecnologia, Viale Regina Elena 291, 00161, Roma, Italy
- CrestOptics S.p.A., Via Di Torre Rossa, 66, 00165, Roma, Italy
| | - Filippo Pederzoli
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
- Università Vita-Salute San Raffaele, Via Olgettina, 60, 20132, Milan, Italy
| | - Elisa Alchera
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Irene Locatelli
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Chiara Venegoni
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Antonello Spinelli
- Experimental Imaging Centre, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Roberta Lucianò
- Pathology Unit, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
- Università Vita-Salute San Raffaele, Via Olgettina, 60, 20132, Milan, Italy
| | - Alessandro Podestà
- Dipartimento Di Fisica "Aldo Pontremoli" and CIMAINA, Università Degli Studi Di Milano, 20133, Milan, Italy
| | - Giancarlo Ruocco
- Center for Life Nano- and Neuro-Science, Istituto Italiano di Tecnologia, Viale Regina Elena 291, 00161, Roma, Italy
- Dipartimento Di Fisica, Universitá Di Roma "La Sapienza", Piazzale Aldo Moro, 5, 00185, Roma, Italy
| | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| |
Collapse
|
5
|
Da Huang J, Shao EX, Tham CM, Chung E, Rhee H. Bladder malignancy as a cause of spontaneous bladder rupture: A systematic review. BJUI COMPASS 2024; 5:12-16. [PMID: 38179032 PMCID: PMC10764159 DOI: 10.1002/bco2.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives To characterise cases of spontaneous rupture of the urinary bladder in the context of bladder cancer. Methods A systematic review was performed to characterise cases of spontaneous bladder rupture in patients with bladder cancer. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) system was utilised, with databases being searched for relevant cases. Patient characteristics were extracted, including age, sex, presenting signs and symptoms, management modalities, tumour histology and mortality. Results Thirty cases were included. Seventeen (57%) were male, and the median age of presentation was 59. Abdominal pain and peritonism were the most common presenting symptoms, in 80% and 60% of patients, respectively. Most patients (n = 16, 53%) had urothelial cell carcinoma. Nine patients (30%) died during their initial hospitalisation. Conclusion Spontaneous bladder perforation in the context of bladder cancer is a rare cause of acute abdomen. The diagnosis is associated with high mortality, highlighting the aggressive nature of the malignancies that cause spontaneous bladder rupture. This raises important questions about the role of emergency cystectomy, the timing of systemic therapy and the appropriate involvement of palliative care.
Collapse
Affiliation(s)
| | | | - Chui Ming Tham
- Department of Urology, Princess Alexandra HospitalUniversity of QueenslandWoolloongabbaQueenslandAustralia
| | - Eric Chung
- Department of Urology, Princess Alexandra HospitalUniversity of QueenslandWoolloongabbaQueenslandAustralia
| | - Handoo Rhee
- Department of Urology, Princess Alexandra HospitalUniversity of QueenslandWoolloongabbaQueenslandAustralia
| |
Collapse
|
6
|
Nakamura K, Ohno T, Inamoto T, Takai T, Uchimoto T, Fukushima T, Nishimura K, Yano Y, Nishio K, Kinoshita S, Matsunaga T, Nakamori K, Tsutsumi T, Tsujino T, Uehara H, Komura K, Takahara K, Azuma H. Pattern of Expression of MicroRNA in Patients with Radiation-Induced Bladder Injury. Oncology 2023; 102:585-592. [PMID: 38160665 PMCID: PMC11216355 DOI: 10.1159/000535993] [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: 11/04/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Bladder cancer (BC) is sensitive to radiation treatment and a subset of patients experience radiation-induced injuries including shrinkage of bladder due to bladder fibrosis. METHODS This study is a retrospective cohort study. Three Japanese BC patients were randomly selected. Using a microRNA (miRNA) array, comparing their samples with or without radiation-induced injuries, we have checked the clustering of miRNA expression. RESULTS Hsa-miR-130a, hsa-miR-200c, hsa-miR-141, and hsa-miR-96 were found to be highly expressed (>50 times) in patients with fibrotic bladder shrinkage (FBS) compared to those with intact bladder (IB) function. In patients with FBS, hsa-miR-6835, hsa-miR-4675, hsa-miR-371a, and hsa-miR-6885 were detected to have lesser than half expression to IB patients. We have analyzed the significance of these genes in relation to overall survival of 409 BC patients retrieved from the Cancer Genome Atlas data set. All available cutoff values between the lower and upper quartiles of expression are used for the selected genes, and false discovery rate using the Benjamini-Hochberg method is computed to correct for multiple hypothesis testing. We have run combined survival analysis of the mean expression of these four miRNAs highly expressed in FBS patients. 175 patients with high expression had a longer median survival of 98.47 months than 23.73 months in 233 patients with low expression (hazard ratio [HR]: 0.53; 0.39-0.72, log-rank p value: 7.3e-0.5). Combination analysis of all 8 genes including hsa-miR-6835, hsa-miR-4675, hsa-miR-371a, and hsa-miR-6885 showed the same HR for OS. Target scanning for these miRNAs matched specific cytokines known as an early biomarker to develop radiation-induced fibrosis. CONCLUSIONS BC patients with fibrotic radiation injury have specific miRNA expression profile targeting profibrotic cytokines and these miRNAs possibly render to favorable survival.
Collapse
Affiliation(s)
- Ko Nakamura
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan,
| | - Takaya Ohno
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Teruo Inamoto
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Tomoaki Takai
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Taizo Uchimoto
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Tatsuo Fukushima
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Kazuki Nishimura
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Yusuke Yano
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Kyosuke Nishio
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Shoko Kinoshita
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Tomohisa Matsunaga
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Keita Nakamori
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Takeshi Tsutsumi
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Takuya Tsujino
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Hirofumi Uehara
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Kazumasa Komura
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| | - Kiyoshi Takahara
- Department of Urology, Fujita-Health University School of Medicine, Toyoake City, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical and Pharmaceutical University, Takatsuki City, Japan
| |
Collapse
|
7
|
Apodaca G. Defining the molecular fingerprint of bladder and kidney fibroblasts. Am J Physiol Renal Physiol 2023; 325:F826-F856. [PMID: 37823192 PMCID: PMC10886799 DOI: 10.1152/ajprenal.00284.2023] [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: 09/11/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023] Open
Abstract
Fibroblasts are integral to the organization and function of all organs and play critical roles in pathologies such as fibrosis; however, we have limited understanding of the fibroblasts that populate the bladder and kidney. In this review, I describe how transcriptomics is leading to a revolution in our understanding of fibroblast biology by defining the molecular fingerprint (i.e., transcriptome) of universal and specialized fibroblast types, revealing gene signatures that allows one to resolve fibroblasts from other mesenchymal cell types, and providing a new comprehension of the fibroblast lineage. In the kidney, transcriptomics is giving us new insights into the molecular fingerprint of kidney fibroblasts, including those for cortical fibroblasts, medullary fibroblasts, and erythropoietin (EPO)-producing Norn fibroblasts, as well as new information about the gene signatures of kidney myofibroblasts and the transition of kidney fibroblasts into myofibroblasts. Transcriptomics has also revealed that the major cell type in the bladder interstitium is the fibroblast, and that multiple fibroblast types, each with their own molecular fingerprint, are found in the bladder wall. Interleaved throughout is a discussion of how transcriptomics can drive our future understanding of fibroblast identification, diversity, function, and their roles in bladder and kidney biology and physiology in health and in disease states.
Collapse
Affiliation(s)
- Gerard Apodaca
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| |
Collapse
|
8
|
Martinez-Vidal L, Chighizola M, Berardi M, Alchera E, Locatelli I, Pederzoli F, Venegoni C, Lucianò R, Milani P, Bielawski K, Salonia A, Podestà A, Alfano M. Micro-mechanical fingerprints of the rat bladder change in actinic cystitis and tumor presence. Commun Biol 2023; 6:217. [PMID: 36823431 PMCID: PMC9950451 DOI: 10.1038/s42003-023-04572-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
Tissue mechanics determines tissue homeostasis, disease development and progression. Bladder strongly relies on its mechanical properties to perform its physiological function, but these are poorly unveiled under normal and pathological conditions. Here we characterize the mechanical fingerprints at the micro-scale level of the three tissue layers which compose the healthy bladder wall, and identify modifications associated with the onset and progression of pathological conditions (i.e., actinic cystitis and bladder cancer). We use two indentation-based instruments (an Atomic Force Microscope and a nanoindenter) and compare the micromechanical maps with a comprehensive histological analysis. We find that the healthy bladder wall is a mechanically inhomogeneous tissue, with a gradient of increasing stiffness from the urothelium to the lamina propria, which gradually decreases when reaching the muscle outer layer. Stiffening in fibrotic tissues correlate with increased deposition of dense extracellular matrix in the lamina propria. An increase in tissue compliance is observed before the onset and invasion of the tumor. By providing high resolution micromechanical investigation of each tissue layer of the bladder, we depict the intrinsic mechanical heterogeneity of the layers of a healthy bladder as compared with the mechanical properties alterations associated with either actinic cystitis or bladder tumor.
Collapse
Affiliation(s)
- Laura Martinez-Vidal
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
- Università Vita-Salute San Raffaele, Via Olgettina, 60, Milan, 20132, Italy
| | - M Chighizola
- C.I.Ma.I.Na and Dipartimento di Fisica "Aldo Pontremoli", Università degli Studi di Milano, Milan, 20133, Italy
| | - M Berardi
- Optics11, Amsterdam, The Netherlands
- LaserLab, Department of Physics and Astronomy, VU University, Amsterdam, The Netherlands
| | - E Alchera
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
| | - I Locatelli
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
| | - F Pederzoli
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
- Università Vita-Salute San Raffaele, Via Olgettina, 60, Milan, 20132, Italy
| | - C Venegoni
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
| | - R Lucianò
- Pathology Unit, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
| | - P Milani
- C.I.Ma.I.Na and Dipartimento di Fisica "Aldo Pontremoli", Università degli Studi di Milano, Milan, 20133, Italy
| | | | - A Salonia
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
- Università Vita-Salute San Raffaele, Via Olgettina, 60, Milan, 20132, Italy
| | - A Podestà
- C.I.Ma.I.Na and Dipartimento di Fisica "Aldo Pontremoli", Università degli Studi di Milano, Milan, 20133, Italy.
| | - M Alfano
- Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele, Milan, 20132, Italy.
| |
Collapse
|
9
|
Brossard C, Pouliet AL, Lefranc A, Benadjaoud M, Dos Santos M, Demarquay C, Buard V, Benderitter M, Simon JM, Milliat F, Chapel A. Mesenchymal stem cells limit vascular and epithelial damage and restore the impermeability of the urothelium in chronic radiation cystitis. Stem Cell Res Ther 2023; 14:5. [PMID: 36627674 PMCID: PMC9832809 DOI: 10.1186/s13287-022-03230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/25/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Cellular therapy seems to be an innovative therapeutic alternative for which mesenchymal stem cells (MSCs) have been shown to be effective for interstitial and hemorrhagic cystitis. However, the action of MSCs on chronic radiation cystitis (CRC) remains to be demonstrated. The aim of this study was to set up a rat model of CRC and to evaluate the efficacy of MSCs and their mode of action. METHODS CRC was induced by single-dose localized irradiation of the whole bladder using two beams guided by tomography in female Sprague-Dawley rat. A dose range of 20-80 Gy with follow-up 3-12 months after irradiation was used to characterize the dose effect and the kinetics of radiation cystitis in rats. For the treatment, the dose of 40 Gy was retained, and in order to potentiate the effect of the MSCs, MSCs were isolated from adipose tissue. After expansion, they were injected intravenously during the pre-chronic phase. Three injections of 5 million MSCs were administered every fortnight. Follow-up was performed for 12 months after irradiation. RESULTS We observed that the intensity and frequency of hematuria are proportional to the irradiation dose, with a threshold at 40 Gy and the appearance of bleeding from 100 days post-irradiation. The MSCs reduced vascular damage as well as damage to the bladder epithelium. CONCLUSIONS These results are in favor of MSCs acting to limit progression of the chronic phase of radiation cystitis. MSC treatment may afford real hope for all patients suffering from chronic radiation cystitis resistant to conventional treatments.
Collapse
Affiliation(s)
- Clément Brossard
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRMed, 92260 Fontenay-aux-Roses, France
| | - Anne-Laure Pouliet
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRMed, 92260 Fontenay-aux-Roses, France
| | - Anne‐Charlotte Lefranc
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRMed, 92260 Fontenay-aux-Roses, France
| | - Mohamedamine Benadjaoud
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed, 92260 Fontenay-aux-Roses, France
| | - Morgane Dos Santos
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRAcc, 92260 Fontenay-aux-Roses, France
| | - Christelle Demarquay
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRMed, 92260 Fontenay-aux-Roses, France
| | - Valerie Buard
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRMed, 92260 Fontenay-aux-Roses, France
| | - Marc Benderitter
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed, 92260 Fontenay-aux-Roses, France
| | - Jean-Marc Simon
- grid.411439.a0000 0001 2150 9058Département de Radiothérapie Oncologie, APHP, Hôpital Universitaire Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France
| | - Fabien Milliat
- grid.418735.c0000 0001 1414 6236Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRMed, 92260 Fontenay-aux-Roses, France
| | - Alain Chapel
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SERAMed/LRMed, 92260, Fontenay-aux-Roses, France.
| |
Collapse
|
10
|
Clayton DR, Ruiz WG, Dalghi MG, Montalbetti N, Carattino MD, Apodaca G. Studies of ultrastructure, gene expression, and marker analysis reveal that mouse bladder PDGFRA + interstitial cells are fibroblasts. Am J Physiol Renal Physiol 2022; 323:F299-F321. [PMID: 35834272 PMCID: PMC9394772 DOI: 10.1152/ajprenal.00135.2022] [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: 05/10/2022] [Revised: 06/07/2022] [Accepted: 07/06/2022] [Indexed: 11/22/2022] Open
Abstract
Fibroblasts are crucial to normal and abnormal organ and tissue biology, yet we lack basic insights into the fibroblasts that populate the bladder wall. Candidates may include bladder interstitial cells (also referred to as myofibroblasts, telocytes, and interstitial cells of Cajal-like cells), which express the fibroblast-associated marker PDGFRA along with VIM and CD34 but whose form and function remain enigmatic. By applying the latest insights in fibroblast transcriptomics, coupled with studies of gene expression, ultrastructure, and marker analysis, we observe the following: 1) that mouse bladder PDGFRA+ cells exhibit all of the ultrastructural hallmarks of fibroblasts including spindle shape, lack of basement membrane, abundant endoplasmic reticulum and Golgi, and formation of homotypic cell-cell contacts (but not heterotypic ones); 2) that they express multiple canonical fibroblast markers (including Col1a2, CD34, LY6A, and PDGFRA) along with the universal fibroblast genes Col15a1 and Pi16 but they do not express Kit; and 3) that PDGFRA+ fibroblasts include suburothelial ones (which express ACTA2, CAR3, LY6A, MYH10, TNC, VIM, Col1a2, and Col15a1), outer lamina propria ones (which express CD34, LY6A, PI16, VIM, Col1a2, Col15a1, and Pi16), intermuscular ones (which express CD34, VIM, Col1a2, Col15a1, and Pi16), and serosal ones (which express CD34, PI16, VIM, Col1a2, Col15a1, and Pi16). Collectively, our study revealed that the ultrastructure of PDFRA+ interstitial cells combined with their expression of multiple canonical and universal fibroblast-associated gene products indicates that they are fibroblasts. We further propose that there are four regionally distinct populations of fibroblasts in the bladder wall, which likely contribute to bladder function and dysfunction.NEW & NOTEWORTHY We currently lack basic insights into the fibroblasts that populate the bladder wall. By exploring the ultrastructure of mouse bladder connective tissue cells, combined with analyses of their gene and protein expression, our study revealed that PDGRA+ interstitial cells (also referred to as myofibroblasts, telocytes, and interstitial cells of Cajal-like cells) are fibroblasts and that the bladder wall contains multiple, regionally distinct populations of these cells.
Collapse
Affiliation(s)
- Dennis R Clayton
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Wily G Ruiz
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Marianela G Dalghi
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Marcelo D Carattino
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gerard Apodaca
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
11
|
Molecular Mechanisms and Key Processes in Interstitial, Hemorrhagic and Radiation Cystitis. BIOLOGY 2022; 11:biology11070972. [PMID: 36101353 PMCID: PMC9311586 DOI: 10.3390/biology11070972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022]
Abstract
Simple Summary Pathologies of the bladder are called cystitis. They cause discomfort for the patient. Due to persistent pain, bleeding, urinary incontinence, and uncontrolled urination, the chronic forms cause considerable degradation to patient quality of life. Currently, there is no curative treatment for the most severe forms. This is both an economic and a societal problem. Although the different forms of cystitis have different causes, they share common mechanisms. We propose to describe in detail the key processes and the associated mechanisms involved in abacterial cystitis. Abstract Cystitis is a bladder disease with a high rate of prevalence in the world population. This report focuses on Interstitial Cystitis (IC), Hemorrhagic Cystitis (HC) and Chronic Radiation Cystitis. These pathologies have different etiologies, but they share common symptoms, for instance, pain, bleeding, and a contracted bladder. Overall, treatments are quite similar for abacterial cystitis, and include bladder epithelium protective or anti-inflammatory agents, alleviating pain and reducing bleeding. This review summarizes the mechanisms that the pathologies have in common, for instance, bladder dysfunction and inflammation. Conversely, some mechanisms have been described as present in only one pathology, such as neural regulation. Based on these specificities, we propose identifying a mechanism that could be common to all the above-mentioned pathologies.
Collapse
|
12
|
Zwaans BMM, Grobbel M, Carabulea AL, Lamb LE, Roccabianca S. Increased extracellular matrix stiffness accompanies compromised bladder function in a murine model of radiation cystitis. Acta Biomater 2022; 144:221-229. [PMID: 35301146 PMCID: PMC9100859 DOI: 10.1016/j.actbio.2022.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/14/2022] [Accepted: 03/08/2022] [Indexed: 11/30/2022]
Abstract
Radiation cystitis, a long-term bladder defect due to pelvic radiation therapy, results in lower urinary tract symptoms, such as urinary frequency and nocturia, suggestive of compromised bladder compliance. The goal of this study was to identify alterations to the mechanical behavior of the urinary bladder extracellular matrix of a murine model of radiation cystitis, at 3 and 6 months after radiation exposure. The results of this study demonstrated that the extracellular matrix of irradiated bladders was significantly less distensible when compared to age matching controls. These findings coincided with functional bladder changes, including increased number of voids and decreased voided volume. Both mechanical and functional changes were apparent at 3 months post-irradiation and were statistically significant at 6 months, demonstrating the progressive nature of radiation cystitis. Overall, the results of this study indicate that irradiation exposure changes both the mechanical and physiological properties of the bladder. STATEMENT OF SIGNIFICANCE: In humans, radiation cystitis results in lower urinary tract symptoms, such as urinary frequency and nocturia, suggestive of compromised bladder compliance. This pathology can significantly affect recovery and quality of life for cancer survivors. Gaining knowledge about how alterations to the mechanical behavior of the urinary bladder extracellular matrix can affect urinary function will have a significant impact on this population. The results of this study demonstrated that the extracellular matrix of irradiated bladders was significantly less distensible when compared to age matching controls, in a mouse model of radiation cystitis. These findings were accompanied by functional voiding changes, including increased number of voids and decreased voided volume. The results of this study uncovered that irradiation exposure changes the mechanical and physiological properties of the bladder.
Collapse
Affiliation(s)
- Bernadette M M Zwaans
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States; Oakland University William Beaumont School of Medicine, Rochester, MI, United States
| | - Marissa Grobbel
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States
| | | | - Laura E Lamb
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States; Oakland University William Beaumont School of Medicine, Rochester, MI, United States
| | - Sara Roccabianca
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, United States.
| |
Collapse
|
13
|
Understanding Molecular Mechanisms and Identifying Key Processes in Chronic Radiation Cystitis. Int J Mol Sci 2022; 23:ijms23031836. [PMID: 35163758 PMCID: PMC8836784 DOI: 10.3390/ijms23031836] [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: 12/26/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
Chronic radiation cystitis (CRC) is a consequence of pelvic radiotherapy and affects 5–10% of patients. The pathology of CRC is without curative treatment and is characterized by incontinence, pelvic pain and hematuria, which severely degrades patients’ quality of life. Current management strategies rely primarily on symptomatic measures and have certain limitations. Thanks to a better understanding of the pathophysiology of radiation cystitis, studies targeting key manifestations such as inflammation, neovascularization and cell atrophy have emerged and are promising avenues for future treatment. However, the mechanisms of CRC are still better described in animal models than in human models. Preclinical studies conducted to elucidate the pathophysiology of CRC use distinct models and are most often limited to specific processes, such as fibrosis, vascular damage and inflammation. This review presents a synthesis of experimental studies aimed at improving our understanding of the molecular mechanisms at play and identifying key processes in CRC.
Collapse
|
14
|
Murugapoopathy V, Cammisotto PG, Mossa AH, Campeau L, Gupta IR. Osr1 Is Required for Mesenchymal Derivatives That Produce Collagen in the Bladder. Int J Mol Sci 2021; 22:ijms222212387. [PMID: 34830270 PMCID: PMC8619163 DOI: 10.3390/ijms222212387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 11/24/2022] Open
Abstract
The extracellular matrix of the bladder consists mostly of type I and III collagen, which are required during loading. During bladder injury, there is an accumulation of collagen that impairs bladder function. Little is known about the genes that regulate production of collagens in the bladder. We demonstrate that the transcription factor Odd-skipped related 1 (Osr1) is expressed in the bladder mesenchyme and epithelium at the onset of development. As development proceeds, Osr1 is mainly expressed in mesenchymal progenitors and their derivatives. We hypothesized that Osr1 regulates mesenchymal cell differentiation and production of collagens in the bladder. To test this hypothesis, we examined newborn and adult mice heterozygous for Osr1, Osr1+/−. The bladders of newborn Osr1+/− mice had a decrease in collagen I by western blot analysis and a global decrease in collagens using Sirius red staining. There was also a decrease in the cellularity of the lamina propria, where most collagen is synthesized. This was not due to decreased proliferation or increased apoptosis in this cell population. Surprisingly, the bladders of adult Osr1+/− mice had an increase in collagen that was associated with abnormal bladder function; they also had a decrease in bladder capacity and voided more frequently. The results suggest that Osr1 is important for the differentiation of mesenchymal cells that give rise to collagen-producing cells.
Collapse
Affiliation(s)
| | - Philippe G. Cammisotto
- Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada; (P.G.C.); (A.H.M.); (L.C.)
| | - Abubakr H. Mossa
- Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada; (P.G.C.); (A.H.M.); (L.C.)
| | - Lysanne Campeau
- Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada; (P.G.C.); (A.H.M.); (L.C.)
- Division of Urology, Department of Surgery, Jewish General Hospital, McGill University, Montreal, QCH3T 1E2, Canada
| | - Indra R. Gupta
- Department of Human Genetics, McGill University, Montreal, QC H3A 0C7, Canada;
- Research Institute of the McGill University Health Center, Montreal, QC H3H 2R9, Canada
- Department of Pediatrics, McGill University, Montreal, QC H4A 3J1, Canada
- Correspondence:
| |
Collapse
|
15
|
Voiding defects in acute radiation cystitis driven by urothelial barrier defect through loss of E-cadherin, ZO-1 and Uroplakin III. Sci Rep 2021; 11:19277. [PMID: 34588475 PMCID: PMC8481534 DOI: 10.1038/s41598-021-98303-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/30/2021] [Indexed: 11/22/2022] Open
Abstract
Long term-side effects from cancer therapies are a growing health care concern as life expectancy among cancer survivors increases. Damage to the bladder is common in patients treated with radiation therapy for pelvic cancers and can result in radiation (hemorrhagic) cystitis (RC). The disease progression of RC consists of an acute and chronic phase, separated by a symptom-free period. Gaining insight in tissue changes associated with these phases is necessary to develop appropriate interventions. Using a mouse preclinical model, we have previously shown that fibrosis and vascular damage are the predominant pathological features of chronic RC. The goal of this study was to determine the pathological changes during acute RC. We identified that radiation treatment results in a temporary increase in micturition frequency and decrease in void volume 4–8 weeks after irradiation. Histologically, the micturition defect is associated with thinning of the urothelium, loss of urothelial cell–cell adhesion and tight junction proteins and decrease in uroplakin III expression. By 12 weeks, the urothelium had regenerated and micturition patterns were similar to littermate controls. No inflammation or fibrosis were detected in bladder tissues after irradiation. We conclude that functional bladder defects during acute RC are driven primarily by a urothelial defect.
Collapse
|
16
|
Zwaans BMM, Nicolai HE, Chancellor MB, Lamb LE. Prostate cancer survivors with symptoms of radiation cystitis have elevated fibrotic and vascular proteins in urine. PLoS One 2020; 15:e0241388. [PMID: 33119677 PMCID: PMC7595289 DOI: 10.1371/journal.pone.0241388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/13/2020] [Indexed: 01/22/2023] Open
Abstract
Radiation for pelvic cancers can result in severe bladder damage and radiation cystitis (RC), which is characterized by chronic inflammation, fibrosis, and vascular damage. RC development is poorly understood because bladder biopsies are difficult to obtain. The goal of this study is to gain understanding of molecular changes that drive radiation-induced cystitis in cancer survivors using urine samples from prostate cancer survivors with history of radiation therapy. 94 urine samples were collected from prostate cancer survivors with (n = 85) and without (n = 9) history of radiation therapy. 15 patients with radiation history were officially diagnosed with radiation cystitis. Levels of 47 different proteins were measured using Multiplex Luminex. Comparisons were made between non-irradiated and irradiated samples, and within irradiated samples based on radiation cystitis diagnosis, symptom scores or hematuria. Statistical analysis was performed using Welch’s t-test. In prostate cancer survivors with history of radiation therapy, elevated levels of PAI 1, TIMP1, TIMP2, HGF and VEGF-A were detected in patients that received a radiation cystitis diagnosis. These proteins were also increased in patients suffering from hematuria or high symptom scores. No inflammatory proteins were detected in the urine, except in patients with gross hematuria and end stage radiation cystitis. Active fibrosis and vascular distress is detectable in the urine through elevated levels of associated proteins. Inflammation is only detected in urine of patients with end-stage radiation cystitis disease. These results suggest that fibrosis and vascular damage drive the development of radiation cystitis and could lead to the development of more targeted treatments.
Collapse
Affiliation(s)
- Bernadette M. M. Zwaans
- Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
| | - Heinz E. Nicolai
- Departamento de Urología, Universidad de Chile, Santiago, Chile
- Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - Michael B. Chancellor
- Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
| | - Laura E. Lamb
- Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
- * E-mail:
| |
Collapse
|
17
|
Singh N, Zabbarova I, Ikeda Y, Maranchie J, Chermansky C, Foley L, Hitchens TK, Yoshimura N, Kanai A, Kaufman J, Tyagi P. Virtual measurements of paracellular permeability and chronic inflammation via color coded pixel-wise T 1 mapping. Am J Physiol Renal Physiol 2020; 319:F506-F514. [PMID: 32715761 DOI: 10.1152/ajprenal.00025.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To assess whether quantitative T1 relaxometry can measure permeability, chronic inflammation and mural thickening of mouse bladder wall. Adult female C57BL6 mice unexposed to radiation (controls) or 40 wk postirradiation of 10 Gy were scanned at 9.4 T before and after instillation (0.1 mL) of aqueous, novel contrast mixture (NCM) containing 4 mM gadobutrol and 5 mM ferumoxytol. Rapid acquisition with refocused echo (RARE) sequence was used with variable repetition times (TR). Pixel-wise maps of T1 relaxation times for the segmented bladder wall layers were generated from voxel-wise, nonlinear least square data fitting of TR-dependent signal intensity acquired with TR array of 0.4-10 s followed by the histology of harvested bladder. Significant differences between precontrast and postcontrast T1 (ΔT1) were noted in urothelium and lamina propria of both groups but only in detrusor of irradiated group (P < 0.001; 2-way ANOVA). Nearly twofold higher gadobutrol permeability (550 ± 73 vs. 294 ± 160 μM; P < 0.01) derived as per 1/ΔT1 = r1. [C] in urothelium of irradiated group. Inflammation and bladder wall thickening (0.75 ± 0. vs. 0.44 ± 0.08 mm; P < 0.001) predicted by MRI was subsequently confirmed by histology and altered expression of CD45 and zonula occludens-1 (ZO-1) relative to controls. NCM enhanced MRI relies on the retention of large molecular weight ferumoxytol in lumen for negative contrast, while permeation of the non-ionic, small molecular weight gadobutrol through ZO-1 generates positive contrast in bladder wall for virtual measurement of paracellular permeability and assessment of chronic inflammation in thin and distensible bladder wall, which is also defined by its variable shape and location within pelvis.
Collapse
Affiliation(s)
- Nishant Singh
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Irina Zabbarova
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Youko Ikeda
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jodi Maranchie
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Lesley Foley
- Advanced Imaging Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - T Kevin Hitchens
- Advanced Imaging Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Naoki Yoshimura
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anthony Kanai
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
18
|
Bartolone SN, Ward EP, Wang Z, Zwaans BMM, Chancellor MB, Bjorling DE, Lamb LE. Micturition defects and altered bladder function in the klotho mutant mouse model of aging. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2020; 8:81-92. [PMID: 32699807 PMCID: PMC7364365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES Symptoms associated with detrusor underactivity (DU) or underactive bladder (UAB) can severely impact a person's quality of life, and growing old is the main etiological factor of DU and UAB. The gene Klotho has been associated with suppression of several aging phenotypes, and there is moderate klotho expression in the bladder. Given this, we hypothesized that the klotho gene is involved in regulation of bladder function. Thus, we examined a premature aging rodent genetic model with hypomorphic klotho expression for alterations in bladder function. METHODS Klotho mutant mice are established as a preclinical model of aging. Male and female klotho mice had micturition measured at weeks 4, 6, and 8 through metabolic cage and void spot assays. Histology was assessed at 4, 6, and 8 weeks. Lastly, bladder contraction was assessed using bladder strip tissue bath. All animals were gender- and age-matched with wild-type littermates for analysis. RESULTS Void spot and bladder contraction assays revealed that klotho mutant mice, similar to other aging models, have increased voiding frequency and decreased voiding volume per micturition event. The in vitro contractile response to electrical stimulation was weaker and muscarinic receptor subtype expression was reduced in the in klotho mutant mouse bladders. These data suggest that klotho mutant mouse bladders had impaired bladder function. CONCLUSIONS Klotho mutant mice recapitulate many characteristics of an older dysfunctional bladder, including altered bladder function. Given the short time frame to bladder dysfunction and robustness of the model, this model will provide new insights to drive aging bladder research.
Collapse
Affiliation(s)
| | - Elijah P Ward
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
| | - Zunyi Wang
- Department of Surgical Services, School of Veterinary Medicine, University of Wisconsin-MadisonMadison, WI, USA
| | - Bernadette MM Zwaans
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
- Oakland University William Beaumont School of MedicineRochester Hills, MI, USA
| | - Michael B Chancellor
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
- Oakland University William Beaumont School of MedicineRochester Hills, MI, USA
| | - Dale E Bjorling
- Department of Surgical Services, School of Veterinary Medicine, University of Wisconsin-MadisonMadison, WI, USA
| | - Laura E Lamb
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
- Oakland University William Beaumont School of MedicineRochester Hills, MI, USA
| |
Collapse
|
19
|
Zwaans BMM, Wegner KA, Bartolone SN, Vezina CM, Chancellor MB, Lamb LE. Radiation cystitis modeling: A comparative study of bladder fibrosis radio-sensitivity in C57BL/6, C3H, and BALB/c mice. Physiol Rep 2020; 8:e14377. [PMID: 32109348 PMCID: PMC7048381 DOI: 10.14814/phy2.14377] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 12/12/2022] Open
Abstract
A subset of patients receiving radiation therapy for pelvic cancer develop radiation cystitis, a complication characterized by mucosal cell death, inflammation, hematuria, and bladder fibrosis. Radiation cystitis can reduce bladder capacity, cause incontinence, and impair voiding function so severely that patients require surgical intervention. Factors influencing onset and severity of radiation cystitis are not fully known. We tested the hypothesis that genetic background is a contributing factor. We irradiated bladders of female C57BL/6, C3H, and BALB/c mice and evaluated urinary voiding function, bladder shape, histology, collagen composition, and distribution of collagen-producing cells. We found that the genetic background profoundly affects the severity of radiation-induced bladder fibrosis and urinary voiding dysfunction. C57BL/6 mice are most susceptible and C3H mice are most resistant. Irradiated C57BL/6 mouse bladders are misshapen and express more abundant collagen I and III proteins than irradiated C3H and BALB/c bladders. We localized Col1a1 and Col3a1 mRNAs to FSP1-negative stromal cells in the bladder lamina propria and detrusor. The number of collagen I and collagen III-producing cells can predict the average voided volume of a mouse. Collectively, we show that genetic factors confer sensitivity to radiation cystitis, establish C57BL/6 mice as a sensitive preclinical model, and identify a potential role for FSP1-negative stromal cells in radiation-induced bladder fibrosis.
Collapse
Affiliation(s)
- Bernadette M. M. Zwaans
- Department of UrologyWilliam Beaumont HospitalRoyal OakMIUSA
- Oakland University William Beaumont School of MedicineRoyal OakMIUSA
| | - Kyle A. Wegner
- Molecular and Environmental Toxicology CenterSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWIUSA
- Department of Comparative BiosciencesSchool of Veterinary MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
| | | | - Chad M. Vezina
- Molecular and Environmental Toxicology CenterSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWIUSA
- Department of Comparative BiosciencesSchool of Veterinary MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Michael B. Chancellor
- Department of UrologyWilliam Beaumont HospitalRoyal OakMIUSA
- Oakland University William Beaumont School of MedicineRoyal OakMIUSA
| | - Laura E. Lamb
- Department of UrologyWilliam Beaumont HospitalRoyal OakMIUSA
- Oakland University William Beaumont School of MedicineRoyal OakMIUSA
| |
Collapse
|