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Ye S, Mahmood DFD, Ma F, Leng L, Bucala R, Vera PL. Urothelial Oxidative Stress and ERK Activation Mediate HMGB1-Induced Bladder Pain. Cells 2023; 12:1440. [PMID: 37408274 PMCID: PMC10217556 DOI: 10.3390/cells12101440] [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: 04/17/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 07/07/2023] Open
Abstract
Activation of intravesical protease activated receptors-4 (PAR4) results in bladder pain through the release of urothelial macrophage migration inhibitory factor (MIF) and high mobility group box-1 (HMGB1). We aimed to identify HMGB1 downstream signaling events at the bladder that mediate HMGB1-induced bladder pain in MIF-deficient mice to exclude any MIF-related effects. We studied whether oxidative stress and ERK activation are involved by examining bladder tissue in mice treated with intravesical disulfide HMGB1 for 1 h and analyzed with Western blot and immunohistochemistry. HMGB1 intravesical treatment increased urothelium 4HNE and phospho-ERK1/2 staining, suggesting that HMGB1 increased urothelial oxidative stress and ERK activation. Furthermore, we examined the functional roles of these events. We evaluated lower abdominal mechanical thresholds (an index of bladder pain) before and 24 h after intravesical PAR4 or disulfide HMGB1. Intravesical pre-treatments (10 min prior) included: N-acetylcysteine amide (NACA, reactive oxygen species scavenger) and FR180204 (FR, selective ERK1/2 inhibitor). Awake micturition parameters (voided volume; frequency) were assessed at 24 h after treatment. Bladders were collected for histology at the end of the experiment. Pre-treatment with NACA or FR significantly prevented HMGB1-induced bladder pain. No significant effects were noted on micturition volume, frequency, inflammation, or edema. Thus, HMGB1 activates downstream urothelial oxidative stress production and ERK1/2 activation to mediate bladder pain. Further dissection of HMGB1 downstream signaling pathway may lead to novel potential therapeutic strategies to treat bladder pain.
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Affiliation(s)
- Shaojing Ye
- Lexington VA Health Care System, Research & Development, Lexington, KY 40502, USA
| | - Dlovan F. D. Mahmood
- Lexington VA Health Care System, Research & Development, Lexington, KY 40502, USA
| | - Fei Ma
- Lexington VA Health Care System, Research & Development, Lexington, KY 40502, USA
| | - Lin Leng
- Department of Internal Medicine, Yale University, New Haven, CT 06510, USA
| | - Richard Bucala
- Department of Internal Medicine, Yale University, New Haven, CT 06510, USA
| | - Pedro L. Vera
- Lexington VA Health Care System, Research & Development, Lexington, KY 40502, USA
- Department of Physiology, University of Kentucky, Lexington, KY 40506, USA
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Oliveira AL, Medeiros ML, de Oliveira MG, Teixeira CJ, Mónica FZ, Antunes E. Enhanced RAGE Expression and Excess Reactive-Oxygen Species Production Mediates Rho Kinase-Dependent Detrusor Overactivity After Methylglyoxal Exposure. Front Physiol 2022; 13:860342. [PMID: 35418871 PMCID: PMC8996136 DOI: 10.3389/fphys.2022.860342] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/11/2022] [Indexed: 12/23/2022] Open
Abstract
Methylglyoxal (MGO) is a highly reactive dicarbonyl compound implicated in diabetes-associated diseases. In vascular tissues, MGO induces the formation of advanced glycation end products (AGEs) that bounds its receptor RAGE, initiating the downstream tissue injury. Outside the cardiovascular system, MGO intake produces mouse voiding dysfunction and bladder overactivity. We have sought that MGO-induced bladder overactivity is due to activation of AGE-RAGE-reactive-oxygen species (ROS) signaling cascade, leading to Rho kinase activation. Therefore, female mice received 0.5% MGO orally for 12 weeks, after which in vitro bladder contractions were evaluated in the presence or not of superoxide dismutase (PEG-SOD) or the Rho kinase inhibitor Y27632. Treatment with MGO significantly elevated the serum levels of MGO and fluorescent AGEs, as well as the RAGE immunostaining in the urothelium, detrusor, and vascular endothelium. RAGE mRNA expression in the bladder was also higher in the MGO group. Methylglyoxal significantly increased the ROS production in both urothelium and detrusor smooth muscle, with the increases in detrusor markedly higher than urothelium. The bladder activity of superoxide dismutase (SOD) was significantly reduced in the MGO group. Gene expressions of L-type Ca2+ channels, RhoA, ROCK-1, and ROCK-2 in bladder tissues were significantly elevated in the MGO group. Increased bladder contractions to electrical-field stimulation, carbachol α,β-methylene ATP, and extracellular Ca2+ were observed after MGO exposure, which was significantly reduced by prior incubation with either PEG-SOD or Y27632. Overall, our data indicate serum MGO accumulation elevates the AGEs levels and activates the RAGE-ROS signaling leading to Rho kinase-induced muscle sensitization, ultimately leading to detrusor overactivity.
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Affiliation(s)
- Akila L Oliveira
- Department of Pharmacology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Matheus L Medeiros
- Department of Pharmacology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Caio Jordão Teixeira
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of Sao Paulo, Sao Paulo, Brazil
| | - Fabíola Z Mónica
- Department of Pharmacology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Edson Antunes
- Department of Pharmacology, University of Campinas (UNICAMP), Campinas, Brazil
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Martin Jensen M, Jia W, Schults AJ, Ye X, Prestwich GD, Oottamasathien S. IL-33 mast cell axis is central in LL-37 induced bladder inflammation and pain in a murine interstitial cystitis model. Cytokine 2018; 110:420-427. [PMID: 29784508 PMCID: PMC6103803 DOI: 10.1016/j.cyto.2018.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 12/23/2022]
Abstract
Interstitial cystitis (IC), also known as painful bladder syndrome (PBS), is a debilitating chronic condition that afflicts over 3 million women above the age of 18 in the U.S., and most patients fail to respond to current treatment options. Mast cells have previously been implicated as both a diagnostic and prognostic marker in IC/PBS. Patients with IC/PBS have been shown to have elevated levels of IL-33, a cytokine released in response to tissue insult, in their urine. We hypothesize that mast cell-mediated inflammation induced from IL-33 may play an important role in initiating pain and inflammation in IC/PBS. A human cathelicidin, LL-37, which is found at elevated levels in IC/PBS patients, was used to induce an IC/PBS-like state of inflammation and bladder pain in mast cell deficient C-kit (-/-) and wild type C57Bl/6 (WT) mice. Inflammation was quantified using myeloperoxidase (MPO) expression in bladder tissues measured via ELISA. Response rate to suprapubic stimulation from von Frey filaments was used to assess the relative pain and discomfort. Both types of mice increased IL-33 expression in response to LL-37 exposure. However, mast cell deficient mice demonstrated significantly lower levels of inflammation (p < 0.001) and reduced pain response (p < 0.001) compared to WT mice. These findings implicate an IL-33-mast cell dependent axis with a potential etiology of pain and inflammation in IC/PBS. Future therapeutics aimed at targeting the IL-33 - mast cell axis could potentially serve as useful targets for treating IC/PBS.
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Affiliation(s)
- M Martin Jensen
- Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Wanjian Jia
- Division of Urology, Section of Pediatric Urology, University of Utah, Salt Lake City, UT, 84113, USA
| | - Austin J Schults
- Division of Urology, Section of Pediatric Urology, University of Utah, Salt Lake City, UT, 84113, USA
| | - Xiangyang Ye
- Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, 84112, USA
| | - Glenn D Prestwich
- Department of Medicinal Chemistry, University of Utah, Salt Lake City, UT, 84112, USA
| | - Siam Oottamasathien
- Division of Urology, Section of Pediatric Urology, University of Utah, Salt Lake City, UT, 84113, USA; Department of Medicinal Chemistry, University of Utah, Salt Lake City, UT, 84112, USA; Department of Surgery and Division of Pediatric Urology, Primary Children's Hospital, Salt Lake City, UT, 84113, USA; Department of Pediatric Surgery, Division of Pediatric Urology, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA 02114, USA.
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Jia W, Schults AJ, Jensen MM, Ye X, Alt JA, Prestwich GD, Oottamasathien S. Bladder pain in an LL-37 interstitial cystitis and painful bladder syndrome model. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2017; 5:10-17. [PMID: 29034266 PMCID: PMC5636891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/04/2017] [Indexed: 06/07/2023]
Abstract
Our goal was to evaluate the pain response in an LL-37 induced murine model for interstitial cystitis/painful bladder syndrome (IC/PBS). In particular, we sought to characterize the dose dependence, time-course, and relationship of LL-37 induced bladder inflammation and pain. The IC/PBS model was induced in C57Bl/6 mice by instilling 50 μL of LL-37, an immunomodulatory human cathelicidin (anti-microbial peptide), in the bladder for 1 hr. Pain responses were measured using von Frey filaments (0.04 gm to 4.0 gm) before and after LL-37 instillation. Inflammation was evaluated using tissue myeloperoxidase (MPO) assay, gross inspection, and microscopic histologic examination. The dose response experiment demonstrated a graded pain response, with higher concentrations of LL-37 challenge yielding higher pain responses across all stimuli tested. Statistical significance was seen when comparing 1.0 gm von Frey filament results at 320 μM (68 ± 8% response) vs. 0 μM (38 ± 6% response). Interestingly, pain responses did not attenuate across time but increased significantly after 5 (p=0.0012) and 7 days (p=0.0096). Comparison with MPO data suggested that pain responses could be independent of inflammation. We demonstrated within our LL-37 induced IC/PBS model pain occurs in a dose-dependent fashion, pain responses persist beyond the initial point of insult, and our dose response and time course experiments demonstrated that pain was independent of inflammation.
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Affiliation(s)
- Wanjian Jia
- Division of Urology, Section of Pediatric Urology, University of UtahSalt Lake City, UT
| | - Austin J Schults
- Division of Urology, Section of Pediatric Urology, University of UtahSalt Lake City, UT
| | | | - Xiangyang Ye
- Department of Pharmacotherapy, University of UtahSalt Lake City, UT
- Center for Therapeutic Biomaterials, Department of Medicinal Chemistry, University of UtahSalt Lake City, UT
| | - Jeremiah A Alt
- Center for Therapeutic Biomaterials, Department of Medicinal Chemistry, University of UtahSalt Lake City, UT
- Department of Surgery and Division of OtolaryngologySalt Lake City, UT
| | - Glenn D Prestwich
- Department of Bioengineering, University of UtahSalt Lake City, UT
- Center for Therapeutic Biomaterials, Department of Medicinal Chemistry, University of UtahSalt Lake City, UT
| | - Siam Oottamasathien
- Division of Urology, Section of Pediatric Urology, University of UtahSalt Lake City, UT
- Center for Therapeutic Biomaterials, Department of Medicinal Chemistry, University of UtahSalt Lake City, UT
- Department of Surgery and Division of Pediatric Urology, Primary Children’s HospitalSalt Lake City, UT
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Ma F, Kouzoukas DE, Meyer-Siegler KL, Westlund KN, Hunt DE, Vera PL. Disulfide high mobility group box-1 causes bladder pain through bladder Toll-like receptor 4. BMC PHYSIOLOGY 2017; 17:6. [PMID: 28545586 PMCID: PMC5445386 DOI: 10.1186/s12899-017-0032-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/18/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Bladder pain is a prominent symptom in several urological conditions (e.g. infection, painful bladder syndrome/interstitial cystitis, cancer). Understanding the mechanism of bladder pain is important, particularly when the pain is not accompanied by bladder pathology. Stimulation of protease activated receptor 4 (PAR4) in the urothelium results in bladder pain through release of urothelial high mobility group box-1 (HMGB1). HGMB1 has two functionally active redox states (disulfide and all-thiol) and it is not known which form elicits bladder pain. Therefore, we investigated whether intravesical administration of specific HMGB1 redox forms caused abdominal mechanical hypersensitivity, micturition changes, and bladder inflammation in female C57BL/6 mice 24 hours post-administration. Moreover, we determined which of the specific HMGB1 receptors, Toll-like receptor 4 (TLR4) or receptor for advanced glycation end products (RAGE), mediate HMGB1-induced changes. RESULTS Disulfide HMGB1 elicited abdominal mechanical hypersensitivity 24 hours after intravesical (5, 10, 20 μg/150 μl) instillation. In contrast, all-thiol HMGB1 did not produce abdominal mechanical hypersensitivity in any of the doses tested (1, 2, 5, 10, 20 μg/150 μl). Both HMGB1 redox forms caused micturition changes only at the highest dose tested (20 μg/150 μl) while eliciting mild bladder edema and reactive changes at all doses. We subsequently tested whether the effects of intravesical disulfide HMGB1 (10 μg/150 μl; a dose that did not produce inflammation) were prevented by systemic (i.p.) or local (intravesical) administration of either a TLR4 antagonist (TAK-242) or a RAGE antagonist (FPS-ZM1). Systemic administration of either TAK-242 (3 mg/kg) or FPS-ZM1 (10 mg/kg) prevented HMGB1 induced abdominal mechanical hypersensitivity while only intravesical TLR4 antagonist pretreatment (1.5 mg/ml; not RAGE) had this effect. CONCLUSIONS The disulfide form of HMGB1 mediates bladder pain directly (not secondary to inflammation or injury) through activation of TLR4 receptors in the bladder. Thus, TLR4 receptors are a specific local target for bladder pain.
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Affiliation(s)
- Fei Ma
- Research and Development, Lexington Veterans Affairs Medical Center, 1101 Veterans Drive, Room C-327, Lexington, Kentucky, 40502, USA.,Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
| | - Dimitrios E Kouzoukas
- Research and Development, Lexington Veterans Affairs Medical Center, 1101 Veterans Drive, Room C-327, Lexington, Kentucky, 40502, USA.,Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, USA.,Present Address: Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Maywood, Illinois, USA
| | | | - Karin N Westlund
- Research and Development, Lexington Veterans Affairs Medical Center, 1101 Veterans Drive, Room C-327, Lexington, Kentucky, 40502, USA.,Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
| | - David E Hunt
- Research and Development, Lexington Veterans Affairs Medical Center, 1101 Veterans Drive, Room C-327, Lexington, Kentucky, 40502, USA
| | - Pedro L Vera
- Research and Development, Lexington Veterans Affairs Medical Center, 1101 Veterans Drive, Room C-327, Lexington, Kentucky, 40502, USA. .,Department of Physiology, University of Kentucky, Lexington, Kentucky, USA. .,Department of Surgery, University of Kentucky, Lexington, Kentucky, USA.
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Pouwels SD, Nawijn MC, Bathoorn E, Riezebos-Brilman A, van Oosterhout AJM, Kerstjens HAM, Heijink IH. Increased serum levels of LL37, HMGB1 and S100A9 during exacerbation in COPD patients. Eur Respir J 2016; 45:1482-5. [PMID: 25931489 DOI: 10.1183/09031936.00158414] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Simon D Pouwels
- Dept of Pathology and Medical Biology, Experimental Pulmonology and Inflammation Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martijn C Nawijn
- Dept of Pathology and Medical Biology, Experimental Pulmonology and Inflammation Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Erik Bathoorn
- Dept of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annelies Riezebos-Brilman
- Dept of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Antoon J M van Oosterhout
- Dept of Pathology and Medical Biology, Experimental Pulmonology and Inflammation Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Huib A M Kerstjens
- GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Dept of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Irene H Heijink
- Dept of Pathology and Medical Biology, Experimental Pulmonology and Inflammation Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Dept of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Protease-Activated Receptor 4 Induces Bladder Pain through High Mobility Group Box-1. PLoS One 2016; 11:e0152055. [PMID: 27010488 PMCID: PMC4806866 DOI: 10.1371/journal.pone.0152055] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/08/2016] [Indexed: 11/28/2022] Open
Abstract
Pain is the significant presenting symptom in Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS). Activation of urothelial protease activated receptor 4 (PAR4) causes pain through release of urothelial macrophage migration inhibitory factor (MIF). High Mobility Group Box-1 (HMGB1), a chromatin-binding protein, mediates bladder pain (but not inflammation) in an experimental model (cyclophosphamide) of cystitis. To determine if PAR4-induced bladder hypersensitivity depends on HMGB1 downstream, we tested whether: 1) bladder PAR4 stimulation affected urothelial HMGB1 release; 2) blocking MIF inhibited urothelial HMGB1 release; and 3) blocking HMGB1 prevented PAR4-induced bladder hypersensitivity. HMGB1 release was examined in immortalized human urothelial cultures (UROtsa) exposed to PAR4-activating peptide (PAR4-AP; 100 μM; 2 hours) or scrambled control peptide. Female C57BL/6 mice, pretreated with a HMGB1 inhibitor (glycyrrhizin: 50 mg/kg; ip) or vehicle, received intravesical PAR4-AP or a control peptide (100 μM; 1 hour) to determine 1) HMGB1 levels at 1 hour in the intravesical fluid (released HMGB1) and urothelium, and 2) abdominal hypersensitivity to von Frey filament stimulation 24 hours later. We also tested mice pretreated with a MIF blocker (ISO-1: 20 mg/kg; ip) to determine whether MIF mediated PAR4-induced urothelial HMGB1 release. PAR4-AP triggered HMGB1 release from human (in vitro) and mice (in vivo) urothelial cells. Intravesical PAR4 activation elicited abdominal hypersensitivity in mice that was prevented by blocking HMGB1. MIF inhibition prevented PAR4-mediated HMGB1 release from mouse urothelium. Urothelial MIF and HGMB1 represent novel targets for therapeutic intervention in bladder pain conditions.
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