Environmental influences on viscero(noci)ceptive brain activities: the effects of sheltering

Corticotropin releasing factor: a mediator of emotional influences on bladder function

PURPOSE

We review evidence linking overactive bladder (OAB) and interstitial cystitis with anxiety and depression, and highlight the importance of corticotropin releasing factor (CRF) as a potential mediator of these conditions.

MATERIALS AND METHODS

We review the literature and describe ongoing experiments.

RESULTS

CRF is expressed in areas of the central nervous system that control voiding and response to stress. CRF is increased during anxiety, depression and pain as well as functional disorders of the pelvic viscera. Epidemiological studies reveal an association between anxiety and voiding disorders. Experiments in our laboratory show that CRF stimulates bladder activity while CRF antagonists inhibit OAB.

CONCLUSIONS

Epidemiological, genetic and neuropharmacological evidence links disorders of voiding and anxiety. CRF may participate in these events and warrants further investigation as a therapeutic target in the treatment of OAB and interstitial cystitis.

COX-2 and prostanoid expression in micturition pathways after cyclophosphamide-induced cystitis in the rat

The purpose of this study was to determine the role of cyclooxygenase-2 (COX-2) and its metabolites in lower urinary tract function after induction of acute (4 h), intermediate (48 h), or chronic (10 day) cyclophosphamide (CYP)-induced cystitis. Bladders were harvested from euthanized female rats for analyses. Conscious cystometry was used to assess the effects of a COX-2-specific inhibitor, 5,5-dimethyl-3-(3-fluorophenyl)-4-(4-methylsulfonyl)phenyl2(5H)-furanone (DFU, 5 mg/kg sc), a disubstituted furanone, in CYP-induced cystitis. COX-2 mRNA was increased in inflamed bladders after acute (12-fold) and chronic (9-fold) treatment. COX-2 protein expression in inflamed bladders paralleled COX-2 mRNA expression. Prostaglandin D2-methoxime expression in the bladder was significantly (P < or = 0.01) increased in acute (3-fold) and chronic (5.5-fold) cystitis. Prostaglandin E2 was significantly (P < or = 0.01) increased (2-fold) in the bladder with intermediate (1.7-fold) and chronic (2.6-fold) cystitis. COX-2-immunoreactive cell profiles were distributed throughout the inflamed bladder and coexpressed histamine immunoreactivity. Conscious cystometry in rats treated with CYP + DFU showed increased micturition intervals 4 and 48 h after CYP treatment and decreased intravesical pressures during filling and micturition compared with rats treated with CYP + vehicle. These studies suggest an involvement of urinary bladder COX-2 and its metabolites in altered micturition reflexes with CYP-induced cystitis.

Environmental influences on viscero(noci)ceptive brain activities: the effects of sheltering

Visceral disorders are always accompanied by pain and/or a sense of ill-being that entails people to isolate themselves both physically and socially. By analogy with what happens in human beings, we have transferred to the rat the question of whether a protective, dark and quiet environment would influence the brain activities induced by visceral chemically-induced (cyclophosphamide [CP], 100 mg/kg/ip) adverse conditions of life. CP is an antitumoral drug that induces severe side effects (cystitis, headache, nausea, photophobia, phonophobia) and produces a strong state of ill-being in human beings. Brain activities were quantified using the expression of the Fos protein, a molecular marker of neuronal activity. The results compare data from groups of paired animals having been offered a shelter or not. Data were collected 4 h after the injection of CP, i. e., when cystitis was fully developed. Sheltered and unsheltered groups did not differ in bladder pathology. Intentional sheltering was shown to attenuate the expression of the CP-related Fos-Li activity within the locus coeruleus (LC) without affecting that of the structures known preferentially to process nociceptive inputs of bladder origin (dorsal vagal complex, ventrocaudal bulbar reticular formation, nucleus centralis of amygdala, dorsolateral portion of bed nucleus of stria terminalis). The LC levels of tyrosine hydroxylase and galanin neuronal contents were not affected. The LC belongs to the emotional activation system and can respond to a wide range of somatosensory and viscerosensory stimuli. Our hypothesis is that the LC would be processing the nervous activities that accompany the sense of ill-being coming from adverse conditions of life, including visceral disorders, and that voluntary isolation, by reducing its activity, would enable animals to minimize their level of distress.