Astragalus Polysaccharides Ameliorate Diabetic Bladder Dysfunction via Normalization of Neuromuscular Conduction

Neuromuscular conduction dysfunction-induced underactive bladder (UAB) is a major urological complication associated with diabetes mellitus (DM), and there remain deficiencies in reliable pharmacological treatment options. Astragalus polysaccharides (APS), as an edible active substance in Astragalus membranaceus, have a therapeutic effect on diabetes and its complications. We investigated the effects and mechanism of APS in high-fat-diet-induced (HFD) diabetic UAB mice. APS significantly reduced fasting plasma glucose, insulin, and HOMA-IR index. Furthermore, APS treatment significantly decreased maximum bladder capacity, residual volume, bladder compliance, contraction intervals, empty and full resting pressure, and increased voiding volume and voided efficiency. In addition, APS ameliorated the hyporesponsiveness of purinergic and cholinergic-mediated neuromuscular contraction of the detrusor and improved the dysregulation of inhibitory and excitatory neurotransmission by downregulating the levels of nNOS and VIP, and upregulating ChAT and SP in HFD mice. This study revealed that APS ameliorates diabetic UAB via the normalization of neuromuscular conduction.