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Umezawa Y, Yoshifuji K, Tanaka K, Nogami A, Nagano K, Tsuji A, Nagao T, Yamamoto M, Kajiwara M, Tohda S, Mori T. Impact of BK polyomavirus viremia on the outcomes of allogeneic hematopoietic stem cell transplantation. Ann Hematol 2024; 103:1737-1744. [PMID: 38509389 DOI: 10.1007/s00277-024-05707-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
Although it is known that BK polyomavirus (BKPyV) causes hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT), the clinical significance of BKPyV viremia has not been fully evaluated. We retrospectively analyzed the results of quantitative polymerase chain reaction (PCR) evaluations for detecting BKPyV in the whole blood samples of patients undergoing allogeneic HSCT during the period from January 2010 to June 2020 at a single institute, Tokyo Medical and Dental University. BKPyV was detected in the blood of 28 of the 107 evaluated patients, and the cumulative incidence of was 27.9% (95%CI: 20.2-37.9%). HC due to BKPyV developed in four of the 28 patients with BKPyV viremia (14.3%) and in two of the 79 patients without it (2.5%; P < 0.05). BKPyV viremia itself did not affect the patients' post-transplant estimated glomerular filtration rate (eGFR), but BKPyV viremia with a high viral load was significantly associated with decreased eGFR values (P < 0.05). BKPyV viremia was also associated with significantly lower progression-free survival at 3 years (35.1% [95%CI: 17.8-53.1%] vs. 60.4% [95%CI: 48.4-70.5], P < 0.05). Our findings demonstrated that BKPyV viremia was associated with onset of HC, an early decline of renal function, and poorer survival after allogeneic HSCT. Further studies are needed to test these results and elucidate the mechanisms of renal dysfunction associated with BKPyV viremia.
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Affiliation(s)
- Yoshihiro Umezawa
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
| | - Kota Yoshifuji
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Keisuke Tanaka
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Ayako Nogami
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
- Department of Laboratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Katsutoshi Nagano
- Department of Clinical Laboratory, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Ayako Tsuji
- Center for Transfusion Medicine and Cell Therapy, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Toshikage Nagao
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Masahide Yamamoto
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Michiko Kajiwara
- Center for Transfusion Medicine and Cell Therapy, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Shuji Tohda
- Department of Laboratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takehiko Mori
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
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Redondo-Sánchez J, Rodríguez-Barrientos R, de-Hoyos-Alonso MDC, Muntañola-Valero C, Almendro Martínez I, Peñalver-Argüeso B, Fernández-Escobar C, Gil-de Miguel Á, del Cura-González I. Trends in hospitalisation for urinary tract infection in adults aged 18-65 by sex in Spain: 2000 to 2015. PLoS One 2024; 19:e0298931. [PMID: 38626199 PMCID: PMC11020983 DOI: 10.1371/journal.pone.0298931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/02/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVE To analyse trends in urinary tract infection (UTIs) hospitalisation among patients adults 18-65 aged in Spain from 2000-2015. METHODS Retrospective observational study using the Spanish Hospitalisation Minimum Data Set (CMBD), with codifications by the International Classification of Diseases (ICD-9). Variables: Type of UTIs (pyelonephritis, prostatitis, cystitis and non-specific-UTIs), sex, age (in 5 categories: 18-49 and 50-64 years in men, and 18-44, 45-55 and 56-64 years in women), comorbidity, length of stay, costs and mortality associated with admission. The incidence of hospitalisation was studied according to sex, age group and type of UTIs per 100,000. Trends were identified using Joinpoint regression. RESULTS From 2000-2015, we found 259,804 hospitalisations for UTIs (51.6% pyelonephritis, 7.5% prostatitis, 0.6% cystitis and 40.3% non-specific UTIs). Pyelonephritis predominated in women and non-specific UTIs in men. The hospital stay and the average cost (2,160 EUR (IQR 1,7872,540 were greater in men. Overall mortality (0.4%) was greater in non-specific UTIs. More women were admitted (rates of 79.4 to 81.7) than in men (30.2 to 41). The greatest increase was found in men aged 50-64 years (from 59.3 to 87). In the Joinpoint analysis, the incidence of pyelonephritis increased in women [AAPC 2.5(CI 95% 1.6;3.4)], and non-specific UTIs decreased [AAPC -2.2(CI 95% -3.3;-1.2)]. Pyelonephritis decreased in men [AAPC -0.5 (CI 95% -1.5;0.5)] and non-specific UTIs increased [AAPC 2.3 (CI 95% 1.9;2.6)] and prostatitis increased [AAPC 2.6 (CI 95% 1.4;3.7)]. CONCLUSIONS The urinary infection-related hospitalisation rate in adults in Spain increased during the period 2000-2015. Pyelonephritis predominated in women and non-specific UTIs in men. The highest hospitalisation rates occurred in the women but the greatest increase was found in men aged 65-74. The lenght of stay and cost were higher in men.
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Affiliation(s)
- Jesús Redondo-Sánchez
- Ramon y Cajal Health Care Centre, Primary Care Management, Servicio Madrileño de Salud, Alcorcón, Madrid, Spain
- Department of Medical Specialities and Public Health, Rey Juan Carlos University, Alcorcón, Madrid, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
| | - Ricardo Rodríguez-Barrientos
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Instituto Investigación Sanitaria Gregorio Marañón IiSGM, Madrid, Spain
| | - Mª del Canto de-Hoyos-Alonso
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
- Pedro Laín Entralgo Health Care Center, Primary Care Management, Madrid Health Service, Alcorcón, Madrid, Spain
| | - Cristina Muntañola-Valero
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Fundación para la Investigación e Innovación Biosanitaria de Atención Primaria (FIIBAP), Madrid, Spain
| | - Isabel Almendro Martínez
- Facultativa del Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Belén Peñalver-Argüeso
- Unidad Docente de Medicina Preventiva y Salud Pública, Escuela Nacional de Sanidad—Instituto de Salud Carlos III, Madrid, Spain
| | - Carlos Fernández-Escobar
- Unidad Docente de Medicina Preventiva y Salud Pública, Escuela Nacional de Sanidad—Instituto de Salud Carlos III, Madrid, Spain
| | - Ángel Gil-de Miguel
- Department of Medical Specialities and Public Health, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Isabel del Cura-González
- Department of Medical Specialities and Public Health, Rey Juan Carlos University, Alcorcón, Madrid, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Instituto Investigación Sanitaria Gregorio Marañón IiSGM, Madrid, Spain
- Karolinska Institutet and Stockholm University, Ageing Research Center, Stockholm, Sweden
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Li ZP, Li J, Li TL, Song ZY, Gong XZ. Uropathogenic Escherichia coli infection: innate immune disorder, bladder damage, and Tailin Fang II. Front Cell Infect Microbiol 2024; 14:1322119. [PMID: 38638825 PMCID: PMC11024302 DOI: 10.3389/fcimb.2024.1322119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
Background Uropathogenic Escherichia coli (UPEC) activates innate immune response upon invading the urinary tract, whereas UPEC can also enter bladder epithelial cells (BECs) through interactions with fusiform vesicles on cell surfaces and subsequently escape from the vesicles into the cytoplasm to establish intracellular bacterial communities, finally evading the host immune system and leading to recurrent urinary tract infection (RUTI). Tailin Fang II (TLF-II) is a Chinese herbal formulation composed of botanicals that has been clinically proven to be effective in treating urinary tract infection (UTI). However, the underlying therapeutic mechanisms remain poorly understood. Methods Network pharmacology analysis of TLF-II was conducted. Female Balb/C mice were transurethrally inoculated with UPEC CFT073 strain to establish the UTI mouse model. Levofloxacin was used as a positive control. Mice were randomly divided into four groups: negative control, UTI, TLF-II, and levofloxacin. Histopathological changes in bladder tissues were assessed by evaluating the bladder organ index and performing hematoxylin-eosin staining. The bacterial load in the bladder tissue and urine sample of mice was quantified. Activation of the TLR4-NF-κB pathway was investigated through immunohistochemistry and western blotting. The urinary levels of interleukin (IL)-1β and IL-6 and urine leukocyte counts were monitored. We also determined the protein expressions of markers associated with fusiform vesicles, Rab27b and Galectin-3, and levels of the phosphate transporter protein SLC20A1. Subsequently, the co-localization of Rab27b and SLC20A1 with CFT073 was examined using confocal fluorescence microscopy. Results Data of network pharmacology analysis suggested that TLF-II could against UTI through multiple targets and pathways associated with innate immunity and inflammation. Additionally, TLF-II significantly attenuated UPEC-induced bladder injury and reduced the bladder bacterial load. Meanwhile, TLF-II inhibited the expression of TLR4 and NF-κB on BECs and decreased the urine levels of IL-1β and IL-6 and urine leukocyte counts. TLF-II reduced SLC20A1 and Galectin-3 expressions and increased Rab27b expression. The co-localization of SLC20A1 and Rab27b with CFT073 was significantly reduced in the TLF-II group. Conclusion Collectively, innate immunity and bacterial escape from fusiform vesicles play important roles in UPEC-induced bladder infections. Our findings suggest that TLF-II combats UPEC-induced bladder infections by effectively mitigating bladder inflammation and preventing bacterial escape from fusiform vesicles into the cytoplasm. The findings suggest that TLF-II is a promising option for treating UTI and reducing its recurrence.
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Affiliation(s)
| | | | | | | | - Xue-zhong Gong
- Department of Nephrology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Wu KY, Cao B, Chen WB, Wu W, Zhao S, Min XY, Yang J, Han J, Dong X, Wang N, Wu Y, Garred P, Sacks SH, Zhou W, Li K. Collectin 11 has a pivotal role in host defense against kidney and bladder infection in mice. Kidney Int 2024; 105:524-539. [PMID: 38158182 DOI: 10.1016/j.kint.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 11/11/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024]
Abstract
The urinary tract is constantly exposed to microorganisms. Host defense mechanisms in protection from microbial colonization and development of urinary tract infections require better understanding to control kidney infection. Here we report that the lectin collectin 11 (CL-11), particularly kidney produced, has a pivotal role in host defense against uropathogen infection. CL-11 was found in mouse urine under normal and pathological conditions. Mice with global gene ablation of Colec11 had increased susceptibility to and severity of kidney and to an extent, bladder infection. Mice with kidney-specific Colec11 ablation exhibited a similar disease phenotype to that observed in global Colec11 deficient mice, indicating the importance of kidney produced CL-11 for protection against kidney and bladder infection. Conversely, intravesical or systemic administration of recombinant CL-11 reduced susceptibility to and severity of kidney and bladder infection. Mechanism analysis revealed that CL-11 can mediate several key innate defense mechanisms (agglutination, anti- adhesion, opsonophagocytosis), and limit local inflammatory responses to pathogens. Furthermore, CL-11-mediated innate defense mechanisms can act on clinically relevant microorganisms including multiple antibiotic resistant strains. CL-11 was detectable in eight of 24 urine samples from patients with urinary tract infections but not detectable in urine samples from ten healthy individuals. Thus, our findings demonstrate that CL-11 is a key factor of host defense mechanisms in kidney and bladder infection with therapeutic potential for human application.
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Affiliation(s)
- Kun-Yi Wu
- Core Research Laboratory, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Bo Cao
- Core Research Laboratory, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Wan-Bing Chen
- Core Research Laboratory, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Weiju Wu
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Shujuan Zhao
- Core Research Laboratory, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xiao-Yun Min
- Core Research Laboratory, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Jurong Yang
- Department of Nephrology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Han
- Department of Nephrology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xia Dong
- Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong, China
| | - Na Wang
- Core Research Laboratory, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Yi Wu
- MOE Key Laboratory of Environment and Genes Related to Diseases, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Steven H Sacks
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Wuding Zhou
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
| | - Ke Li
- Core Research Laboratory, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
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Rosen AL, Lint MA, Voelker DH, Gilbert NM, Tomera CP, Santiago-Borges J, Wallace MA, Hannan TJ, Burnham CAD, Hultgren SJ, Kau AL. Secretory leukocyte protease inhibitor protects against severe urinary tract infection in mice. mBio 2024; 15:e0255423. [PMID: 38270443 PMCID: PMC10865866 DOI: 10.1128/mbio.02554-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/15/2023] [Indexed: 01/26/2024] Open
Abstract
Millions suffer from urinary tract infections (UTIs) worldwide every year with women accounting for the majority of cases. Uropathogenic Escherichia coli (UPEC) causes most of these primary infections and leads to 25% becoming recurrent or chronic. To repel invading pathogens, the urinary tract mounts a vigorous innate immune response that includes the secretion of antimicrobial peptides (AMPs), rapid recruitment of phagocytes, and exfoliation of superficial umbrella cells. Here, we investigate secretory leukocyte protease inhibitor (SLPI), an AMP with antiprotease, antimicrobial, and immunomodulatory functions, known to play protective roles at other mucosal sites, but not well characterized in UTIs. Using a preclinical model of UPEC-caused UTI, we show that urine SLPI increases in infected mice and that SLPI is localized to bladder epithelial cells. UPEC-infected SLPI-deficient (Slpi-/-) mice suffer from higher urine bacterial burdens, prolonged bladder inflammation, and elevated urine neutrophil elastase (NE) levels compared to wild-type (Slpi+/+) controls. Combined with bulk bladder RNA sequencing, our data indicate that Slpi-/- mice have a dysregulated immune and tissue repair response following UTI. We also measure SLPI in urine samples from a small group of female subjects 18-49 years old and find that SLPI tends to be higher in the presence of a uropathogen, except in patients with a history of recent or recurrent UTI, suggesting a dysregulation of SLPI expression in these women. Taken together, our findings show SLPI promotes clearance of UPEC in mice and provides preliminary evidence that SLPI is likewise regulated in response to uropathogen exposure in women.IMPORTANCEAnnually, millions of people suffer from urinary tract infections (UTIs) and more than $3 billion are spent on work absences and treatment of these patients. While the early response to UTI is known to be important in combating urinary pathogens, knowledge of host factors that help curb infection is still limited. Here, we use a preclinical model of UTI to study secretory leukocyte protease inhibitor (SLPI), an antimicrobial protein, to determine how it protects the bladder against infection. We find that SLPI is increased during UTI, accelerates the clearance of bacteriuria, and upregulates genes and pathways needed to fight an infection while preventing prolonged bladder inflammation. In a small clinical study, we show SLPI is readily detectable in human urine and is associated with the presence of a uropathogen in patients without a previous history of UTI, suggesting SLPI may play an important role in protecting from bacterial cystitis.
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Affiliation(s)
- Anne L. Rosen
- Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael A. Lint
- Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Dayne H. Voelker
- Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nicole M. Gilbert
- Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Christopher P. Tomera
- Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jesús Santiago-Borges
- Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Meghan A. Wallace
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Thomas J. Hannan
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carey-Ann D. Burnham
- Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Scott J. Hultgren
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andrew L. Kau
- Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Yang Y, Yang GW, Lu JJ, Chen HR, Guo YQ, Yang N, Zhu YZ, Liu XQ, Su TT, Liu YY, Yu L, Li YS, Hu LF, Li JB. Fabrication of levofloxacin-loaded porcine acellular dermal matrix hydrogel and functional assessment in urinary tract infection. J Nanobiotechnology 2024; 22:52. [PMID: 38321555 PMCID: PMC10848372 DOI: 10.1186/s12951-024-02322-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/30/2024] [Indexed: 02/08/2024] Open
Abstract
Bacterial cystitis, a commonly occurring urinary tract infection (UTI), is renowned for its extensive prevalence and tendency to recur. Despite the extensive utilization of levofloxacin as a conventional therapeutic approach for bacterial cystitis, its effectiveness is impeded by adverse toxic effects, drug resistance concerns, and its influence on the gut microbiota. This study introduces Lev@PADM, a hydrogel with antibacterial properties that demonstrates efficacy in the treatment of bacterial cystitis. Lev@PADM is produced by combining levofloxacin with decellularized porcine acellular dermal matrix hydrogel and exhibits remarkable biocompatibility. Lev@PADM demonstrates excellent stability as a hydrogel at body temperature, enabling direct administration to the site of infection through intravesical injection. This localized delivery route circumvents the systemic circulation of levofloxacin, resulting in a swift and substantial elevation of the antimicrobial agent's concentration specifically at the site of infection. The in vivo experimental findings provide evidence that Lev@PADM effectively prolongs the duration of levofloxacin's action, impedes the retention and invasion of E.coli in the urinary tract, diminishes the infiltration of innate immune cells into infected tissues, and simultaneously preserves the composition of the intestinal microbiota. These results indicate that, in comparison to the exclusive administration of levofloxacin, Lev@PADM offers notable benefits in terms of preserving the integrity of the bladder epithelial barrier and suppressing the recurrence of urinary tract infections.
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Affiliation(s)
- Yi Yang
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Guang-Wei Yang
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Jian-Juan Lu
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Hao-Ran Chen
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Ya-Qin Guo
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Ning Yang
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Yun-Zhu Zhu
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Xiao-Qiang Liu
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Ting-Ting Su
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Yan-Yan Liu
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Liang Yu
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China
| | - Ya-Sheng Li
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China.
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China.
| | - Li-Fen Hu
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China.
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China.
| | - Jia-Bin Li
- Department of Infectious Diseases and Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People's Republic of China.
- Anhui Province Key Laboratory of Infectious Diseases and, Institute of Bacterial Resistance, Anhui Medical University, Hefei, 230022, People's Republic of China.
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Cui X, Bi X, Zhang X, Zhang Z, Yan Q, Wang Y, Huang X, Wu X, Jing X, Wang H. MiR-9-enriched mesenchymal stem cells derived exosomes prevent cystitis-induced bladder pain via suppressing TLR4/NLRP3 pathway in interstitial cystitis mice. Immun Inflamm Dis 2024; 12:e1140. [PMID: 38415918 PMCID: PMC10836038 DOI: 10.1002/iid3.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/10/2023] [Accepted: 12/25/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Inflammatory response of central nervous system is an important component mechanism in the bladder pain of interstitial cystitis/bladder pain syndrome (IC/BPS). Exosomes transfer with microRNAs (miRNA) from mesenchymal stem cell (MSCs) might inhibit inflammatory injury of the central nervous system. Herein, the purpose of our study was to explore the therapeutic effects by which extracellular vesicles (EVs) derived from miR-9-edreched MSCs in IC/BPS and further investigate the potential mechanism to attenuate neuroinflammation. METHODS On the basis of IC/BPS model, we used various techniques including bioinformatics, cell and molecular biology, and experimental zoology, to elucidate the role and molecular mechanism of TLR4 in regulating the activation of NLRP3 inflammasome in bladder pain of IC/BPS, and investigate the mechanism and feasibility of MSC-EVs enriched with miR-9 in the treatment of bladder pain of IC/BPS. RESULTS The inflammatory responses in systemic and central derived by TLR4 activation were closely related to the cystitis-induced pelvic/bladder nociception in IC/BPS model. Intrathecal injection of miR-9-enreched MSCs derived exosomes were effective in the treatment of cystitis-induced pelvic/bladder nociception by inhibiting TLR4/NF-κb/NLRP3 signal pathway in central nervous system of IC/BPS mice. CONCLUSIONS This study demonstrated that miR-9-enreched MSCs derived exosomes alleviate neuroinflammaiton and cystitis-induced bladder pain by inhibiting TLR4/NF-κb/NLRP3 signal pathway in interstitial cystitis mice, which is a promising strategy against cystitis-induced bladder pain.
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Affiliation(s)
- Xiangrong Cui
- Reproductive Medicine Center, The affiliated Children's Hospital of Shanxi Medical University, Children's Hospital of ShanxiShanxi Maternal and Child Health HospitalTaiyuanChina
| | - Xingyu Bi
- Reproductive Medicine Center, The affiliated Children's Hospital of Shanxi Medical University, Children's Hospital of ShanxiShanxi Maternal and Child Health HospitalTaiyuanChina
| | - Xiuping Zhang
- Reproductive Medicine Center, The affiliated Children's Hospital of Shanxi Medical University, Children's Hospital of ShanxiShanxi Maternal and Child Health HospitalTaiyuanChina
| | - Zhiping Zhang
- Reproductive Medicine Center, The affiliated Children's Hospital of Shanxi Medical University, Children's Hospital of ShanxiShanxi Maternal and Child Health HospitalTaiyuanChina
| | - Qin Yan
- Reproductive Medicine Center, The affiliated Children's Hospital of Shanxi Medical University, Children's Hospital of ShanxiShanxi Maternal and Child Health HospitalTaiyuanChina
| | - Yanni Wang
- Clinical LaboratoryShanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical UniversityTaiyuanChina
| | - Xia Huang
- Clinical LaboratoryShanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical UniversityTaiyuanChina
| | - Xueqing Wu
- Reproductive Medicine Center, The affiliated Children's Hospital of Shanxi Medical University, Children's Hospital of ShanxiShanxi Maternal and Child Health HospitalTaiyuanChina
| | - Xuan Jing
- Clinical LaboratoryShanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical UniversityTaiyuanChina
| | - Hongwei Wang
- Laboratory of HematologySecond Hospital of Shanxi Medical UniversityTaiyuanChina
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Laus K, Eng S, Nguyen JN. Impact of Preoperative Urinary Tract Infection Screening in Asymptomatic Women Undergoing Midurethral Sling. Int Urogynecol J 2024; 35:423-430. [PMID: 38180507 DOI: 10.1007/s00192-023-05716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION There is limited information regarding the utility of preoperative urine culture (Ucx) screening to decrease postoperative UTI rates following midurethral sling (MUS). HYPOTHESIS The primary objective of this study was to determine if the rate of postoperative UTI within the first 6 weeks after surgery is lower in women undergoing MUS when preoperative Ucx is obtained compared to when it is not. Secondary objectives were to determine clinical factors associated with postoperative UTI risk. METHODS This is a retrospective cohort study of women who did not have symptoms of or a diagnosis of cystitis at the time of their preoperative evaluation and are undergoing MUS. Patients were grouped into those who had preoperative Ucx screening within 6 weeks preceding surgery and those who did not. UTI rates 6 weeks following surgery were compared between groups. Additionally, factors impacting the risk of developing a UTI within 6 weeks of surgery were assessed. RESULTS Among 661 patients, 13.2% had a UTI within the first 6 weeks. There was no significant difference in UTI rates between those who did and did not have preoperative Ucx, respectively (14.9% vs 10.2%, p = 0.09). On multivariable analysis, current smoker status (OR 3.02, 95% CI 1.10-8.26), history of recurrent UTI (OR 3.00, 95% CI 1.14-7.86), and requiring postoperative SIC (OR 8.75, 95% CI 1.83-41.74) were independently associated with a UTI within 6 weeks of MUS. CONCLUSION Obtaining preoperative Ucx in asymptomatic women prior to MUS does not appear to be associated with lower postoperative UTIs rates within 6 weeks of surgery.
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Affiliation(s)
- Katharina Laus
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente Downey Medical Center, Downey, CA, USA.
| | - Sarah Eng
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - John N Nguyen
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente Downey Medical Center, Downey, CA, USA
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Sun Z, Zhang L, Wang R, Wang Z, Liang X, Gao J. Identification of shared pathogenetic mechanisms between COVID-19 and IC through bioinformatics and system biology. Sci Rep 2024; 14:2114. [PMID: 38267482 PMCID: PMC10808107 DOI: 10.1038/s41598-024-52625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/22/2024] [Indexed: 01/26/2024] Open
Abstract
COVID-19 increased global mortality in 2019. Cystitis became a contributing factor in SARS-CoV-2 and COVID-19 complications. The complex molecular links between cystitis and COVID-19 are unclear. This study investigates COVID-19-associated cystitis (CAC) molecular mechanisms and drug candidates using bioinformatics and systems biology. Obtain the gene expression profiles of IC (GSE11783) and COVID-19 (GSE147507) from the Gene Expression Omnibus (GEO) database. Identified the common differentially expressed genes (DEGs) in both IC and COVID-19, and extracted a number of key genes from this group. Subsequently, conduct Gene Ontology (GO) functional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis on the DEGs. Additionally, design a protein-protein interaction (PPI) network, a transcription factor gene regulatory network, a TF miRNA regulatory network, and a gene disease association network using the DEGs. Identify and extract hub genes from the PPI network. Then construct Nomogram diagnostic prediction models based on the hub genes. The DSigDB database was used to forecast many potential molecular medicines that are associated with common DEGs. Assess the precision of hub genes and Nomogram models in diagnosing IC and COVID-19 by employing Receiver Operating Characteristic (ROC) curves. The IC dataset (GSE57560) and the COVID-19 dataset (GSE171110) were selected to validate the models' diagnostic accuracy. A grand total of 198 DEGs that overlapped were found and chosen for further research. FCER1G, ITGAM, LCP2, LILRB2, MNDA, SPI1, and TYROBP were screened as the hub genes. The Nomogram model, built using the seven hub genes, demonstrates significant utility as a diagnostic prediction model for both IC and COVID-19. Multiple potential molecular medicines associated with common DEGs have been discovered. These pathways, hub genes, and models may provide new perspectives for future research into mechanisms and guide personalised and effective therapeutics for IC patients infected with COVID-19.
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Affiliation(s)
- Zhenpeng Sun
- Department of Urology, Qingdao Municipal Hospital, No.5, Donghai Middle Road, Shinan District, Qingdao, 266001, Shandong, China
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Li Zhang
- Institute of Systems Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Suzhou Institute of Systems Medicine, Suzhou, China
| | - Ruihong Wang
- Department of Outpatient, Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Zheng Wang
- Zhucheng People's Hospital, Zhucheng, China
| | - Xin Liang
- Department of Urology, Qingdao Municipal Hospital, No.5, Donghai Middle Road, Shinan District, Qingdao, 266001, Shandong, China
| | - Jiangang Gao
- Department of Urology, Qingdao Municipal Hospital, No.5, Donghai Middle Road, Shinan District, Qingdao, 266001, Shandong, China.
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10
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Wang Z, Jiang Z, Zhang Y, Wang C, Liu Z, Jia Z, Bhushan S, Yang J, Zhang Z. Exosomes derived from bladder epithelial cells infected with uropathogenic Escherichia coli increase the severity of urinary tract infections (UTIs) by impairing macrophage function. PLoS Pathog 2024; 20:e1011926. [PMID: 38190378 PMCID: PMC10798623 DOI: 10.1371/journal.ppat.1011926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/19/2024] [Accepted: 12/24/2023] [Indexed: 01/10/2024] Open
Abstract
Uropathogenic Escherichia coli (UPEC) is the primary causative agent of urinary tract infections (UTIs) in humans. Moreover, as one of the most common bacterial pathogens, UPEC imposes a substantial burden on healthcare systems worldwide. Epithelial cells and macrophages are two major components of the innate immune system, which play critical roles in defending the bladder against UPEC invasion. Yet, the routes of communication between these cells during UTI pathogenesis are still not fully understood. In the present study, we investigated the role of membrane-bound nanovesicles (exosomes) in the communication between bladder epithelial cells and macrophages during UPEC infection, using an array of techniques such as flow cytometry, miRNA profiling, RNA sequencing, and western blotting. Moreover, our in vitro findings were validated in a mouse model of UPEC-induced cystitis. We found that UPEC infection induced the bladder epithelial MB49 cell line to secrete large numbers of exosomes (MB49-U-Exo), which were efficiently absorbed by macrophages both in vivo and in vitro. Assimilation of MB49-U-Exo induced macrophages to produce proinflammatory cytokines, including tumor necrosis factor (TNF)α. Exposure of macrophages to MB49-U-Exo reduced their phagocytic activity (by downregulating the expression of phagocytosis-related genes) and increased their rate of apoptosis. Mechanistically, we showed that MB49-U-Exo were enriched in miR-18a-5p, which induced TNFα expression in macrophages by targeting PTEN and activating the MAPK/JNK signaling pathway. Moreover, administration of the exosome secretion inhibitor GW4869 or a TNFα-neutralizing antibody alleviated UPEC-mediated tissue damage in mice with UPEC-induced cystitis by reducing the bacterial burden of the bladder and dampening the associated inflammatory response. Collectively, these findings suggest that MB49-U-Exo regulate macrophage function in a way that exacerbates UPEC-mediated tissue impairment. Thus, targeting exosomal -release or TNFα signaling during UPEC infection may represent promising non-antibiotic strategies for treating UTIs.
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Affiliation(s)
- Zihao Wang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ziming Jiang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yu Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Congwei Wang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhaoyang Liu
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhankui Jia
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Sudhanshu Bhushan
- Institute of Anatomy and Cell Biology, Unit of Reproductive Biology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Jinjian Yang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhengguo Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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11
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Qiu D, Gao L, Zhang S, Zhu Y, Lin G. β-Sitosterol Alleviates the Proliferation and Migration of Cystitis Glandularis-Associated Cells by Targeting HMGCR to Induce NLRP3-Dependent Pyroptosis. Discov Med 2024; 36:150-159. [PMID: 38273755 DOI: 10.24976/discov.med.202436180.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
BACKGROUND Cystitis glandularis (CG) is a proliferative lesion of the bladder mucosa, and the incidence rate of CG has increased year by year. Considering the potential function of β-sitosterol in CG, we aim to fathom its effect and mechanism of CG. METHODS Primary human cells isolated from CG patients and following transfection as needed, were treated with different concentrations of β-sitosterol. Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and transwell assay was used to test the cell migration. Meanwhile, co-immunoprecipitation was employed to evaluate the interaction between 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) and NLR family pyrin domain containing 3 (NLRP3). Additionally, pyroptosis-associated proteins and HMGCR expressions were tested using western blot or quantitative real-time reverse transcription polymerase chain reaction. RESULTS β-sitosterol suppressed cell viability and migration, enhanced cell pyroptosis, and upregulated expressions of NLRP3, Cleaved Caspase-1, interleukin-1β (IL-1β), gasdermin D-N-terminal domain (GSDMD-N), and HMGCR in CG primary cells (p < 0.05). HMGCR silencing promoted cell viability and migration, inhibited cell pyroptosis, and downregulated expressions of NLRP3, Cleaved Caspase-1, IL-1β, and GSDMD-N in β-sitosterol-affected CG primary cells (p < 0.05). HMGCR interacted with NLRP3. CONCLUSIONS β-sitosterol alleviates the proliferation and migration of CG-associated cells by targeting HMGCR to induce NLRP3-dependent pyroptosis. These findings confirmed the therapeutic effect of β-sitosterol on treating CG.
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Affiliation(s)
- Dandan Qiu
- Department of Urology, The First Affiliated Hospital of Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, China
| | - Lingling Gao
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang, China
| | - Shuo Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, China
| | - Yan Zhu
- Department of Urology, The First Affiliated Hospital of Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, China
| | - Gang Lin
- Department of Radiotherapy, The First Affiliated Hospital of Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, China
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12
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Palenca I, Seguella L, Zilli A, Basili Franzin S, Del Re A, Pepi F, Troiani A, Pesce M, Rurgo S, De Palma FDE, Luglio G, Tropeano FP, Sarnelli G, Esposito G. Intrarectal Administration of Adelmidrol plus Hyaluronic Acid Gel Ameliorates Experimental Colitis in Mice and Inhibits Pro-Inflammatory Response in Ex Vivo Cultured Biopsies Derived from Ulcerative Colitis-Affected Patients. Int J Mol Sci 2023; 25:165. [PMID: 38203336 PMCID: PMC10778920 DOI: 10.3390/ijms25010165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Improving clinical outcomes and delaying disease recrudescence in Ulcerative Colitis (UC) patients is crucial for clinicians. In addition to traditional and new pharmacological therapies that utilize biological drugs, the development of medical devices that can ameliorate UC and facilitate the remission phase should not be overlooked. Drug-based therapy requires time to be personalized and to evaluate the benefit/risk ratio. However, the increasing number of diagnosed UC cases worldwide necessitates the exploration of new strategies to enhance clinical outcomes. By incorporating medical devices alongside pharmacological treatments, clinicians can provide additional support to UC patients, potentially improving their condition and slowing down the recurrence of symptoms. Chemically identified as an azelaic acid derivative and palmitoylethanolamide (PEA) analog, adelmidrol is a potent anti-inflammatory and antioxidant compound. In this study, we aimed to evaluate the effect of an intrarectal administration of 2% adelmidrol (Ade) and 0.1% hyaluronic acid (HA) gel formulation in both the acute and resolution phase of a mouse model of colitis induced via DNBS enema. We also investigated its activity in cultured human colon biopsies isolated from UC patients in the remission phase at follow-up when exposed in vitro to a cytomix challenge. Simultaneously, with its capacity to effectively alleviate chronic painful inflammatory cystitis when administered intravesically to urological patients such as Vessilen, the intrarectal administration of Ade/HA gel has shown remarkable potential in improving the course of colitis. This treatment approach has demonstrated a reduction in the histological damage score and an increase in the expression of ZO-1 and occludin tight junctions in both in vivo studies and human specimens. By acting independently on endogenous PEA levels and without any noticeable systemic absorption, the effectiveness of Ade/HA gel is reliant on a local antioxidant mechanism that functions as a "barrier effect" in the inflamed gut. Building on the findings of this preliminary study, we are confident that the Ade/HA gel medical device holds promise as a valuable adjunct in supporting traditional anti-UC therapies.
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Affiliation(s)
- Irene Palenca
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Luisa Seguella
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Aurora Zilli
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Silvia Basili Franzin
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Alessandro Del Re
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Federico Pepi
- Department of Chemistry and Drug Technologies, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy; (F.P.); (A.T.)
| | - Anna Troiani
- Department of Chemistry and Drug Technologies, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy; (F.P.); (A.T.)
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Fatima Domenica Elisa De Palma
- Department of Molecular Medicine and Medical Biotechnologies, Centro Ingegneria Genetica-Biotecnologie Avanzate s.c.a rl, 80131 Naples, Italy;
| | - Gaetano Luglio
- Endoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, Italy; (G.L.); (F.P.T.)
| | - Francesca Paola Tropeano
- Endoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, Italy; (G.L.); (F.P.T.)
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
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Montalbetti N, Dalghi MG, Parakala-Jain T, Clayton D, Apodaca G, Carattino MD. Antinociceptive effect of the calcitonin gene-related peptide receptor antagonist BIBN4096BS in mice with bacterial cystitis. Am J Physiol Renal Physiol 2023; 325:F779-F791. [PMID: 37823199 PMCID: PMC10878727 DOI: 10.1152/ajprenal.00217.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 10/13/2023] Open
Abstract
Patients with urinary tract infections (UTIs) suffer from urinary frequency, urgency, dysuria, and suprapubic pain, but the mechanisms by which bladder afferents sense the presence of uropathogens and encode this information is not well understood. Calcitonin gene-related peptide (CGRP) is a 37-mer neuropeptide found in a subset of bladder afferents that terminate primarily in the lamina propria. Here, we report that the CGRP receptor antagonist BIBN4096BS lessens lower urinary tract symptoms and prevents the development of pelvic allodynia in mice inoculated with uropathogenic Escherichia coli (UPEC) without altering urine bacterial loads or the host immune response to the infection. These findings indicate that CGRP facilitates the processing of noxious/inflammatory stimuli during UPEC infection. Using fluorescent in situ hybridization, we identified a population of suburothelial fibroblasts in the lamina propria, a region where afferent fibers containing CGRP terminate, that expresses the canonical CGRP receptor components Calcrl and Ramp1. We propose that these fibroblasts, in conjunction with CGRP+ afferents, form a circuit that senses substances released during the infection and transmit this noxious information to the central nervous system.NEW & NOTEWORTHY Afferent C fibers release neuropeptides including calcitonin gene-related peptide (CGRP). Here, we show that the specific CGRP receptor antagonist, BIBN409BS, ameliorates lower urinary tract symptoms and pelvic allodynia in mice inoculated with uropathogenic E. coli. Using fluorescent in situ hybridization, we identified a population of suburothelial fibroblasts in the lamina propria that expresses the canonical CGRP receptor. Our findings indicate that CGRP contributes to the transmission of nociceptive information arising from the bladder.
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Affiliation(s)
- Nicolas Montalbetti
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Marianela G Dalghi
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Tanmay Parakala-Jain
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Dennis Clayton
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Gerard Apodaca
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Marcelo D Carattino
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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Cystitis cystica bei rezidivierenden Harnwegsinfekten. Aktuelle Urol 2023; 54:437. [PMID: 37972618 DOI: 10.1055/a-2082-4134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
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15
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Odegard EA, Meeds HL, Kleiboeker SB, Ziady A, Sabulski A, Jodele S, Seif AE, Davies SM, Laskin BL, Blackard JT. BK Polyomavirus Diversity After Hematopoietic Stem Cell Transplantation. J Infect Dis 2023; 228:1208-1218. [PMID: 37165301 PMCID: PMC10629712 DOI: 10.1093/infdis/jiad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/21/2023] [Indexed: 05/12/2023] Open
Abstract
BK polyomavirus (BKPyV) infection is common after hematopoietic stem cell transplantation (HSCT) and is associated with the development of hemorrhagic cystitis (HC). The role that BKPyV plays in the pathogenesis of HC is not well characterized. We investigated the impact of BKPyV diversity on the development of HC using a previously established cohort of pediatric HSCT patients. There were 147 urine samples with quantifiable BKPyV at month 1 after HSCT; 137 (93.2%) were amplified using our in-house polymerase chain reaction approach and sent for next-generation sequencing. Subtype Ia was most frequent (61.3%), followed by subtype Ib1 (31.4%). The median viral load of subtype Ia samples was higher than for subtype Ib1 at month 1. Across the protein coding regions, APOBEC-induced mutations and signature patterns associated with HC were identified. This is the largest sequencing study of a single cohort of HSCT patients, providing a vast resource of sequence data for future analyses.
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Affiliation(s)
- Elizabeth A Odegard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Ohio
| | - Heidi L Meeds
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Ohio
| | | | - Assem Ziady
- Department of Pediatrics, University of Cincinnati College of Medicine, Ohio
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Ohio
| | - Anthony Sabulski
- Department of Pediatrics, University of Cincinnati College of Medicine, Ohio
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Ohio
| | - Sonata Jodele
- Department of Pediatrics, University of Cincinnati College of Medicine, Ohio
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Ohio
| | - Alix E Seif
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania
- Division of Oncology, The Children's Hospital of Philadelphia, Pennsylvania
| | - Stella M Davies
- Department of Pediatrics, University of Cincinnati College of Medicine, Ohio
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Ohio
| | - Benjamin L Laskin
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania
- Division of Nephrology, The Children's Hospital of Philadelphia, Pennsylvania
| | - Jason T Blackard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Ohio
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Kuo HC. Intravesical injections of autologous platelet-rich plasma for the treatment of refractory interstitial cystitis. Low Urin Tract Symptoms 2023; 15:210-215. [PMID: 37702275 DOI: 10.1111/luts.12504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/23/2023] [Accepted: 09/02/2023] [Indexed: 09/14/2023]
Abstract
The urothelium acts as a barrier for the urinary bladder that prevents the influx of urinary toxic substances, electrolytes, urea nitrogen, and pathogens into the circulation. Acute or chronic inflammation of the urinary bladder may impair the regenerative function of urothelial cells and thus urothelial cell differentiation. In an inflamed bladder wall, mature apical cells are defective, resulting in impaired barrier function and thus increased urothelial permeability. This is considered to be the potential mechanism of the symptom trigger in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Previous studies have revealed that increased bladder inflammation, impaired urothelial cell maturation, a defective umbrella cell barrier, and defective junction proteins are prominent in IC/BPS bladders. Platelet-rich plasma (PRP) contains many growth factors and cytokines that are essential proteins for modulating inflammation and promoting tissue regeneration and thus wound healing. As such, PRP has been used as a regenerative therapy in many medical fields. Our preliminary studies have demonstrated that multiple intravesical PRP injections could improve symptoms in 70% of IC/BPS patients. Repeated PRP treatments also improve junctional protein, increase cytoskeleton protein expression, and decrease urinary inflammatory proteins. These preliminary results suggest that PRP injections might reduce bladder inflammation and improve urothelial cell regeneration in IC/BPS patients. This article reviews recently published clinical and basic research on the treatment potential of PRP for IC/BPS patients.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan
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17
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Ribeiro-Filho LA, Braz NDSF, Nahas WC. Editorial Comments on Transvaginal ultrasonography for trigonitis diagnosis in women. Int J Urol 2023; 30:1062. [PMID: 37431964 DOI: 10.1111/iju.15242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Affiliation(s)
| | | | - William Carlos Nahas
- Division of Urology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
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Jeon J, Ha JS, Shin SJ, Ham WS, Choi YD, Cho KS. Differences in clinical features between focal and extensive types of cystitis glandularis in patients without a previous history of urinary tract malignancy. Investig Clin Urol 2023; 64:597-605. [PMID: 37932571 PMCID: PMC10630690 DOI: 10.4111/icu.20230210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/31/2023] [Accepted: 08/16/2023] [Indexed: 11/08/2023] Open
Abstract
PURPOSE To understand the clinical differences of cystitis glandularis (CG), a proliferative disorder of urinary bladder epithelium, based on the extent of cystoscopic findings in patients without a history of urinary tract malignancy. MATERIALS AND METHODS We conducted a review of patients diagnosed with CG in two tertiary hospitals from 2005 to 2021. Patients with previous or concurrent history of urinary tract malignancy were excluded. Medical records, including demographics, endoscopic and all available imaging studies, and managements, were reviewed. Patients were divided into two types according to extent of the lesion, and their clinical features were compared. RESULTS In total, 110 patients were enrolled in the final analysis, with 36 (32.7%) classified as extensive type and 74 (67.3%) as focal type. Patients with extensive type were predominantly males and relatively younger than those with focal type (p=0.025). Voiding problems were more strongly associated and hydronephrosis caused by CG was significantly more common in the extensive type (p=0.005 and p=0.003, respectively). Multiple transurethral resection procedures were more frequently performed in the extensive type (p=0.017). Subsequent urinary tract malignancy was observed in four patients, all of whom had focal-type CG. CONCLUSIONS There were significant differences in clinical features between the extensive- and focal-types CG. The extensive type was more often associated with urologic complications. Meanwhile, in the focal type, subsequent urinary tract malignancy might develop during the follow-up period. Thus, thorough initial work-up and careful follow-up is necessary despite the benign nature of CG. Annual surveillance cystoscopy may be appropriate.
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Affiliation(s)
- Jinhyung Jeon
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Soo Ha
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Su-Jin Shin
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Ham
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kang Su Cho
- Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea.
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19
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Pieper CC, Geiger S, Kupczyk P, Luetkens JA, Köster T, Attenberger UI, Schild HH. Post-interventional infectious complications in percutaneous transabdominal lymphatic interventions: an observational study. Sci Rep 2023; 13:17643. [PMID: 37848443 PMCID: PMC10582110 DOI: 10.1038/s41598-023-42197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 09/06/2023] [Indexed: 10/19/2023] Open
Abstract
The purpose of this retrospective study was to evaluate the occurrence of infectious complications and inflammatory reactions after transabdominal lymphatic-interventions. 63 lymphatic-interventions were performed in 60 patients (male/female: 35/25; mean age 56 [9-85] years) [chylothorax n = 48, chylous ascites n = 7, combined chylothorax/chylous ascites n = 5]. Post-interventional clinical course and laboratory findings were analyzed in the whole cohort as well as subgroups without (group A; n = 35) and with peri-interventional antibiotics (group B; n = 25) (pneumonia n = 16, drainage-catheter inflammation n = 5, colitis n = 1, cystitis n = 1, transcolonic-access n = 2). No septic complications associated with the intervention occurred. Leucocytes increased significantly, peaking on post-interventional day-1 (8.6 ± 3.9 × 106 cells/mL vs. 9.8 ± 4.7 × 106 cells/mL; p = 0.009) and decreased thereafter (day-10: 7.3 ± 2.7 × 106 cells/mL, p = 0.005). CRP-values were pathological in 89.5% of patients already at baseline (40.1 ± 63.9 mg/L) and increased significant on day-3 (77.0 ± 78.8 mg/L, p < 0.001). Values decreased thereafter (day-15: 25.3 ± 34.4 mg/L, p = 0.04). In subgroup B, 13/25 patients had febrile episodes post-interventionally (pneumonia n = 11, cystitis n = 1, drainage-catheter inflammation n = 1). One patient developed biliary peritonitis despite continued antibiotics and underwent cholecystectomy. Baseline leucocytes and CRP-levels were higher in group B than A, but with comparable post-interventional profiles. Clinically relevant infectious complications associated with transabdominal lymphatic-interventions are rare irrespective of peri-interventional antibiotic use. Post-interventional elevation of leucocytes and CRP are observed with normalization over 10-15 days.
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Affiliation(s)
- Claus Christian Pieper
- Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany.
- Department of Radiology, University of Bonn, Venusberg-Campus 1, 53105, Bonn, Germany.
| | - Sergej Geiger
- Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
| | - Patrick Kupczyk
- Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
| | - Julian A Luetkens
- Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
| | - Thomas Köster
- Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
| | - Ulrike I Attenberger
- Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
| | - Hans Heinz Schild
- Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
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20
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Dikken B. Mit Bärentraubenblättern gegen akute Zystitis. MMW Fortschr Med 2023; 165:74. [PMID: 37828341 DOI: 10.1007/s15006-023-3058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
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21
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Watanabe T, Sadahira T, Hirakawa H, Huang P, Zhou T, Iwata T, Sekito T, Ishii A, Watanabe M, Araki M. Exploration of the protein-dependent mechanism of Lactobacillus crispatus GAI98322 to prevent recurrent cystitis. J Infect Chemother 2023; 29:1001-1004. [PMID: 37343926 DOI: 10.1016/j.jiac.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/14/2023] [Accepted: 06/18/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVES To elucidate the mechanism of Lactobacillus crispatus (L. crispatus) suppositories to prevent patients from recurrent cystitis (RC), independent from viable-Lactobacilli-bacteria- and acid-dependent ones such as hydrogen peroxide and lactate. METHODS We used the GAI98322 strain of L. crispatus in all experiments and pH-matched. cell-free culture supernatant of L. crispatus (CFCS) was collected. The growth inhibitory activity and the biofilm formation inhibitory activity of the CFCS against uropathogenic Escherichia coli (UPEC), Extended Spectrum beta (β) Lactamase producing (ESBL+) UPEC, and Pseudomonas aeruginosa (P. aeruginosa) was assessed by agar-disk diffusion tests and crystal violet assay. Also, CFCS was subjected to mass spectrometry to specify ingredients. RESULTS The CFCS suppressed the proliferation of E. coli, ESBL + E. coli, and P. aeruginosa. Also, the CFCS at a concentration of 40% significantly impeded the biofilm formation of these three bacteria. The aggregation-promoting factor and Lysin was detected from CFCS. CONCLUSIONS The cell-free supernatant from the GAI98322 strain of L. crispatus inhibits the growth/biofilm formation of broad pathogens by aggregation promoting factor and lysin, which may prevent hosts from RC regardless of the antimicrobial resistance of the pathogens and even under pH modulation.
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Affiliation(s)
- Tomofumi Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Hidetada Hirakawa
- Department of Bacteriology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, 371-8511, Japan
| | - Peng Huang
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Neutron Therapy Research Center, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Tianyun Zhou
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Neutron Therapy Research Center, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; The Second Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Takehiro Iwata
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takanori Sekito
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Ayano Ishii
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Masami Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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22
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Baskin A, Cowan JE, Braun A, Lonergan PE, Mohamad O, Washington SL, Zhao S, Broering JM, Cooperberg MR, Breyer BN, Carroll PR. Long-term complications and health-related quality of life outcomes after radical prostatectomy with or without subsequent radiation treatment for prostate cancer. Urol Oncol 2023; 41:429.e9-429.e14. [PMID: 37407420 DOI: 10.1016/j.urolonc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/25/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND To report objective long-term complications and health related quality of life (HRQOL) outcomes after radical prostatectomy (RP) with and without radiation therapy (RT) for prostate cancer (CaP). METHODS We analyzed patients diagnosed with CaP who underwent RP from the UCSF Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry between 1995 and 2020. Cox proportional hazards were used to assess risk of postoperative complications which included cystitis, gastrointestinal (GI) toxicity, incontinence requiring a surgical procedure, ureteral injury and urinary stricture. Repeated measures mixed models were used to assess the effects of radiation and complications on patient-reported urinary, bowel, and sexual function after surgery. RESULTS Of 6,258 men who underwent RP, cumulative incidence of EBRT was 9.1% at 5 years after surgery. Patients who received postoperative radiation were at increased risk for onset of cystitis (HR 5.60, 95% CI 3.40-9.22, P < 0.01). Receipt of RT was not associated with other complications. In repeated measures analysis, postoperative RT was associated with worsening general health scores, adjusting for complications of incontinence, urinary stricture, GI toxicity or ureteral injury, independent of whether patients had those complications. CONCLUSIONS RT after RP was associated with an increase in the risk of cystitis and worse general health in the long term. Other complications and HRQOL outcomes did not demonstrate differences by whether patients had RT or not. While post-operative RT is the only curative option for CaP after RP, patients and providers should be aware of the increased risks when making treatment decisions.
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Affiliation(s)
- Avi Baskin
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Janet E Cowan
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Avery Braun
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA.
| | - Peter E Lonergan
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA; Department of Urology, St. James's Hospital, Dublin, Ireland; Department of Surgery, Trinity College, Dublin, Ireland
| | - Osama Mohamad
- Department of Radiation Oncology, University of California, San Francisco, CA
| | - Samuel L Washington
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California, San Francisco, CA
| | - Shoujun Zhao
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Jeanette M Broering
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA; Department of Surgery, University of California, San Francisco, CA
| | - Matthew R Cooperberg
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California, San Francisco, CA
| | - Benjamin N Breyer
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California, San Francisco, CA
| | - Peter R Carroll
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
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23
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Azak C, Kavak G, Ertan F, Alioğlu F, Akkaş EA, Göksel F, Karakaya E. The effect of lower urinary tract substructure doses on side effects of cervical cancer image-guided adaptive brachytherapy. J Cancer Res Ther 2023; 19:1825-1830. [PMID: 38376285 DOI: 10.4103/jcrt.jcrt_2353_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/29/2022] [Indexed: 02/21/2024]
Abstract
OBJECTIVE Image-Guided Adaptive Brachytherapy (IGABT) provides a survival advantage in locally advanced cervical cancer (LACC). Although side effects are seen less with this technique, dose parameters that cause urinary side effects are still questionable. We aim to investigate whether the radiotherapy doses of the lower urinary tract substructures (LUSS) affect the urinary system side effects (USSE) of cervical cancer external beam radiotherapy (EBRT) and the IGABT. METHODS LUSS (bladder, trigone, bladder neck, and urethra) doses were calculated in 40 patients diagnosed with LACC and receiving primary EBRT, IGABT, and concomitant chemotherapy. D0.1cc, D2cc, and D50% values were examined by contouring the bladder, trigone, bladder neck, and urethra from the intracavitary BT planning computed tomography (CT) images taken every 4 BT fractions, retrospectively. Besides, late USSE (urgency, dysuria (recurrent), frequency, obstruction, incontinence, hematuria, fistula, cystitis) were queried and categorized according to Common Toxicity Criteria for Adverse Events version 5.0. STATISTICAL ANALYSIS USED The Chi-square and Fisher's exact tests, Mann-Whitney U-test. RESULTS For the whole study population, for both incontinence and dysuria, trigone (D50%), urethra (D50%, D0.1cc,), and bladder neck (D50%, D0.1cc, D2cc) volume and hot spot doses remained significant. For cystitis, urethra (D50%, D0.1cc,) and bladder neck doses (D0.1cc, D50%, D2cc) are worth investigating. CONCLUSIONS Although USSE is less common in the intensity-modulated radiation therapy and IGABT era, it may be meaningful to take the doses of LUSS into account when planning IGABT. In addition, delineation of LUSS using only CT seems feasible. More proof is needed to determine delineation technique and dose constraints for LUSS for IGABT.
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Affiliation(s)
- Can Azak
- Department of Radiation Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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24
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Yuan FF, Fu YW, Zhao MY, Li MH, Li GP, Wei XD. [Efficacy and safety analysis of umbilical cord blood combined with haploid hematopoietic stem cell transplantation in the treatment of malignant hematological malignancies]. Zhonghua Yi Xue Za Zhi 2023; 103:2778-2785. [PMID: 37723052 DOI: 10.3760/cma.j.cn112137-20230202-00158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Objective: To investigate the efficacy and safety of umbilical cord blood combined with haploid HSCT (haplo-cord HSCT) in the treatment of hematological malignancies. Methods: The data of 82 patients with hematologic malignancies who received haplo-cord HSCT from January 2017 to June 2021 in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. There were 52 male and 30 female patients, aged [M(Q1, Q3)] 29 (20, 41) years. All patients received myeloablative preconditioning regimen. The day of the donor stem cell infusion was recorded as day 0 (0 d), the day before the infusion was recorded as day-1 (-1 d), and the day after the infusion was recorded as day+1 (+1 d), and so on. Eighty-two patients received transfusion of peripheral blood and/or bone marrow stem cells from unrelated cord blood and haplotype donors after the myeloablative preconditioning regimen. The graft-versus-host disease (GVHD) prophylaxis regimen was 8 mg/kg ATG combined with cyclosporine, morte-macrolide, and methotrexate. Patients were evaluated for implantation and the occurrence of transplant-related complications such as GVHD, infection, hemorrhagic cystitis, and long-term patient survival. Results: The time of neutrophil engraftment [M(Q1, Q3)] was 13 (11, 15) days and 15 (13, 21) days for platelet. The 30-day cumulative incidence of neutrophil engraftment was 98.8% (81/82) and 100-day cumulative incidence of platelet engraftment was 92.7% (76/82). The cumulative incidence of acute graft-versus-host disease (aGVHD) in degree Ⅱ-Ⅳ and Ⅲ-Ⅳ was 24.4% (20/82) and 6.1% (5/82), respectively. The cumulative incidence of chronic GVHD in+18 months was 13.5% (11/82). The follow-up time [M(Q1, Q3)] was 26 (13, 41) months, and the overall survival (OS) rate, event-free survival (EFS) rate, cumulative recurrence rate (CIR) and non-recurrence mortality (NRM) rate at 3 years after transplantation were 70.5% (95%CI: 59.7%-81.3%), 66.1% (95%CI: 56.1%-76.1%), 6.3% (95%CI: 5.7%-26.9%) and 20.8% (95%CI: 12.0%-29.6%), respectively. The cumulative incidence of cytomegalovirus and EBV reactivation was 37.8% (31/82) and 14.6% (12/82), respectively. The cumulative incidence of hemorrhagic cystitis was 32.9% (27/82). Conclusion: The efficacy of haplo-cord HSCT in the treatment of hematologic malignancies is reliable, with rapid hematopoietic reconstitution, low incidence of GVHD and virus reactivation.
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Affiliation(s)
- F F Yuan
- Department of Haematology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Y W Fu
- Department of Haematology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - M Y Zhao
- Department of Haematology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - M H Li
- Department of Haematology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - G P Li
- Department of Haematology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - X D Wei
- Department of Haematology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
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Wang Y, Fang Y, Yan Z, Xia R, Zeng W, Deng W, Xu J, Feng X, Peng J, Miao Y. Fatal BK polyomavirus-associated pneumonia: report of two cases with literature review. BMC Infect Dis 2023; 23:592. [PMID: 37697264 PMCID: PMC10494412 DOI: 10.1186/s12879-023-08577-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 08/31/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND In immunocompromised populations, such as patients with AIDS and recipients of solid organ and hematopoietic stem cell transplants, BK polyomavirus (BKPyV) can reactivate and cause several diseases, which can lead to death in their severe forms. Unlike hemorrhagic cystitis and BKPyV-associated nephropathy, BKPyV-associated pneumonia is rare, with only seven known cases worldwide. However, the disease can rapidly progress with extremely high mortality. CASE PRESENTATION Herein, we report two cases of BKPyV-associated pneumonia following hematopoietic stem cell transplantation. Both patients had consistent infectious pneumonia and graft-versus-host disease after stem cell transplantation. The diagnosis of BKPyV-associated pneumonia was confirmed by metagenomic next-generation sequencing and polymerase chain reaction after the sudden worsening of the pulmonary infection signs and symptoms concomitant with renal dysfunction and systemic immune weakening. Both patients eventually died of systemic multi-organ failure caused by severe pneumonia. CONCLUSIONS Currently, BKPyV reactivation cannot be effectively prevented. Immunocompromised patients must actively manage their primary lung infections, pay close attention to pulmonary signs and imaging changes. Especially during and after steroid pulse therapy or immunosuppressive therapy for graft versus host diseases, BKPyV load in blood/urine needs to be regularly measured, and the immunosuppressive intensity should be adjusted properly after the BKPyV reactivation diagnosis. Clinical trials of new antiviral drugs and therapies for BKPyV are urgently needed.
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Affiliation(s)
- Yuchen Wang
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Yiling Fang
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Ziyan Yan
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Renfei Xia
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Wenli Zeng
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Wenfeng Deng
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Jian Xu
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Xiaoqin Feng
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
| | - Yun Miao
- Department of Transplantation, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
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26
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Burchert D. Zystitis in der hausärztlichen Versorgung von Diabetespatienten. MMW Fortschr Med 2023; 165:20-21. [PMID: 37653300 DOI: 10.1007/s15006-023-2672-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Dieter Burchert
- Facharzt für Innere u. Allgemeinmedizin, Diabetologie, Römerstraße 14, 55129, Mainz, Germany
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Lonergan PE, Baskin A, Greenberg SA, Mohamad O, Washington SL, Zhao S, Cowan JE, Broering JM, Nguyen HG, Cooperberg MR, Breyer BN, Carroll PR. The Long-term Incidence and Quality of Life Outcomes Associated With Treatment-Related Toxicities of External Beam Radiotherapy for Prostate Cancer. Urology 2023; 178:114-119. [PMID: 37244430 DOI: 10.1016/j.urology.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To assess the long-term incidence of treatment-related toxicities and quality of life (QOL) outcomes associated with toxicity after external beam radiotherapy (EBRT) for prostate cancer. METHODS We identified all men who had EBRT between 1994 and 2017 from Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a longitudinal, nationwide prostate cancer registry. CaPSURE was queried for patient-reported and International Classification of Diseases-9/10 and Current Procedural Terminology codes. The Medical Outcomes Studies Short Form 36 and the University of California, Los Angeles Prostate Cancer Index were used to provide measures of general health, sexual, urinary, and bowel function. Repeated measures mixed models were used to determine QOL change after onset of toxicity. RESULTS From a total of 15,332, 1744 (11.4%) men had EBRT. The median follow-up was 7.9years (interquartile range [IQR] 4.3-12.7). The median time to onset of any toxicity including urinary pad usage in 265 (15.4% at 8years) men was 4.3years (IQR 1.8-8.0). The most frequent toxicity was hemorrhagic cystitis (104, 5.9% at 8years) after a median of 3.7years (1.3-7.8), gastrointestinal (48, 2.7% at 8years) after a median of 4.2years (IQR 1.3-7.8), followed by urethral stricture (47, 2.4% at 8years) after a median of 3.7years (IQR 1.9-9.1). Repeated measures mixed models found that onset of hemorrhagic cystitis was associated with change in general health over time. CONCLUSION EBRT for prostate cancer is associated with distinct treatment-related toxicities which can occur many years after treatment and can affect QOL. These results may help men understand the long-term implications of treatment decisions.
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Affiliation(s)
- Peter E Lonergan
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA; Department of Urology, St. James's Hospital, Dublin, Ireland; Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Avi Baskin
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Scott A Greenberg
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Osama Mohamad
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA; Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
| | - Samuel L Washington
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Shoujun Zhao
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Janet E Cowan
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Jeanette M Broering
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA; Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Hao G Nguyen
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Matthew R Cooperberg
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Benjamin N Breyer
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Peter R Carroll
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
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Faris A, Lane GI, Mehra R, Dadhania V, Crescenze I, Clemens JQ, Romo PB, Stoffel J, Malaeb B, Blair Y, Goh M, Gupta P, Cameron AP. Destroyed bladders: Characterization of progressive inflammatory cystitis. Neurourol Urodyn 2023; 42:1194-1202. [PMID: 37126389 DOI: 10.1002/nau.25195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/09/2023] [Accepted: 04/12/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE We identified a subset of patients with noninfectious cystitis who develop refractory symptoms marked by diffuse inflammatory changes, reduced bladder capacity, and vesicoureteral reflux (VUR), termed here as "progressive inflammatory cystitis" (PIC). Our objective was to describe the phenotype, disease outcomes, and pathologic findings of PIC. MATERIAL AND METHODS A single institution retrospective cohort study of patients with PIC. Patients with a history of pelvic radiation, urologic malignancy, or neurogenic bladder were excluded. We describe cohort characteristics and use bivariate analyses to compare subgroups. Kaplan-Meier methods estimate time to urinary diversion. RESULTS From 2008 to 2020, 46 patients with PIC were identified. The median age of symptom onset was 63 years old (interquartile range [IQR]: 56, 70) and the most common presenting symptoms were urinary urgency/frequency (54%) and incontinence (48%). Urodynamics showed a median maximum bladder capacity of 80 mL (IQR: 34, 152), commonly with VUR (68%) and hydronephrosis (59%). Ultimately 36 patients (78%) underwent urinary diversion at a median of 4.5 years (IQR: 2, 6.5) after symptom onset. Significant pathologic findings include presence of ulceration (52%), acute and chronic inflammation (68%), including eosinophils (80%), lymphoid follicles (56%), and mast cells in both lamina and muscularis propria (76%). CONCLUSIONS PIC is a newly defined entity characterized by significantly diminished bladder capacity, upper tract changes, and relatively quick progression to urinary diversion. Larger prospective cohort studies are required to further characterize this severe phenotype of chronic noninfectious cystitis, aid earlier diagnosis, and guide management decisions.
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Affiliation(s)
- Anna Faris
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Giulia I Lane
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Iryna Crescenze
- Department of Urology, Ohio State University, Columbus, Ohio, USA
| | - J Quentin Clemens
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - John Stoffel
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Bahaa Malaeb
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yooni Blair
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Meidee Goh
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Priyanka Gupta
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Anne P Cameron
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
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Matsuo T, Imamura R. Editorial Comments on Transvaginal ultrasonography for trigonitis diagnosis in women. Int J Urol 2023; 30:519-520. [PMID: 36890718 DOI: 10.1111/iju.15175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Affiliation(s)
- Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryoichi Imamura
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Redondo Sánchez J, Domínguez Lázaro AM, Rodríguez Barrientos R, Barrio Cortes J, Seoane Sanz A, Bravo Acuna J, Del Cura-González I. Trends in hospitalization for urinary tract infection in the paediatric age group in the 2000-2015 period in Spain. An Pediatr (Barc) 2023; 98:175-184. [PMID: 36804332 DOI: 10.1016/j.anpede.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/07/2022] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVE To analyse the trends in hospital admissions related to urinary tract infection among children aged 0-14 years in Spain in the 2000-2015 period. METHODS We conducted a retrospective observational study using the minimum basic hospital discharge dataset system of Spain, which applies the International Classification of Diseases, version 9 (ICD-9) coding system. We included every hospitalisation due to cystitis, pyelonephritis and unspecified UTI among children aged less than 15 years. We collected data on patient sex and age, type of discharge, main diagnosis, comorbidities, length of stay and overall cost. We calculated crude hospitalization rates per 1000 inhabitants aged less than 15 years and performed a joinpoint regression analysis to identify temporal trends. RESULTS In the 2000-2015 period, there were 124 696 hospitalizations in children under 15 years. Of these patients, 72.97% were aged 0-1 year and 60.12% had a diagnosis of unspecified UTI, 39.27% of pyelonephritis, and 0.52% of cystitis. The crude rate of hospitalization due to UTI ranged from 1.24 in year 2000 to 0.98 in 2015. The rate of hospitalization was higher in female versus male patients. The joinpoint analysis found a decreasing trend in the rate of hospitalization due to UTI, with an average annual percent change (AAPC) of -1.5% (95% confidence interval [CI], -2.4 a -0.6). The largest decreases occurred in female patients (AAPC, -1.8; 95% CI, -2.5 a -1.0) and children aged 7-10 years (AAPC - 5.9; 95% CI, -6.7 a -5.2). CONCLUSIONS The rate of hospitalization related to UTI in Spain in patients aged up to 14 years decreased during the 2000-2015 period. The highest hospitalization rates occurred in female patients and in the 0-to-1 year age group.
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Affiliation(s)
- Jesús Redondo Sánchez
- Centro de Salud Ramon y Cajal, Alcorcón, Spain; Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - Alberto Manuel Domínguez Lázaro
- Medicina Preventiva y Salud Pública, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ricardo Rodríguez Barrientos
- Instituto de Investigación Sanitaria Gregorio Marañón, Servicio Madrileño de Salud, Madrid, Spain; Unidad de Investigación, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) y Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
| | - Jaime Barrio Cortes
- Unidad de Investigación, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Fundación para la Investigación e Innovación Biosanitaria en Atención Primaria, Madrid, Spain
| | - Andrea Seoane Sanz
- Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan Bravo Acuna
- Centro de Salud El Greco, Getafe. Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Isabel Del Cura-González
- Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Servicio Madrileño de Salud, Madrid, Spain; Unidad de Investigación, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) y Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
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Persu C, Ciofu I, Petrescu A, Chirca N, Cauni V. Bladder Wall Structure Alterations in Patients Treated With Botulinum Toxin for Detrusor Overactivity - A Morphological Study. In Vivo 2023; 37:898-903. [PMID: 36881062 PMCID: PMC10026681 DOI: 10.21873/invivo.13159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND/AIM The overactive bladder syndrome (OAB) is a bothersome condition that affects up to 33% of the population. In up to 69% of the cases, the underlying condition is an overactive detrusor (DO). Treatment options rely on behavioral changes, medical treatment, neuromodulation, and invasive treatment, such as injecting botulinum toxin (BoNT) in the detrusor or augmentation cystoplasty. The aim of this study was to evaluate, by morphological assessment on cold-cup biopsies of the bladder, the effect of botulinum toxin injections on the bladder wall, focusing on the histological structure and signs of inflammation and fibrosis. PATIENTS AND METHODS We evaluated consecutive patients with DO that received BoNT intradetrusor injections. We analyzed inflammation and fibrosis in 36 patients, divided into two groups based on their history of BoNT treatment. Our patients underwent at least one round of injections and specimens were compared individually, before and after each injection. RESULTS A decrease in inflammation was found in 26.3% of the cases, a reactive increase in 31.5%, and no change in 42.1%. No de novo or increase in preexisting fibrosis was found. In some cases, fibrosis diminished after a second round of BoNT. CONCLUSION In most cases, BoNT intradetrusor injections in DO patients showed no effect on bladder wall inflammation and actually improved the inflammatory condition of the muscle in a significant number of samples.
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Affiliation(s)
- Cristian Persu
- Department of Urology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pathology, "Prof. Dr. Th. Burghele" Clinical Hospital, Bucharest, Romania
| | - Irina Ciofu
- Department of Urology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
| | - Amelia Petrescu
- Department of Pathology, "Prof. Dr. Th. Burghele" Clinical Hospital, Bucharest, Romania
| | - Narcis Chirca
- Department of Urology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pathology, "Prof. Dr. Th. Burghele" Clinical Hospital, Bucharest, Romania
| | - Victor Cauni
- Department of Urology, Colentina Clinical Hospital, Bucharest, Romania
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Wo S, Cirrone F, Al-Homsi AS. A Clinical Review of the Different Strategies to Minimize Hemorrhagic Cystitis Associated with the Use of Post-Transplantation Cyclophosphamide in Allogeneic Transplantation. Transplant Cell Ther 2023; 29:210-211. [PMID: 36436781 DOI: 10.1016/j.jtct.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/17/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Stephanie Wo
- Adult Blood and Marrow Transplantation, NYU Langone Health, New York, New York.
| | - Frank Cirrone
- Adult Blood and Marrow Transplantation, NYU Langone Health, New York, New York
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Schmidt KT, Karzai F, Bilusic M, Cordes LM, Chau CH, Peer CJ, Wroblewski S, Huitema ADR, Schellens JHM, Gulley JL, Dahut WL, Figg WD, Madan RA. A Single-arm Phase II Study Combining NLG207, a Nanoparticle Camptothecin, with Enzalutamide in Advanced Metastatic Castration-resistant Prostate Cancer Post-Enzalutamide. Oncologist 2022; 27:718-e694. [PMID: 35640474 PMCID: PMC9438911 DOI: 10.1093/oncolo/oyac100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Despite the clinical efficacy of enzalutamide monotherapy in patients with advanced prostate cancer, therapeutic resistance and disease progression are inevitable. We proposed a study to evaluate NLG207, a nanoparticle-drug conjugate (NDC) of the potent topoisomerase I inhibitor camptothecin, in combination with enzalutamide, in patients with metastatic castration-resistant prostate cancer (mCRPC) following progression on enzalutamide. METHODS This was a single-arm, optimal two-stage, phase II study to evaluate the efficacy of NLG207 in combination with enzalutamide in patients with mCRPC who received prior enzalutamide. A lead-in dose escalation evaluated the recommended phase 2 dose of NLG207 in combination with enzalutamide. Patients received NLG207 via IV infusion every 2 weeks and enzalutamide 160 mg orally once daily. RESULTS Between March 2019 and June 2021, four patients were accrued to the lead-in dose escalation. Two of the four patients were evaluable and both experienced DLTs at the NLG207 12 mg/m2 dose level; one DLT was related to a dose delay for noninfective cystitis and myelosuppression, the other a grade 3 noninfective cystitis. Further evaluation of NLG207 in combination with enzalutamide was halted and the study was ultimately terminated. PSA declines from baseline were observed in two patients. CONCLUSION NLG207 12 mg/m2 in combination with enzalutamide was not well tolerated in patients with mCRPC following several lines of the standard of care therapy. CLINICALTRIALS.GOV IDENTIFIER NCT03531827.
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Affiliation(s)
- Keith T Schmidt
- Clinical Pharmacology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Fatima Karzai
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marijo Bilusic
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lisa M Cordes
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cindy H Chau
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cody J Peer
- Clinical Pharmacology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Susan Wroblewski
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alwin D R Huitema
- Department Pharmacy & Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Pharmacology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jan H M Schellens
- Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - James L Gulley
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - William L Dahut
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - William D Figg
- Corresponding author: William D. Figg, 9000 Rockville Pike, Building 10/Room 5A03, Bethesda, MD 20892, USA. Tel: +1 240 760 6179;
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Choi T, Lee DG. Cystitis Induces Altered CREB Expression Related with Micturition Reflex. Medicina (Kaunas) 2022; 58:medicina58091210. [PMID: 36143887 PMCID: PMC9500846 DOI: 10.3390/medicina58091210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022]
Abstract
Background and objectives: Bladder stimulation upregulates neurotrophins associated with voiding reflex. Bacterial cystitis can be a stimulant that activates this system, resulting in a pathological state. Phosphorylated responsive element of binding protein (p-CREB) is a pivotal transcriptional factor in the neurotrophin signaling cascade. The goal of our study was to examine the change in expression of p-CREB in dorsal root ganglia (DRG) of rats after uropathogenic Escherichia coli infection of the bladder. Materials and methods: A total of 19 adult female Sprague−Dawley rats were induced with acute E. coli infection (n = 7), chronic E. coli infection (n = 6), or served as controls (n = 6). In each group, the profiles of p-CREB cell were counted in 6−10 sections of each of the DRG collected. DRG cells exhibiting intense nuclear staining were considered to be positive for p-CREB immunoreactivity (p-CREB-IR). Results: Overall, the immunoreactivity of p-CREB was examined in smaller cell profiles with nuclear staining or nuclear and cytoplasmic staining in the DRGs (L1−L6, S1). In the chronic cystitis group, p-CREB-IR in the L1−L6 and S1 DRG was significantly higher than the control group (p < 0.05). Further, p-CREB-IR in the L3−L6 and S1 DRG of the chronic cystitis group was significantly greater than that in the acute cystitis group (p < 0.05). In the control and acute cystitis groups, p-CREB-IR in the L4−L5 DRG was significantly lower than that found in the other DRG sections (p < 0.05). Conclusions: Altogether, acute or chronic E.coli cystitis changed the immunoreactivity of p-CREB in lumbosacral DRG cells. In particular, chronic E. coli infection triggered p-CREB overexpression in L1−L6 and S1 DRG, indicating subsequent pathologic changes.
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Affiliation(s)
| | - Dong-Gi Lee
- Correspondence: ; Tel.: +82-2-440-7735; Fax: +82-2-440-7744
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Li L, Li Y, Yang J, Xie X, Chen H. The immune responses to different Uropathogens call individual interventions for bladder infection. Front Immunol 2022; 13:953354. [PMID: 36081496 PMCID: PMC9445553 DOI: 10.3389/fimmu.2022.953354] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
Urinary tract infection (UTI) caused by uropathogens is the most common infectious disease and significantly affects all aspects of the quality of life of the patients. However, uropathogens are increasingly becoming antibiotic-resistant, which threatens the only effective treatment option available-antibiotic, resulting in higher medical costs, prolonged hospital stays, and increased mortality. Currently, people are turning their attention to the immune responses, hoping to find effective immunotherapeutic interventions which can be alternatives to the overuse of antibiotic drugs. Bladder infections are caused by the main nine uropathogens and the bladder executes different immune responses depending on the type of uropathogens. It is essential to understand the immune responses to diverse uropathogens in bladder infection for guiding the design and development of immunotherapeutic interventions. This review firstly sorts out and comparatively analyzes the immune responses to the main nine uropathogens in bladder infection, and summarizes their similarities and differences. Based on these immune responses, we innovatively propose that different microbial bladder infections should adopt corresponding immunomodulatory interventions, and the same immunomodulatory intervention can also be applied to diverse microbial infections if they share the same effective therapeutic targets.
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Affiliation(s)
- Linlong Li
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
| | - Yangyang Li
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
| | - Jiali Yang
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
| | - Xiang Xie
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
- Public Center of Experimental Technology, Model Animal and Human Disease Research of Luzhou Key Laboratory, Southwest Medical University, Luzhou, China
- *Correspondence: Xiang Xie, ; Huan Chen,
| | - Huan Chen
- The School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
- Nucleic Acid Medicine of Luzhou Key Laboratory, Southwest Medical University, Luzhou, China
- *Correspondence: Xiang Xie, ; Huan Chen,
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Chung SD, Praveen Rajneesh C, Chen KC, Tai HC, Chang ML, Tseng XW, Cheng JH, Tsai WK, Chiang HS, Wu YN. Specific Impacts of Ketamine on Bladder Dysfunction and Associated Histological Alterations in Rats-A Time Course Validation through Transmission Electron Microscopy. Int J Mol Sci 2022; 23:ijms23042194. [PMID: 35216309 PMCID: PMC8878520 DOI: 10.3390/ijms23042194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 02/01/2023] Open
Abstract
This study explored the specific effects of ketamine on bladder function followed by a sequence of histological changes in a rat bladder at fixed time course intervals. The rats were grouped into normal control and experimental animals, and ketamine (100 mg/kg/day) was administrated to the experimental animals for 2, 4, and 8 weeks, respectively; similarly, the control animals received saline. All animals were evaluated for bladder function and histological responses to the treatment. Ultrastructural changes were observed by transmission electron microscopy (TEM). The results showed progressive bladder dysfunctions with hyperactive bladder conditions according to the time course and frequency of exposure to ketamine. Significantly, decreased inter contraction intervals, residual urine volume, peak micturition pressure, and increased micturition frequency were observed. Bladder histology results revealed substantial inflammation and comprehensive submucosa edema in week 2 and 4 rats along with fibrosis and significant bladder detrusor hypertrophy in week 8 rats. TEM analysis revealed bladder wall thickening, deformed blood vessels, detrusor hypertrophy, wobbled gap junction, and barrier dysfunction at different time course levels in experimental animals. These results provided a profound knowledge about the prognosis and step-by-step pathophysiology of the disease, which might help in developing new therapeutic interventions.
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Affiliation(s)
- Shiu-Dong Chung
- Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan;
- Department of Nursing, College of Healthcare & Management, Asia Eastern University of Science and Technology, New Taipei City 220, Taiwan
- Graduate Insitute of Medicine, Yuan Ze University, Taoyuan City 320, Taiwan
| | - Chellappan Praveen Rajneesh
- School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan; (C.P.R.); (K.-C.C.); (H.-C.T.); (M.-L.C.)
| | - Kuo-Chiang Chen
- School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan; (C.P.R.); (K.-C.C.); (H.-C.T.); (M.-L.C.)
- Department of Urology, Cathay General Hospital, Taipei City 106, Taiwan
| | - Huai-Ching Tai
- School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan; (C.P.R.); (K.-C.C.); (H.-C.T.); (M.-L.C.)
- Department of Urology, Fu Jen Catholic University Hospital, New Taipei City 242, Taiwan;
| | - Meng-Lin Chang
- School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan; (C.P.R.); (K.-C.C.); (H.-C.T.); (M.-L.C.)
- Department of Urology, Fu Jen Catholic University Hospital, New Taipei City 242, Taiwan;
| | - Xiao-Wen Tseng
- Program in Pharmaceutical Biotechnology, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan;
| | - Jai-Hong Cheng
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan;
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Department of Leisure and Sports Management, Cheng Shiu University, Kaohsiung 833, Taiwan
| | - Wei-Kung Tsai
- Department of Urology, Mackay Memorial Hospital, Taipei City 104, Taiwan;
- Ph.D. Program in Nutrition and Food Science, Fu Jen Catholic University, New Taipei City 242, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
- Mackay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan
- Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City 242, Taiwan
| | - Han-Sun Chiang
- Department of Urology, Fu Jen Catholic University Hospital, New Taipei City 242, Taiwan;
- Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City 242, Taiwan
| | - Yi-No Wu
- School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan; (C.P.R.); (K.-C.C.); (H.-C.T.); (M.-L.C.)
- Correspondence: ; Tel.: +886-2-2905-6442
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Flor JMS, Gaston MJFV, Lapitan MCM. Pelvic lipomatosis associated with bilateral obstructive uropathy and proliferative cystitis. BMJ Case Rep 2021; 14:e233428. [PMID: 34404639 PMCID: PMC8372792 DOI: 10.1136/bcr-2019-233428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/04/2022] Open
Abstract
Pelvic lipomatosis is a rare benign entity characterised by excessive deposition of adipose tissue in the perirectal and perivesical spaces. We describe a 43-year-old man with bilateral distal ureteral obstruction secondary to pelvic lipomatosis with concomitant proliferative cystitis resulting in severe hydronephrosis. We performed urinary diversion with percutaneous nephrostomy tube insertion to prevent further renal impairment. The patient was advised close follow-up to monitor the increased risk of bladder adenocarcinoma transformation observed in patients with cystitis glandularis. This report, compliant with the CARE (CAse REport) guidelines for clinical case reporting, presents another case of pelvic lipomatosis associated with acute kidney failure, bilateral hydronephrosis and proliferative cystitis without urodynamic evidence of bladder outlet obstruction that may serve to guide urologists in managing patients with a similar profile.
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Ibishev KS, Lapteva TO, Todorov SS, Krakhotkin DV, N RN, Mantsov AA, Kogan MI. [Cystoscopic and morphological features of chronic recurrent papillomavirus cystitis]. Urologiia 2021:45-49. [PMID: 34251100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Chronic recurrent cystitis (CRC) is a common disease in the female population and a serious medical problem. There are not enough data about etiology of this desiase and effective treatment. OBJECTIVE To increase the accuracy of the differential diagnosis of bacterial and papillomavirus chronic recurrent cystitis. MATERIALS AND METHODS Analysis of endoscopic and morphological diagnostic methods of 118 patients with CRC, which, depending on the etiological factor, were divided into two groups. Group I (n=65) patients with CRC of HPV etiology and Group II (n=53) - CRC of bacterial etiology (E. coli). All patients were examined according to the EAU and RSU recommendations, and an endoscopic examination of the bladder (cystoscopy) was additionally included, followed by morphological examination of biopsy specimen of the urinary bladder. RESULTS The endoscopic picture of bacterial CRC usually is caused by hyperemia of the mucous membrane of the bladder, hyperemia and injection of vessels with the participation of (small-puncture/diapedesic) hemorrhages without signs of proliferative changes. The endoscopic picture in papillomavirus CRC in all patients presented by focal or diffuse, slightly elevated, exophytic, often polypoid formations of a whitish or whitish-gray color, usually localized in the Leto triangle. Morphological analysis of biopsy tissue of the urinary bladder in patients with bacterial cystitis in the mucous and submucous layer showed edema, thickening of the urothelium, capillary abundance, inflammatory infiltration, represented by lymphocytes, plasma cells and leukocytes, among which neutrophilic macrophage leukocytes were predominant. Morphological analysis of the bladder mucosa in all examined patients with signs of HPV-related lesions showed a thickening of the urothelium, squamous metaplasia of the urothelium, chronic inflammation, microcirculatory vascular reaction and edema. An important distinctive pathomorphological sign of HPV within urinary bladder was the presence of koilocytic transformation of urothelium cells due to the cytopathic effect of the virus. CONCLUSIONS Papillomavirus CR has characterized by an infectious-inflammatory process in the bladder paries, with lymphocytic-plasmatic infiltration and coylocytic transformation of the urothelium.
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Affiliation(s)
- K S Ibishev
- Rostov State Medical University, Rostov-on-Don, Russia
| | - T O Lapteva
- Rostov State Medical University, Rostov-on-Don, Russia
| | | | | | | | - A A Mantsov
- Rostov State Medical University, Rostov-on-Don, Russia
| | - M I Kogan
- Rostov State Medical University, Rostov-on-Don, Russia
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Iqbal N, Taseer AR, Ahsan N, Kumari P, Portillo TP, Razzack AA, Khan F, Akhter S. Managing Patient With Coexisting Emphysematous Pyelonephritis And Cystitis. J Ayub Med Coll Abbottabad 2021; 33:162-164. [PMID: 33774976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Emphysematous pyelonephritis (EPN) is a type of critical renal infection having dire consequences at times. It is said to be result of gases produced inside renal parenchymal tissue or pelvicalyceal system. Rarely coexistence of emphysematous pyelonephritis and emphysematous cystitis (EC) may lead to an intimidating condition in case it is not dealt with swiftly. The resent case report narrates the management of a 45-year-old female patient who suffered from EPN with concomitant EC. Right-sided emergency percutaneous nephrostomy was passed. Afterwards, Double J stent was passed under general anaesthesia. Although she had an initial improvement clinically but later on due to recurrent urinary tract infections and non-resolving right kidney abscess and fever right sided nephrectomy was done. This is a very rare presentation and has not previously reported much in literature.
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Affiliation(s)
- Nadeem Iqbal
- Department of Urology and Kidney Transplant, Pakistan Kidney and Liver Institute, Lahore, Pakistan
| | | | | | | | | | | | | | - Saeed Akhter
- Department of Urology and Kidney Transplant, Pakistan Kidney and Liver Institute, Lahore Pakistan
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40
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El-Ghar MA, Farg H, Sharaf DE, El-Diasty T. CT and MRI in Urinary Tract Infections: A Spectrum of Different Imaging Findings. Medicina (Kaunas) 2021; 57:medicina57010032. [PMID: 33401464 PMCID: PMC7824127 DOI: 10.3390/medicina57010032] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022]
Abstract
There are many acute and chronic infections affecting the urinary tract including bacterial, fungal and viral infections. Urinary tract infections (UTIs) can present in many different patterns with variable degrees of severity varying from asymptomatic and uncomplicated forms to life threatening complicated infections. Cross-sectional imaging techniques—including both computed tomography (CT) and magnetic resonance imaging (MRI)—have become very important tools not only for evaluation of UTIs, but also for detection of associated complications. Selection of either CT or MRI in the UTI evaluation depends on several factors such as the presence of contraindication, experience, cost and availability. CT and MRI help in early detection and management of UTIs that reduce the prevalence and severity of complications. In this article we will present the radiologic findings at CT and MRI in different types of upper and lower UTIs including acute pyelonephritis, intrarenal and perinephric abscesses, pyonephrosis, chronic pyelonephritis, emphysematous UTIs, xanthogranulomatous pyelonephritis, tuberculosis (TB), bilharziasis, fungal infection, corynebacterium infection, ureteritis, cystitis, prostatitis, prostatic abscess and urethritis.
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41
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Khetan P, Ramteke V, Ashtekar J. Abdominal Pain and Fever in an Elderly Patient with Diabetes Mellitus. Kidney360 2020; 1:1180-1181. [PMID: 35368793 PMCID: PMC8815495 DOI: 10.34067/kid.0002402020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/04/2020] [Indexed: 06/14/2023]
Affiliation(s)
- Prakash Khetan
- Department of Nephrology, Kingsway Hospitals, Nagpur, India
| | - Vishal Ramteke
- Department of Nephrology, Kingsway Hospitals, Nagpur, India
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42
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Bruyère F. [Urogenital infections: what distinguishes French and European recommendations?]. Rev Prat 2020; 70:825-826. [PMID: 33739677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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43
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Kuz'min IV, Slesarevskaya MN, Al-Shukri SH. [D-mannose for prevention and treatment of lower urinary tract infection: pathogenetic basics and clinical results]. Urologiia 2020:131-138. [PMID: 32897027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Non-antibacterial methods of prevention and treatment of lower urinary tract infection are described in the article. The current view on the mechanism of treatment effect of D-mannose is presented, which contributes to the prevention of bacterial invasion. Pathogenetic concepts for using D-mannose as specific antiadhesin or a competitive blocker of bacterial invasion is provided. In addition, we discussed the results of basic and clinical studies, proving the efficiency of D-mannose for prevention and treatment of lower urinary tract infection.
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Affiliation(s)
- I V Kuz'min
- Department of Urology of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - M N Slesarevskaya
- Department of Urology of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - S H Al-Shukri
- Department of Urology of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of First Pavlov Saint-Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
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44
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Verheij TJM, Platteel TN. Looking for the optimal treatment of uncomplicated urinary tract infections. Lancet Infect Dis 2020; 20:1001-1002. [PMID: 32446326 DOI: 10.1016/s1473-3099(20)30163-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 02/27/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Theo J M Verheij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Tamara N Platteel
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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45
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Masood B, Iqbal W, Iqbal N, Hussain I, Haq AU, Rehman U, Haroon A, Khan F, Iqbal D, Hasan A. Incidental Findings Of Polypoid Cystitis In A 6-Year Old Child Without Any History Of Lower Urinary Tract Symptoms And Previous Urinary Catheterization. J Ayub Med Coll Abbottabad 2020; 32:410-412. [PMID: 32829562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 6-year-old boy presented to ER with acute pain in right iliac fossa without any history of lower urinary tract symptoms, haematuria and urinary catheterization. Ultrasound showed loculated cystic area in pelvis with non-visualized appendix. A CT scan abdomen and pelvis revealed loculated, multi-septated cystic lesion in right hemipelvis thought to be a collection from possible appendicular inflammation / perforation. The laboratory findings revealed raised CRP and normal urine routine examination and culture. Exploratory laparotomy revealed cystic urinary bladder growth involving dome with normal appendix, partial cystectomy was done. Histopathology confirmed polypoid cystitis with no evidence of malignancy. This is a very rare presentation of polypoidal cystitis, not previously reported in literature.
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Affiliation(s)
- Basit Masood
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Waqas Iqbal
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Nadeem Iqbal
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Ijaz Hussain
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Anwar Ul Haq
- Department of Urology, Shifa International Hospital Islamabad,Pakistan
| | - Usama Rehman
- Department of Urology, Shifa International Hospital Islamabad, Pakistan
| | - Asna Haroon
- Department of Urology, Shifa International Hospital Islamabad,Pakistan
| | - Faheemullah Khan
- Department of Radiology, Hyatabad Medical Complex, Peshawar, Pakistan
| | - Daud Iqbal
- Department of Cardiology, Ayub Teaching Hospital, Abbottabad, Pakistan
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46
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Petrov SB, Slesarevskaya MN, Chibirov KH, Topuzov ME, Kagan OF, Voronova EN. [Efficiency and safety of phenazopyridine for treatment of uncomplicated urinary tract infection: results of multi-center, randomized, placebo-controlled, clinical study]. Urologiia 2020:15-21. [PMID: 32597580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM to evaluate the efficiency and safety of phenazopyridine for the treatment of patients with uncomplicated lower urinary tract infection, accompanied by pain. MATERIALS AND METHODS A multicenter double-blind, randomized, placebo-controlled study with parallel groups to evaluate the efficacy and safety of phenazopyridine in patients with acute uncomplicated cystitis was performed. A total of 60 women were divided into two groups of 30 patients. In the main group (average age 32.6+/-7.4 years) phenazopyridine was prescribed (2 tablets of 100 mg p.o., with a total dose of 200 mg, once). In the control group, patients (mean age 35.53+/-8.79 years) received a placebo according to the same scheme. To evaluate the efficiency of treatment, the severity of the main symptoms 6 hours after taking the drug was analyzed. After that, patients started antibiotic therapy. They were followed-up for the next three days. The tolerance of therapy was evaluated by the presence of adverse events. RESULTS All 30 patients taking phenazopyridine had an improvement after 6 hours, and the most frequent response was "significant improvement" (43.3%). The responses of patients in the main group significantly (p<0.05) differed from responses of patients in the control group. Six hours after taking phenazopyridine/placebo, the severity of all values according to VAS score, including the degree of general discomfort, pain during urination and increased frequency of urination improved significantly in the main group compared to the control group. The average assessment of general discomfort in the main group decreased by 53.4% in comparison with 28.8% in the control group, while the severity of pain during urination and urination frequency decreased by 57.4 vs. 35.9% and 39.6 vs. 27.6%, respectively. An analysis of the time before the complete absence of the general discomfort was performed. In the main group this period of time was significantly less than in the control group (p<0.05). There were no serious adverse events while taking phenazopyridine. Rate of adverse events was comparable between two groups. CONCLUSION The results of the study showed that phenazopyridine is an effective and well-tolerated drug for symptomatic therapy in patients with acute uncomplicated cystitis and can be recommended in addition to etiological therapy.
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Affiliation(s)
- S B Petrov
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of Pavlov First Saint Petersburg State Medical University of the Ministry of Health of Russia, Saint Petersburg, Russia
- FGBOU Saint Petersburg Scientific and Research Institute of Phthisiopulmonology of Ministry of Health of Russia, Saint Petersburg, Russia
- North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
- Ltd MedEsteticCenter Laboratory, Saint Petersburg, Russia
- Ltd Avrora Medi, Saint Petersburg, Russia
| | - M N Slesarevskaya
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of Pavlov First Saint Petersburg State Medical University of the Ministry of Health of Russia, Saint Petersburg, Russia
- FGBOU Saint Petersburg Scientific and Research Institute of Phthisiopulmonology of Ministry of Health of Russia, Saint Petersburg, Russia
- North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
- Ltd MedEsteticCenter Laboratory, Saint Petersburg, Russia
- Ltd Avrora Medi, Saint Petersburg, Russia
| | - K H Chibirov
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of Pavlov First Saint Petersburg State Medical University of the Ministry of Health of Russia, Saint Petersburg, Russia
- FGBOU Saint Petersburg Scientific and Research Institute of Phthisiopulmonology of Ministry of Health of Russia, Saint Petersburg, Russia
- North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
- Ltd MedEsteticCenter Laboratory, Saint Petersburg, Russia
- Ltd Avrora Medi, Saint Petersburg, Russia
| | - M E Topuzov
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of Pavlov First Saint Petersburg State Medical University of the Ministry of Health of Russia, Saint Petersburg, Russia
- FGBOU Saint Petersburg Scientific and Research Institute of Phthisiopulmonology of Ministry of Health of Russia, Saint Petersburg, Russia
- North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
- Ltd MedEsteticCenter Laboratory, Saint Petersburg, Russia
- Ltd Avrora Medi, Saint Petersburg, Russia
| | - O F Kagan
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of Pavlov First Saint Petersburg State Medical University of the Ministry of Health of Russia, Saint Petersburg, Russia
- FGBOU Saint Petersburg Scientific and Research Institute of Phthisiopulmonology of Ministry of Health of Russia, Saint Petersburg, Russia
- North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
- Ltd MedEsteticCenter Laboratory, Saint Petersburg, Russia
- Ltd Avrora Medi, Saint Petersburg, Russia
| | - E N Voronova
- Scientific and Research Center of Urology in Scientific and Research Institute for Surgery and Emergency Medicine of Pavlov First Saint Petersburg State Medical University of the Ministry of Health of Russia, Saint Petersburg, Russia
- FGBOU Saint Petersburg Scientific and Research Institute of Phthisiopulmonology of Ministry of Health of Russia, Saint Petersburg, Russia
- North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
- Ltd MedEsteticCenter Laboratory, Saint Petersburg, Russia
- Ltd Avrora Medi, Saint Petersburg, Russia
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47
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Kotov SV, Perov RA. [Combined prophylaxis of recurrent lower urinary tract infections in children and pregnant women]. Urologiia 2020:122-126. [PMID: 32351075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The use of the combined herbal preparation Cystenium II for the prevention of recurrent lower urinary tract infections, including those in children and pregnant women, is described in the review. The etiological component of infectious and inflammatory diseases of the lower urinary tract and specific features of the interaction of microorganisms with bladder mucosa were studied. A detailed analysis of pharmacodynamic effects of Cysteniums II components is provided. The specific features of the treatment of acute cystitis in pregnant women and children older than 7 years are presented.
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Affiliation(s)
- S V Kotov
- Department of Urology and Andrology of Medical Faculty of N.I. Pirogov RNRMU of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - R A Perov
- Department of Urology and Andrology of Medical Faculty of N.I. Pirogov RNRMU of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
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48
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Ibishev KS, Lapteva TO, Krachotkin DV, Ryabenchenko NN. [The role of viral infection in the development of recurrent lower urinary tract infections]. Urologiia 2019:136-139. [PMID: 31808649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This review is dedicated to the problems of diagnosing recurrent lower urinary tract infections caused by viruses. The literature search was conducted using the Medline, PubMed, EMBASE, CNKI, and WANG FANG databases. Further study of virobiota and microbiome of urine both in normal and in pathological conditions are warranted.
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Affiliation(s)
- K S Ibishev
- Department of urology and reproductive health with the course of pediatric urology and andrology of FGBOU VO Rostov State Medical University of the Minzdrav of Russia, Rostov-on-Don, Russia
| | - T O Lapteva
- Department of urology and reproductive health with the course of pediatric urology and andrology of FGBOU VO Rostov State Medical University of the Minzdrav of Russia, Rostov-on-Don, Russia
| | - D V Krachotkin
- Department of urology and reproductive health with the course of pediatric urology and andrology of FGBOU VO Rostov State Medical University of the Minzdrav of Russia, Rostov-on-Don, Russia
| | - N N Ryabenchenko
- Department of urology and reproductive health with the course of pediatric urology and andrology of FGBOU VO Rostov State Medical University of the Minzdrav of Russia, Rostov-on-Don, Russia
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49
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Clarke R. HBO2 for radiation cystitis. Undersea Hyperb Med 2019; 46:725-727. [PMID: 31689017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Richard Clarke
- National Baromedical Services, Columbia, South Carolina, U.S
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50
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Kulchavenya EV, Neymark AI, Borisenko DV, Kapsargin FP. [Acute uncomplicated cysititis: do we follow the guidelines?]. Urologiia 2018:66-69. [PMID: 30742380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Lower urinary tract infection are a common urologic disease, but a therapy is not always optimal. AIM to evaluate the compliance of prescriptions made by urologists in treatment of patients with lower urinary tract infection, in particular with acute uncomplicated cystitis. MATERIALS AND METHODS A specially designed questionnaire was filled out by 161 urologists from Novosibirsk, Barnaul and Krasnoyarsk, as well as participants of VII Congress of urologists of Siberia. RESULTS The survey showed that 34.8%, 27.9%, 22.4% and 14.9% of urologists had 6-10, 11-20, 1-5 and more than 20 patients with acute uncomplicated cystitis a month, respectively. According to results, 91.9% of urologists are familiar to National guidelines on treatment of lower urinary tract infections and 91.2% of doctors consider them to be reasonable. Among those surveyed, 29.2% of urologists believe that National Guidelines differ from European Guidelines; 95.7% of participants adhere to recommendations, but only 47.4% respect it almost always, 16.9% do it in half of cases and the remaining 35.7% comply with them in less than 40% cases. Moreover, 86.4% of urologists started a treatment of acute cystitis with antimicrobial therapy and preferred fosfomycin in 41.0%, nitrofurans in 20.9%, fluoroquinolones in 21.6% and cephalosporins in 16.5% cases, respectively. Almost all respondents (93.8%) are convinced that antibiotic therapy should be accompanied by phytotherapy, and 71.5% of urologists administer Canephron. CONCLUSION In the urologic community there are controversies in the treatment of patients with acute uncomplicated cystitis. The choice of therapy is not always optimal.
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Affiliation(s)
- E V Kulchavenya
- FGBU Tuberculosis Research Institute of Minzdrav of Russia, Novosibirsk, Russia
- FGBU VO Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
- FGBOU VO Altai State Medical University of the Ministry of Health of Russia, Barnaul, Russia
- FGBOU VO Krasnoyarsk State Medical University of the Ministry of Health of Russia, Krasnoyarsk, Russia
| | - A I Neymark
- FGBU Tuberculosis Research Institute of Minzdrav of Russia, Novosibirsk, Russia
- FGBU VO Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
- FGBOU VO Altai State Medical University of the Ministry of Health of Russia, Barnaul, Russia
- FGBOU VO Krasnoyarsk State Medical University of the Ministry of Health of Russia, Krasnoyarsk, Russia
| | - D V Borisenko
- FGBU Tuberculosis Research Institute of Minzdrav of Russia, Novosibirsk, Russia
- FGBU VO Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
- FGBOU VO Altai State Medical University of the Ministry of Health of Russia, Barnaul, Russia
- FGBOU VO Krasnoyarsk State Medical University of the Ministry of Health of Russia, Krasnoyarsk, Russia
| | - F P Kapsargin
- FGBU Tuberculosis Research Institute of Minzdrav of Russia, Novosibirsk, Russia
- FGBU VO Novosibirsk State Medical University of Minzdrav of Russia, Novosibirsk, Russia
- FGBOU VO Altai State Medical University of the Ministry of Health of Russia, Barnaul, Russia
- FGBOU VO Krasnoyarsk State Medical University of the Ministry of Health of Russia, Krasnoyarsk, Russia
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