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Sekerci CA, Yucel S, Tarcan T. Urinary biomarkers in children with neurogenic and non-neurogenic lower urinary tract dysfunction: A systematic review and meta-analysis. Neurourol Urodyn 2024; 43:1003-1018. [PMID: 38238982 DOI: 10.1002/nau.25382] [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: 11/14/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 04/19/2024]
Abstract
AIM The aim of this systematic review is to assess urinary biomarkers studied in children with neurogenic and non-neurogenic lower urinary tract dysfunction (LUTD). MATERIALS AND METHODS The systematic review was conducted in accordance with the PRISMA guidelines. The screening was performed on PUBMED without any publication date limitation. Only original articles were included. Parameters related to the following topics were obtained: study design, characteristics of participants, number of participants, age, control group, types of biomarkers, measurement technique in urine, subgroup analysis, urodynamic findings, and outcome. Dutch Cochrane Checklist (DCC) and level of evidence by EBRO platform were used for quality assessment. Meta-analysis was performed with the Comprehensive Meta-Analysis Version 4 program. RESULTS A total of 494 studies were screened and 16 studies were included. 11 (68.75%) were conducted in children with non-neurogenic LUTD and 5 (31.25%) neurogenic LUTD. Nerve growth factor (NGF) was evaluated in 12 studies, brain-derived neurotrophic factor (BDNF) in 5, Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) in 2, transforming growth factor beta-1 (TGF Beta-1) in 2, neutrophil gelatinase-associated lipocalin (NGAL) in 1, and Aquaporin-2 in 1. According to DCC, 10 (62.5%) articles were evaluated on 4 (37.5%) items and 4 articles on 5 items. The average score was 3.91+/-0.56. The level of evidence was found as B for 13 (81.25%) articles and C for 3 (18.75%). In meta-analysis, urinary NGF levels in children with non-neurogenic LUTS were significantly higher than in the healthy control group (Hedges's g = 1.867, standard error = 0.344, variance = 0.119, p = 0.0001). CONCLUSION Urinary biomarkers are promising for the future with their noninvasive features. However, prospective studies with larger sample sizes are needed to better understand the potential of urinary biomarkers to reflect urodynamic and clinical findings in children with LUTD.
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Affiliation(s)
- Cagri Akin Sekerci
- Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Selcuk Yucel
- Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Tufan Tarcan
- Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey
- Department of Urology, School of Medicine, Koç University, Istanbul, Turkey
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Neurophysiological control of urinary bladder storage and voiding-functional changes through development and pathology. Pediatr Nephrol 2021; 36:1041-1052. [PMID: 32415328 DOI: 10.1007/s00467-020-04594-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
The effective storage of urine and its expulsion relies upon the coordinated activity of parasympathetic, sympathetic, and somatic innervations to the lower urinary tract (LUT). At birth, all mammalian neonates lack the ability to voluntary regulate bladder storage or voiding. The ability to control urinary bladder activity is established as connections to the central nervous system (CNS) form through development. The neural regulation of the LUT has been predominantly investigated in adult animal models where comparatively less is known about the neonatal and postnatal neurophysiological development that facilitate urinary continence. Furthermore, congenital neurological or anatomical defects can adversely affect both storage and voiding functions through postnatal development and into adulthood, leading to secondary conditions including vesicoureteral reflux, chronic urinary tract infections, and end-stage renal disease. Therefore, the aim of the review is to provide the current knowledge available on neurophysiological regulation of the LUT through pre- to postnatal development of human and animal models and the consequences of congenital anomalies that can affect LUT neural function.
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Bagińska J, Korzeniecka-Kozerska A. Non-invasive markers in the management of pediatric neurogenic bladder over the last two decades - A review. Adv Med Sci 2021; 66:162-169. [PMID: 33621833 DOI: 10.1016/j.advms.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/31/2020] [Accepted: 02/04/2021] [Indexed: 12/26/2022]
Abstract
Neurogenic bladder (NB) is one of the most challenging problems in nephro-urological management in pediatrics. It is an important risk factor of secondary upper urinary tract damage. A complete clinical evaluation is necessary and requires life-long extensive medical attention including invasive procedures that affect patients' quality of life. Potential non-invasive biomarkers would be desirable, especially in the pediatric population. The aim of this review was to analyze two decades of data regarding potential non-invasive biomarkers in the assessment and follow-up of children with NB. This paper summarizes and appraises the knowledge about both biochemical and imaging-based markers in 3 aspects: markers of urinary tract infections (UTIs), bladder and renal function, and this paper looks at their prospective application in everyday clinical care.
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Affiliation(s)
- Joanna Bagińska
- Department of Pediatrics and Nephrology, Medical University of Bialystok, Poland.
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Peyronnet B, Richard C, Bendavid C, Naudet F, Hascoet J, Brochard C, Senal N, Jezequel M, Alimi Q, Khene Z, Corlu A, Clément B, Siproudhis L, Bouguen G, Kerdraon J, Manunta A, Gamé X. Urinary TIMP‐2 and MMP‐2 are significantly associated with poor bladder compliance in adult patients with spina bifida. Neurourol Urodyn 2019; 38:2151-2158. [DOI: 10.1002/nau.24163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/25/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Benoit Peyronnet
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
| | - Claire Richard
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
| | | | - Florian Naudet
- Service de pharmaco‐épidémiologieCHU Rennes Rennes France
| | - Juliette Hascoet
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
| | - Charlène Brochard
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
- Service de Gastro‐EntérologieCHU Rennes Rennes France
| | - Nelly Senal
- Centre de référence spina bifidaCHU Rennes Rennes France
- Service de médecine physique et réadaptationFondation Calvé Berck‐sur‐mer France
| | | | - Quentin Alimi
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
| | | | | | | | - Laurent Siproudhis
- Centre de référence spina bifidaCHU Rennes Rennes France
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
- Service de pharmaco‐épidémiologieCHU Rennes Rennes France
| | - Guillaume Bouguen
- Equipe thématique INPHY CIC 1414 et INSERM UMR 991CHU Rennes Rennes France
- Service de Gastro‐EntérologieCHU Rennes Rennes France
| | - Jacques Kerdraon
- Centre de référence spina bifidaCHU Rennes Rennes France
- Service des blessés médullairesCentre de rééducation de Kerpape Ploemeur France
| | - Andrea Manunta
- Service d'urologieCHU Rennes Rennes France
- Centre de référence spina bifidaCHU Rennes Rennes France
| | - Xavier Gamé
- Département d’Urologie, Transplantation Rénale et AndrologieCHU Rangueil Toulouse France
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Tang L, Zhong H, Chen H, Shen J, Bi Y, Xiao X. In utero repair of fetal rat myelomeningocele affects neuromuscular development in the bladder. Exp Ther Med 2017; 14:3681-3687. [PMID: 29042964 PMCID: PMC5639334 DOI: 10.3892/etm.2017.4978] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 06/05/2017] [Indexed: 11/23/2022] Open
Abstract
Fetal repair of myelomeningocele (MMC) has been proven to be beneficial for the central nervous system development; however, the effect of fetal MMC repair on bladder function remains controversial. The objective of the present study was to establish an early timepoint for in utero MMC repair using a rat model, and to investigate the changes in bladder development subsequent to that intervention. Sprague Dawley rats were divided into the MMC, MMC repair and control groups. MMC rat fetus models were created by treating pregnant rats with all-trans retinoic acid. The MMC defect was then repaired in utero at embryonic day 17 (E17) using a chitosan-gelatin membrane patch. Fetal rat bladders were removed at E19 and E21 in each group, as well as at stage E17 in the MMC and control groups. Differential expression of β-III-tubulin, α-smooth muscle actin (α-SMA), nerve growth factor (NGF) and acetylcholinesterase (AChE) mRNA, and β-III-tubulin and α-SMA protein in the bladder following fetal repair was measured and compared among the three groups. In addition, the expression of NGF mRNA was significantly elevated at E21 in the MMC group compared with that of the control group, however, the level decreased in the repair group at stage E21. The expression of α-SMA mRNA significantly increased at E19 and then decreased at E21 in the repair group compared with that of the MMC group; however, there were no significant changes in α-SMA protein following the repair. Furthermore, the repair enhanced β-III-tubulin mRNA expression at E19, but ameliorated the decrease of β-III-tubulin protein at E21. The expression of AChE mRNA increased in the MMC group at E19 and E21 compared with that of the control group, although it was not significantly altered following repair as compared with that of the MMC group. In conclusion, in the current study, abnormal neuromuscular development was observed in the MMC bladder, which enabled a certain degree of improvement in the in utero MMC repair.
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Affiliation(s)
- Liangfeng Tang
- Department of Urology, Children's Hospital, Fudan University, Shanghai 201102, P.R. China
| | - Haijun Zhong
- Department of Urology, Children's Hospital, Fudan University, Shanghai 201102, P.R. China
| | - Hong Chen
- Department of Urology, Children's Hospital, Fudan University, Shanghai 201102, P.R. China
| | - Jian Shen
- Department of Urology, Children's Hospital, Fudan University, Shanghai 201102, P.R. China
| | - Yunli Bi
- Department of Urology, Children's Hospital, Fudan University, Shanghai 201102, P.R. China
| | - Xianmin Xiao
- Department of Surgery, Children's Hospital, Fudan University, Shanghai 201102, P.R. China
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Krebs J, Pavlicek D, Stoyanov J, Pannek J, Wöllner J. Nerve growth factor does not seem to be a biomarker for neurogenic lower urinary tract dysfunction after spinal cord injury. Neurourol Urodyn 2016; 36:659-662. [PMID: 26950046 DOI: 10.1002/nau.22987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/12/2016] [Indexed: 12/24/2022]
Abstract
AIM To prospectively investigate the association of bladder function with the nerve growth factor (NGF) concentration in the urine of individuals with neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI). METHODS Individuals with chronic SCI and NLUTD presenting for a routine urologic examination at a tertiary urologic referral center were recruited for the study. Patient characteristics, the current bladder evacuation method and urodynamic parameters were collected. As controls, individuals with normal bladder function were recruited from the staff of a SCI rehabilitation center. The urinary NGF concentration was measured in triplicates by enzyme linked immunosorbent assay with a minimal sensitivity of 10 pg/ml. RESULTS The data of 10 and 37 individuals with normal bladder function and NLUTD, respectively, were analyzed. The urinary NGF concentration was below 10 pg/ml in all investigated samples. CONCLUSIONS The urinary NGF concentration did not differentiate between individuals with normal bladder function and those with NLUTD. At least in patients with SCI, the urinary NGF concentration does not seem to be a clinically relevant biomarker for NLUTD. Neurourol. Urodynam. 36:659-662, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jörg Krebs
- Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland
| | | | | | - Jürgen Pannek
- Neurourology, Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Jens Wöllner
- Neurourology, Swiss Paraplegic Centre, Nottwil, Switzerland
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Peyronnet B, Bendavid C, Manunta A, Damphousse M, Cheensse C, Brochard C, Castel-Lacanal E, Siproudhis L, Bensalah K, Gamé X. [The role of urinary markers in the assessment and follow-up of lower urinary tract disorders: a literature review]. Prog Urol 2014; 25:188-99. [PMID: 25482921 DOI: 10.1016/j.purol.2014.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 11/07/2014] [Accepted: 11/10/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To conduct a literature review on the role of urinary biomarkers in the initial assessment and follow-up of lower urinary tract symptoms. METHODS A literature review was conducted in August 2014 using the Medline/Pubmed database limiting the search to work in English or French. RESULTS Most studies were of level of evidence 2 or 3 (prospective cohort, controlled or not) and mainly about overactive bladder and bladder pain syndrome. Nerve Growth Factor (NGF) was the most studied and apparently the most promising in the evaluation of overactive bladder (OAB) and neurogenic detrusor overactivity (NDO). Urinary levels of ATP, prostaglandin E2 (PGE2), Brain-Derived Neurotrophic Factor (BDNF) and some cytokines were also significantly higher in most studies in patients with NDO or OAB. Epidermal Growth Factor (EGF), Heparin-Binding EGF (HBEGF) and Antiproliferative Factor (APF) were the most studied urinary markers in bladder pain syndrome, with a significant increase (EGF APF) or decrease (HBEGF) in cases of interstitial cystitis (compared to healthy controls). The urinary N-terminal-telopeptide (NTx) could be predictive of a failed mid-urethral sling. However, few studies reported the diagnostic values of the markers, their association with urodynamic parameters were rarely evaluated and the existence of a publication bias is likely. No randomized controlled study has so far compared the urinary markers to urodynamic evaluation. CONCLUSION In the future, urinary markers could complete or replace urodynamic examination. However, to date, there is no high level of evidence study comparing these markers to urodynamics and their use can therefore not be recommended in daily practice.
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Affiliation(s)
- B Peyronnet
- Service d'urologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse, France.
| | - C Bendavid
- Service de biochimie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - A Manunta
- Service d'urologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - M Damphousse
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de médecine physique et rééducation, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - C Cheensse
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de médecine physique et rééducation, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - C Brochard
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de gastro-entérologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - E Castel-Lacanal
- Service de médecine physique et rééducation, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhes, 31400 Toulouse, France
| | - L Siproudhis
- Centre de référence maladies rares spina bifida, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France; Service de gastro-entérologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - K Bensalah
- Service d'urologie, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse, France
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Korzeniecka-Kozerska A, Wasilewska A. Urinary nerve growth factor in patients with detrusor overactivity. Ir J Med Sci 2014; 184:737-43. [PMID: 24951086 PMCID: PMC4611025 DOI: 10.1007/s11845-014-1162-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 06/15/2014] [Indexed: 12/15/2022]
Abstract
Background Detrusor overactivity (DO) is one of the most frequent bladder dysfunctions in children up to the age of 18. Nowadays, the only way to confirm DO is by urodynamic investigation, which is an invasive procedure. Among the many mediators influencing bladder function, nerve growth factor (NGF) plays an important role. The present study was designed to measure urinary NGF (uNGF) levels in patients with DO diagnosed by urodynamic study in comparison with healthy controls. Methods The investigation was conducted on 44 children, divided into two groups (24 patients with DO, 20 healthy children). Uroflowmetry was performed in all enrolled to the study and cystometry only to patients. uNGF levels were estimated in both studied groups. Results The median uNGF level in patients with DO before treatment was higher compared with healthy controls. There were no differences between uNGF levels in patients after anticholinergic treatment and the controls. We found differences in uroflowmetry parameters between the reference group and the patients. We found correlations between uroflowmetry parameters and uNGF/cr. level. Conclusions The uNGF level could be used for detecting DO in children and adolescents. Measuring uNGF level is a simple, noninvasive procedure and very useful for choosing therapy in patients with DO in various clinical conditions.
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Affiliation(s)
- A Korzeniecka-Kozerska
- Department of Pediatrics and Nephrology, Medical University of Bialystok, 17 Waszyngtona Street, 15-274, Bialystok, Poland.
| | - A Wasilewska
- Department of Pediatrics and Nephrology, Medical University of Bialystok, 17 Waszyngtona Street, 15-274, Bialystok, Poland
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