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Hashitani H, Mitsui R, Hirai Y, Tanaka H, Miwa-Nishimura K. Nitrergic inhibition of sympathetic arteriolar constrictions in the female rodent urethra. J Physiol 2024; 602:2199-2226. [PMID: 38656747 DOI: 10.1113/jp285583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
During the urine storage phase, tonically contracting urethral musculature would have a higher energy consumption than bladder muscle that develops phasic contractions. However, ischaemic dysfunction is less prevalent in the urethra than in the bladder, suggesting that urethral vasculature has intrinsic properties ensuring an adequate blood supply. Diameter changes in rat or mouse urethral arterioles were measured using a video-tracking system. Intercellular Ca2+ dynamics in arteriolar smooth muscle (SMCs) and endothelial cells were visualised using NG2- and parvalbumin-GCaMP6 mice, respectively. Fluorescence immunohistochemistry was used to visualise the perivascular innervation. In rat urethral arterioles, sympathetic vasoconstrictions were predominantly suppressed by α,β-methylene ATP (10 μM) but not prazosin (1 μM). Tadalafil (100 nM), a PDE5 inhibitor, diminished the vasoconstrictions in a manner reversed by N-ω-propyl-l-arginine hydrochloride (l-NPA, 1 μM), a neuronal NO synthesis (nNOS) inhibitor. Vesicular acetylcholine transporter immunoreactive perivascular nerve fibres co-expressing nNOS were intertwined with tyrosine hydroxylase immunoreactive sympathetic nerve fibres. In phenylephrine (1 μM) pre-constricted rat or mouse urethral arterioles, nerve-evoked vasodilatations or transient SMC Ca2+ reductions were largely diminished by l-nitroarginine (l-NA, 10 μM), a broad-spectrum NOS inhibitor, but not by l-NPA. The CGRP receptor antagonist BIBN-4096 (1 μM) shortened the vasodilatory responses, while atropine (1 μM) abolished the l-NA-resistant transient vasodilatory responses. Nerve-evoked endothelial Ca2+ transients were abolished by atropine plus guanethidine (10 μM), indicating its neurotransmitter origin and absence of non-adrenergic non-cholinergic endothelial NO release. In urethral arterioles, NO released from parasympathetic nerves counteracts sympathetic vasoconstrictions pre- and post-synaptically to restrict arteriolar contractility. KEY POINTS: Despite a higher energy consumption of the urethral musculature than the bladder detrusor muscle, ischaemic dysfunction of the urethra is less prevalent than that of the bladder. In the urethral arterioles, sympathetic vasoconstrictions are predominately mediated by ATP, not noradrenaline. NO released from parasympathetic nerves counteracts sympathetic vasoconstrictions by its pre-synaptic inhibition of sympathetic transmission as well as post-synaptic arteriolar smooth muscle relaxation. Acetylcholine released from parasympathetic nerves contributes to endothelium-dependent, transient vasodilatations, while CGRP released from sensory nerves prolongs NO-mediated vasodilatations. PDE5 inhibitors could be beneficial to maintain and/or improve urethral blood supply and in turn the volume and contractility of urethral musculature.
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Affiliation(s)
- Hikaru Hashitani
- Department of Cell Physiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Retsu Mitsui
- Department of Cell Physiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yuuna Hirai
- Department of Cell Physiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Hidekazu Tanaka
- Department of Cell Physiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Kyoko Miwa-Nishimura
- Department of Cell Physiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
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Son HS, Moon SY, Kwon J, Kim JH. Effect of β3-adrenoceptor agonist on the micromotion of bilateral major pelvic ganglion-excised rat bladder. Neurourol Urodyn 2023; 42:530-538. [PMID: 36633527 DOI: 10.1002/nau.25127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023]
Abstract
AIMS Micromotion is an autonomous intramural movement of the bladder, and is believed to be an initial step in the generation of urinary urgency. Therefore, controlling micromotion may be a novel target in overactive bladder (OAB) treatment. However, developing micromotion treatment has been limited by the absence of a standardized animal model. We attempted to create a micromotion animal model and investigated the effectiveness of a β3 -adrenoceptor agonist (CL316,243) on micromotion. METHODS Bilateral major pelvic ganglia (MPGs) were excised in 18 male Sprague-Dawley rats, resulting in an almost completely denervated bladder. On postoperative Day 7, cystometry was performed. Rats were divided into three treatment groups: CL316,243; β3- adrenoceptor antagonist (SR59230A) pretreated CL316,243; and a nonselective antimuscarinic agent (oxybutynin). Changes in micromotion were evaluated after the intra-arterial administration of each agent. RESULTS Low-amplitude oscillations in intravesical pressure (micromotion) were observed 1 week after MPGs excision. Micromotion frequency significantly (p = 0.003) decreased (2.17 ± 3.54 times/5 min) with CL316,243 compared with vehicle (6.33 ± 1.97 times/5 min). Micromotion amplitude also decreased with CL316,243 (1.15 ± 1.93 cmH2 O) compared with vehicle (5.96 ± 5.12 cmH2 O), approaching conventional significance (p = 0.090). No significant decreases in frequency or amplitude were observed with oxybutynin treatment. CONCLUSIONS Systemic administration of the β3 -adrenoceptor agonist CL316,243 effectively controlled micromotion in bilateral MPGs-excised, almost completely denervated rat bladders. This result indicates that β3 -adrenoceptor agonist may affect the bladder directly, suggesting that it might be effective for overall OAB, regardless of the presence or level of neurological deficits. Bilateral MPGs-excised rats are considered a plausible micromotion animal model suitable for future research.
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Affiliation(s)
- Hee Seo Son
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Soo Young Moon
- Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Joonbeom Kwon
- Department of Urology, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Jang Hwan Kim
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
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Dang LH, Chen YC, Tseng H, Su CH, Hung SH. The sialodynamic test: A preliminary porcine head study. J Int Med Res 2022. [PMCID: PMC9364205 DOI: 10.1177/03000605221115382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives To provide a concept of measuring pressure changes under constant fluid
infusion for the diagnosis of sialolithiasis, termed the sialodynamic test,
in a porcine head model. Methods Using a porcine head model, a constant infusion of water into the
submandibular gland of the two groups over 30 s was performed and the outlet
pressure was measured. Metal beads were inserted into the salivary duct for
obstruction simulation after the normal submandibular gland sialodynamic
measurements were completed. Statistical analyses were performed to evaluate
the differences between the measured individuals and the experimental group
(n = 3). Results The results showed no significant difference between individuals in the
control group, but intergroup variation was noted in the simulated
sialolithiasis group. The volume-dependent linear increase in pressure was
exacerbated in the simulated sialolithiasis group compared with the
control. Conclusion This study indicated that evaluating the relationship between pressure and
volume changes can help to determine whether stones are present in the
submandibular gland. The sialodynamic test might serve as a potential
diagnostic method for salivary diseases.
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Affiliation(s)
- Luong Huu Dang
- Department of Otolaryngology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Yen-Chun Chen
- Department of Otolaryngology, Taipei Medical University Hospital, Taipei
| | - How Tseng
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Chin-Hui Su
- Department of Otolaryngology, Mackay Memorial Hospital, Taipei
| | - Shih-Han Hung
- Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei
- International Master/PhD Programme in Medicine, College of Medicine, Taipei Medical University, Taipei
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei
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Role of PTHrP in attenuating transient pressure rises and associated afferent nerve activity of the rat bladder. Pflugers Arch 2022; 474:1077-1090. [PMID: 35907965 DOI: 10.1007/s00424-022-02736-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/21/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022]
Abstract
Parathyroid hormone-related protein (PTHrP) released from detrusor smooth muscle (DSM) as the bladder fills acts as an endogenous DSM relaxant to facilitate bladder storage function. Here, the effects of exogenous PTHrP on transient pressure rises (TPRs) in the bladder and associated afferent nerve activity during bladder filling were investigated. In anaesthetized rats, changes in the intravesical pressure were measured while the bladder was gradually filled with saline. Afferent nerve activity was simultaneously recorded from their centrally disconnected left pelvic nerves. In DSM strips, spontaneous and nerve-evoked contractions were isometrically recorded. The distribution of PTHrP receptors (PTHrPRs) in the bladder wall was also examined by fluorescence immunostaining. The bladders in which the contralateral pelvic nerve was also centrally disconnected developed nifedipine, an L-type voltage-dependent Ca2+ channel blocker-sensitive TPRs (< 3 mmHg). Intravenous administration of PTHrP suppressed these TPRs and associated bursts of afferent nerve activity. In the bladders with centrally connected contralateral pelvic nerves, atropine, a muscarinic receptor antagonist-sensitive large TPRs (> 3 mmHg) developed in the late filling phase. PTHrP diminished the large TPRs and corresponding surges of afferent nerve activity. In DSM strips, bath-applied PTHrP (10 nM) suppressed spontaneous phasic contractions, while less affecting nerve-evoked contractions. PTHrPRs were expressed in DSM cells but not in intramural nerve fibers. Thus, PTHrP appears to suppress bladder TPRs and associated afferent nerve activity even under the influence of low degree of parasympathetic neural input during storage phases. Endogenous PTHrP may indirectly attenuate afferent nerve activity by suppressing TPRs to facilitate urinary accommodation.
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Ruetten H, Vezina CM. Relevance of dog as an animal model for urologic diseases. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 189:35-65. [PMID: 35595352 DOI: 10.1016/bs.pmbts.2021.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We utilize animal models in urologic research to improve understanding of urinary physiology, determine the etiology of many urologic diseases, and discover and test novel therapeutic interventions. Dogs have a similar urinary tract anatomy and physiology to human and they develop many urologic diseases spontaneously. This chapter offers detailed comparisons of urinary tract anatomy, physiology, and the most common urologic diseases between humans and dogs. Dogs offer a unique opportunity for urologic research because they can be studied in research colonies and in client owned cohorts. Dogs also are among a limited number of non-human species that require continence and socially appropriate urinary behaviors (ex. going to the bathroom outside, training to not have submissive urination, etc.). These features make dogs unique in the animal kingdom and make them an ideal animal model for urologic research.
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Affiliation(s)
- Hannah Ruetten
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Chad M Vezina
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States.
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Lee H, Koh BH, Peri LE, Woodward HJ, Perrino BA, Sanders KM, Koh SD. Role of detrusor PDGFRα + cells in mouse model of cyclophosphamide-induced detrusor overactivity. Sci Rep 2022; 12:5071. [PMID: 35332235 PMCID: PMC8948241 DOI: 10.1038/s41598-022-09155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022] Open
Abstract
Cyclophosphamide (CYP)-induced cystitis is a rodent model that shares many features common to the cystitis occurring in patients, including detrusor overactivity (DO). Platelet-derived growth factor receptor alpha positive (PDGFRα+) cells have been proposed to regulate muscle excitability in murine bladders during filling. PDGFRα+ cells express small conductance Ca2+-activated K+ channels (predominantly SK3) that provide stabilization of membrane potential during filling. We hypothesized that down-regulation of the regulatory functions of PDGFRα+ cells and/or loss of PDGFRα+ cells generates the DO in CYP-treated mice. After CYP treatment, transcripts of Pdgfrα and Kcnn3 and PDGFRα and SK3 protein were reduced in detrusor muscle extracts. The distribution of PDGFRα+ cells was also reduced. Inflammatory markers were increased in CYP-treated detrusor muscles. An SK channel agonist, CyPPA, increased outward current and hyperpolarization in PDGFRα+ cells. This response was significantly depressed in PDGFRα+ cells from CYP-treated bladders. Contractile experiments and ex vivo cystometry showed increased spontaneous contractions and transient contractions, respectively in CYP-treated bladders with a reduction of apamin sensitivity, that could be attributable to the reduction in the SK conductance expressed by PDGFRα+ cells. In summary, PDGFRα+ cells were reduced and the SK3 conductance was downregulated in CYP-treated bladders. These changes are consistent with the development of DO after CYP treatment.
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Affiliation(s)
- Haeyeong Lee
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, 89557, USA.
| | - Byoung H Koh
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, 89557, USA
| | - Lauren E Peri
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, 89557, USA
| | - Holly J Woodward
- The Roslin Institute, The University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG, UK
| | - Brian A Perrino
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, 89557, USA
| | - Kenton M Sanders
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, 89557, USA
| | - Sang Don Koh
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, 89557, USA
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Huang R, Tamalunas A, Waidelich R, Strittmatter F, Stief CG, Hennenberg M. Inhibition of full smooth muscle contraction in isolated human detrusor tissues by mirabegron is limited to off-target inhibition of neurogenic contractions. J Pharmacol Exp Ther 2022; 381:176-187. [DOI: 10.1124/jpet.121.001029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/08/2022] [Indexed: 11/22/2022] Open
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Lee K, Park SO, Choi PC, Ryoo SB, Lee H, Peri LE, Zhou T, Corrigan RD, Yanez AC, Moon SB, Perrino BA, Sanders KM, Koh SD. Molecular and functional characterization of detrusor PDGFRα positive cells in spinal cord injury-induced detrusor overactivity. Sci Rep 2021; 11:16268. [PMID: 34381120 PMCID: PMC8357952 DOI: 10.1038/s41598-021-95781-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/23/2021] [Indexed: 12/02/2022] Open
Abstract
Volume accommodation occurs via a novel mechanism involving interstitial cells in detrusor muscles. The interstitial cells in the bladder are PDGFRα+, and they restrain the excitability of smooth muscle at low levels and prevents the development of transient contractions (TCs). A common clinical manifestation of spinal cord injury (SCI)-induced bladder dysfunction is detrusor overactivity (DO). Although a myogenic origin of DO after SCI has been suggested, a mechanism for development of SCI-induced DO has not been determined. In this study we hypothesized that SCI-induced DO is related to loss of function in the regulatory mechanism provided by PDGFRα+ cells. Our results showed that transcriptional expression of Pdgfra and Kcnn3 was decreased after SCI. Proteins encoded by these genes also decreased after SCI, and a reduction in PDGFRα+ cell density was also documented. Loss of PDGFRα+ cells was due to apoptosis. TCs in ex vivo bladders during filling increased dramatically after SCI, and this was related to the loss of regulation provided by SK channels, as we observed decreased sensitivity to apamin. These findings show that damage to the mechanism restraining muscle contraction during bladder filling that is provided by PDGFRα+ cells is causative in the development of DO after SCI.
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Affiliation(s)
- Ken Lee
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Sang O Park
- Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Pil-Cho Choi
- Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
| | - Seung-Bum Ryoo
- Department of Surgery, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea
| | - Haeyeong Lee
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Lauren E Peri
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Tong Zhou
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Robert D Corrigan
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Andrew C Yanez
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Suk B Moon
- Department of Surgery, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Brian A Perrino
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Kenton M Sanders
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA
| | - Sang Don Koh
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, 89557, USA.
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van Duyl WA, Coolsaet BLRA. Biomechanics of the urinary bladder: spontaneous contraction activity and micromotions related to accommodation. Int Urol Nephrol 2021; 53:1345-1353. [PMID: 33713288 DOI: 10.1007/s11255-021-02814-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Knowledge of the fundamental properties of the urinary bladder is required to better understand its pathological conditions. Research on the passive and active properties of the bladder during stretching and contraction is important. The bladder is not passive during the filling phase. Spontaneous contractions are observed as variations in pressure, which are mostly related to urgency and/or incontinence and sometimes to pelvic pain. The purpose of this study was to describe distributed spontaneous contractions and micromotions (MMs), which besides being related to symptoms, are crucial in the physiological process of accommodation, and to express accommodation in a concept. METHOD After describing MMs in the bladder wall as the type of spontaneous activity that may not be reflected in detrusor pressure and as a source of afferent nerve activity, its biomechanical effects are considered. In a simple mechanical model, contractions and elongations are related to the plastic elongated state of the bladder. The changing distributed character of contractions and elongations in the bladder wall is represented in a modular scheme. RESULTS Distributed transient contractions and MMs yield a balanced dynamic plastic state of the regions of the bladder wall. An almost constant detrusor pressure can be attributed to the active accommodation of detrusor pressure to changes in bladder volume. CONCLUSION Localized contractile activity and MMs that change the plastic elongated state of varying bladder regions are biomechanically effective in the active accommodation of detrusor pressure to changes in bladder volume. According to this concept, autonomous bladder wall activity as a source of nerve activity, also is crucial for active accommodation.
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Lim I, Mitsui R, Kameda M, Sellers DJ, Chess-Williams R, Hashitani H. Comparative effects of angiotensin II on the contractility of muscularis mucosae and detrusor in the pig urinary bladder. Neurourol Urodyn 2020; 40:102-111. [PMID: 33074588 DOI: 10.1002/nau.24548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 01/20/2023]
Abstract
To explore contractile actions of angiotensin II (ATII) on the muscularis mucosae (MM) of the bladder, ATII-induced contractions were compared between MM and the detrusor smooth muscle (DSM) of the pig bladder by isometric tension recordings. Effects of ATII on spontaneous Ca2+ transients in MM were visualized using Cal-520 fluorescence. ATII receptor type 1 (ATR1) expression in MM and DSM was also examined by immunohistochemistry. ATII (1 nM-1 μM) caused phasic contractions of MM in a concentration-dependent manner, while ATII (10 nM-10 μM) had no or marginal effects on DSM contractility. ATII (100 nM)-induced MM contractions had an amplitude of approximately 70% of carbachol (1 μM)-induced or 90% of U46619 (100 nM)-induced contractions. Candesartan (10 nM), an ATR1 blocker, prevented the contractile effects of ATII (1 nM) in MM, while ATR1 immunofluorescence was greater in MM than DSM. ATII (10-100 pM) increased the frequency but not the amplitude of spontaneous Ca2+ transients in MM. Both urothelium-intact and -denuded MM strips developed comparable spontaneous phasic contractions, but ATII, carbachol and U46619-induced contractions were significantly larger in urothelium-denuded than urothelium-intact MM strips. In conclusion, the MM appears to have a much greater sensitivity to ATII compared with DSM that could well sense circulating ATII, suggesting that MM may be the predominant target of contractile actions induced by ATII in the bladder while the urothelium appears to inhibit MM contractility.
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Affiliation(s)
- Iris Lim
- Center for Urology, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Retsu Mitsui
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masashi Kameda
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Donna Jayne Sellers
- Center for Urology, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Russ Chess-Williams
- Center for Urology, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Hikaru Hashitani
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Ito H, Sales AC, Fry CH, Kanai AJ, Drake MJ, Pickering AE. Probabilistic, spinally-gated control of bladder pressure and autonomous micturition by Barrington's nucleus CRH neurons. eLife 2020; 9:56605. [PMID: 32347794 PMCID: PMC7217699 DOI: 10.7554/elife.56605] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/28/2020] [Indexed: 12/27/2022] Open
Abstract
Micturition requires precise control of bladder and urethral sphincter via parasympathetic, sympathetic and somatic motoneurons. This involves a spino-bulbospinal control circuit incorporating Barrington’s nucleus in the pons (Barr). Ponto-spinal glutamatergic neurons that express corticotrophin-releasing hormone (CRH) form one of the largest Barr cell populations. BarrCRH neurons can generate bladder contractions, but it is unknown whether they act as a simple switch or provide a high-fidelity pre-parasympathetic motor drive and whether their activation can actually trigger voids. Combined opto- and chemo-genetic manipulations along with multisite extracellular recordings in urethane anaesthetised CRHCre mice show that BarrCRH neurons provide a probabilistic drive that generates co-ordinated voids or non-voiding contractions depending on the phase of the micturition cycle. CRH itself provides negative feedback regulation of this process. These findings inform a new inferential model of autonomous micturition and emphasise the importance of the state of the spinal gating circuit in the generation of voiding.
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Affiliation(s)
- Hiroki Ito
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom.,Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Anna C Sales
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
| | - Christopher H Fry
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
| | - Anthony J Kanai
- Department of Medicine and Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, United States
| | - Marcus J Drake
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom.,Bristol Urology Institute, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anthony E Pickering
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom.,Anaesthetic, Pain and Critical Care research group, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Kuo HC, Lee CL, Ong HL. Therapeutic efficacy of mirabegron 25 mg monotherapy in patients with nocturia-predominant hypersensitive bladder. Tzu Chi Med J 2020; 32:30-35. [PMID: 32110517 PMCID: PMC7015015 DOI: 10.4103/tcmj.tcmj_226_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/29/2018] [Accepted: 12/11/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: The objective of this study was to evaluate the efficacy of mirabegron 25 mg daily in patients with nocturia-predominant hypersensitive bladder (HSB). Materials and Methods: This study prospectively investigated 219 consecutive patients with nocturia-predominant HSB and treated with mirabegron 25 mg daily from July 2015 to 2016. Patient with nocturia episode decreased by ≥1/night after treatment was considered successful. The subjective symptom score, such as International Prostate Symptom Score (IPSS), Quality of life index, Overactive Bladder Symptom Score (OABSS), Urgency Severity Scale, patient perception of bladder condition (PPBC), and nocturia episodes per night, was assessed before and 1 month after mirabegron treatment and between successful and failed groups. Results: A total of 219 patients, including 51 women and 168 men, were enrolled. The mean age of the population was 72.3 ± 11.0 years. Totally, 58 (26.5%) of the patients had improvement in nocturia at 1 month after treatment. Among them, 14 (27.5%) women and 44 (26.2%) men had improvement in nocturia episodes after treatment (P = 0.858). Compared the clinical data between successful and failed group, the baseline symptom scores were more severe in successful group, including IPSS-storage subscore (4.84 ± 2.09 vs. 4.11 ± 2.19, P = 0.031), OABSS (3.21 ± 0.67 vs. 2.91 ± 1.00, P = 0.037), and nocturia episodes (3.81 ± 0.95 vs. 3.095 ± 1.32, P = 0.000). Multivariate analysis revealed only a higher nocturia episodes (P = 0.046) predict a successful treatment result. Mirabegron 25 mg daily significantly improved PPBC score along the 3 months' follow-up (P < 0.05), and postvoid residual volume did not increase after mirabegron treatment in overall patients. Conclusions: Mirabegron 25 mg daily treatment showed a limited therapeutic effect on nocturia-predominant HSB patients. The patients with higher OAB symptoms predict a successful result.
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13
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Mitsui R, Lee K, Uchiyama A, Hayakawa S, Kinoshita F, Kajioka S, Eto M, Hashitani H. Contractile elements and their sympathetic regulations in the pig urinary bladder: a species and regional comparative study. Cell Tissue Res 2019; 379:373-387. [PMID: 31446446 DOI: 10.1007/s00441-019-03088-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/05/2019] [Indexed: 12/18/2022]
Abstract
Contractile behaviour of the urinary bladder and its sympathetic inhibition during storage phases are not well understood. Here, we explore muscularis mucosae (MM) as a predominant mucosal contractile element and the capability of sympathetic nerves to relax detrusor smooth muscle (DSM) or MM. Distribution of α-smooth muscle actin (α-SMA)-immunoreactive cells was compared in pig, human, guinea pig, rat and mouse bladders by immunohistochemistry, while contractility of the bladder mucosa was compared in these species by isometric tension recordings. In pig, human and guinea pig bladders, DSM and MM located in the lamina propria expressed α-SMA immunoreactivity, while both rat and mouse bladders lacked a MM. Consistent with this presence or absence of MM, bladder mucosa of pig, human and guinea pig but not rat and mouse developed spontaneous phasic contractions (SPCs). Distribution of tyrosine hydroxylase (TH)-immunoreactive sympathetic nerve fibres was compared in pig DSM, MM, trigone and urethra, as were their sympathetic nerve-evoked contractile/relaxing responses examined. In pig DSM or MM, where TH-immunoreactive sympathetic fibres exclusively projected to the vasculature, sympathetic relaxations were difficult to demonstrate. In contrast, sympathetic contractions were invariably evoked in pig trigone and urethra where the smooth muscle cells receive TH-immunoreactive sympathetic innervations. Thus, SPCs of bladder mucosa appear to predominantly arise from the MM displaying species differences. Despite the currently accepted concept of sympathetic nerve-mediated DSM relaxation during the storage phase, it is unlikely that neurally released noradrenaline acts on β-adrenoceptors to relax either DSM or MM due to the anatomical lack of sympathetic innervation.
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Affiliation(s)
- Retsu Mitsui
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan.
| | - Ken Lee
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aoi Uchiyama
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan
| | - Shunta Hayakawa
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan
| | - Fumio Kinoshita
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunichi Kajioka
- Department of Applied Urology and Molecular Medicine, Kyushu University, Fukuoka, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hikaru Hashitani
- Department of Cell Physiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan
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14
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Fry CH, McCloskey KD. Spontaneous Activity and the Urinary Bladder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1124:121-147. [PMID: 31183825 DOI: 10.1007/978-981-13-5895-1_5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The urinary bladder has two functions: to store urine, when it is relaxed and highly compliant; and void its contents, when intravesical pressure rises due to co-ordinated contraction of detrusor smooth muscle in the bladder wall. Superimposed on this description are two observations: (1) the normal, relaxed bladder develops small transient increases of intravesical pressure, mirrored by local bladder wall movements; (2) pathological, larger pressure variations (detrusor overactivity) can occur that may cause involuntary urine loss and/or detrusor overactivity. Characterisation of these spontaneous contractions is important to understand: how normal bladder compliance is maintained during filling; and the pathophysiology of detrusor overactivity. Consideration of how spontaneous contractions originate should include the structural complexity of the bladder wall. Detrusor smooth muscle layer is overlain by a mucosa, itself a complex structure of urothelium and a lamina propria containing sensory nerves, micro-vasculature, interstitial cells and diffuse muscular elements.Several theories, not mutually exclusive, have been advanced for the origin of spontaneous contractions. These include intrinsic rhythmicity of detrusor muscle; modulation by non-muscular pacemaking cells in the bladder wall; motor input to detrusor by autonomic nerves; regulation of detrusor muscle excitability and contractility by the adjacent mucosa and spontaneous contraction of elements of the lamina propria. This chapter will consider evidence for each theory in both normal and overactive bladder and how their significance may vary during ageing and development. Further understanding of these mechanisms may also identify novel drug targets to ameliorate the clinical consequences of large contractions associated with detrusor overactivity.
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Affiliation(s)
- Christopher H Fry
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.
| | - Karen D McCloskey
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
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15
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Hulls CM, Lentle RG, King QM, Chambers JP, Reynolds GW. Pharmacological modulation of the spatiotemporal disposition of micromotions in the intact resting urinary bladder of the rabbit; their pattern is under both myogenic and autonomic control. BJU Int 2019; 123 Suppl 5:54-64. [PMID: 31017744 DOI: 10.1111/bju.14715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To explore and characterize the disposition and dynamics of micromotions in the wall of the intact resting teradotoxinized urinary bladder of the rabbit before and after the administration of adrenergic and cholinergic pharmaceutical agents. METHODS Spatiotemporal maps and related intravesical pressure were used to analyse propagating patches of contractions (PPCs) and their component individual myogenic contractions [propagating individual contractions (PICs)] in the wall of the tetradotoxinized urinary bladder. RESULTS The bladder wall exhibited two contractile states that were of similar frequencies to those of the two types of electrophysiological discharge described in previous studies; the first, in which cyclic PPCs predominated, the second in which small irregular PICs predominated. The addition of carbachol increased the size, frequency, speed and distance of propagation of PPCs, whereas the addition of isoprenaline temporarily halted the incorporation of PICs into PPCs, and reduced patch size and total area undergoing contraction. The RhoA kinase (ROCK) inhibitor Y-27632 reduced both largest patch index and mean patch size. Both carbenoxolone and ROCK inhibition decreased the duration of PPCs. Carbenoxolone also prolonged duration and accelerated PPC propagation velocity. The authors postulate that these differences arise from differing effects of these agents on myocytes and interstitial cells within the stress environment of the bladder, influencing the development, coordination and propagation of PPCs. CONCLUSIONS The timings and structure of spontaneous micromotions in the wall of the isolated bladder change when it is treated with sympathetic/parasympathetic agonists and with myogenically active agents. Correspondingly, disorders of bladder wall contraction may result from disorders of either neurogenic or myogenic signalling and may be amenable to treatment with combinations of agents that influence both.
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Affiliation(s)
- Corrin Murray Hulls
- Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, New Zealand
| | - Roger Graham Lentle
- Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, New Zealand
| | | | - John Paul Chambers
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
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16
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Lawson K. Pharmacology and clinical applications of flupirtine: Current and future options. World J Pharmacol 2019; 8:1-13. [DOI: 10.5497/wjp.v8.i1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/17/2018] [Accepted: 01/05/2019] [Indexed: 02/06/2023] Open
Abstract
Flupirtine is the first representative in a class of triaminopyridines that exhibits pharmacological properties leading to the suppression of over-excitability of neuronal and non-neuronal cells. Consequently, this drug has been used as a centrally acting analgesic in patients with a range of acute and persistent pain conditions without the adverse effects characteristic of opioids and non-steroidal anti-inflammatory drug and is well tolerated. The pharmacological profile exhibited involves actions on several cellular targets, including Kv7 channels, G-protein-regulated inwardly rectifying K channels and γ-aminobutyric acid type A receptors, but also there is evidence of additional as yet unidentified mechanisms of action involved in the effects of flupirtine. Flupirtine has exhibited effects in a range of cells and tissues related to the locations of these targets. In additional to analgesia, flupirtine has demonstrated pharmacological properties consistent with use as an anticonvulsant, a neuroprotectant, skeletal and smooth muscle relaxant, in treatment of auditory and visual disorders, and treatment of memory and cognitive impairment. Flupirtine is providing important information and clues regarding novel mechanistic approaches to the treatment of a range of clinical conditions involving hyper-excitability of cells. Identification of molecules exhibiting specificity for the pharmacological targets (e.g., Kv7 isoforms) involved in the actions of flupirtine will provide further insight into clinical applications. Whether the broad-spectrum pharmacology of flupirtine or target-specific actions is preferential to gain benefit, especially in complex clinical conditions, requires further investigation. This review will consider recent advancement in understanding of the pharmacological profile and related clinical applications of flupirtine.
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Affiliation(s)
- Kim Lawson
- Department of Biosciences and Chemistry, Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield S1 1WB, United Kingdom
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17
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Chakrabarty B, Bijos DA, Vahabi B, Clavica F, Kanai AJ, Pickering AE, Fry CH, Drake MJ. Modulation of Bladder Wall Micromotions Alters Intravesical Pressure Activity in the Isolated Bladder. Front Physiol 2019; 9:1937. [PMID: 30687132 PMCID: PMC6335571 DOI: 10.3389/fphys.2018.01937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 12/21/2018] [Indexed: 12/20/2022] Open
Abstract
Micromotions are phasic contractions of the bladder wall. During urine storage, such phasic activity has little effect on intravesical pressure, however, changed motile activity may underlie urodynamic observations such as detrusor overactivity. The potential for bladder motility to affect pressure reflects a summation of the overall movements, comprising the initiation, propagation, and dissipation components of micromotions. In this study, the influence of initiation of micromotions was investigated using calcium activated chloride channel blocker niflumic acid, and the effect of propagation using blockers of gap junctions. The overall bladder tone was modulated using isoprenaline. Isolated tissue strips and whole bladder preparations from juvenile rats were used. 18β-glycyrrhetinic acid was used to block gap junctions, reducing the amplitude and frequency of micromotions in in vitro and ex vivo preparations. Niflumic acid reduced the frequency of micromotions but had no effect on the amplitude of pressure fluctuations. Isoprenaline resulted in a reduction in pressure fluctuations and a decrease in pressure baseline. Using visual video data analysis, bladder movement was visible, irrespective of lack of pressure changes, which persisted during bladder relaxation. However, micromotions propagated over shorter distances and the overall bladder tone was reduced. All these results suggest that phasic activity of the bladder can be characterised by a combination of initiation and propagation of movement, and overall bladder tone. At any given moment, intravesical pressure recordings are an integration of these parameters. This synthesis gives insight into the limitations of clinical urodynamics, where intravesical pressure is the key indicator of detrusor activity.
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Affiliation(s)
- Basu Chakrabarty
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
| | - Dominika A Bijos
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Southmead Hospital, Bristol Urological Institute, Bristol, United Kingdom
| | - Bahareh Vahabi
- Department of Applied Sciences, University of West England, Bristol, Bristol, United Kingdom
| | - Francesco Clavica
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Anthony J Kanai
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anthony E Pickering
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom.,Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Christopher H Fry
- School of Physiology, Pharmacology and Neuroscience, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
| | - Marcus J Drake
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Southmead Hospital, Bristol Urological Institute, Bristol, United Kingdom
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18
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Hunter DV, Holland SD, Ramer MS. Preserved Adrenal Function After Lumbar Spinal Cord Transection Augments Low Pressure Bladder Activity in the Rat. Front Physiol 2018; 9:1239. [PMID: 30233411 PMCID: PMC6130007 DOI: 10.3389/fphys.2018.01239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 08/15/2018] [Indexed: 11/13/2022] Open
Abstract
Spinal cord injury (SCI) disconnects supraspinal micturition centers from the lower urinary tract resulting in immediate and long-term changes in bladder structure and function. While cervical and high thoracic SCI have a greater range of systemic effects, clinical data suggest that those with lower (suprasacral) injuries develop poorer bladder outcomes. Here we assess the impact of SCI level on acute changes in bladder activity. We used two SCI models, T3 and L2 complete transections in male Wistar rats, and compared bladder pressure fluctuations to those of naïve and bladder-denervated animals. By 2 days after L2 transection, but not T3 transection or bladder denervation, small amplitude rhythmic contractions (1 mmHg, 0.06 Hz) were present at low intravesical pressures (<6 mmHg); these were still present 1 month following injury, and at 3 months, bladders from L2 SCI animals were significantly larger than those from T3 SCI or naïve animals. Low-pressure contractions were unaffected by blocking ganglionic signaling or bladder denervation at the time of measurements. L2 (and sham surgery) but not T3 transection preserves supraspinal adrenal control, and by ELISA we show lower plasma adrenal catecholamine concentration in the latter. When an adrenalectomy preceded the L2 transection, the aberrant low-pressure contractions more closely resembled those after T3 transection, indicating that the increased bladder activity after lumbar SCI is mediated by preserved adrenal function. Since ongoing low-pressure contractions may condition the detrusor and exacerbate detrusor-sphincter dyssynergia, moderating bladder catecholamine signaling may be a clinically viable intervention strategy.
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Affiliation(s)
- Diana V Hunter
- International Collaboration on Repair Discoveries, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Seth D Holland
- International Collaboration on Repair Discoveries, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Matt S Ramer
- International Collaboration on Repair Discoveries, Department of Zoology, Faculty of Science, The University of British Columbia, Vancouver, BC, Canada
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19
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Grundy L, Chess-Williams R, Brierley SM, Mills K, Moore KH, Mansfield K, Rose'Meyer R, Sellers D, Grundy D. NKA enhances bladder-afferent mechanosensitivity via urothelial and detrusor activation. Am J Physiol Renal Physiol 2018; 315:F1174-F1185. [PMID: 29897284 DOI: 10.1152/ajprenal.00106.2018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Tachykinins are expressed within bladder-innervating sensory afferents and have been shown to generate detrusor contraction and trigger micturition. The release of tachykinins from these sensory afferents may also activate tachykinin receptors on the urothelium or sensory afferents directly. Here, we investigated the direct and indirect influence of tachykinins on mechanosensation by recording sensory signaling from the bladder during distension, urothelial transmitter release ex vivo, and direct responses to neurokinin A (NKA) on isolated mouse urothelial cells and bladder-innervating DRG neurons. Bath application of NKA induced concentration-dependent increases in bladder-afferent firing and intravesical pressure that were attenuated by nifedipine and by the NK2 receptor antagonist GR159897 (100 nM). Intravesical NKA significantly decreased bladder compliance but had no direct effect on mechanosensitivity to bladder distension (30 µl/min). GR159897 alone enhanced bladder compliance but had no effect on mechanosensation. Intravesical NKA enhanced both the amplitude and frequency of bladder micromotions during distension, which induced significant transient increases in afferent firing, and were abolished by GR159897. NKA increased intracellular calcium levels in primary urothelial cells but not bladder-innervating DRG neurons. Urothelial ATP release during bladder distention was unchanged in the presence of NKA, whereas acetylcholine levels were reduced. NKA-mediated activation of urothelial cells and enhancement of bladder micromotions are novel mechanisms for NK2 receptor-mediated modulation of bladder mechanosensation. These results suggest that NKA influences bladder afferent activity indirectly via changes in detrusor contraction and urothelial mediator release. Direct actions on sensory nerves are unlikely to contribute to the effects of NKA.
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Affiliation(s)
- Luke Grundy
- Centre for Urology Research, Faculty of Health Sciences and Medicine, Bond University , Gold Coast, Queensland , Australia.,Visceral Pain Research Group, Human Physiology, Centre for Neuroscience, College of Medicine and Public Health, Flinders University , Bedford Park, South Australia , Australia.,Centre for Nutrition and Gastrointestinal Diseases, Discipline of Medicine, University of Adelaide, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Russ Chess-Williams
- Centre for Urology Research, Faculty of Health Sciences and Medicine, Bond University , Gold Coast, Queensland , Australia
| | - Stuart M Brierley
- Visceral Pain Research Group, Human Physiology, Centre for Neuroscience, College of Medicine and Public Health, Flinders University , Bedford Park, South Australia , Australia.,Centre for Nutrition and Gastrointestinal Diseases, Discipline of Medicine, University of Adelaide, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Kylie Mills
- Centre for Urology Research, Faculty of Health Sciences and Medicine, Bond University , Gold Coast, Queensland , Australia
| | - Kate H Moore
- Department of Urogynaecology, St. George Hospital, University of New South Wales , Sydney, New South Wales , Australia
| | - Kylie Mansfield
- Graduate School of Medicine, University of Wollongong , Wollongong, New South Wales , Australia
| | | | - Donna Sellers
- Centre for Urology Research, Faculty of Health Sciences and Medicine, Bond University , Gold Coast, Queensland , Australia
| | - David Grundy
- Department of Biomedical Science, University of Sheffield , Sheffield , United Kingdom
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20
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Vaughan CP, Markland AD, Smith PP, Burgio KL, Kuchel GA. Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside-to-Bench Conference on Urinary Incontinence in Older Adults: A Translational Research Agenda for a Complex Geriatric Syndrome. J Am Geriatr Soc 2018; 66:773-782. [PMID: 29205261 PMCID: PMC5906179 DOI: 10.1111/jgs.15157] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The American Geriatrics Society, with support from the National Institute on Aging and other funders, held its ninth Bedside-to-Bench research conference, entitled "Urinary Incontinence in the Older Adult: A Translational Research Agenda for a Complex Geriatric Syndrome," October 16 to 18, 2016, in Bethesda, Maryland. As part of a conference series addressing three common geriatric syndromes-delirium, sleep and circadian rhythm disturbance, and urinary incontinence-the series highlighted relationships and pertinent clinical and pathophysiological commonalities between these conditions. The conference provided a forum for discussing current epidemiology, basic science, and clinical and translational research on urinary incontinence in older adults; for identifying gaps in knowledge; and for developing a research agenda to inform future investigative efforts. The conference also promoted networking involving emerging researchers and thought leaders in the field of incontinence, aging, and other fields of research, as well as National Institutes of Health program personnel.
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Affiliation(s)
- Camille P Vaughan
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Birmingham/Atlanta, Atlanta, Georgia, Birmingham, Alabama
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia
| | - Alayne D Markland
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Birmingham/Atlanta, Atlanta, Georgia, Birmingham, Alabama
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Phillip P Smith
- Division of Urology, University of Connecticut Health Center, Farmington, Connecticut
- UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
| | - Kathryn L Burgio
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Birmingham/Atlanta, Atlanta, Georgia, Birmingham, Alabama
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - George A Kuchel
- UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut
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21
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Persson PB, Bondke Persson A. Borders and beyond. Acta Physiol (Oxf) 2017; 221:84-86. [PMID: 28795790 DOI: 10.1111/apha.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P. B. Persson
- Charité - Universitätsmedizin Berlin; corporate member of Freie Universität Berlin; Humboldt-Universität zu Berlin, and Berlin Institute of Health; Berlin Germany
- Institute of Vegetative Physiology; Berlin Germany
| | - A. Bondke Persson
- Charité - Universitätsmedizin Berlin; corporate member of Freie Universität Berlin; Humboldt-Universität zu Berlin, and Berlin Institute of Health; Berlin Germany
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22
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Kitta T, Kanno Y, Chiba H, Higuchi M, Ouchi M, Togo M, Moriya K, Shinohara N. Benefits and limitations of animal models in partial bladder outlet obstruction for translational research. Int J Urol 2017; 25:36-44. [PMID: 28965358 DOI: 10.1111/iju.13471] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
The functions of the lower urinary tract have been investigated for more than a century. Lower urinary tract symptoms, such as incomplete bladder emptying, weak urine stream, daytime urinary frequency, urgency, urge incontinence and nocturia after partial bladder outlet obstruction, is a frequent cause of benign prostatic hyperplasia in aging men. However, the pathophysiological mechanisms have not been fully elucidated. The use of animal models is absolutely imperative for understanding the pathophysiological processes involved in bladder dysfunction. Surgical induction has been used to study lower urinary tract functions of numerous animal species, such as pig, dog, rabbit, guinea pig, rat and mouse, of both sexes. Several morphological and functional modifications under partial bladder outlet obstruction have not only been observed in the bladder, but also in the central nervous system. Understanding the changes of the lower urinary tract functions induced by partial bladder outlet obstruction would also contribute to appropriate drug development for treating these pathophysiological conditions. In the present review, we discuss techniques for creating partial bladder outlet obstruction, the characteristics of several species, as well as issues of each model, and their translational value.
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Affiliation(s)
- Takeya Kitta
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yukiko Kanno
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hiroki Chiba
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Madoka Higuchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mifuka Ouchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mio Togo
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kimihiko Moriya
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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23
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Igawa Y, Aizawa N. Incontinence: How do β 3-adrenoceptor agonists work in the bladder? Nat Rev Urol 2017; 14:330-332. [PMID: 28322259 DOI: 10.1038/nrurol.2017.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Yasuhiko Igawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Naoki Aizawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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24
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Persyn S, Eastham J, De Wachter S, Gillespie J. Adrenergic signaling elements in the bladder wall of the adult rat. Auton Neurosci 2016; 201:40-48. [PMID: 27659399 DOI: 10.1016/j.autneu.2016.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/04/2016] [Accepted: 09/09/2016] [Indexed: 01/25/2023]
Abstract
A growing body of work is describing the absence of a significant sympathetic innervation of the detrusor implying little sympathetic regulation of bladder contractility. However, low doses of adrenergic agonists are capable of relaxing the bladder smooth muscle. If these effects underpin a physiological response then the cellular nature and operation of this system are currently unknown. The present immunohistochemistry study was done to explore the existence of alternative adrenergic signaling elements in the rat bladder wall. Using antibodies to tyrosine hydroxylase (TH) and vesicular mono-amine transporter (vmat), few adrenergic nerves were found in the detrusor although TH immunoreactive (IR) nerves were apparent in the bladder neck. TH-IR and vmat-IR nerves were however abundant surrounding blood vessels. A population of vmat-IR cells was found within the network of interstitial cells that surround the detrusor muscle bundles. These vmat-IR cells were not or only weakly TH-IR. This suggests that these interstitial cells have the capacity to store and release catecholamines that may involve noradrenaline. Cells expressing the β1-adrenoceptor (β1AR-IR) were also detected within the interstitial cell network. Double staining with antibodies to β1AR and vmat suggests that the majority of vmat-IR interstitial cells show β1AR-IR indicative of an autocrine signaling system. In conclusion, a population of interstitial cells has the machinery to store, release and respond to catecholamines. Thus, there might exist a non-neuronal β-adrenergic system operating in the bladder wall possibly linked to one component of motor activity, micro-contractions, a system that may be involved in mechanisms underpinning bladder sensation.
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Affiliation(s)
- Sara Persyn
- Department of Urology, Antwerp University Hospital and University of Antwerp, Faculty of Medicine, Antwerp, Belgium.
| | - Jane Eastham
- Uro-physiology Research Group, The Dental and Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, England.
| | - Stefan De Wachter
- Department of Urology, Antwerp University Hospital and University of Antwerp, Faculty of Medicine, Antwerp, Belgium.
| | - James Gillespie
- Department of Urology, Antwerp University Hospital and University of Antwerp, Faculty of Medicine, Antwerp, Belgium.
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25
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Li J, Wang W, An H, Wang F, Rexiati M, Wang Y. In vitro culture of rat hair follicle stem cells on rabbit bladder acellular matrix. SPRINGERPLUS 2016; 5:1461. [PMID: 27652036 PMCID: PMC5007223 DOI: 10.1186/s40064-016-3152-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 08/24/2016] [Indexed: 11/17/2022]
Abstract
Background The aim of this work was to create a xenogeneic cell scaffold complex with rabbit bladder acellular matrix and rat hair follicle stem cells, to study the feasibility of construct tissue engineer bladder through biocompatibility of hair follicle stem cells and heterogeneous bladder acellular matrix. Material and Methods New Zealand rabbit bladder acellular matrix was prepared. Scanning electron microscope and Masson staining were used to analyse the acellular material. Two-steps precipitation method was used to place the third generation of hair follicle stem cells onto the surface of the bladder acellular matrix. The in vitro cell growth on the scaffold complex was regularly monitored through an inverted microscope. Cell growth curve was established and histological examination and scanning electron microscopic were used to analyse the progresses of the cell growth on the matrix material. Results The prepared bladder acellular matrix was white, translucent and membranous. It possessed a fibrous network and collagen structure without any significant cell residues as displayed by the scanning electron microscope, and Masson staining. After 48 h of culture, observation by inverted microscope showed that the hair follicle stem cells grew well around the bladder acellular matrix. After 1 week of culture, scanning electron microscopy showed that the hair follicle stem cells spread and adhered on the surface of the scaffold. Conclusions The in vitro culture of rat hair follicle stem cells and the rabbit bladder acellular matrix possessed a good biocompatibility, which provides a good experiment support for hair follicle stem cells to repair the bladder defects disease.
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Affiliation(s)
- Jia Li
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Address: No. 137, Liyushan Road, Urumqi, Xinjiang Uygur Autonomous Region China
| | - Wenguang Wang
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Address: No. 137, Liyushan Road, Urumqi, Xinjiang Uygur Autonomous Region China
| | - Hengqing An
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Address: No. 137, Liyushan Road, Urumqi, Xinjiang Uygur Autonomous Region China
| | - Feng Wang
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Address: No. 137, Liyushan Road, Urumqi, Xinjiang Uygur Autonomous Region China
| | - Mulati Rexiati
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Address: No. 137, Liyushan Road, Urumqi, Xinjiang Uygur Autonomous Region China
| | - Yujie Wang
- Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Address: No. 137, Liyushan Road, Urumqi, Xinjiang Uygur Autonomous Region China
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Drake MJ, Kanai A, Bijos DA, Ikeda Y, Zabbarova I, Vahabi B, Fry CH. The potential role of unregulated autonomous bladder micromotions in urinary storage and voiding dysfunction; overactive bladder and detrusor underactivity. BJU Int 2016; 119:22-29. [PMID: 27444952 DOI: 10.1111/bju.13598] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The isolated bladder shows autonomous micromotions, which increase with bladder distension, generate sensory nerve activity, and are altered in models of urinary dysfunction. Intravesical pressure resulting from autonomous activity putatively reflects three key variables; the extent of micromotion initiation, distances over which micromotions propagate, and overall bladder tone. In vivo, these variables are subordinate to the efferent drive of the central nervous system. In the micturition cycle storage phase, efferent inhibition keeps autonomous activity generally at a low level, where it may signal 'state of fullness', whilst maintaining compliance. In the voiding phase, mass efferent excitation elicits generalised contraction (global motility initiation). In lower urinary tract dysfunction, efferent control of the bladder can be impaired, for example due to peripheral 'patchy' denervation. In this case, loss of efferent inhibition may enable unregulated micromotility, and afferent stimulation, predisposing to urinary urgency. If denervation is relatively slight, the detrimental impact on voiding may be low, as the adjacent innervated areas may be able to initiate micromotility synchronous with the efferent nerve drive, so that even denervated areas can contribute to the voiding contraction. This would become increasingly inefficient the more severe the denervation, such that ability of triggered micromotility to propagate sufficiently to engage the denervated areas in voiding declines, so the voiding contraction increasingly develops the characteristics of underactivity. In summary, reduced peripheral coverage by the dual efferent innervation (inhibitory and excitatory) impairs regulation of micromotility initiation and propagation, potentially allowing emergence of overactive bladder and, with progression, detrusor underactivity.
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Affiliation(s)
- Marcus J Drake
- School of Clinical Sciences, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.,Bristol Urological Institute, Southmead Hospital, University of West of England, Bristol, UK
| | | | - Dominika A Bijos
- Bristol Urological Institute, Southmead Hospital, University of West of England, Bristol, UK
| | - Youko Ikeda
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Bahareh Vahabi
- Bristol Urological Institute, Southmead Hospital, University of West of England, Bristol, UK.,School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
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Effects of K(+) channel openers on spontaneous action potentials in detrusor smooth muscle of the guinea-pig urinary bladder. Eur J Pharmacol 2016; 789:179-186. [PMID: 27455901 DOI: 10.1016/j.ejphar.2016.07.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/22/2016] [Accepted: 07/22/2016] [Indexed: 12/18/2022]
Abstract
The modulation of spontaneous excitability in detrusor smooth muscle (DSM) upon the pharmacological activation of different populations of K(+) channels was investigated. Effects of distinct K(+) channel openers on spontaneous action potentials in DSM of the guinea-pig bladder were examined using intracellular microelectrode techniques. NS1619 (10μM), a large conductance Ca(2+)-activated K(+) (BK) channel opener, transiently increased action potential frequency and then prevented their generation without hyperpolarizing the membrane in a manner sensitive to iberiotoxin (IbTX, 100nM). A higher concentration of NS1619 (30μM) hyperpolarized the membrane and abolished action potential firing. NS309 (10μM) and SKA31 (100μM), small conductance Ca(2+)-activated K(+) (SK) channel openers, dramatically increased the duration of the after-hyperpolarization and then abolished action potential firing in an apamin (100nM)-sensitive manner. Flupirtine (10μM), a Kv7 channel opener, inhibited action potential firing without hyperpolarizing the membrane in a manner sensitive to XE991 (10μM), a Kv7 channel blocker. BRL37344 (10μM), a β3-adrenceptor agonist, or rolipram (10nM), a phosphodiesterase 4 inhibitor, also inhibited action potential firing. A higher concentration of rolipram (100nM) hyperpolarized the DSM and abolished the action potentials. IbTX (100nM) prevented the rolipram-induced blockade of action potentials but not the hyperpolarization. BK and Kv7 channels appear to predominantly contribute to the stabilization of DSM excitability. Spare SK channels could be pharmacologically activated to suppress DSM excitability. BK channels appear to be involved in the cyclic AMP-induced inhibition of action potentials but not the membrane hyperpolarization.
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28
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Heppner TJ, Tykocki NR, Hill-Eubanks D, Nelson MT. Transient contractions of urinary bladder smooth muscle are drivers of afferent nerve activity during filling. ACTA ACUST UNITED AC 2016; 147:323-35. [PMID: 26976828 PMCID: PMC4810069 DOI: 10.1085/jgp.201511550] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/12/2016] [Indexed: 01/23/2023]
Abstract
Activation of afferent nerves during urinary bladder (UB) filling conveys the sensation of UB fullness to the central nervous system (CNS). Although this sensory outflow is presumed to reflect graded increases in pressure associated with filling, UBs also exhibit nonvoiding, transient contractions (TCs) that cause small, rapid increases in intravesical pressure. Here, using an ex vivo mouse bladder preparation, we explored the relative contributions of filling pressure and TC-induced pressure transients to sensory nerve stimulation. Continuous UB filling caused an increase in afferent nerve activity composed of a graded increase in baseline activity and activity associated with increases in intravesical pressure produced by TCs. For each ∼4-mmHg pressure increase, filling pressure increased baseline afferent activity by ∼60 action potentials per second. In contrast, a similar pressure elevation induced by a TC evoked an ∼10-fold greater increase in afferent activity. Filling pressure did not affect TC frequency but did increase the TC rate of rise, reflecting a change in the length-tension relationship of detrusor smooth muscle. The frequency of afferent bursts depended on the TC rate of rise and peaked before maximum pressure. Inhibition of small- and large-conductance Ca(2+)-activated K(+) (SK and BK) channels increased TC amplitude and afferent nerve activity. After inhibiting detrusor muscle contractility, simulating the waveform of a TC by gently compressing the bladder evoked similar increases in afferent activity. Notably, afferent activity elicited by simulated TCs was augmented by SK channel inhibition. Our results show that afferent nerve activity evoked by TCs represents the majority of afferent outflow conveyed to the CNS during UB filling and suggest that the maximum TC rate of rise corresponds to an optimal length-tension relationship for efficient UB contraction. Furthermore, our findings implicate SK channels in controlling the gain of sensory outflow independent of UB contractility.
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Affiliation(s)
- Thomas J Heppner
- Department of Pharmacology, University of Vermont, Burlington, VT 05405
| | - Nathan R Tykocki
- Department of Pharmacology, University of Vermont, Burlington, VT 05405
| | | | - Mark T Nelson
- Department of Pharmacology, University of Vermont, Burlington, VT 05405 Institute of Cardiovascular Sciences, University of Manchester, Manchester M13 9NT, England, UK
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Lammers WJ, van der Vusse GJ. Introduction to 'electrical propagation in smooth muscle organs'. Acta Physiol (Oxf) 2015; 213:347-8. [PMID: 25482098 DOI: 10.1111/apha.12434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- W. J. Lammers
- Department of Physiology; College of Medicine & Health Sciences; UAE University; Al Ain United Arab Emirates
| | - G. J. van der Vusse
- Emeritus of Physiology; Cardiovascular Research Institute Maastricht; Maastricht University; Maastricht the Netherlands
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