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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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Miceli LM, Antosh DD, Nisar T, Stewart J, Rutledge EC, Khavari R. Pain Related to Intradetrusor BotulinumtoxinA: A Randomized Clinical Trial. Urogynecology (Phila) 2024; 30:337-344. [PMID: 38484251 DOI: 10.1097/spv.0000000000001487] [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] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
IMPORTANCE OnabotulinumtoxinA (BTX-A) is an effective treatment for overactive bladder (OAB), but few studies have been done to evaluate injection techniques. OBJECTIVE The primary objective was to evaluate procedural discomfort between 2 commonly used injection techniques for BTX-A. STUDY DESIGN This was a single-blinded, randomized clinical trial of women undergoing injection of 100 U BTX-A for idiopathic OAB. Patients were randomized to 5 mL/5 injection or 10 mL/10 injection groups. Bladder pain was assessed by a validated Numeric Pain Rating Scale. Overactive bladder symptoms were assessed with a standardized questionnaire (Overactive Bladder Questionnaire Short Form). Patient satisfaction, treatment efficacy, and adverse events were assessed at 30 days after procedure. RESULTS One hundred eight patients were randomized to 52 in the 5 mL/5 injection arm and 56 in the 10 mL/10 injection arm. Mean procedural pain scores were 3.2 (±2.3) in the 5 mL/5 injection group versus 3.6 (±2.1) in the 10 mL/10 injection group (P = 0.21). No difference was found when categorizing pain scores into ordinal outcomes of low (P = 0.55), medium (P = 0.70), and high (P = 1.0) or a binary outcome of low (P = 0.55) versus medium + high (P = 0.55). Multivariate analyses did not effect statistical significance between the 2 groups for the ordinal outcome (odds ratio = 1.86; 95% confidence interval = 0.77 = 4.52; P = 0.17) or the binary outcome (odds ratio = 1.81; 95% confidence interval = 0.68-4.77; P = 0.28). No difference was observed between overall patient satisfaction, global impression of improvement, Overactive Bladder Questionnaire Short Form scores, or adverse outcomes. CONCLUSIONS Procedural discomfort related to BTX-A injection for idiopathic OAB was not different between 2 injection protocols. Overall satisfaction was high for both groups, and there was no difference in symptom scores or adverse events.
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Affiliation(s)
- Lia M Miceli
- From the Division of Female Pelvic Medicine and Reconstructive Surgery, Houston Methodist Department of Obstetrics and Gynecology
| | - Danielle D Antosh
- From the Division of Female Pelvic Medicine and Reconstructive Surgery, Houston Methodist Department of Obstetrics and Gynecology
| | - Tariq Nisar
- Houston Methodist Research Institute, Center for Health Data Science & Analytics
| | - Julie Stewart
- Division of Female Pelvic Medicine and Reconstructive Surgery, Houston Methodist Department of Urology, Houston, TX
| | - Emily C Rutledge
- From the Division of Female Pelvic Medicine and Reconstructive Surgery, Houston Methodist Department of Obstetrics and Gynecology
| | - Rose Khavari
- Division of Female Pelvic Medicine and Reconstructive Surgery, Houston Methodist Department of Urology, Houston, TX
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Wu ZS, Wang HJ, Lee WC, Luo HL, Lin TK, Chuang YC. Low-Energy Shock Wave Suppresses Prostatic Pain and Inflammation by Modulating Mitochondrial Dynamics Regulators on a Carrageenan-Induced Prostatitis Model in Rats. Int J Mol Sci 2023; 24:ijms24043898. [PMID: 36835316 PMCID: PMC9968097 DOI: 10.3390/ijms24043898] [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: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
A low-energy shock wave (LESW) has therapeutic effects on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS); however, its mechanism of action remains unclear. We explored the effects of LESW on the prostate and mitochondrial dynamics regulators in a rat model of carrageenan-induced prostatitis. The imbalance of mitochondrial dynamics regulators may affect the inflammatory process and molecules and contribute to CP/CPPS. Male Sprague-Dawley rats received intraprostatic 3% or 5% carrageenan injections. The 5% carrageenan group also received LESW treatment at 24 h, 7 days, and 8 days. Pain behavior was evaluated at baseline, 1 week, and 2 weeks after a saline or carrageenan injection. The bladder and the prostate were harvested for immunohistochemistry and quantitative reverse-transcription polymerase chain reaction analysis. Intraprostatic carrageenan injection induced inflammatory reaction in the prostate and the bladder, decreased the pain threshold, and resulted in the upregulation of Drp-1, MFN-2, NLRP3 (mitochondrial integrity markers), substance P, and CGRP-RCP, whose effects were maintained for 1-2 weeks. LESW treatment suppressed carrageenan-induced prostatic pain, inflammatory reaction, mitochondrial integrity markers, and expression of sensory molecules. These findings support a link between the anti-neuroinflammatory effects of LESW in CP/CPPS and the reversal of cellular perturbations caused by imbalances in mitochondrial dynamics in the prostate.
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Affiliation(s)
- Zong-Sheng Wu
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Hung-Jen Wang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Wei-Chia Lee
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Hou Lun Luo
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Tsu-Kung Lin
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 833, Taiwan
- Center for Mitochondrial Research and Medicine, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Yao-Chi Chuang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 833, Taiwan
- Correspondence: ; Tel.: +886-7-7317123 (ext. 8094)
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Corcostegui SP, Doutre M, Marchandeau M. Rare complication of antimalarial prophylaxis by doxycycline: drug-related pollakiuria. Med Sante Trop 2019; 29:108-109. [PMID: 31031234 DOI: 10.1684/mst.2019.0879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We report the case of a French soldier deployed in Chad, who developed disabling pollakiuria after starting antimalarial prophylaxis by doxycycline. This rare secondary effect is not mentioned in reference books.
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Affiliation(s)
- S P Corcostegui
- 1re Antenne médicale spécialisée, 34 rue de la Martinière 78000 Versailles, France
| | - M Doutre
- Centre médical des armées de Saint-Dizier, Saint-Dizier
| | - M Marchandeau
- Pharmacie centrale des armées, 45400 Chanteau, France
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Wein AJ. Re: One-stop clinic for ketamine-associated uropathy: report on service delivery model, patients' characteristics and non-invasive investigations at baseline by a cross-sectional study in a prospective cohort of 318 teenagers and young adults. J Urol 2015; 193:2033-4. [PMID: 25986813 DOI: 10.1016/j.juro.2015.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 11/19/2022]
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Reinhardt S, Fode M. [Bladder pain and urinary tract symptoms as a consequence of ketamine abuse]. Ugeskr Laeger 2014; 176:240-242. [PMID: 24629752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A recent study has shown that ketamine has become popular among Danish clubgoers. The drug can induce psychedelic effects but it also has serious urological side effects, such as frequency and urgency in relation to voiding as well as pain from the bladder and haematuria. Ketamine can also induce histological bladder changes. Mild changes are reversible on cessation of ketamine abuse but long-term abuse can cause fibrosis of the bladder and may necessitate cystectomy. Therefore, physicians should ask young patients with bladder symptoms of unknown pathology about ketamine abuse.
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Affiliation(s)
- Susanne Reinhardt
- Urologisk Afdeling D, Rigshospitalet, Blegdamsvej 9, 2100 København Ø.
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Mathlouthi N, Slimani O, Ferchichi A, Ben Temime R, Makhlouf T, Attia L, Chachia A. [Medical treatment of ectopic pregnancy]. Tunis Med 2013; 91:435-439. [PMID: 24008873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The ectopic pregnancy (EP) is a public health problem and its frequency has doubled in most industrialized countries in 20 years. aim: To evaluate the effectiveness of medical treatment of ectopic pregnancy with methotrexate (MTX) intramuscularly (IM). METHODS prospective study supported between October 2006 and December 2010. The selected patients received methotrexate IM (1 mg per kg). The monitoring was based on: the kinetics of plasma HCG, clinical examination and ultrasound. A second injection was performed if hCG on day 4 was increased by more than 25% or J7> the initial rate. Healing corresponded to obtain a zero rate of HCG in a stable manner. RESULTS We used the first-line medical treatment in 122 patients. The average age of patients was 31.94 years. A haematosalpinx was found in 87.70% of cases. The initial rate of HCG plasma varied between 40 IU/ml and 4088 IU / ml, with an average of 805.88 m IU / ml. The primary success rate obtained after a single injection of intramuscular MTX was 67%. The high success rate obtained after two injections of MTX was 27%. The overall success rate after 1 or 2 injections of MTX was 82%. 17 patients underwent surgical treatment after a first injection of methotrexate. 5 patients underwent surgery after receiving two doses of methotrexate. The period of normalization of plasma levels of h CG was 24 days on average, with extremes ranging from 4 to 43 days for 67 patients cured after a single injection of MTX. This period was 33 days on average, with extremes ranging from 8 to 62 days for patients healed after two injections of MTX. CONCLUSION Medical treatment applied to 38% of ectopic pregnancies diagnosed in our department is effective in 82% of cases if the inclusion criteria are strictly adhered to. Successful treatment is limited by patient compliance and demanding nature of monitoring.
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Ziltener JL, Leal S. [Pelvic pain in the athlete: not always that simple...]. Rev Med Suisse 2012; 8:210-212. [PMID: 22338520] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- J-L Ziltener
- Unité de médecine physique, Service d'orthopédie, Département de chirurgie, HUG, 1211 Genève 14.
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Jun SH, Lathi RB. Pelvic pain after gonadotropin administration as a potential sign of endometriosis. Fertil Steril 2007; 88:986-7. [PMID: 17428478 DOI: 10.1016/j.fertnstert.2006.12.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Revised: 12/27/2006] [Accepted: 12/27/2006] [Indexed: 10/23/2022]
Abstract
We describe five patients who developed significant pelvic pain, requiring narcotics, during a controlled ovarian hyperstimulation cycle and who were surgically diagnosed with significant endometriosis. Severe pain, especially if it requires narcotics, is unusual for patients undergoing controlled ovarian hyperstimulation and may be an indicator of endometriosis.
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Affiliation(s)
- Sunny Hee Jun
- Department of Reproductive Endocrinology and Infertility, Stanford University Medical Center, Stanford, California 94305, USA
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Nirmal D, Griffiths AN, Jose G, Evans J. Warming Echovist contrast medium for hysterocontrastsonography and the effect on the incidence of pelvic pain. A randomized controlled study. Hum Reprod 2005; 21:1052-4. [PMID: 16373408 DOI: 10.1093/humrep/dei440] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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: 11/13/2022] Open
Abstract
BACKGROUND Hysterocontrastsonography (HyCoSy) is a simple effective investigation of tubal patency. One common side effect is pelvic pain at the time of the procedure. The temperature of the contrast media used may be a causative agent for pelvic pain. This study was designed to assess the effect of warming the contrast to body temperature compared to room temperature on the incidence of pelvic pain. METHODS A randomized controlled trial was carried out at the Cardiff Assisted Reproduction Unit. Following ethical approval, all women having HyCoSy for tubal assessment were asked if they would be willing to participate in the study. Computer-generated numbers were placed in opaque sealed envelopes, which were opened by the fertility nurse at the time of procedure. The women were randomized into two arms to receive the contrast medium at either room temperature or at body temperature. Randomization was done according to CONSORT guidelines. The pain experienced was then recorded by the patient on a 10-cm visual analogue scale. RESULTS The mean pain scores in the room temperature and the body temperature arms were 5.1 and 3.86, respectively. This was statistically significant (P = 0.006). CONCLUSION Warming of Echovist contrast media to body temperature is a simple and effective intervention in reducing discomfort at the time of HyCoSy.
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Affiliation(s)
- D Nirmal
- Cardiff Assisted Reproduction Unit, Department of Obstetrics and Gynaecology, University Hospital of Wales, Heath Park, Cardiff, UK
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Coutinho SV, Su X, Sengupta JN, Gebhart GF. Role of sensitized pelvic nerve afferents from the inflamed rat colon in the maintenance of visceral hyperalgesia. Prog Brain Res 2001; 129:375-87. [PMID: 11098705 DOI: 10.1016/s0079-6123(00)29029-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- S V Coutinho
- Department of Pharmacology, College of Medicine, University of Iowa, Iowa City 52242, USA
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Björklund K, Nordström ML, Odlind V. Combined oral contraceptives do not increase the risk of back and pelvic pain during pregnancy or after delivery. Acta Obstet Gynecol Scand 2000; 79:979-83. [PMID: 11081684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVES To elucidate whether the duration of previous use of combined oral contraceptives (COC) is associated with disabling back or pelvic pain during pregnancy and pain persisting eight months after delivery. METHODS Questionnaires were distributed to a group of women at 36 weeks of pregnancy and eight months after their delivery. There were no exclusion criteria. Disabling pain was defined as moderate or severe pain restricting physical activity. Multiple logistic regression analysis of disabling pain during pregnancy and persistent pain after delivery comprised the duration of COC use adjusted for age, pain in a previous pregnancy and a history of back pain when not pregnant. RESULTS The study comprised 161 women. Pain during pregnancy was classified as disabling in 57 of the women (35%), pain in a previous pregnancy being a risk factor, odds ratio (OR) 5.0 (95% CI 2.1; 12.1), whereas no association was found with the duration of COC use. Persistent pain eight months after delivery was reported by 41 women (26%), risk factors being a history of back pain when not pregnant; OR 7.5 (2.8; 19.5), disabling pain in the recent pregnancy; OR 5.0 (1.9; 13.4), and short use of COC; 0-<1 year; OR 4.2 (1.3; 12.9), 1-<5 years; OR 4.6 (1.5; 14.4) (reference=>10 years). CONCLUSION The results indicate that non- or short term users of COC have an increased risk of persistent pain after delivery compared to long term users. No association was found between the duration of COC use and back or pelvic pain during pregnancy.
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Affiliation(s)
- K Björklund
- Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Sweden
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Ruggieri MR, Filer-Maerten S, Hieble JP, Hay DW. Role of neurokinin receptors in the behavioral effect of intravesical antigen infusion in guinea pig bladder. J Urol 2000; 164:197-202. [PMID: 10840459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE To characterize a guinea pig behavior model of bladder pain due to intravesical antigen infusion and to determine the role of neurokinin receptor subtypes in mediating this behavior. MATERIALS AND METHODS The influence of subtype-selective neurokinin receptor antagonists on increased abdominal licking behavior in response to intravesical antigen infusion in guinea pigs immunized with ovalbumin (OA) was determined. RESULTS Intravesical OA infusion for 30 minutes induced a significantly greater frequency (about 3-fold) of abdominal licking behavior than during either the 30 minutes pre-challenge or post challenge saline infusions. Treatment with IP capsaicin 7 to 10 days before OA challenge abolished the intravesical antigen-induced behavior. IP injection of the NK1 receptor antagonist CP 99994 (10 mg./kg. or 30 mg./kg.), 30 minutes pretreatment, inhibited the increase in the average number of abdominal licks during antigen infusion. The 30 mg./kg., but not the 10 mg./kg. dose increased the percent of animals showing antinociceptive activity (defined as 4 or less abdominal licks during the antigen infusion). The NK2 receptor antagonist SR 48968 reduced the antigen-induced abdominal licking behavior at IP doses of 3 and 10 mg./kg. but was ineffective at 1 mg./kg. The NK3 receptor antagonist SB 235375 (30 mg./kg., IP) did not reduce this behavior. CONCLUSIONS These results suggest a role for activation of NK1 and NK2, but not NK3 receptors, by tachykinins released from capsaicin-sensitive nerves, in the increased abdominal licking behavior response of guinea pigs to intravesical antigen infusion.
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Affiliation(s)
- M R Ruggieri
- Department of Pharmacology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA
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Abstract
OBJECTIVE To measure the timing, frequency, and severity of hormone-related symptoms in oral contraceptive (OC) users, specifically to compare active-pill with hormone-free intervals. METHODS Using daily diaries, women recorded pelvic pain, bleeding, headaches, analgesic use, nausea or vomiting, bloating or swelling, and breast tenderness during active-pill intervals and hormone-free intervals. Participants either had no prior OC use, had taken OCs and were restarting, or had been taking OCs continuously for 12 months or longer. RESULTS Two hundred sixty-two women, 26 with no previous OC use, 43 prior users, and 193 current users, provided daily records of hormone-related symptoms. Subjects with no prior OC use and prior users restarting were similar in no recent OC use, and because of the small sample, they were pooled for analysis as new-start OC users. Current users had patterns of symptoms that were more frequent during hormone-free intervals than during the three active-pill weeks. These included pelvic pain (70% versus 21%, P < .001), headaches (70% versus 53%, P < .001), use of pain medication (69% versus 43%, P < .001), bloating or swelling (58% versus 19%, P < .001), and breast tenderness (38% versus 16%, P < .001). Similar patterns were seen in new-start OC users after the first cycle. Among new-start OC users, menstrual flow patterns, headache, bloating or swelling, and breast-tenderness symptoms decreased during the three cycles to approach those levels of current users. CONCLUSION Almost all symptoms assessed were significantly worse during the 7-day hormone-free interval than during the 21 days of hormone-containing pills.
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Affiliation(s)
- P J Sulak
- Department of Obstetrics and Gynecology, Scott and White Clinic and Memorial Hospital, Texas A&M University Health Science Center College of Medicine, Temple 76508, USA.
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