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Gan A, Delgado L, Swafford K, Brown D, Soneji M. Hemorrhagic Cystitis Due to Cephalexin and Review of the Literature. Clin Pediatr (Phila) 2024; 63:423-427. [PMID: 37208912 PMCID: PMC10893768 DOI: 10.1177/00099228231175473] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- Arnold Gan
- University of Riverside School of Medicine, Riverside, CA, USA
| | - Luis Delgado
- University of Riverside School of Medicine, Riverside, CA, USA
| | - Kimberly Swafford
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Dayton Brown
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Maulin Soneji
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
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Xiao H, Wang T, Gao B, Liu J, Li S, Ma J. The effects of a galectin-3 inhibitor on bladder pain syndrome in mice with cyclophosphamide-induced cystitis. Neurourol Urodyn 2024; 43:754-766. [PMID: 38356381 DOI: 10.1002/nau.25415] [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: 09/26/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024]
Abstract
AIMS To explore the effect of blocking galectin-3 in the bladder pain syndrome associated with interstitial cystitis. METHODS A galectin-3 inhibitor was used to treat mice with cyclophosphamide-induced cystitis. The expression of galectin-3 in bladder tissues and urine was examined by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA), respectively. Suprapubic-pelvic pain, bladder voiding, bladder pain-like nociceptive behavior, and referred hyperalgesia were assessed. The weights of the bladders were also measured, and inflammatory cell infiltration and inflammatory cytokine levels were examined by histopathological evaluation. The inflammatory cytokines interleukin 1β (IL-1β), nerve growth factor (NGF), IL-6, and tumor necrosis factor α (TNF-α) were measured by ELISA. RESULTS Increases in galectin-3 levels, inflammation, bladder weight, and bladder pain-related symptoms were observed in bladders with cyclophosphamide-induced cystitis. Administration of the galectin-3 inhibitor significantly mitigated bladder pain-related symptoms and inflammatory response. In response to the 500 μM dose of the galectin-3 inhibitor, nociceptive behaviors, nociceptive score, and bladder-to-body weight ratios were reduced by 65.1%, 65.3%, and 40.3%, respectively, while 500 μM Gal-3 inhibitor increased pelvic pain threshold by 86.7%. Moreover, galectin-3 inhibitor treatment inhibited the inflammation. Compared to untreated CYP-induced mice, there were significant changes in the levels of IL-1β (41.72 ± 2.05 vs. 18.91 ± 2.26 pg/mg tissues), NGF (9.64 ± 0.38 vs. 1.88 ± 0.05 pg/mg tissues), IL-6 (42.67 + 1.51 vs. 21.26 + 2.78 pg/mg tissues, and TNF-α (22.02 ± 1.08 vs. 10.70 ± 0.80 pg/mg tissues) in response to the highest dose of the Gal-3 inhibitor subgroup (500 μM), and 500 μM Gal-3 inhibitor reduced mast cell infiltration ratios by 71.8%. CONCLUSIONS The galectin-3 inhibitor relieved pelvic pain, urinary symptoms, and bladder inflammation in mice with cyclophosphamide-induced cystitis. Thus, galectin-3 inhibitors may be novel agents in interstitial cystitis treatment.
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Affiliation(s)
- Helong Xiao
- Department of Surgery, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Ting Wang
- Department of Cardiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Bo Gao
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Junjiang Liu
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Shoubin Li
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Jianguo Ma
- Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Chang M, Juruena MF, Young AH. Ketamine cystitis following ketamine therapy for treatment-resistant depression - case report. BMC Psychiatry 2024; 24:9. [PMID: 38166893 PMCID: PMC10763323 DOI: 10.1186/s12888-023-05468-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Ketamine is a novel and exciting putative antidepressant medication for patients with treatment-resistant depression. A complication commonly seen in frequent and heavy recreational use of ketamine is ulcerative cystitis, which presents with lower urinary tract symptoms (LUTS) and upper renal tract damage and can be seen in over 25% of regular users. Although Ketamine-induced cystitis (KIC) is a recognised complication in recreational use of ketamine, its occurrence in therapeutic use of ketamine in depression has so far not been reported. The exact pathogenesis of KIC is currently unknown, making treatment and prevention advice much more difficult. Early diagnosis of KIC and immediate cessation of ketamine has been shown to improve adverse urinary tract symptoms and prevent further damage. CASE PRESENTATION We present a case of a 28-year-old female who was started on ketamine treatment for depression, and who then developed symptoms of KIC, which was confirmed by urine microscopy, culture and analysis. CONCLUSIONS To our knowledge, this is the first reported case of KIC in a patient receiving treatment-dose ketamine as part of their antidepressant therapy.
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Affiliation(s)
- Minna Chang
- Epsom and St Helier Hospital University and Hospital Trust, Epsom Surrey, KT18 7EG, UK.
| | - Mario F Juruena
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
- Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
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Kusakabe N, Kamijo TC, Wada N, Chiba H, Shinohara N, Miyazato M. Effects of low-intensity extracorporeal shock wave therapy on lipopolysaccharide cystitis in a rat model of interstitial cystitis/bladder pain syndrome. Int Urol Nephrol 2024; 56:77-86. [PMID: 37668867 DOI: 10.1007/s11255-023-03770-3] [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: 06/17/2023] [Accepted: 08/26/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To investigate the effect of low-intensity extracorporeal shock wave therapy (LiESWT) on lipopolysaccharide (LPS)-induced cystitis in an animal model of interstitial cystitis/bladder pain syndrome (IC/BPS). METHODS Sprague-Dawley rats were divided into three groups: control, cystitis (LPS group, intravesical injection of LPS (1 mg) twice), and cystitis with LiESWT (LiESWT group). On the third and fourth days, LiESWT was administered (0.12 mJ/mm2, 300 shots each time) on the lower abdomen toward the bladder. On the seventh day, the rats underwent pain assessment and a metabolic cage study. Subsequently, a continuous cystometrogram (CMG) was performed under urethane anaesthesia. Immunohistochemical studies were also performed, including S-100 staining, an immunohistochemical marker of Schwann cells in the bladder. RESULTS In the LPS group, the pain threshold in the lower abdomen was significantly lower than that in the control group. In the metabolic cage study, the mean voided volume in the LPS group significantly increased. The CMG also revealed a significant decrease in bladder contraction amplitude, compatible with detrusor underactivity in the LPS group. Immunohistochemical studies showed inflammatory changes in the submucosa, increased fibrosis, and decreased S-100 stain-positive areas in the muscle layer of the LPS group. In the LiESWT group, tactile allodynia and bladder function were ameliorated, and S-100 stain-positive areas were increased. CONCLUSION By restoring nerve damage, LiESWT improved lower abdominal pain sensitivity and bladder function in an LPS-induced cystitis rat model. This study suggests that LiESWT may be a new therapeutic modality for IC/BPS.
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Affiliation(s)
- Naohisa Kusakabe
- Department of System Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tadanobu Chuyo Kamijo
- Department of System Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Naoki Wada
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroki Chiba
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Minoru Miyazato
- Department of System Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
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Mandal M, Rakib A, Kiran S, Al Mamun MA, Raghavan S, Kumar S, Singla B, Park F, Leo MD, Singh UP. Inhibition of microRNA-34c reduces detrusor ROCK2 expression and urinary bladder inflammation in experimental cystitis. Life Sci 2024; 336:122317. [PMID: 38040245 PMCID: PMC10872291 DOI: 10.1016/j.lfs.2023.122317] [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: 09/15/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
Interstitial cystitis (IC), also called painful bladder syndrome (PBS), is 2 to 5 times more common in women than in men, yet its cause and pathogenesis remain unclear. In our study using the cyclophosphamide (CYP)-induced mouse model of cystitis, histological evaluation of the urinary bladder (UB) lamina propria (LP) showed immune cell infiltrations, indicating moderate to severe inflammation. In this study, we noticed a differential expression of a subset of microRNAs (miRs) in the UB cells (UBs) of CYP-induced cystitis as compared to the control. UB inflammatory scores and inflammatory signaling were also elevated in CYP-induced cystitis as compared to control. We identified eight UBs miRs that exhibited altered expression after CYP induction and are predicted to have a role in inflammation and smooth muscle function (miRs-34c-5p, -34b-3p, -212-3p, -449a-5p, -21a-3p, -376b-3p, -376b-5p and - 409-5p). Further analysis using ELISA for inflammatory markers and real-time PCR (RT-PCR) for differentially enriched miRs identified miR-34c as a potential target for the suppression of UB inflammation in cystitis. Blocking miR-34c by antagomir ex vivo reduced STAT3, TGF-β1, and VEGF expression in the UBs, which was induced during cystitis as compared to control. Interestingly, miR-34c inhibition also downregulated ROCK2 but elevated ROCK1 expression in bladder and detrusor cells. Thus, the present study shows that targeting miR-34c can mitigate the STAT3, TGF-β, and VEGF, inflammatory signaling in UB, and suppress ROCK2 expression in UBs to effectively suppress the inflammatory response in cystitis. This study highlights miR-34c as a potential biomarker and/or serves as the basis for new therapies for the treatment of cystitis.
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Affiliation(s)
- Mousumi Mandal
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - Ahmed Rakib
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - Sonia Kiran
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - Md Abdullah Al Mamun
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - Somasundaram Raghavan
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - Santosh Kumar
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - Bhupesh Singla
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - Frank Park
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA
| | - M Dennis Leo
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA.
| | - Udai P Singh
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN 38163, USA.
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Fang W, Song Q, Lv T, Lv J, Cai Z, Wang Z, Song X, Ji X, Huang J. Serpina3n/serpina3 alleviates cyclophosphamide-induced interstitial cystitis by activating the Wnt/β-catenin signal. Int Urol Nephrol 2023; 55:3065-3075. [PMID: 37594700 PMCID: PMC10611603 DOI: 10.1007/s11255-023-03726-7] [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: 02/14/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND/OBJECTIVE Serpina3n/Serpina3 has been identified to be implicated in inflammatory diseases, but its role in interstitial cystitis/bladder pain syndrome (IC/BPS) remains unknown. Here, we aimed to reveal serpina3n/serpina3 role in IC/BPS in vivo and in vitro. METHODS The IC/BPS model in mice was induced by intraperitoneal injection of 150 mg/kg of cyclophosphamide (CYP). HE and toluidine blue staining were used for histology assessment. Serpina3n/serpina3 expression in the bladder tissues from IC/BPS patients and mouse models were determined by qPCR, immunohistochemistry and western blotting. XAV-939 treatment was applied to inhibit β-catenin activation. Serpina3 role in modulating the growth and apoptosis of HBlEpCs, a human primary bladder epithelial cell line, was assessed by CCK-8 and flow cytometry assays. RESULTS Serpina3n/serpina3 expression was decreased in both human and mice bladder tissues with IC/BPS. Upregulation of serpina3n significantly alleviated CYP-induced bladder injury, with decreased mast cells and pro-inflammatory factor levels, including IL-1β, IL-6, and TNF-α, while increased IL-10 level. In addition, serpina3 overexpression inhibited the apoptosis of HBlEpCs, and increased cell growth. In mechanism, we found that serpina3 overexpression promoted the activation of wnt/β-catenin signaling. And, the inhibition of wnt/β-catenin signaling with XAV-939 abolished serpina3n/serpina3 role in protecting bladder tissues from CYP-induced cystitis, as well as inhibiting HBlEpC apoptosis. CONCLUSION Serpina3n/serpina3 expression was decreased in IC/BPS. Overexpression of serpina3n could alleviate CYP-induced IC/BPS by activating the Wnt/β-catenin signal. This study may provide a new therapeutic strategy for IC/BPS.
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Affiliation(s)
- Weilin Fang
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China
| | - Qixiang Song
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201112, China
| | - Tingting Lv
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China
| | - Jianwei Lv
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China.
| | - Zhikang Cai
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China
| | - Zhong Wang
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China
| | - Xin Song
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China
| | - Xiang Ji
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China
| | - Jin Huang
- Department of Urology and Andrology, Shanghai Pudong New Area Gongli Hospital, No. 219, Miaopu Road, Pudong New District, Shanghai, 200135, China
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Javed J, Anjum I, Najm S, Ali N, Nasir Hayat Malik M, Jahan S, Dawoud TM, Nafidi HA, Bourhia M. Uroprotective Potential of Campesterol in Cyclophosphamide Induced Interstitial Cystitis; Molecular Docking Studies. Chem Biodivers 2023; 20:e202301534. [PMID: 37984454 DOI: 10.1002/cbdv.202301534] [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: 09/29/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 11/22/2023]
Abstract
Cyclophosphamide (CYP) is commonly used to treat cancer of the ovaries, breast, lymph, and blood system and produces interstitial cystitis (IC) via its urotoxic metabolite: i. e., acrolein. The present study was aimed to investigate the uroprotective effect of campesterol (a steroidal phytochemical) in cyclophosphamide induced IC. IC was induced by CYP (150 mg/kg, i. p.) in rats. The Enzyme linked immunosorbent assays for oxidative stress markers and Polymerase Chain Reaction (PCR) for inflammatory cytokines were carried out. The Tissue Organ Bath Technique was used for the evaluation of the spasmolytic effect of campesterol. Different pharmacological antagonists have been used to explore the mechanism of action of campesterol. Treatment with campesterol (70 mg/kg) reduced nociception (55 %), edema (67 %), hemorrhage (67 %), and protein leakage significantly (94 %). The antioxidant activity of campesterol was exhibited by a fall in MDA, NO, and an elevation in SOD, CAT, and GPX levels. Campesterol presented anti-inflammatory potential by decreasing IL-1, TNF-α, and TGF-β expression levels. Histologically, it preserved urothelium from the deleterious effect of CYP. Campesterol showed a spasmolytic effect by reducing bladder overactivity that was dependent on muscarinic receptors, voltage-gated calcium and KATP channels, and cyclo-oxygenase pathways. In silico studies confirmed the biochemical findings. The findings suggest that campesterol could be valorized as a possible therapeutic agent against cyclophosphamide-induced interstitial cystitis.
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Affiliation(s)
- Joham Javed
- Faculty of Pharmacy, The University of Lahore, Lahore, 55150, Pakistan
| | - Irfan Anjum
- Department of Basic Medical Sciences, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, 44000, Pakistan
| | - Saima Najm
- Lahore College of Pharmaceutical Sciences, Department of Pharmacy, Lahore, 55150, Pakistan
| | - Naila Ali
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, 55150, Pakistan
| | | | - Shah Jahan
- Department of Immunology, University of Health Sciences, Lahore, 55150, Pakistan
| | - Turki M Dawoud
- Department of Botany and Microbiology, College of Science, King Saud University, P. O. BOX 2455, Riyadh, 11451, Saudi Arabia
| | - Hiba-Allah Nafidi
- Department of Food Science, Faculty of Agricultural and Food Sciences, Laval University, 2325, Quebec City, QC G1 V0 A6, Canada
| | - Mohammed Bourhia
- Department of Chemistry and Biochemistry, Faculty of Medicine and Pharmacy, Ibn Zohr University, Laayoune, 70000, Morocco
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Anjum I, Ali D, Bourhia M, Chaudhry MA, Siddique F, Bibi M, Gaafar ARZ, Zair T, Khallouki F. Cuminum cyminum Ameliorates Urotoxic Effects of Cyclophosphamide by Modulating Antioxidant, Inflammatory Cytokines, and Urinary Bladder Overactivity: In vivo and in Silico Investigations. Chem Biodivers 2023; 20:e202301268. [PMID: 37843082 DOI: 10.1002/cbdv.202301268] [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: 08/21/2023] [Revised: 10/14/2023] [Accepted: 10/15/2023] [Indexed: 10/17/2023]
Abstract
Interstitial Cystitis (IC) is a chronic inflammatory disease that lacks effective treatment. The present study aimed to investigate the potential of aqueous ethanol extract of Cuminum cyminum (AEECC) on oxidative stress, inflammation and overactivity of urinary bladder induced by cyclophosphamide (CYP). Female Sprague-Dawley rats received intraperitoneal administration of cyclophosphamide (150 mg/kg, i. p. 1st , 4th , and 7th days). To investigate the urothelial damage, the bladder weight, nociception behavior, and Evans blue dye extravasation method was used. The antioxidants CAT, GPX and NO were measured. ELISA determined the IL-6 and TNF-α levels. The spasmolytic effect of AEECC was investigated on isolated bladder strips and its mechanisms were determined. The enhanced nociception behavior, bladder weight, vascular permeability, edema, hemorrhage, nitric oxide, IL-6 and TNF-α levels by CYP administration were significantly reduced by AEECC (250 and 500 mg/kg). A significant increase in serum antioxidant system such as CAT and GPx was also observed in AEECC-treated rats. The AEECC (3 mg/ml) significantly reduced urinary bladder tone in the strips pre-contracted with carbachol in both control and CYP-treated rats. This relaxation was demolished by atropine, nifedipine, glibenclamide, and indomethacin but not with propranolol. The plant extract showed the presence of antioxidant and anti-inflammatory phytochemicals. These results suggest that Cuminum cyminum offers uroprotective activity and can ameliorate CYP-induced bladder toxicity by modulating antioxidant parameters, pro-inflammatory cytokine levels and bladder smooth muscle overactivity. The in silico binding interactions of antioxidant 2I3Y and anti-inflammatory protein 1TNF with various ligands from Cuminum cyminum seeds revealed potential bioactive compounds with promising antioxidant and anti-inflammatory properties, providing valuable insights for drug development and nutraceutical research.
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Affiliation(s)
- Irfan Anjum
- Department of Basic Medical Sciences, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, 44000, Pakistan
| | - Daanyaal Ali
- Faculty of Pharmacy, The University of Lahore, Lahore, 54590, Pakistan
| | - Mohammed Bourhia
- Department of Chemistry and Biochemistry, Faculty of Medicine and Pharmacy, Ibn Zohr University, Laayoune, 70000, Morocco
| | | | - Farhan Siddique
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, 300072, China
| | - Mehvish Bibi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - Abdel-Rhman Z Gaafar
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 11451, Riyadh, 12211, Saudi Arabia
| | - Touriya Zair
- Research Team of Bioactive Molecules and Environment Chemistry, Laboratory of Innovative Materials and Biotechnology of Natural Resources, Faculty of Sciences, Moulay Ismail University, Meknes, 50070, Morocco
| | - Farid Khallouki
- Biology Department, FSTE, University Moulay Ismail BP. 609, 52000, Errachidia, Morocco
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Kerimoğlu G, Arıcı T, Bıyık AF, Kulaber A, Türkmen Alemdar N, Demir S, Aliyazıcıoğlu Y, Yenilmez E. Protective potential of pterostilbene against cyclophosphamide-induced nephrotoxicity and cystitis in rats. Int Urol Nephrol 2023; 55:3077-3087. [PMID: 37566321 DOI: 10.1007/s11255-023-03735-6] [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: 06/07/2023] [Accepted: 08/05/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE Cyclophosphamide (CYP) is an antitumor drug. However, in addition to its antitumor affect, CYP can also lead to nephrotoxicity and hemorrhagic cystitis. The purpose of this study was to investigate the potential protective effects of Pterostilbene (Pte), a natural antioxidant as a resveratrol analog against CYP-induced nephrotoxicity and cystitis in rats. METHODS Twenty-one male Sprague Dawley rats were divided into 3 equal groups. The control group and the CYP group (CYPG) received 1 ml/kg sunflower oil per day, and the CYP + Pte group (CYP + PteG) 40 mg/kg per day Pte dissolved in sunflower oil once a day via the oral route for 14 days. In addition, on day 9 of the experiment, CYPG and CYP + PteG received a single dose of 200 mg/kg CYP dissolved in saline solution, while the control group received a single dose of 10 ml/kg saline solution, via the intraperitoneal route. Bladder and kidney tissues were collected for histological and biochemical evaluations. RESULTS Pte was observed to reduce CYP-derived increases in malondialdehyde level, total oxidant status (TOS), the oxidative stress index (OSI), and apoptosis in kidney tissues and to cause an increase in superoxide dismutase levels. It also reduced CYP-derived increases in TOS, OSI, and apoptosis in bladder tissue. Moreover, Pte also ameliorated histopathological findings associated with CYP-induced tissue damage in both the kidney and bladder. CONCLUSION Our study findings show that Pte may exhibit a protective effect against CYP-induced nephrotoxicity and cystitis.
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Affiliation(s)
- Gökçen Kerimoğlu
- Department of Histology and Embryology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Türkiye.
| | - Tuğba Arıcı
- Department of Histology and Embryology, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Ayşe Firuze Bıyık
- Department of Histology and Embryology Kanuni Training and Research Hospital, Trabzon, Türkiye
| | - Ali Kulaber
- Department of Histology and Embryology, Institute of Health Sciences, Karadeniz Technical University, Trabzon, Türkiye
| | - Nihal Türkmen Alemdar
- Department of Medical Biochemistry, Institute of Health Sciences, Karadeniz Technical University, Trabzon, Türkiye
| | - Selim Demir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Türkiye
| | - Yüksel Aliyazıcıoğlu
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Türkiye
| | - Engin Yenilmez
- Department of Histology and Embryology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Türkiye
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Zhou Q, Qin Z, Yan P, Wang Q, Qu J, Chen Y. Immune-related adverse events with severe pain and ureteral expansion as the main manifestations: a case report of tislelizumab-induced ureteritis/cystitis and review of the literature. Front Immunol 2023; 14:1226993. [PMID: 37869004 PMCID: PMC10587548 DOI: 10.3389/fimmu.2023.1226993] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023] Open
Abstract
Immune checkpoint inhibitor (ICI) is an up-to-date therapy for cancer with a promising efficacy, but it may cause unique immune-related adverse events (irAEs). Although irAEs could affect any organ, irAEs-induced whole urinary tract expansion was rarely reported. Herein, we reported a 27-year-old male patient with thymic carcinoma who received the treatment of tislelizumab, paclitaxel albumin and carboplatin. He was hospitalized for severe bellyache and lumbago after 6 courses of treatment. Antibiotic and antispasmodic treatment did not relieve his symptoms. The imaging examinations reported whole urinary tract expansion and cystitis. Therefore, we proposed that the patient's pain was caused by tislelizumab-induced ureteritis/cystitis. After the discontinuation of tislelizumab and the administration of methylprednisolone, his symptoms were markedly alleviated. Herein, we reported a rare case of ICI-induced ureteritis/cystitis in the treatment of thymic cancer and reviewed other cases of immunotherapy-related cystitis and tislelizumab-related adverse events, which will provide a reference for the diagnosis and treatment of ICI-related irAEs.
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Affiliation(s)
| | | | | | | | | | - Yun Chen
- Cancer Center, Department of Medical Oncology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, China
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Zhang L, Chen X, Li M, Lv R, Gu B, Chen Z. Activation of the adenosine A1 receptor in the lumbosacral spinal cord improves bladder overactivity in rats with cystitis induced by cyclophosphamide. Int Urol Nephrol 2023; 55:2183-2191. [PMID: 37330931 DOI: 10.1007/s11255-023-03659-1] [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: 04/12/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE To investigate the effect of intrathecal administration of CCPA, an adenosine A1 receptor agonist, on voiding function in rats with cystitis induced by cyclophosphamide (CYP). METHODS Thirty 8-week-old Sprague Dawley rats were randomly divided into a control group (n = 15) and a cystitis group (n = 15). Cystitis was induced by a single intraperitoneal injection of CYP (200 mg/kg, dissolved in physiological saline) in rats. Control rats were injected intraperitoneally with physiological saline. The PE10 catheter reached the level of L6-S1 spinal cord through L3-4 intervertebral space for intrathecal injection. Forty-eight hours after intraperitoneal injection, urodynamic tests were conducted to observe the effect of intrathecal administration of 10% dimethylsulfoxide (vehicle) and 1 nmol CCPA on micturition parameters, including basal pressure (BP), threshold pressure (TP), maximal voiding pressure (MVP), intercontraction interval (ICI), voided volume (VV), residual volume (RV), bladder capacity (BC), and voiding efficiency (VE). Histological changes of the bladder of cystitis rats were studied through hematoxylin-eosin staining (HE staining). Moreover, Western blot and immunofluorescence were used to study the expression of adenosine A1 receptor in the L6-S1 dorsal spinal cord in both groups of rats. RESULTS HE staining revealed submucosal hemorrhage, edema, and inflammatory cell infiltration in the bladder wall of cystitis rats. The urodynamic test showed significant increase in BP, TP, MVP and RV in cystitis rats, while ICI, VV, BC and VE decreased significantly, indicating bladder overactivity. CCPA inhibited the micturition reflex in both control and cystitis rats, and significantly increased TP, ICI, VV, BC, and VE, but had no significant effect on BP, MVP and RV. Western blot and immunofluorescence showed that there was no significant difference in the expression of adenosine A1 receptor in the L6-S1 dorsal spinal cord between the control and cystitis rats. CONCLUSION The findings of this study suggest that intrathecal administration of the adenosine A1 receptor agonist CCPA alleviates CYP-induced bladder overactivity. Furthermore, our results indicate that the adenosine A1 receptor in the lumbosacral spinal cord may be a promising target for treatment of bladder overactivity.
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Affiliation(s)
- Lin Zhang
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Xun Chen
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Mingzhuo Li
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Rong Lv
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Baojun Gu
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
| | - Zhong Chen
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
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12
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Liu L, Zhao Y, An W, Zhao M, Ding N, Liu H, Ge N, Wen J, Zhang X, Zu S, Sun W. Piezo2 Channel Upregulation is Involved in Mechanical Allodynia in CYP-Induced Cystitis Rats. Mol Neurobiol 2023; 60:5000-5012. [PMID: 37227654 PMCID: PMC10415424 DOI: 10.1007/s12035-023-03386-9] [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: 02/01/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023]
Abstract
Mechanical sensing Piezo2 channel in primary sensory neurons has been shown contribute to mechanical allodynia in somatic chronic pain conditions. Interstitial cystitis (IC)-associated pain is often triggered by bladder filling, a presentation that mimics the mechanical allodynia. In the present study, we aimed to examine the involvement of sensory Piezo2 channel in IC-associated mechanical allodynia using a commonly employed cyclophosphamide (CYP)-induced IC model rat. Piezo2 channels in dorsal root ganglia (DRGs) was knocked down by intrathecal injections of Piezo2 anti-sense oligodeoxynucleotides (ODNs) in CYP-induced cystitis rats, and mechanical stimulation-evoked referred bladder pain was measured in the lower abdomen overlying the bladder using von Frey filaments. Piezo2 expression at the mRNA, protein, and functional levels in DRG neurons innervating the bladder was detected by RNA-fluorescence in situ hybridization, western blotting, immunofluorescence, and Ca2+ imaging, respectively. We found that Piezo2 channels were expressed on most (> 90%) of the bladder primary afferents, including afferents that express CGRP, TRPV1 and stained with isolectin B4. CYP-induced cystitis was associated with Piezo2 upregulation in bladder afferent neurons at the mRNA, protein, and functional levels. Knockdown of Piezo2 expression in DRG neurons significantly suppressed mechanical stimulation-evoked referred bladder pain as well as bladder hyperactivity in CYP rats compared to CYP rats treated with mismatched ODNs. Our results suggest upregulation of Piezo2 channels is involved in the development of bladder mechanical allodynia and bladder hyperactivity in CYP-induced cystitis. Targeting Piezo2 might be an attractive therapeutic approach for IC-related bladder pain.
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Affiliation(s)
- Lei Liu
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Yan Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China
| | - Wenhan An
- Department of Rehabilitation, The Second Hospital of Shandong University, Jinan, Shandong, P. R. China
| | - Mengmeng Zhao
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Ning Ding
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Hanwen Liu
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Nan Ge
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Jiliang Wen
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Xiulin Zhang
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Shulu Zu
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Wendong Sun
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China.
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Saleh DO, El-Nasr NMEA, Fayez AM, Ahmed KA, Mohamed RA. Uro-protective role of chrysin against cyclophosphamide-induced hemorrhagic cystitis in rats involving the turning-off NF-κB/P38-MAPK, NO/PARP-1 and STAT-3 signaling cascades. Chem Biol Interact 2023; 382:110585. [PMID: 37263553 DOI: 10.1016/j.cbi.2023.110585] [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: 03/02/2023] [Revised: 05/06/2023] [Accepted: 05/29/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Chemotherapeutic agents are used to treat a wide range of cancer types, but they cause serious side effects which must be managed after treatment. Cyclophosphamide (CYP) is one of chemotherapeutic drugs that causes hemorrhagic cystitis (HC) induced by acrolein. OBJECTIVE The current investigation intended to uncover the role of chrysin (CHR) in CYP-induced HC in rats and explore the signaling pathway beyond this effect. ANALYSIS process: A single dose of CYP (200 mg/kg/IP) was injected, meanwhile CHR (25, 50 and 100 mg/kg, P.O) was administered respectively for 7 days prior to CYP administration and resume for 7 days afterwards. Urinary bladder tissue was then isolated from all rats to assess oxidative stress and inflammatory biomarkers. Moreover, histopathological examinations were performed. RESULTS Treatment with CHR showed a marked alleviation in oxidative stress biomarkers induced by CYP. Furthermore, CHR treatment presented a dose-dependent boost in the anti-inflammatory; IL-10 levels and a drop in the pro-inflammatory biomarkers; IL-1β, IL-6, and TNF-α. Additionally, stabilization of the PARP-1 protein expression was also detected thus preventing DNA damage. Similarly, CHR restored the urinary bladder cGMP levels. Notably, CHR treatment was accompanied with inhibition in NF-κB/p38-MAPK, NO/PARP-1 and STAT-3 signaling pathways inflammatory cascades. All these findings conformed with the histopathological examinations as well as iNOS immunostaining in the urinary bladder tissue. CONCLUSION Co-administration of CHR and CYP attained uro-protective therapeutic potential to guard against HC as well as spot the tangled mechanism of CHR in attenuating the HC induced by CYP.
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Affiliation(s)
- Dalia O Saleh
- Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt.
| | - Nesma M E Abo El-Nasr
- Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
| | - Ahmed M Fayez
- Pharmacology and Toxicology Department, School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, New Administrative Capital, Cairo, Egypt
| | - Kawkab A Ahmed
- Pathology Department, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Reem A Mohamed
- Department of Pharmacology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
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14
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Hinden L, Ludyansky R, Leidershnaider S, Harris Y, Nemirovski A, Gofrit ON, Tam J, Hidas G. Peripheral Cannabinoid-1 Receptor Blockade Ameliorates Cystitis Severity. Cannabis Cannabinoid Res 2023; 8:623-633. [PMID: 35647939 PMCID: PMC10442677 DOI: 10.1089/can.2022.0077] [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] [Indexed: 11/12/2022] Open
Abstract
Background: The endocannabinoid system (ECS) plays a key physiological role in bladder function and it has been suggested as a potential target for relieving lower urinary tract symptoms (LUTSs). Whereas most studies indicate that activating the ECS has some beneficial effects on the bladder, some studies imply the opposite. In this study, we investigated the therapeutic potential of peripheral cannabinoid-1 receptor (CB1R) blockade in a mouse model for LUTSs. Materials and Methods: To this end, we used the cyclophosphamide (CYP; 300 mg/kg, intraperitoneal)-induced cystitis model of bladder dysfunction, in which 12-week-old, female C57BL/6 mice were treated with the peripherally restricted CB1R antagonist, JD5037 (3 mg/kg), or vehicle for three consecutive days. Bladder dysfunction was assessed using the noninvasive voiding spot assay (VSA) as well as the bladder-to-body weight (BW) ratio and gene and protein expression levels; ECS tone was assessed at the end of the study. Results: Peripheral CB1R blockade significantly ameliorated the severity of CYP-induced cystitis, manifested by reduced urination events measured in the VSA and an increased bladder-to-BW ratio. Moreover, JD5037 normalized CYP-mediated bladder ECS tone imbalance by affecting both the expression of CB1R and the endocannabinoid levels. These effects were associated with the ability of JD5037 to reduce CYP-induced inflammatory response, manifested by a reduction in levels of the proinflammatory cytokine, tumor necrosis factor alpha (TNFα), in the bladder and serum. Conclusions: Collectively, our results highlight the therapeutic relevance of peripheral CB1R blockade in ameliorating CYP-induced cystitis; they may further support the preclinical development and clinical use of peripherally restricted CB1R antagonism for treatment of LUTSs.
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Affiliation(s)
- Liad Hinden
- Obesity and Metabolism Laboratory, Department of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rami Ludyansky
- Department of Urology Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sary Leidershnaider
- In partial fulfillment of MD requirements, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yoav Harris
- In partial fulfillment of MD requirements, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Alina Nemirovski
- Obesity and Metabolism Laboratory, Department of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ofer N. Gofrit
- Department of Urology Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Joseph Tam
- Obesity and Metabolism Laboratory, Department of Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Guy Hidas
- Department of Urology Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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15
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Ferreira FCS, Clementino M, Rodrigues FAP, Veras HN, Martins DS, Queiroga ML, Lima MA, Silva DO, de Freitas TM, Ribeiro SA, Mota MRL, da Silva JA, Lima AAM, Havt A. [8] and [10]-Gingerol reduces urothelial damage in ifosfamide-induced hemorrhagic cystitis via JAK/STAT/FOXO signaling pathway via IL-10. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:1773-1786. [PMID: 36843129 DOI: 10.1007/s00210-023-02436-2] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/19/2023] [Indexed: 02/28/2023]
Abstract
Acrolein is the main toxic metabolite of ifosfamide (IFO) that causes urothelial damage by oxidative stress and inflammation. Here, we investigate the molecular mechanism of action of gingerols, Zingiber officinale bioactive molecules, as an alternative treatment for ifosfamide-induced hemorrhagic cystitis. Female Swiss mice were randomly divided into 5 groups: control; IFO; IFO + Mesna; and IFO + [8]- or [10]-gingerol. Mesna (80 mg/kg, i.p.) was given 5 min before, 4 and 8 h after IFO (400mg/kg, i.p.). Gingerols (25 mg/kg, p.o.) were given 1 h before and 4 and 8 h after IFO. Animals were euthanized 12 h after IFO injection. Bladders were submitted to macroscopic and histological evaluation. Oxidative stress and inflammation were assessed by malondialdehyde (MDA) or myeloperoxidase assays, respectively. mRNA gene expression was performed to evaluate mesna and gingerols mechanisms of action. Mesna was able to protect bladder tissue by activating NF-κB and NrF2 pathways. However, we demonstrated that gingerols acted as an antioxidant and anti-inflammatory agent stimulating the expression of IL-10, which intracellularly activates JAK/STAT/FOXO signaling pathway.
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Affiliation(s)
- Francisco C S Ferreira
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Marco Clementino
- Institute of Biomedicine for Brazilian Semiarid, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Herlice N Veras
- Institute of Biomedicine for Brazilian Semiarid, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Dainesy S Martins
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Marcus L Queiroga
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Mikael A Lima
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Dayara O Silva
- Institute of Biomedicine for Brazilian Semiarid, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Thiago M de Freitas
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Samilly A Ribeiro
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Mario R L Mota
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil
| | - James A da Silva
- Department of Pharmacy, Federal University of Sergipe, Lagarto, SE, Brazil
| | - Aldo A M Lima
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
- Institute of Biomedicine for Brazilian Semiarid, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Alexandre Havt
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil.
- Institute of Biomedicine for Brazilian Semiarid, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
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16
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Guo L, Ma C, Wang M, Du Y. Tropisetron Ameliorated Cyclophosphamide-Induced Hemorrhagic Cystitis via Restraining TLR-4/NF-κB and JAK1/STAT3 Signaling Pathways. ARCH ESP UROL 2023; 76:56-64. [PMID: 36914420 DOI: 10.56434/j.arch.esp.urol.20237601.5] [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] [Indexed: 03/09/2023]
Abstract
OBJECTIVE The main pathological changes of hemorrhagic cystitis (HC) are bladder inflammation, bladder epithelial damage and mast cell infiltration. Tropisetron has been corroborate to conduct a protective role in HC, but its specific etiology remains unclear. The objective of this research was to estimate the mechanism of action of Tropisetron in haemorrhagic cystitis tissue. METHODS Cyclophosphamide (CTX) was utilized to induce the construction of HC rat model, and rats were handled with different doses of Tropisetron. The impact of Tropisetron on the expression of inflammatory factors and oxidative stress factors in the rats with cystitis were measured by western blot, as well as the related proteins of toll-like receptor 4/nuclear transcription factor-κB (TLR-4/NF-κB) and januskinase 1/signal transducer and activator of transcription 3 (JAK1/STAT3) pathways. RESULTS CTX-induced cystitis in rats was accompanied by notable pathological tissue damage and increased bladder wet weight ratio, elevated mast cell numbers and collagen fibrosis compared to controls. Tropisetron ameliorated CTX-induced injury in a concentration-dependent manner. Futhermore, CTX induced oxidative stress and inflammatory damage, while Tropisetron can alleviate these injuries. Besides, Tropisetron ameliorated CTX-induced cystitis by restraining TLR-4/NF-κB and JAK1/STAT3 signalling pathways. CONCLUSIONS Taken together, Tropisetron ameliorates cyclophosphamide-induced haemorrhagic cystitis via modulating TLR-4/NF-κB and JAK1/STAT3 signalling pathways. These findings carry important implication for the study of the molecular mechanisms of pharmacological treatment of hemorrhagic cystitis.
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Affiliation(s)
- Li Guo
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061 Xi'an, Shaanxi, China
- Oncology Research Lab, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, 710061 Xi'an, Shaanxi, China
| | - Chen Ma
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061 Xi'an, Shaanxi, China
- Oncology Research Lab, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, 710061 Xi'an, Shaanxi, China
| | - Meiyu Wang
- Department of Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, 710061 Xi'an, Shaanxi, China
| | - Yuefeng Du
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061 Xi'an, Shaanxi, China
- Oncology Research Lab, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, 710061 Xi'an, Shaanxi, China
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17
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Sekiguchi F, Koike N, Shimada Y, Sugimoto K, Masuda H, Nakamura T, Yamaguchi H, Tanabe G, Marumoto S, Kasanami Y, Tsubota M, Ohkubo T, Yoshida S, Kawabata A. A hydrolysate of poly-trans-[(2-carboxyethyl)germasesquioxane] (Ge-132) suppresses Ca v3.2-dependent pain by sequestering exogenous and endogenous sulfide. Redox Biol 2023; 59:102579. [PMID: 36563535 PMCID: PMC9800310 DOI: 10.1016/j.redox.2022.102579] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Poly-trans-[(2-carboxyethyl)germasesquioxane] (Ge-132), an organogermanium, is hydrolyzed to 3-(trihydroxygermyl)propanoic acid (THGP) in aqueous solutions, and reduces inflammation, pain and cancer, whereas the underlying mechanisms remain unknown. Sulfides including H2S, a gasotransmitter, generated from l-cysteine by some enzymes including cystathionine-γ-lyase (CSE), are pro-nociceptive, since they enhance Cav3.2 T-type Ca2+ channel activity expressed in the primary afferents, most probably by canceling the channel inhibition by Zn2+ linked via coordinate bonding to His191 of Cav3.2. Given that germanium is reactive to sulfur, we tested whether THGP would directly trap sulfide, and inhibit sulfide-induced enhancement of Cav3.2 activity and sulfide-dependent pain in mice. Using mass spectrometry and 1H NMR techniques, we demonstrated that THGP directly reacted with sulfides including Na2S and NaSH, and formed a sulfur-containing reaction product, which decreased in the presence of ZnCl2. In Cav3.2-transfected HEK293 cells, THGP inhibited the sulfide-induced enhancement of T-type Ca2+ channel-dependent membrane currents. In mice, THGP, administered systemically or locally, inhibited the mechanical allodynia caused by intraplantar Na2S. In the mice with cyclophosphamide-induced cystitis and cerulein-induced pancreatitis, which exhibited upregulation of CSE in the bladder and pancreas, respectively, systemic administration of THGP as well as a selective T-type Ca2+ channel inhibitor suppressed the cystitis-related and pancreatitis-related visceral pain. These data suggest that THGP traps sulfide and inhibits sulfide-induced enhancement of Cav3.2 activity, leading to suppression of Cav3.2-dependent pain caused by sulfide applied exogenously and generated endogenously.
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Affiliation(s)
- Fumiko Sekiguchi
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Kowakae 3-4-1, Higashi-Osaka, 577-8502, Japan
| | - Nene Koike
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Kowakae 3-4-1, Higashi-Osaka, 577-8502, Japan
| | - Yasuhiro Shimada
- Asai Germanium Research Institute Co., Ltd., Suzuranoka, Hakodate, Hokkaido, 042-0958, Japan
| | - Kaho Sugimoto
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Kowakae 3-4-1, Higashi-Osaka, 577-8502, Japan
| | - Hiroshi Masuda
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Kowakae 3-4-1, Higashi-Osaka, 577-8502, Japan
| | - Takashi Nakamura
- Asai Germanium Research Institute Co., Ltd., Suzuranoka, Hakodate, Hokkaido, 042-0958, Japan
| | - Hiroaki Yamaguchi
- Yamagata University Graduate School of Medicine, Iida-nishi 2-2-2, Yamagata, 990-9585, Japan; Department of Pharmacy, Yamagata University Hospital, Iida-nishi 2-2-2, Yamagata, 990-9585, Japan
| | - Genzoh Tanabe
- Laboratory of Pharmaceutical Organic Chemistry, Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, 577-8502, Japan
| | - Shinsuke Marumoto
- Joint Research Center, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, 577-8502, Japan
| | - Yoshihito Kasanami
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Kowakae 3-4-1, Higashi-Osaka, 577-8502, Japan
| | - Maho Tsubota
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Kowakae 3-4-1, Higashi-Osaka, 577-8502, Japan
| | - Tsuyako Ohkubo
- Division of Basic Medical Sciences and Fundamental Nursing, Faculty of Nursing, Fukuoka Nursing College, Fukuoka, 814-0193, Japan
| | - Shigeru Yoshida
- Department of Life Science, Faculty of Science and Engineering, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, 577-8502, Japan
| | - Atsufumi Kawabata
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Kowakae 3-4-1, Higashi-Osaka, 577-8502, Japan.
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18
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Hughes FM, Odom MR, Cervantes A, Livingston AJ, Purves JT. Why Are Some People with Lower Urinary Tract Symptoms (LUTS) Depressed? New Evidence That Peripheral Inflammation in the Bladder Causes Central Inflammation and Mood Disorders. Int J Mol Sci 2023; 24:2821. [PMID: 36769140 PMCID: PMC9917564 DOI: 10.3390/ijms24032821] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 01/06/2023] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Anecdotal evidence has long suggested that patients with lower urinary tract symptoms (LUTS) develop mood disorders, such as depression and anxiety, at a higher rate than the general population and recent prospective studies have confirmed this link. Breakthroughs in our understanding of the diseases underlying LUTS have shown that many have a substantial inflammatory component and great strides have been made recently in our understanding of how this inflammation is triggered. Meanwhile, studies on mood disorders have found that many are associated with central neuroinflammation, most notably in the hippocampus. Excitingly, work on other diseases characterized by peripheral inflammation has shown that they can trigger central neuroinflammation and mood disorders. In this review, we discuss the current evidence tying LUTS to mood disorders, its possible bidirectionally, and inflammation as a common mechanism. We also review modern theories of inflammation and depression. Finally, we discuss exciting new animal studies that directly tie two bladder conditions characterized by extensive bladder inflammation (cyclophosphamide-induced hemorrhagic cystitis and bladder outlet obstruction) to neuroinflammation and depression. We conclude with a discussion of possible mechanisms by which peripheral inflammation is translated into central neuroinflammation with the resulting psychiatric concerns.
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Affiliation(s)
- Francis M. Hughes
- Department Urology, Duke University Medical Center, P.O. Box 3831, Durham, NC 27710, USA
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19
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Abdelrahman RS, Nashar EME, Alghamdi MA, Al-Khater KM, Taha RI. Phosphodiesterase1 inhibitor "Vinpocetine" ameliorates the inflammation, apoptosis and oxidative stress induced by cyclophosphamide in urinary bladder: an experimental study. Int Urol Nephrol 2023; 55:129-139. [PMID: 35817991 DOI: 10.1007/s11255-022-03246-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: 02/16/2022] [Accepted: 06/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Hemorrhagic cystitis often develops in patients treated with cyclophosphamide (CP). Vincamine (vinca alkaloid) is the source of the synthetic derivative vinpocetine (Vinpo). Worldwide, Vinpo is used as a cerebroprotective drug. As it has anti-oxidant, anti-thrombotic and anti-inflammatory effects but the power of Vinpo to prevent CP induced cystitis has not been studied. AIM OF STUDY This research was planned to explore the effect of Vinpo (10-30 mg/kg, orally) administered 1 or 4 h before inducing cystitis by CP injection (300 mg/kg, i.p.) on the urinary bladder of mice. RESULTS Administration of Vinpo 30 mg/kg, 4 h before CP injection ameliorated inflammatory markers. It reduced inducible nitric oxide synthase (iNOS), tumor necrosis factor- α (TNF-α), and BCL2 Associated X (Bax) expression in the bladder and increased the total antioxidant capacity level. Histological examination of the bladder has further supported these results. The present study suggests a protective effect of Vinpo (30 mg/kg, 4 h before CP injection) against CP-induced bladder inflammation. CONCLUSION This proposes that Vinpo 30 mg/kg may become a promising pharmacological drug to prevent urinary adverse effects in patients treated with chemotherapy using CP.
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Affiliation(s)
- Rehab Sabri Abdelrahman
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, 35516, Egypt
- Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Al-Madina Al-Munawwarah, Riyadh, 30001, Saudi Arabia
| | - Eman Mohamad El Nashar
- Department of Anatomy, College of Medicine, King Khalid University, King Khalid University Post Office Box: 960, Abha, Postal Code: 61421, Saudi Arabia.
- Department of Histology and Cell Biology College of Medicine, Benha University, Benha, Egypt.
| | - Mansour Abdullah Alghamdi
- Department of Anatomy, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia
- Genomics and Personalized Medicine Unit, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia
| | - Khulood Mohammed Al-Khater
- Department of Anatomy, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 31441, Saudi Arabia
| | - Reham Ismail Taha
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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20
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Ness TJ, DeWitte C, Randich A. The Double Insult of Neonatal Cystitis Plus Adult Somatic Inflammation Results in Corticotropin Releasing Factor Type II Receptor-Dependent Bladder Hypersensitivity in Female Rats. J Pain 2022; 23:2167-2178. [PMID: 36089237 PMCID: PMC9729390 DOI: 10.1016/j.jpain.2022.08.005] [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] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 01/04/2023]
Abstract
The spinal mechanisms of visceral hypersensitivity are poorly understood, particularly when there is an interaction with somatic systems. Recently we demonstrated that rats which were pretreated with neonatal bladder inflammation (NBI) and subsequently pretreated as adults with bladder re-inflammation had augmented reflex and neuronal responses to urinary bladder distension via a corticotropin-releasing factor receptor type II (CRFR2) mechanism. Another insult producing similar augmented responses is somatic inflammation induced by Complete Freund's Adjuvant (CFA) in the hindlimb. Using neurochemical measures and both reflex and neuronal responses to urinary bladder distension as endpoints, the present study probed the role of CRFR2-related mechanisms in bladder hyperalgesia secondary to NBI and CFA-induced hindlimb inflammation. ELISA measures of the lumbosacral spinal cord demonstrated increased CRFR2 protein following pretreatment with NBI+CFA. Intrathecal CRFR2 antagonists blocked the augmentation of visceromotor responses to distension following pretreatment with both NBI+CFA. Lumbosacral dorsal horn neuronal responses to bladder distension in rats pretreated with NBI+CFA were attenuated by the spinal topical administration of a CRFR2 antagonist. These findings are the first demonstration of a somatovisceral interaction working via CRFR2 receptors and support the therapeutic value of these agents in the treatment of painful bladder disorders, particularly when triggered by somatic events. (Word Count 199). PERSPECTIVE: Bladder hypersensitivity occurs following neonatal cystitis and an adult insult such as somatic inflammation. This paper demonstrates that CRFR2-related mechanisms are associated with this hypersensitivity. This supports the therapeutic value of these agents in the treatment of painful bladder disorders, particularly when triggered by somatic events.
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Affiliation(s)
- Timothy J Ness
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Cary DeWitte
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alan Randich
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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21
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Purkerson JM, Everett CA, Schwartz GJ. Ammonium chloride-induced acidosis exacerbates cystitis and pyelonephritis caused by uropathogenic E. coli. Physiol Rep 2022; 10:e15471. [PMID: 36151614 PMCID: PMC9508385 DOI: 10.14814/phy2.15471] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023] Open
Abstract
Acute pyelonephritis caused by uropathogenic E. coli (UPEC) can cause renal scarring and lead to development of chronic kidney disease. Prevention of kidney injury requires an understanding of host factors and/or UPEC adaptive responses that are permissive for UPEC colonization of the urinary tract. Although some studies have suggested urine acidification limits UPEC growth in culture, other studies have described acid-resistance mechanisms (AR) in E. coli such as the CadC/CadBA module that promotes adaptation to acid and nitrosative stress. Herein we confirm and extend our previous study by demonstrating that despite urine acidification, metabolic acidosis induced by dietary ammonium chloride (NH4 Cl-A) exacerbates cystitis and pyelonephritis in innate immune competent (C3H-HeN) mice characterized by: (1) markedly elevated UPEC burden and increased chemokine/cytokine and NOS2 mRNA expression, (2) accumulation of intravesicular debris noninvasively detected by Power Doppler Ultrasound (PDUS), and (3) collecting duct (CD) dysfunction that manifests as a urine concentration defect. Bladder debris and CD dysfunction were due to the inflammatory response, as neither was observed in Tlr4-deficient (C3H-HeJ) mice. The effect of NH4 Cl-A was unrelated to acidosis as dietary administration of hydrochloric acid (HCl-A) yielded a comparable acid-base status yet did not increase UPEC burden. NH4 Cl-A increased polyamines and decreased nitric oxide (NO) metabolites in urine indicating that excess dietary ammonium shifts arginine metabolism toward polyamines at the expense of NO synthesis. Furthermore, despite increased expression of NOS2, NO production post UPEC infection was attenuated in NH4 Cl-A mice compared to controls. Thus, in addition to induction of metabolic acidosis and urine acidification, excess dietary ammonium alters the polyamine:NO balance and thereby compromises NOS2-mediated innate immune defense.
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Affiliation(s)
- Jeffrey M. Purkerson
- Pediatric NephrologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
- Strong Children's Research CenterUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Coralee A. Everett
- Pediatric NephrologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
- Strong Children's Research CenterUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - George J. Schwartz
- Pediatric NephrologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
- Strong Children's Research CenterUniversity of Rochester Medical CenterRochesterNew YorkUSA
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22
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Zou S, Shimizu T, Kurabayashi A, Yamamoto M, Shimizu S, Higashi Y, Shimizu N, Karashima T, Saito M. Protective effects of hydrogen sulfide pretreatment on cyclophosphamide-induced bladder dysfunction in rats via suppression of bladder afferent nerves. Nitric Oxide 2022; 127:54-63. [PMID: 35918055 DOI: 10.1016/j.niox.2022.07.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022]
Abstract
Cyclophosphamide (CYP), a broad-spectrum anticancer drug, causes serious side effects, such as haemorrhagic cystitis (HC). Hydrogen sulfide (H2S), an endogenous gasotransmitter, has physiological properties, including anti-inflammation, anti-oxidation, and neuromodulation. In this study, we investigated the effects of NaHS (H2S donor) pretreatment on bladder dysfunction in CYP-treated rats. Male Wistar rats were intraperitoneally pretreated with NaHS (3 or 10 μmol/kg) or vehicle once daily for 7 days before cystometry, and CYP (150 mg/kg) or saline was intraperitoneally administered 2 days before cystometry. After cystometry, the bladder tissues were collected for haematoxylin and eosin staining. In some rats, capsaicin (CAP), which can desensitise CAP-sensitive afferent nerves, was subcutaneously injected at 125 mg/kg 4 days before cystometry. CYP reduced intercontraction intervals (ICI) and bladder compliance (Comp) and increased the number of non-voiding contractions (NVCs) compared with the saline-treated control group. NaHS pretreatment dose-dependently improved the CYP-induced these changes. In bladder tissues, CYP increased histological scores of neutrophil infiltration, haemorrhage, and oedema, while NaHS had no effect on these CYP-induced changes. CAP showed a tendency to suppress CYP-induced changes in ICI. NaHS-induced improvement in CYP-induced changes in urodynamic parameters were not detected in CAP-treated rats. These findings suggest that NaHS pretreatment prevented bladder dysfunction in CYP-treated rats by suppressing CAP-sensitive bladder afferent nerves, but not by suppressing bladder inflammation. Therefore, H2S represents a new candidate as a protective drug for bladder dysfunction induced by HC, a side effect of CYP chemotherapy.
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Affiliation(s)
- Suo Zou
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Takahiro Shimizu
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan.
| | - Atsushi Kurabayashi
- Department of Pathology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Masaki Yamamoto
- Department of Pediatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Shogo Shimizu
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Youichirou Higashi
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Nobutaka Shimizu
- Department of Pelvic Floor Center, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Takashi Karashima
- Department of Urology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Motoaki Saito
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
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23
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Hameed N, Mahmood SN, Naveed AK. Cytomegalovirus-related Cystitis in a Patient with Membranous Glomerulonephritis Receiving Cyclophosphamide: A Case Study. Saudi J Kidney Dis Transpl 2022; 33:593-597. [PMID: 37929554 DOI: 10.4103/1319-2442.388195] [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] [Indexed: 11/07/2023] Open
Abstract
Hemorrhagic cystitis is a familiar complication of cyclophosphamide therapy in patients receiving high doses of intravenous cyclophosphamide, which is commonly used as part of a chemotherapeutic regimen and as an immunosuppressant for various malignancies and connective tissue diseases. Acrolein, an active and urotoxic metabolite of cyclophosphamide, is the leading cause of this hazardous complication. However, there are very few case reports indicating the role of pathogens such as BK virus, adenovirus, cytomegalovirus (CMV), Escherichia coli, Proteus mirabilis, Klebsiella, and Candida as the triggers for hemorrhagic cystitis, after short courses and oral use of cyclophosphamide therapy. Here, we report a case of CMV-related cystitis in a patient with membranous glomerulonephritis, who received conventional doses of oral cyclophosphamide for a short duration and presented with hematuria. Cystoscopy, along with a microscopic examination of the bladder mucosa, revealed mononuclear viral inclusions indicating CMV were observed. The patient responded to antiviral therapy.
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Affiliation(s)
- Najia Hameed
- Department of Nephrology, Ziauddin University Hospital, Karachi, Pakistan
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24
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Tóth B, Jávorházy A, Nyirády P, Csupor-Löffler B, Birinyi P, Zhanel G, Naber K, Länger R, Vörhendi N, Gede N, Váncsa S, Hegyi P, Csupor D. Bea rberry in the treatment of acute unco mpl icated cystitis (BRUMI): protocol of a multicentre, randomised double-blind clinical trial. BMJ Open 2022; 12:e057982. [PMID: 35750460 PMCID: PMC9234905 DOI: 10.1136/bmjopen-2021-057982] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Bearberry (Arctostaphylos uva-ursi) leaf is available as a treatment of uncomplicated cystitis in several European countries. The antimicrobial activity of its extracts and some of its individual constituents has been observed in vitro; however, the efficacy of bearberry compared with standard antimicrobial therapy has not been assessed yet. OBJECTIVE The objective of the study is to assess the safety and non-inferiority of bearberry as an alternative therapy in the treatment of acute uncomplicated cystitis in comparison with standard antibiotic therapy (fosfomycin). METHODS AND ANALYSIS This is a randomised controlled double-blinded multicentre trial. Eligible patients will be premenopausal women with a sum score of ≥6 for the typical acute uncomplicated cystitis symptoms (frequency, urgency, painful urination, incomplete emptying, suprapubic pain and visible haematuria) reported on the Acute Cystitis Symptom Score (ACSS) typical domain and pyuria. Patients will be randomly assigned to receive 3 g single dose of fosfomycin powder and two placebo tablets three times a day for 7 days or B a single dose of placebo powder and two tablets containing a dry extract of Uvae ursi folium. At least 504 patients (allocated as 1:1) will need to be enrolled to access non-inferiority with a non-inferiority limit of 14% for the primary endpoint.Improvement of symptoms of uncomplicated cystitis (based on the ACSS score) at day 7 is defined as the primary endpoint, whereas several secondary endpoints such as the number and ratio of patients with bacteriuria at day 7, frequency and severity of side effects; recurrence of urinary tract infection, concurrent use of other over the counter (OTC) medications and food supplements will be determined to elucidate more detailed differences between the groups. The number of recurrences and medications taken for treatment will be monitored for a follow-up period of 90 days (80-100 days). ETHICS AND DISSEMINATION This study has been approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (IV/4225-1/2021/EKU). The results will be disseminated by publication of peer-reviewed manuscripts. TRIAL REGISTRATION NUMBER NCT05055544.
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Affiliation(s)
- Barbara Tóth
- Department of Pharmacognosy, University of Szeged, Szeged, Hungary
| | - András Jávorházy
- Urology Clinic, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Nyirády
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Boglárka Csupor-Löffler
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Birinyi
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - George Zhanel
- Departmental of Medical Microbiology/Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kurt Naber
- Department of Urology, Technical University of Munich, Munich, Germany
| | - Reinhard Länger
- Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | - Nóra Vörhendi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Noémi Gede
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Dezső Csupor
- Department of Pharmacognosy, University of Szeged, Szeged, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
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25
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Prajapati C, Agrawal YO, Agnihotri VV, Mahajan UB, Patil KR, Patil DD, Patil CR. Development and biological evaluation of protective effect of kidney targeted N-acetylated chitosan nanoparticles containing thymoquinone for the treatment of DNA damage in cyclophosphamide-induced haemorrhagic cystitis. Int J Biol Macromol 2022; 214:391-401. [PMID: 35714868 DOI: 10.1016/j.ijbiomac.2022.06.070] [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: 01/13/2022] [Revised: 06/01/2022] [Accepted: 06/10/2022] [Indexed: 11/19/2022]
Abstract
Thymoquinone (TQ), the most prominent constituent of Nigella sativa seeds, essential oil, is reported to possess an organ protective effect via Nrf2 expression and activation of Phase-II antioxidant enzymes. Haemorrhagic cystitis is the sudden onset of haematuria combined with bladder pain and irritable bladder symptoms are the known toxic effects of cyclophosphamide (CYP) chemotherapy. The objective of the present study was to investigate and compare the protective effect of thymoquinone (TQ) and thymoquinone nanoparticles (TQ-NP) in the kidney against CYP-induced haemorrhagic cystitis. Primarily, TQ-NP was fabricated by synthesis of N-acetylated chitosan and nanoparticle preparation by the ionic gelation technique. They were characterized by particle size, polydispersive index (PDI), zeta potential, entrapment efficiency (EE), SEM, and dynamic scattering calorimetry (DSC). Moreover, fluorescein isothiocyanate (FITC) labeled NPs were prepared for biodistribution studies. The protective mechanisms of TQ-NP included its anti-inflammatory activity, inhibitory effects on cytokine levels, and protection against the DNA damage in the bladder epithelium. The cystitis was induced in rats by orally administering 200 mg/kg of CYP. The dose-dependent protective effect of the TQ-NP was determined by intravenously administering 1, 2, and 5 mg/kg of the TQ-NP to CYP-treated rats. The present study revealed that the TQ-NP prepared by ionic gelation method provides kidney targeted delivery of TQ as compared to TQ solution. The mean particle size, PDI, and %EE of TQ-NP were 272.6 nm, 0.216, 70.81 ± 0.12% respectively. The zeta potential of thymoquinone-loaded nanoparticles was found to be -20.7 mV and - 22.6 mV respectively before and after lyophilization. SEM study also confirmed the small size and spherical shape. Pharmacokinetic studies revealed the improvement in half-life and prolonged action of the TQ-NP as compared to the TQ solution. Also, TQ-NP administration showed more protection against the characteristic histological alterations in the bladder in comparison to TQ solution. The present study indicates that TQ-NP exerts potent anti-oxidant, DNA protective and cytokine inhibitory activity at considerably lower concentrations as compared to plain TQ solution. The nano formulation of TQ using N-acetylated chitosan provides effective kidney targeted delivery of TQ, which in turn improves its retention and protective efficacy against CYP-induced haemorrhagic cystitis.
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Affiliation(s)
- Chaitali Prajapati
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Dist. Dhule, Shirpur 425405, Maharashtra, India
| | - Yogeeta O Agrawal
- Shri Vile Parle Kelavani Mandal's Institute of Pharmacy, Dhule 424001, Maharashtra, India.
| | - Vinit V Agnihotri
- Shri Vile Parle Kelavani Mandal's Institute of Pharmacy, Dhule 424001, Maharashtra, India
| | - Umesh B Mahajan
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Dist. Dhule, Shirpur 425405, Maharashtra, India
| | - Kalpesh R Patil
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Dist. Dhule, Shirpur 425405, Maharashtra, India
| | - Dipak D Patil
- Department of Pharmaceutical Chemistry, H. R. Patel Institute of Pharmaceutical Education and Research, Dist. Dhule, Shirpur 425405, Maharashtra, India
| | - Chandragouda R Patil
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Dist. Dhule, Shirpur 425405, Maharashtra, India.
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26
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Chueh KS, Huang KH, Lu JH, Juan TJ, Chuang SM, Lin RJ, Lee YC, Long CY, Shen MC, Sun TW, Juan YS. Therapeutic Effect of Platelet-Rich Plasma Improves Bladder Overactivity in the Pathogenesis of Ketamine-Induced Ulcerative Cystitis in a Rat Model. Int J Mol Sci 2022; 23:ijms23105771. [PMID: 35628581 PMCID: PMC9147926 DOI: 10.3390/ijms23105771] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 12/15/2022] Open
Abstract
The present study attempted to elucidate whether intravesical instillation of platelet-rich plasma (PRP) could decrease bladder inflammation and ameliorate bladder hyperactivity in ketamine ulcerative cystitis (KIC) rat model. Female Sprague Dawley (S-D) rats were randomly divided into control group, ketamine-treated group, ketamine with PRP treated group, and ketamine with platelet-poor plasma (PPP) treated group. Cystometry and micturition frequency/volume studies were performed to investigate bladder function. The morphological change of bladder was investigated by Mason’s trichrome staining. Western blotting analysis were carried out to examine the protein expressions of inflammation, urothelial differentiation, proliferation, urothelial barrier function, angiogenesis and neurogenesis related proteins. The results revealed that treatment with ketamine significantly deteriorated bladder capacity, decreased voiding function and enhanced bladder overactivity. These pathological damage and interstitial fibrosis may via NF-κB/COX-2 signaling pathways and muscarinic receptor overexpression. PRP treatment decreased inflammatory fibrotic biosynthesis, attenuated oxidative stress, promoted urothelial cell regeneration, and enhanced angiogenesis and neurogenesis, thereafter recovered bladder dysfunction and ameliorate the bladder hyperactivity in KIC rat model. These findings suggested that the PRP therapy may offer new treatment options for those clinical KIC patients.
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Affiliation(s)
- Kuang-Shun Chueh
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (C.-Y.L.)
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Kuan-Hua Huang
- Divisions of Urological Oncology, Department of Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan;
| | - Jian-He Lu
- Emerging Compounds Research Center, Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan;
| | - Tai-Jui Juan
- Department of Medicine, National Defense Medical College, Taipei 11490, Taiwan;
| | - Shu-Mien Chuang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Rong-Jyh Lin
- Department of Parasitology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Chen Lee
- Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Cheng-Yu Long
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (C.-Y.L.)
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 80708, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Mei-Chen Shen
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Ting-Wei Sun
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
| | - Yung-Shun Juan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (C.-Y.L.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (S.-M.C.); (M.-C.S.); (T.-W.S.)
- Correspondence: ; Tel.: +886-7-3121101
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Kono J, Ueda M, Sengiku A, Suadicani SO, Woo JT, Kobayashi T, Ogawa O, Negoro H. Flavonoid Nobiletin Attenuates Cyclophosphamide-Induced Cystitis in Mice through Mechanisms That Involve Inhibition of IL-1β Induced Connexin 43 Upregulation and Gap Junction Communication in Urothelial Cells. Int J Mol Sci 2022; 23:5037. [PMID: 35563427 PMCID: PMC9102543 DOI: 10.3390/ijms23095037] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 11/23/2022] Open
Abstract
Bladder inflammatory diseases cause various urinary symptoms, such as urinary frequency and painful urination, that impair quality of life. In this study, we used a mouse model of cyclophosphamide (CYP)-induced bladder inflammation and immortalized human urothelial (TRT-HU1) cells to explore the preventive potential of nobiletin (NOB), a polymethoxylated flavone enriched in citrus fruit peel, and investigate its mechanism of action in the bladder. Prophylaxis with PMF90 (60% NOB) attenuated the development of bladder inflammation and urinary symptoms in CYP-treated mice. PMF90 also reduced the upregulation of connexin 43 (Cx43), a major component of gap junction channels, in the bladder mucosa of CYP-treated mice. Stimulation of TRT-HU1 cells with the pro-inflammatory cytokine IL-1β increased Cx43 mRNA and protein expression and enhanced gap junction coupling-responses that were prevented by pre-treatment with NOB. In urothelium-specific Cx43 knockout (uCx43KO) mice, macroscopic signs of bladder inflammation and changes in voiding behavior induced by CYP treatment were significantly attenuated when compared to controls. These findings indicate the participation of urothelial Cx43 in the development of bladder inflammation and urinary symptoms in CYP-treated mice and provide pre-clinical evidence for the preventive potential of NOB through its anti-inflammatory effects on IL-1β signaling and urothelial Cx43 expression.
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Affiliation(s)
- Jin Kono
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; (J.K.); (M.U.); (A.S.); (T.K.); (O.O.)
| | - Masakatsu Ueda
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; (J.K.); (M.U.); (A.S.); (T.K.); (O.O.)
- Department of Urology, Shizuoka General Hospital, Shizuoka 420-8527, Japan
| | - Atsushi Sengiku
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; (J.K.); (M.U.); (A.S.); (T.K.); (O.O.)
- Sengiku Urology Clinic, Shiga 524-0045, Japan
| | - Sylvia O. Suadicani
- Department of Urology, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Je Tae Woo
- Department of Biological Chemistry, College of Bioscience and Biotechnology, Chubu University, Kasugai 487-8501, Japan;
| | - Takashi Kobayashi
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; (J.K.); (M.U.); (A.S.); (T.K.); (O.O.)
| | - Osamu Ogawa
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; (J.K.); (M.U.); (A.S.); (T.K.); (O.O.)
| | - Hiromitsu Negoro
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan; (J.K.); (M.U.); (A.S.); (T.K.); (O.O.)
- Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan
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Affiliation(s)
- Eric Kutscher
- Internal Medicine, NYU Langone Health, New York, NY, USA.
- Internal Medicine, Bellevue Hospital Center, New York, NY, USA.
| | - Richard E Greene
- Internal Medicine, NYU Langone Health, New York, NY, USA
- Internal Medicine, Bellevue Hospital Center, New York, NY, USA
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Abstract
This case study discusses a patient who presented with severe lower urinary tract symptoms and pain after commencing immunotherapy for eosinophilic asthma. Initial aetiology was presumed to be infective but cultures were negative. Cross-sectional imaging showed extensive perivesical and periprostatic stranding and inflammation. He was initially treated with antibiotics and anti-inflammatories but a lack of clinical improvement led to a rigid cystoscopy which identified an inflamed, oedematous urothelium which was biopsied. Histology demonstrated extensive, full thickness superficial detrusor inflammation, with marked congestion, oedema and a mixed inflammatory infiltrate in keeping with a severe active chronic non-infectious cystitis, possibly secondary to benralizumab therapy. His benralizumab was stopped and his symptoms completely settled. We believe this is the first described case of severe non-infective cystitis which may be secondary to benralizumab. This case adds to the isolated reports of this rare side effect of some of the newer biological agents in use.
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Affiliation(s)
- Toby Murray
- Urology, Frimley Park Hospital NHS Foundation Trust, Frimley, UK
| | - Ben Haagsma
- Histopathology, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Andrew Chetwood
- Urology, Frimley Park Hospital NHS Foundation Trust, Frimley, UK
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Abstract
Interstitial cystitis (IC) is a bladder syndrome of unclear etiology with no generally accepted treatment. Growing evidence suggest that periostin (POSTN) is an important homeostatic component in the tissue repair and regeneration in adulthood, but its function in urinary bladder regeneration is still unknown. Here we investigate whether POSTN is involved in bladder tissue repair in a cyclophosphamide (CYP)-induced interstitial cystitis model. POSTN is primarily expressed in bladder stroma (detrusor smooth muscle and lamina propria) and upregulated in response to CYP-induced injury. POSTN deficiency resulted in more severe hematuria, aggravated edema of the bladder, and delayed umbrella cell recovery. Besides, less proliferative urothelial cells (labeled by pHH3, Ki67, and EdU) and lower expression of Krt14 (a urothelial stem cell marker) were detected in POSTN−/− mice post CYP exposure, indicating a limited urothelial regeneration. Further investigations revealed that POSTN could induce Wnt4 upregulation and activate AKT signaling, which together activates β-catenin signaling to drive urothelial stem cell proliferation. In addition, POSTN can promote resident macrophage proliferation and polarization to a pro-regenerative (M2) phenotype, which favors urothelial regeneration. Furthermore, we generated injectable P-GelMA granular hydrogel as a biomaterial carrier to deliver recombinant POSTN into the bladder, which could increase urothelial stem cells number, decrease umbrella cells exfoliation, and hence alleviate hematuria in a CYP-induced interstitial cystitis model. In summary, our findings identify a pivotal role of POSTN in bladder urothelial regeneration and suggest that intravesical biomaterials-assisted POSTN delivery may be an efficacious treatment for interstitial cystitis.
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Affiliation(s)
| | | | | | - Minjie Liu
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Andy Peng Xiang
- Program of Stem Cells and Regenerative Medicine, Affiliated Guangzhou Women and Children’s Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
- Center for Stem Cell Biology and Tissue Engineering, Key Laboratory for Stem Cells and Tissue Engineering, Ministry of Education, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Chunhua Deng
- Chunhua Deng, Department of Andrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, People’s Republic of China. Tel: +86 20 87335633; Fax: +86 20 87332200;
| | - Mei Hua Jiang
- Corresponding authors: Mei Hua Jiang, Department of Anatomy, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, People’s Republic of China. Tel: +86 20 87330639; Fax: +86 20 87330709;
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Vanneste M, Mulier M, Nogueira Freitas AC, Van Ranst N, Kerstens A, Voets T, Everaerts W. TRPM3 Is Expressed in Afferent Bladder Neurons and Is Upregulated during Bladder Inflammation. Int J Mol Sci 2021; 23:ijms23010107. [PMID: 35008533 PMCID: PMC8745475 DOI: 10.3390/ijms23010107] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/02/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 02/06/2023] Open
Abstract
The cation channel TRPM3 is activated by heat and the neurosteroid pregnenolone sulfate. TRPM3 is expressed on sensory neurons innervating the skin, where together with TRPV1 and TRPA1, it functions as one of three redundant sensors of acute heat. Moreover, functional upregulation of TRPM3 during inflammation contributes to heat hyperalgesia. The role of TRPM3 in sensory neurons innervating internal organs such as the bladder is currently unclear. Here, using retrograde labeling and single-molecule fluorescent RNA in situ hybridization, we demonstrate expression of mRNA encoding TRPM3 in a large subset of dorsal root ganglion (DRG) neurons innervating the mouse bladder, and confirm TRPM3 channel functionality in these neurons using Fura-2-based calcium imaging. After induction of cystitis by injection of cyclophosphamide, we observed a robust increase of the functional responses to agonists of TRPM3, TRPV1, and TRPA1 in bladder-innervating DRG neurons. Cystometry and voided spot analysis in control and cyclophosphamide-treated animals did not reveal differences between wild type and TRPM3-deficient mice, indicating that TRPM3 is not critical for normal voiding. We conclude that TRPM3 is functionally expressed in a large proportion of sensory bladder afferent, but its role in bladder sensation remains to be established.
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Affiliation(s)
- Matthias Vanneste
- Laboratory of Ion Channel Research (LICR), VIB-KU Leuven Center for Brain & Disease Research, Belgium & Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; (M.V.); (M.M.); (A.C.N.F.); (N.V.R.)
| | - Marie Mulier
- Laboratory of Ion Channel Research (LICR), VIB-KU Leuven Center for Brain & Disease Research, Belgium & Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; (M.V.); (M.M.); (A.C.N.F.); (N.V.R.)
| | - Ana Cristina Nogueira Freitas
- Laboratory of Ion Channel Research (LICR), VIB-KU Leuven Center for Brain & Disease Research, Belgium & Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; (M.V.); (M.M.); (A.C.N.F.); (N.V.R.)
| | - Nele Van Ranst
- Laboratory of Ion Channel Research (LICR), VIB-KU Leuven Center for Brain & Disease Research, Belgium & Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; (M.V.); (M.M.); (A.C.N.F.); (N.V.R.)
| | - Axelle Kerstens
- VIB Bio Imaging Core, VIB-KU Leuven Center for Brain & Disease Research, Belgium & Research Group Molecular Neurobiology, Department of Neuroscience, KU Leuven, 3000 Leuven, Belgium;
| | - Thomas Voets
- Laboratory of Ion Channel Research (LICR), VIB-KU Leuven Center for Brain & Disease Research, Belgium & Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; (M.V.); (M.M.); (A.C.N.F.); (N.V.R.)
- Correspondence: ; Tel.: +32-16-33-02-17
| | - Wouter Everaerts
- Laboratory of Organ Systems, Department of Development and Regeneration, KU Leuven, Belgium & Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium;
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Chen NW, Gao JL, Li HL, Xu H, Wu LF, Meng FG, Chen W, Cao YF, Xie WH, Zhang XQ, Liu SH, Jin J, He Y, Lv JW. The protective effect of manganese superoxide dismutase from thermophilic bacterium HB27 on hydrochloric acid-induced chemical cystitis in rats. Int Urol Nephrol 2021; 54:1681-1691. [PMID: 34783980 PMCID: PMC9184365 DOI: 10.1007/s11255-021-03054-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Abstract
Purpose To evaluate the effects of manganese superoxide dismutase (Mn-SOD) from thermophilic bacterium HB27 (name as Tt-SOD) on chemical cystitis. Methods Control and experimental rats were infused by intravesical saline or hydrochloric acid (HCl) on the first day of the experiments. Saline, sodium hyaluronate (SH) or Tt-SOD were infused intravesically once a day for three consequent days. On the fifth day, the rats were weighted and sacrificed following a pain threshold test. The bladder was harvested for histological and biochemical analyses. Results Tt-SOD could reduce the bladder index, infiltration of inflammatory cells in tissues, serum inflammatory factors and SOD levels, mRNA expression of inflammatory factors in tissues, and increase perineal mechanical pain threshold and serum MDA and ROS levels in HCl-induced chemical cystitis. Furthermore, Tt-SOD alleviated inflammation and oxidative stress by the negative regulation of the NF-κB p65 and p38 MAPK signaling pathway. Conclusions Intravesical instillation of Tt-SOD provides protective effects against HCl-induced cystitis.
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Affiliation(s)
- Nai-Wen Chen
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China
| | - Jin-Lai Gao
- Department of Pharmacology, College of Medical, Jiaxing University, Jiaxing, Zhejiang, 314001, People's Republic of China
| | - Hai-Long Li
- Redox Medical Center for Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China
| | - Hong Xu
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China
| | - Ling-Feng Wu
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China
| | - Fan-Guo Meng
- Redox Medical Center for Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China
| | - Wei Chen
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China
| | - Yi-Fang Cao
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China
| | - Wen-Hua Xie
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China
| | - Xiao-Qin Zhang
- Department of Pharmacy, College of Medical, Jiaxing University, Jiaxing, Zhejiang, 314001, People's Republic of China
| | - Shi-Hui Liu
- Department of Pharmacy, College of Medical, Jiaxing University, Jiaxing, Zhejiang, 314001, People's Republic of China
| | - Jing Jin
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China.
| | - Yi He
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang, China.
| | - Jian-Wei Lv
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People's Republic of China.
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Montalbetti N, Carattino MD. Acid-sensing ion channels modulate bladder nociception. Am J Physiol Renal Physiol 2021; 321:F587-F599. [PMID: 34514879 PMCID: PMC8813206 DOI: 10.1152/ajprenal.00302.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/05/2021] [Revised: 08/30/2021] [Accepted: 09/07/2021] [Indexed: 01/23/2023] Open
Abstract
Sensitization of neuronal pathways and persistent afferent drive are major contributors to somatic and visceral pain. However, the underlying mechanisms that govern whether afferent signaling will give rise to sensitization and pain are not fully understood. In the present report, we investigated the contribution of acid-sensing ion channels (ASICs) to bladder nociception in a model of chemical cystitis induced by cyclophosphamide (CYP). We found that the administration of CYP to mice lacking ASIC3, a subunit primarily expressed in sensory neurons, generates pelvic allodynia at a time point at which only modest changes in pelvic sensitivity are apparent in wild-type mice. The differences in mechanical pelvic sensitivity between wild-type and Asic3 knockout mice treated with CYP were ascribed to sensitized bladder C nociceptors. Deletion of Asic3 from bladder sensory neurons abolished their ability to discharge action potentials in response to extracellular acidification. Collectively, the results of our study support the notion that protons and their cognate ASIC receptors are part of a mechanism that operates at the nerve terminals to control nociceptor excitability and sensitization.NEW & NOTEWORTHY Our study indicates that protons and their cognate acid-sensing ion channel receptors are part of a mechanism that operates at bladder afferent terminals to control their function and that the loss of this regulatory mechanism results in hyperactivation of nociceptive pathways and the development of pain in the setting of chemical-induced cystitis.
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Affiliation(s)
- Nicolas Montalbetti
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Marcelo D Carattino
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Schneider S, Alezra E, Yacoub M, Ducharme O, Gerard E, Dutriaux C, Prey S. Aseptic cystitis induced by nivolumab and ipilimumab combination for metastatic melanoma. Melanoma Res 2021; 31:487-489. [PMID: 34433197 DOI: 10.1097/cmr.0000000000000765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced melanoma. Combination of ICI with ipilimumab cytotoxic T-lymphocyte antigen-4 and nivolumab [anti-programmed cell death-1 (PD-1)] improves tumoral response compared to anti-PD1 monotherapy in melanoma patients, but is associated with more severe and multiple immune-related adverse events. We report the first case of aseptic cystitis induced by ipilimumab and nivolumab combination in a 61-year-old melanoma patient. She described after two infusions, diarrhea, pollakiuria, intense bladder pain, urinary urgency, and nocturia. Repeated negative urine culture tests led to perform cystoscopy. Mucosal bladder biopsies showed lymphocytic T-cells infiltration in intraepithelial and in subepithelial connective tissue, which were consistent with the diagnosis of immune-related aseptic cystitis. Aseptic cystitis is a rare and poorly known side-effect related to ICI. Only four other cases with anti-PD1 monotherapy were found in literature, only in Japanese patients. It simulates bacterial cystitis with negative urinary tests, and is often associated with atypical symptoms like diarrhea, which may delay the diagnosis. Oral steroids appear to be the most efficient therapeutic options.
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Affiliation(s)
| | - Eric Alezra
- CHU de Bordeaux, Service de chirurgie urologique
| | | | | | | | - Caroline Dutriaux
- CHU de Bordeaux, Service de Dermatologie
- Univ. Bordeaux, Inserm U-1035, Bordeaux, France
| | - Sorilla Prey
- CHU de Bordeaux, Service de Dermatologie
- Univ. Bordeaux, Inserm U-1035, Bordeaux, France
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35
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Van Batavia JP, Butler S, Lewis E, Fesi J, Canning DA, Vicini S, Valentino RJ, Zderic SA. Corticotropin-Releasing Hormone from the Pontine Micturition Center Plays an Inhibitory Role in Micturition. J Neurosci 2021; 41:7314-7325. [PMID: 34193553 PMCID: PMC8387110 DOI: 10.1523/jneurosci.0684-21.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/31/2021] [Revised: 06/04/2021] [Accepted: 06/17/2021] [Indexed: 11/21/2022] Open
Abstract
Lower urinary tract or voiding disorders are prevalent across all ages and affect >40% of adults over 40 years old, leading to decreased quality of life and high health care costs. The pontine micturition center (PMC; i.e., Barrington's nucleus) contains a large population of neurons that localize the stress-related neuropeptide, corticotropin-releasing hormone (CRH) and project to neurons in the spinal cord to regulate micturition. How the PMC and CRH-expressing neurons in the PMC control volitional micturition is of critical importance for human voiding disorders. To investigate the specific role of CRH in the PMC, neurons in the PMC-expressing CRH were optogenetically activated during in vivo cystometry in unanesthetized mice of either sex. Optogenetic activation of CRH-PMC neurons led to increased intermicturition interval and voided volume, similar to the altered voiding phenotype produced by social stress. Female mice showed a significantly more pronounced phenotype change compared with male mice. These effects were eliminated by CRH-receptor 1 antagonist pretreatment. Optogenetic inhibition of CRH-PMC neurons led to an altered voiding phenotype characterized by more frequent voids and smaller voided volumes. Last, in a cyclophosphamide cystitis model of bladder overactivity, optogenetic activation of CRH-PMC neurons returned the voiding pattern to normal. Collectively, our findings demonstrate that CRH from PMC spinal-projecting neurons has an inhibitory function on micturition and is a potential therapeutic target for human disease states, such as voiding postponement, urinary retention, and underactive or overactive bladder.SIGNIFICANCE STATEMENT The pontine micturition center (PMC), which is a major regulator of volitional micturition, is neurochemically heterogeneous, and excitatory neurotransmission derived from PMC neurons is thought to mediate the micturition reflex. In the present study, using optogenetic manipulation of CRH-containing neurons in double-transgenic mice, we demonstrate that CRH, which is prominent in PMC-spinal projections, has an inhibitory function on volitional micturition. Moreover, engaging this inhibitory function of CRH can ameliorate bladder hyperexcitability induced by cyclophosphamide in a model of cystitis. The data underscore CRH as a novel target for the treatment of voiding dysfunctions, which are highly prevalent disease processes in children and adults.
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Affiliation(s)
- Jason P Van Batavia
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - Stephan Butler
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - Eleanor Lewis
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - Joanna Fesi
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - Douglas A Canning
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - Stefano Vicini
- Department of Pharmacology and Physiology, Georgetown, University Medical Center, Washington, DC 20007
| | - Rita J Valentino
- Department of Anesthesia and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - Stephen A Zderic
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
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Slack D, Ray S, Lee B, Sastry J. An Unusual Cause of Hemorrhagic Cystitis in a Teenager With Medulloblastoma. J Pediatr Hematol Oncol 2021; 43:e861-e863. [PMID: 32925398 DOI: 10.1097/mph.0000000000001949] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022]
Abstract
Hemorrhagic cystitis is a life-threatening condition in which the transitional epithelium and blood vessels of the bladder necrose leading to severe hematuria, abdominal pain, and voiding lower urinary tract symptoms. Etiology includes chemotherapy (cyclophosphamide, ifosfamide, busulfan), radiotherapy, or infectious agents. We present a pediatric case of a 15-year-old boy with medulloblastoma who developed hemorrhagic cystitis following cisplatin chemotherapy. All other causes were ruled out and it is therefore likely that the agent, in this case, was cisplatin, which has never had hemorrhagic cystitis reported as a side effect. We also suggest a mechanism for urothelial injury centered around OCT-2 receptors.
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Affiliation(s)
| | - Satyajit Ray
- Department of Paediatric Oncology, Schiehallion Unit
| | - Boma Lee
- Departments of Paediatric Urology
| | - Jairam Sastry
- Paediatric Oncology, Royal Hospital for Children Glasgow, Glasgow, UK
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37
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Tachibana I, Calaway AC, Abedali Z, Szymanski KM, Mellon MJ, Masterson TA, Cary C, Kaimakliotis HZ, Boris RS. Definitive surgical therapy for refractory radiation cystitis: Evaluating effectiveness, tolerability, and extent of surgical approach. Urol Oncol 2021; 39:789.e1-789.e7. [PMID: 34247908 DOI: 10.1016/j.urolonc.2021.05.038] [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: 01/13/2021] [Revised: 05/06/2021] [Accepted: 05/30/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION AND OBJECTIVE The management of severe symptoms secondary to radiation changes to the bladder can be difficult. Many patients often endure costly procedures, hospitalizations, transfusions, and physician visits for intractable symptoms. Our aim was to evaluate the short-term efficacy and feasibility of urinary diversion in patients with severe, debilitating symptoms related to radiation cystitis by focusing on perioperative data examining surgical feasibility and assess for any improvement in the number of procedures, transfusions, hospitalizations, and office visits required. METHODS With IRB approval, we queried our institutional database for patients with a diagnosis code of radiation cystitis who underwent urinary diversion with or without bladder removal from 2011 to 2018. We reviewed institutional and regional record to assess pre, peri and postoperative outcomes, including rates of surgical procedures, hospitalizations, transfusions and clinic visits, in the year before and after treatment. Non-parametric statistics and linear regression were used. RESULTS Of the 286 patients with radiation cystitis, 45 patients underwent definitive urinary diversion - 31 with concomitant cystectomy and 14 with diversion alone. Analysis of perioperative variables such as estimated blood loss, surgical time, post-operative hospital stay or complication rates were similar to our experience with cystectomy in non-radiated patients. With a mean follow up of 14.6 months, we found that the number of procedures, hospitalizations and transfusions objectively improved following radical surgery. Office visits, however, did not seem to be impacted by performing urinary diversion. There were no significant differences in post-operative benefits between patients that received a concomitant cystectomy and those that only underwent diversion. CONCLUSION Patients suffering from severe refractory symptomatic radiation cystitis may be best treated with a radical surgical approach. Definitive urinary diversion with or without cystectomy can lower burden of disease by reducing the need for additional procedures, hospitalizations, and blood transfusions on short term follow-up.
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Affiliation(s)
- Isamu Tachibana
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202.
| | - Adam C Calaway
- Department of Urology, Case Western Reserve University School of Medicine, 11100 Euclid Ave Cleveland, OH 44106
| | - Zain Abedali
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202
| | - Konrad M Szymanski
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202
| | - Matthew J Mellon
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202
| | - Timothy A Masterson
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202.
| | - Clint Cary
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202
| | - Hristos Z Kaimakliotis
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202
| | - Ronald S Boris
- Department of Urology, Indiana University School of Medicine, 535 Barnhill Drive RT 473, Indianapolis, IN 46202
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Ni B, Chen Z, Shu L, Shao Y, Huang Y, Tamrat NE, Wei Z, Shen B. Nrf2 Pathway Ameliorates Bladder Dysfunction in Cyclophosphamide-Induced Cystitis via Suppression of Oxidative Stress. Oxid Med Cell Longev 2021; 2021:4009308. [PMID: 34306306 PMCID: PMC8279868 DOI: 10.1155/2021/4009308] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/12/2021] [Accepted: 06/10/2021] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To investigate the protective effect and molecular mechanism of nuclear factor E2-related factor 2 (Nrf2) pathway in interstitial cystitis (IC). METHODS We established a mouse model of IC by cyclophosphamide (CYP) in wild-type mice and Nrf2 gene knockout mice. We examined the histological and functional alterations, the changes of oxidative stress markers, and the expression of the antioxidant genes downstream of Nrf2 pathway. RESULTS After CYP administration, the mice showed urinary frequency and urgency, pain sensitization, decreased contractility, bladder edema, and oxidative stress disorder. Notably, the Nrf2-/- CYP mice had more severe symptoms. The mRNA and protein levels of antioxidant genes downstream of Nrf2 pathway were significantly upregulated in the Nrf2+/+ CYP mice, while there were no significant changes in the Nrf2-/- CYP mice. CONCLUSION Nrf2 pathway protects bladder injury and ameliorates bladder dysfunction in IC, possibly by upregulating antioxidant genes and inhibiting oxidative stress.
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Affiliation(s)
- Bin Ni
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Zhengsen Chen
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Le Shu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Yunpeng Shao
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Yi Huang
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Nebiyu Elias Tamrat
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Zhongqing Wei
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Baixin Shen
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
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Yoshizumi M, Watanabe C, Mizoguchi H. Gabapentin reduces painful bladder hypersensitivity in rats with lipopolysaccharide-induced chronic cystitis. Pharmacol Res Perspect 2021; 9:e00697. [PMID: 33340266 PMCID: PMC7749515 DOI: 10.1002/prp2.697] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
Although interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition causing bladder pain and urinary symptoms, effective treatments have not been established. The aim of this study was to adapt a chronic cystitis model in rats using lipopolysaccharide (LPS), which reflects IC/BPS pathology, and characterize the model's histological and behavioral effects. Furthermore, we investigated the effect of an α2 δ subunit ligand, gabapentin (GBP), on bladder hypersensitivity of rats with chronic cystitis. Cystitis models were created by repeated intravesical injections of LPS. In the histological examination, the LPS-injected group had greater inflammatory response, fibrosis, and abnormally thick re-epithelialization. In the LPS-injected group, LPS prompted hyperalgesia in both the lower abdomen and hind paw regions after day 1 of the first injection compared with the saline-injected controls, without any recovery for 21 days at least. During cystometry, the LPS-injected group showed bladder hyperactivity at all times. Systemic administration of GBP reduced cystitis-related pain due to chronic inflammation and reduced the increased frequency of voiding in the LPS-injected group. These results suggest that repeated intravesical injections of LPS induce long-lasting bladder inflammation, pain, and overactivity in rats, while GBP is effective in the management of those symptoms in this chronic cystitis model. The current study identifies a relatively simple method to develop an animal model for chronic cystitis and provides evidence that GBP may be an effective treatment option for patients with IC/BPS.
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Affiliation(s)
- Masaru Yoshizumi
- Department of Physiology and Anatomy Faculty of Pharmaceutical SciencesTohoku Medical and Pharmaceutical UniversitySendaiJapan
| | - Chizuko Watanabe
- Department of Physiology and Anatomy Faculty of Pharmaceutical SciencesTohoku Medical and Pharmaceutical UniversitySendaiJapan
| | - Hirokazu Mizoguchi
- Department of Physiology and Anatomy Faculty of Pharmaceutical SciencesTohoku Medical and Pharmaceutical UniversitySendaiJapan
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Vu DM, Freyre K, Opsha O, Opsha Y. Recreational ketamine-induced cholangiopathy and ulcerative cystitis. Am J Emerg Med 2020; 45:682.e7-682.e9. [PMID: 33358897 DOI: 10.1016/j.ajem.2020.12.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 12/28/2022] Open
Abstract
Ketamine is a versatile analgesic that has become an increasingly popular recreational drug. Chronic ketamine use has been found to cause biliary duct damage and bladder dysfunction. Ketamine-induced cholangiopathy and ulcerative cystitis are uncommon diagnoses presenting with nonspecific symptoms, creating diagnostic challenges for emergency physicians. We report a case of a teenage patient with the rare simultaneous presentation of ketamine-induced cholangiopathy and ulcerative cystitis. Due to increased recreational and chronic ketamine use, cases of ketamine-induced cholangiopathy and ulcerative cystitis are likely to rise with the increased knowledge, awareness, and reporting of these entities by radiologists and emergency physicians.
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Affiliation(s)
- David M Vu
- Maimonides Medical Center, Department of Radiology, 4802 10th Avenue, Brooklyn, New York 11219, United States of America.
| | - Katerina Freyre
- Maimonides Medical Center, Department of Radiology, 4802 10th Avenue, Brooklyn, New York 11219, United States of America.
| | - Oleg Opsha
- Maimonides Medical Center, Department of Radiology, 4802 10th Avenue, Brooklyn, New York 11219, United States of America.
| | - Yekaterina Opsha
- Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, 160 Frelinghuysen Road Piscataway, NJ 08854, United States of America; Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, NJ 07039, United States of America.
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Yang Y, Zhang H, Lu Q, Liu X, Fan Y, Zhu J, Sun B, Zhao J, Dong X, Li L. Suppression of adenosine A 2a receptors alleviates bladder overactivity and hyperalgesia in cyclophosphamide-induced cystitis by inhibiting TRPV1. Biochem Pharmacol 2020; 183:114340. [PMID: 33189675 DOI: 10.1016/j.bcp.2020.114340] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 09/16/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 01/09/2023]
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a type of chronic bladder inflammation characterized by increased voiding frequency, urgency and pelvic pain. The sensitization of bladder afferents is widely regarded as one of the pathophysiological changes in the development of IC/BPS. There is evidence that adenosine A2a receptors are involved in regulating the sensitization of sensory afferents. However, the effect of adenosine A2a receptors on cystitis remains unknown. In the present study, a rat model of chronic cystitis was established by intraperitoneal injection with cyclophosphamide (CYP). Cystometry and behavioral tests were performed to investigate bladder micturition function and nociceptive pain. The rats with chronic cystitis showed symptoms of bladder overactivity, characterized by an increase in bladder voiding frequency and voiding pressure. CYP treatment significantly increased the expression of the A2a receptor in bladder afferent fibers and dorsal root ganglion (DRG) neurons. The A2a receptor antagonist ZM241385 prevented bladder overactivity and hyperalgesia elicited by CYP-induced cystitis. In addition, the A2a receptor and TRPV1 were coexpressed on DRG neurons. The TRPV1 antagonist capsazepine blocked bladder overactivity induced by the A2a receptor agonist CGS21680. In contrast, ZM241385 significantly inhibited the capsaicin-induced increase in intracellular calcium concentration in DRG neurons. These results suggest that suppression of adenosine A2a receptors in bladder afferents alleviates bladder overactivity and hyperalgesia elicited by CYP-induced cystitis in rats by inhibiting TRPV1, indicating that the adenosine A2a receptor in bladder afferents is a potential therapeutic target for the treatment of IC/BPS.
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Affiliation(s)
- Yang Yang
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Hengshuai Zhang
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Qudong Lu
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Xin Liu
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Yi Fan
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Jingzhen Zhu
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Bishao Sun
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Jiang Zhao
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China
| | - Xingyou Dong
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China.
| | - Longkun Li
- Department of Urology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, China.
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Ou SH, Wu LY, Chen HY, Huang CW, Hsu CY, Chen CL, Chou KJ, Fang HC, Lee PT. Risk of Renal Function Decline in Patients with Ketamine-Associated Uropathy. Int J Environ Res Public Health 2020; 17:ijerph17197260. [PMID: 33020445 PMCID: PMC7579140 DOI: 10.3390/ijerph17197260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/08/2020] [Revised: 09/24/2020] [Accepted: 09/29/2020] [Indexed: 01/29/2023]
Abstract
Ketamine-associated diseases have been increasing with the rise in ketamine abuse. Ketamine-associated uropathy is one of the most common complications. We investigated the effects of ketamine-associated uropathy on renal health and determined predictors of renal function decline in chronic ketamine abusers. This retrospective cohort study analyzed 51 patients (22 with ketamine-associated hydronephrosis and 29 with ketamine cystitis) from Kaohsiung Veterans General Hospital in Taiwan. Primary renal outcome was end-stage renal disease or estimated glomerular filtration rate decline >30% from baseline. Compared with the ketamine cystitis group, the hydronephrosis group had lower initial and final estimated glomerular filtration rates and higher alkaline phosphatase and gamma-glutamyl transferase levels (p < 0.05). Elevated cholestatic liver enzyme levels correlated with renal dysfunction in ketamine-associated uropathy. The hydronephrosis group had a higher proportion of patients reaching endpoints than the ketamine cystitis group (50% and 7%, respectively, p < 0.001). After adjusting for age, sex, and initial serum creatinine level, hydronephrosis remained an independent risk factor for renal function deterioration. Ketamine-associated hydronephrosis was a poor renal outcome and strong predictor of renal function decline in chronic ketamine abusers. Elevated cholestatic liver enzyme levels correlated with the severity of ketamine-associated uropathy. Ultrasonography screening of these high-risk groups and regular renal function follow-ups are necessary.
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Affiliation(s)
- Shih-Hsiang Ou
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ling-Ying Wu
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
| | - Hsin-Yu Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Chien-Wei Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Chih-Yang Hsu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Kang-Ju Chou
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Hua-Chang Fang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Po-Tsang Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (S.-H.O.); (H.-Y.C.); (C.-W.H.); (C.-Y.H.); (C.-L.C.); (K.-J.C.); (H.-C.F.)
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
- Correspondence: ; Tel.: +886-7342-2121 (ext. 8090)
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Chen H, Vandorpe DH, Xie X, Alper SL, Zeidel ML, Yu W. Disruption of Cav1.2-mediated signaling is a pathway for ketamine-induced pathology. Nat Commun 2020; 11:4328. [PMID: 32859919 PMCID: PMC7455701 DOI: 10.1038/s41467-020-18167-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/04/2020] [Indexed: 01/03/2023] Open
Abstract
The general anesthetic ketamine has been repurposed by physicians as an anti-depressant and by the public as a recreational drug. However, ketamine use can cause extensive pathological changes, including ketamine cystitis. The mechanisms of ketamine's anti-depressant and adverse effects remain poorly understood. Here we present evidence that ketamine is an effective L-type Ca2+ channel (Cav1.2) antagonist that directly inhibits calcium influx and smooth muscle contractility, leading to voiding dysfunction. Ketamine prevents Cav1.2-mediated induction of immediate early genes and transcription factors, and inactivation of Cav1.2 in smooth muscle mimics the ketamine cystitis phenotype. Our results demonstrate that ketamine inhibition of Cav1.2 signaling is an important pathway mediating ketamine cystitis. In contrast, Cav1.2 agonist Bay k8644 abrogates ketamine-induced smooth muscle dysfunction. Indeed, Cav1.2 activation by Bay k8644 decreases voiding frequency while increasing void volume, indicating Cav1.2 agonists might be effective drugs for treatment of bladder dysfunction.
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Affiliation(s)
- Huan Chen
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - David H Vandorpe
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Xiang Xie
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Seth L Alper
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mark L Zeidel
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Weiqun Yu
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Zirak MR, Karimi G, Rahimian R, Jafarian AH, Hayes AW, Mehri S. Tropisetron ameliorates cyclophosphamide-induced hemorrhagic cystitis in rats. Eur J Pharmacol 2020; 883:173310. [PMID: 32619674 DOI: 10.1016/j.ejphar.2020.173310] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/16/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 01/05/2023]
Abstract
Hemorrhagic cystitis is one of the most important complications of cyclophosphamide, a drug widely used in cancer chemotherapy and bone marrow transplantation. 5-HT3 antagonists are anti-emetic agents and have been shown to have notable anti-inflammatory and antioxidant properties. This study was designed to investigate the possible protective effects of tropisetron against cyclophosphamide-induced hemorrhagic cystitis in rats. Hemorrhagic cystitis was induced in female rats by cyclophosphamide (270 mg/kg). Tropisetron (2.5, 5 and 7.5 mg/kg), granisetron (2.5 and 5 mg/kg), and ondansetron (5 mg/kg) were injected 15 min before, 4 and 8 h after cyclophosphamide. To evaluate the role of alpha7 nicotinic acetylcholine receptor (α7nAChR), its antagonist, methyllycaconitine (5 mg/kg) was administered 30 min before tropisetron. After 24 h, animals were killed under anesthesia. Macroscopic and histological changes were evaluated. Malondialdehyde (MDA), glutathione (GSH) and Evans blue were measured spectrophotometrically. Furthermore, the protein levels of p38 mitogen-activated protein kinases (P38 MAPK), p-P38, signal transducer and activator of transcription 3 (STAT3), p-STAT3 and Poly (ADP-ribose) polymerase (PARP) were determined using Western blot. Cyclophosphamide administration significantly induced histopathological damages and increased MDA, p-p38/p38, p-STAT3/STAT3, and PARP levels compared with the saline group. Tropisetron treatment diminished histopathological injuries as well as MDA level, and STAT3 activity compared to cyclophosphamide treated rats. Co-administration of methyllycaconitine with tropisetron, partially or completely reversed the protective effects of tropisetron. Our results showed that prophylactic administration of tropisetron markedly ameliorated the cyclophosphamide-induced bladder hemorrhage and inflammation in rats. These effects of tropisetron were α7nAChR dependent.
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Affiliation(s)
- Mohammad Reza Zirak
- Pharmaceutical Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gholamreza Karimi
- Pharmaceutical Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Rahimian
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Amir Hossein Jafarian
- Cancer Molecular Pathology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Wallace Hayes
- University of South Florida College of Public Health, Tampa, FL, USA; Michigan State University, East Lansing, MI, USA
| | - Soghra Mehri
- Pharmaceutical Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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Wróbel A, Zapała Ł, Zapała P, Piecha T, Radziszewski P. The effect of O-1602, a GPR55 agonist, on the cyclophosphamide-induced rat hemorrhagic cystitis. Eur J Pharmacol 2020; 882:173321. [PMID: 32615180 DOI: 10.1016/j.ejphar.2020.173321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/25/2020] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 11/19/2022]
Abstract
The goal of our study was to determine whether GPR55 agonists, O-1602, could reverse the cyclophosphamide (CYP)-induced changes in cystometric and inflammatory parameters, indicative of the development of bladder inflammation and overactivity. If confirmed, the stimulation of novel cannabinoid receptor - GPR55, could be a reasonable strategy as a treatment of CYP-induced haemorrhagic cystitis. The experiments were conducted in female Wistar rats. Based on the methodology of our published studies on CYP-induced heamorrhagic cystitis we performed experiments after administration of CYP, O-1602 or CYP plus O-1602. These included surgical procedures, conscious cystometry, measurements of bladder oedema and urothelium thickness using the Evans Blue dye leakage technique, as well as biochemical analyses with particular ELISA kits. O-1602 ameliorated the symptoms of CYP-induced detrusor overactivity leading to an increase in voided volume (0.59 vs. 0.93 ml), and lowering the detrusor overactivity index (703 vs. 115 cm H2O/ml). Intravenous administration of the GPR55 agonist to animals that received CYP significantly decreased Evans Blue extravasation and increased urothelium thickness. O-1602 also reversed the pro-inflammatory activity of CYP by restoring concentrations of brain-derived neurotrophic factor, nerve growth factor, calcitonin gene related peptide, interleukin 1-beta, interleukin-6, tumour necrosis factor alpha, malondialdehyde, nitrotyrosine, occludin, and organic cation transporter 3. GPR55 agonist, O-1602, represents a novel class of uroprotective agents, targeting the inflammatory basis of cystitis. To our knowledge, this is the first paper proposing O-1602 agent, as a candidate for future studies in the treatment of CYP-induced cystitis.
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Affiliation(s)
- Andrzej Wróbel
- Second Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, 20-090, Lublin, Poland.
| | - Łukasz Zapała
- Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
| | - Piotr Zapała
- Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland
| | - Tomasz Piecha
- Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland
| | - Piotr Radziszewski
- Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland
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González-Cano R, Artacho-Cordón A, Romero L, Tejada MA, Nieto FR, Merlos M, Cañizares FJ, Cendán CM, Fernández-Segura E, Baeyens JM. Urinary bladder sigma-1 receptors: A new target for cystitis treatment. Pharmacol Res 2020; 155:104724. [PMID: 32105755 DOI: 10.1016/j.phrs.2020.104724] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 02/12/2020] [Accepted: 02/23/2020] [Indexed: 02/06/2023]
Abstract
No adequate treatment is available for painful urinary bladder disorders such as interstitial cystitis/bladder pain syndrome, and the identification of new urological therapeutic targets is an unmet need. The sigma-1 receptor (σ1-R) modulates somatic pain, but its role in painful urological disorders is unexplored. The urothelium expresses many receptors typical of primary sensory neurons (e.g. TRPV1, TRPA1 and P2X3) and high levels of σ1-R have been found in these neurons; we therefore hypothesized that σ1-R may also be expressed in the urothelium and may have functional relevance in this tissue. With western blotting and immunohistochemical methods, we detected σ1-R in the urinary bladder in wild-type (WT) but not in σ1-R-knockout (σ1-KO) mice. Interestingly, σ1-R was located in the bladder urothelium not only in mouse, but also in human bladder sections. The severity of histopathological (edema, hemorrhage and urothelial desquamation) and biochemical alterations (enhanced myeloperoxidase activity and phosphorylation of extracellular regulated kinases 1/2 [pERK1/2]) that characterize cyclophosphamide-induced cystitis was lower in σ1-KO than in WT mice. Moreover, cyclophosphamide-induced pain behaviors and referred mechanical hyperalgesia were dose-dependently reduced by σ1-R antagonists (BD-1063, NE-100 and S1RA) in WT but not in σ1-KO mice. In contrast, the analgesic effect of morphine was greater in σ1-KO than in WT mice. Together these findings suggest that σ1-R plays a functional role in the mechanisms underlying cyclophosphamide-induced cystitis, and modulates morphine analgesia against urological pain. Therefore, σ1-R may represent a new drug target for urinary bladder disorders.
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Affiliation(s)
- Rafael González-Cano
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, 18016, Spain; Anesthesia Department and Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain; Instituto de Investigación Biosanitaria, Ibs Granada, Spain
| | - Antonia Artacho-Cordón
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, 18016, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain
| | - Lucía Romero
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, 18016, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain
| | - Miguel A Tejada
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, 18016, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain
| | - Francisco R Nieto
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, 18016, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain; Instituto de Investigación Biosanitaria, Ibs Granada, Spain
| | - Manuel Merlos
- Drug Discovery and Preclinical Development, Esteve Pharmaceuticals SA, Barcelona, 08028, Spain
| | - Francisco J Cañizares
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain; Instituto de Investigación Biosanitaria, Ibs Granada, Spain; Department of Histology, Faculty of Medicine, University of Granada, Granada, 18016, Spain
| | - Cruz M Cendán
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, 18016, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain; Instituto de Investigación Biosanitaria, Ibs Granada, Spain
| | - Eduardo Fernández-Segura
- Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain; Instituto de Investigación Biosanitaria, Ibs Granada, Spain; Department of Histology, Faculty of Medicine, University of Granada, Granada, 18016, Spain
| | - José M Baeyens
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, 18016, Spain; Institute of Neuroscience, Biomedical Research Center, University of Granada, Armilla (Granada), 18100, Spain; Instituto de Investigación Biosanitaria, Ibs Granada, Spain.
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Patel B, Perez F, Aronsson P, Alothmani R, Carlsson T, Winder M. Combination drug therapy against OAB normalizes micturition parameters and increases the release of nitric oxide during chemically induced cystitis. Pharmacol Res Perspect 2020; 8:e00564. [PMID: 32030913 PMCID: PMC7005531 DOI: 10.1002/prp2.564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/12/2020] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 01/25/2023] Open
Abstract
Today, monotherapy is the most common pharmacological treatment option for patients suffering from overactive bladder (OAB). Recent reports have indicated potential benefits of combination therapy, using a muscarinic antagonist and a β3 -adrenoceptor agonist. This may be of particular interest for therapy-resistant patients with OAB and concomitant cystitis. The objective of the current study was to assess how combination therapy affects bladder parameters in health and cystitis and if the efficacy of the drugs can be linked to altered release of nitric oxide (NO). Rats were pretreated with either a combination of the muscarinic antagonist tolterodine and β3 -selective adrenoceptor agonist mirabegron or saline for 10 days. Forty-eight hours prior to assessing micturition parameters in a metabolic cage, the rats were intraperitoneally injected with cyclophosphamide, causing cystitis, or saline. Urine samples were collected and analyzed for NO content. Bladder contractile properties were assessed in an organ bath setup. Induction of cystitis led to bladder overactivity. Combination therapy normalized bladder parameters. Both induction of cystitis and drug treatment increased the release of NO. The innate contractile properties of the bladder were unaffected by combination therapy. This study demonstrates positive effects of combination drug therapy on symptoms of OAB, possibly indicating it to be a good option for treatment of OAB during concomitant cystitis. It remains to be determined if increased release of NO is crucial for successful pharmacological treatment of bladder overactivity during cystitis.
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Affiliation(s)
- Bhavik Patel
- Department of Pharmacy and Biomolecular SciencesUniversity of BrightonBrightonUK
- Centre for Stress and Age‐Related DiseasesUniversity of BrightonBrightonUK
| | - Fernando Perez
- Department of Pharmacy and Biomolecular SciencesUniversity of BrightonBrightonUK
- Centre for Stress and Age‐Related DiseasesUniversity of BrightonBrightonUK
| | - Patrik Aronsson
- Department of PharmacologyInstitute of Neuroscience and PhysiologyThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Ranya Alothmani
- Department of PharmacologyInstitute of Neuroscience and PhysiologyThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Thomas Carlsson
- Department of PharmacologyInstitute of Neuroscience and PhysiologyThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Michael Winder
- Department of PharmacologyInstitute of Neuroscience and PhysiologyThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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Narla ST, Bushnell DS, Schaefer CM, Nouraie M, Bates CM. Keratinocyte Growth Factor Reduces Injury and Leads to Early Recovery from Cyclophosphamide Bladder Injury. Am J Pathol 2020; 190:108-124. [PMID: 31654636 PMCID: PMC6943803 DOI: 10.1016/j.ajpath.2019.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/24/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022]
Abstract
Keratinocyte growth factor (KGF) improves cyclophosphamide-induced bladder injury. To understand the mechanisms, we subcutaneously administered KGF to mice 24 hours before i.p. cyclophosphamide administration, followed by histologic assays and immunostaining. In vehicle (phosphate-buffered saline)-pretreated mice, nonapoptotic superficial cell death from 2 to 6 hours and apoptosis in intermediate and basal cells from 4 to 24 hours was observed after cyclophosphamide. Despite superficial cell loss, KGF suppressed intermediate and basal cell apoptosis, likely via AKT signaling. At 6 and 24 hours after cyclophosphamide, KGF-pretreated mice also had apparent extracellular signal-regulated kinase (ERK)-driven proliferation of mostly keratin 5 (KRT5)+/KRT14- intermediate cells. At 1 to 28 days after cyclophosphamide treatment, mostly KRT14+ basal progenitor cells proliferated in response to injury, peaking at 3 days in both treatment groups; however, proliferation rates were lower in the KGF group at 3 days, consistent with less injury. Three days after injury, unlike controls, KGF-pretreated mice had regenerated superficial cells. At 10 and 28 days after cyclophosphamide treatment, KGF-pretreated mice had little proliferation and marked restoration of urothelial layers, whereas the phosphate-buffered saline group had ongoing regeneration. Administration of KGF to uninjured mice reproduced ERK-driven KRT5+/KRT14- proliferation seen in injured mice; KRT14+ cells were unaffected. KGF pretreatment blocks cyclophosphamide-induced intermediate and basal cell apoptosis, likely by phosphorylated AKT, and drives phosphorylated ERK-mediated KRT5+/KRT14- cell proliferation, leading to early urothelial regeneration.
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Affiliation(s)
- Sridhar T Narla
- Division of Nephrology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Daniel S Bushnell
- Division of Nephrology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Caitlin M Schaefer
- Division of Nephrology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Mehdi Nouraie
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Carlton M Bates
- Division of Nephrology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Division of Nephrology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
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Nausch B, Pace S, Pein H, Koeberle A, Rossi A, Künstle G, Werz O. The standardized herbal combination BNO 2103 contained in Canephron ® N alleviates inflammatory pain in experimental cystitis and prostatitis. Phytomedicine 2019; 60:152987. [PMID: 31257118 DOI: 10.1016/j.phymed.2019.152987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 06/03/2019] [Accepted: 06/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Urinary tract infections are among the most common types of infections and give rise to inflammation with pain as one of the main symptoms. The herbal medicinal product Canephron® N contains BNO 2103, a defined mixture of pulverized rosemary leaves, centaury herb, and lovage root, and has been used in the treatment of urinary tract infections for more than 25 years. PURPOSE To test the hypothesis that BNO 2103 reduces pain in cystitis and prostatitis by virtue of anti-inflammatory properties, and to reveal potential mechanisms underlying the anti-inflammatory features. STUDY DESIGN BNO 2103 was studied for anti-inflammatory and analgesic properties in three animal models in vivo, and the mode of action underlying the anti-inflammatory features was investigated in human leukocytes and cell-free assays in vitro. METHODS To assess the anti-inflammatory and analgesic efficacy of BNO 2103 we employed cyclophosphamide-induced cystitis and carrageenan-induced prostatitis in rats, and zymosan-induced peritonitis in mice. Human neutrophils and monocytes as well as isolated human 5-lipoxygenase and microsomal prostaglandin E2 synthase-1-containing microsomes were utilized to assess inhibition of leukotriene and/or prostaglandin E2 production by HPLC and/or ELISA. RESULTS When given orally, BNO 2103 reduced inflammation and hyperalgesia in experimental cystitis in rats, while individual components of BNO 2103 also reduced hyperalgesia. Furthermore, BNO 2103 reduced hyperalgesia in rats with carrageenan-induced prostatitis. Cell-based and cell-free studies implicate inhibition of prostaglandin E2 and leukotriene B4 biosynthesis as potential mechanisms underlying the analgesic and anti-inflammatory effects. CONCLUSION Our data support the hypothesis that BNO 2103 reduces pain by virtue of its anti-inflammatory properties, possibly related to suppression of prostaglandin E2 and leukotriene B4 formation, and suggest that this combination has the potential to treat clinical symptoms such as inflammatory pain. Thus BNO 2103 may represent an alternative to reduce the use of antibiotics in urinary tract infections.
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Affiliation(s)
- Bernhard Nausch
- Bionorica SE, Kerschensteinerstrasse 11-15, 92318 Neumarkt, Germany.
| | - Simona Pace
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Helmut Pein
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Andreas Koeberle
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Antonietta Rossi
- Department of Pharmacy, School of Medicine, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Gerald Künstle
- Bionorica SE, Kerschensteinerstrasse 11-15, 92318 Neumarkt, Germany
| | - Oliver Werz
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany.
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Ryu CM, Shin JH, Yu HY, Ju H, Kim S, Lim J, Heo J, Lee S, Shin DM, Choo MS. N-acetylcysteine prevents bladder tissue fibrosis in a lipopolysaccharide-induced cystitis rat model. Sci Rep 2019; 9:8134. [PMID: 31148586 PMCID: PMC6544636 DOI: 10.1038/s41598-019-44631-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/16/2019] [Indexed: 12/24/2022] Open
Abstract
Therapeutic options for non-Hunner type interstitial cystitis (IC), which is histologically characterized by fibrosis and mast cell infiltration, are limited. We developed a rat model that replicates chronic inflammation and fibrosis and evaluated the therapeutic effect of N-acetylcysteine (NAC), a well-known anti-fibrotic agent, on the model. Intravesical instillation of lipopolysaccharide (LPS, 750 μg) after protamine sulfate (10 mg) was conducted twice per week for five consecutive weeks. One week after final instillation, 200 mg/kg NAC (n = 10, IC + NAC group) or phosphate-buffered saline (n = 10, IC group) was daily injected intraperitoneally once daily for 5 days. LPS instillation induced bladder fibrosis, mast cell infiltration, and apoptotic tissue damage. Functionally, LPS insult led to irregular micturition, decreased inter-contraction intervals, and decreased micturition volume. NAC significantly improved most of the voiding parameters and reversed histological damages including fibrosis. NAC inhibited the induction and nuclear localization of phospho-Smad2 protein in bladder tissues and the upregulation of genes related to fibrosis, such as Tgfb2, Tgfb3, Smad2, Smad3, Cxcl10, and Card10. This is the first study to demonstrate the beneficial effects on NAC in restoring voiding function, relieving tissue fibrosis and related bladder injuries, in the LPS-induced cystitis rat model.
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Affiliation(s)
- Chae-Min Ryu
- Department of Urology, University of Ulsan College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Hyun Shin
- Department of Urology, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwan Yeul Yu
- Department of Urology, University of Ulsan College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyein Ju
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
- Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sujin Kim
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
- Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jisun Lim
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
- Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinbeom Heo
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
- Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seungun Lee
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea
- Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Myung Shin
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, Korea.
- Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Myung-Soo Choo
- Department of Urology, University of Ulsan College of Medicine, Seoul, Korea.
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