Urothelial Barrier Deficits, Suburothelial Inflammation and Altered Sensory Protein Expression in Detrusor Underactivity

No AccessJournal of UrologyAdult Urology1 Jan 2017Urothelial Barrier Deficits, Suburothelial Inflammation and Altered Sensory Protein Expression in Detrusor Underactivity Yuan-Hong Jiang and Hann-Chorng Kuo Yuan-Hong JiangYuan-Hong Jiang More articles by this author and Hann-Chorng KuoHann-Chorng Kuo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.07.071AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The pathophysiology of detrusor underactivity remains unclear and impaired bladder afferent function is considered one of the important etiologies. We investigated urothelial barrier deficits, suburothelial inflammation and sensory proteins expressed in the bladder mucosa of patients with detrusor underactivity. Materials and Methods: Bladder mucosa biopsies were performed in 34 patients with videourodynamic proven detrusor underactivity as the study group and in 10 women with stress urinary incontinence as controls. The expression of zona occuldens-1, E-cadherin in the urothelium, tryptase and apoptosis levels in the suburothelium, β3-adrenoceptor, M2 and M3 muscarinic receptors, P2X3 receptor, and inducible and endothelial nitric oxide synthase were compared between study patients and controls. Results: Study patients included 22 women and 12 men with a mean ± SD age of 56.3 ± 19.7 years, of whom 15 had a history of diabetes. Study patients had significantly lower E-cadherin expression, and a higher number of mast cells and apoptotic cells than controls. Additionally, lower expression of M2 and M3 muscarinic receptors, P2X3 receptors and endothelial nitric oxide synthase was detected in study patients but higher expression of β3-adrenoceptor. In study patients a positive correlation was noted between tryptase and apoptosis levels (r = 0.527) and between the expression of M2 muscarinic receptor and P2X3 receptor (r = 0.403). However, β3-adrenoceptor expression negatively correlated with E-cadherin expression (r = –0.490, each p <0.05). Conclusions: Urothelial dysfunction, increased suburothelial inflammation and altered sensory protein expressions in bladder mucosa were prominent in patients with detrusor underactivity. Impaired urothelial signaling and sensory transduction pathways appear to reflect the pathophysiology of detrusor underactivity. References 1 : Detrusor underactivity: a plea for new approaches to a common bladder dysfunction. Neurourol Urodyn2011; 30: 723. Google Scholar 2 : The other bladder syndrome: underactive bladder. Rev Urol2013; 15: 11. Google Scholar 3 : Aging and the underactive detrusor: a failure of activity or activation?. Neurourol Urodyn2010; 29: 408. 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Volume 197Issue 1January 2017Page: 197-203 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordsurinary bladder neck obstructionproteininflammationmuscle contractionafferent pathwaysMetricsAuthor Information Yuan-Hong Jiang More articles by this author Hann-Chorng Kuo More articles by this author Expand All Advertisement PDF downloadLoading ...