De Ridder D, Roskams T, Van Poppel H, Baert L
Nationaal MS Centrum, Steenokkerzeel.
Acta Neurol Belg. 1999 Mar;99(1):57-60.
Neurogenic bladders are susceptible to bladder cancer development, especially in the case of chronic indwelling catheters. The classic carcinogenesis theory involves the formation of carcinogenic nitrosamines by bacteria due to chronic infection. We designed a pilot study to evaluate the expression of the of Nitric Oxide Synthase (NOS) isoforms in bladder tissue to study the role of the endogenous formation of NO (Nitric Oxide) in neurogenic bladders. Immunohistochemistry was performed on bladder biopsies from neurogenic, normal, and obstructed bladders. The neurogenic bladder had a higher expression of endothelial NOS (eNOS), but especially of neuronal NOS (nNOS). Besides, this extra-neuronal expression of nNOS by urothelium and interstitial cells was observed. This study proves the important role of endogenous formation of NO by suburothelial nerves but also by urothelium and interstitial cells. This overexpression could possibly be a factor in the higher incidence of bladder cancer in neurogenic bladders. On the other hand, it shows the plasticity of the NO pathways in these cases and raises important research questions concerning the physiological role of these changes.
神经源性膀胱易发生膀胱癌，尤其是在长期留置导尿管的情况下。经典的致癌理论认为，由于慢性感染，细菌会形成致癌亚硝胺。我们设计了一项初步研究，以评估膀胱组织中一氧化氮合酶（NOS）亚型的表达，从而研究内源性一氧化氮（NO）在神经源性膀胱中的作用。对神经源性膀胱、正常膀胱和梗阻性膀胱的活检组织进行了免疫组织化学检测。神经源性膀胱中内皮型NOS（eNOS）的表达较高，尤其是神经元型NOS（nNOS）。此外，还观察到尿路上皮和间质细胞存在这种nNOS的神经元外表达。这项研究证明了膀胱上皮下神经以及尿路上皮和间质细胞内源性生成NO的重要作用。这种过表达可能是神经源性膀胱中膀胱癌发病率较高的一个因素。另一方面，它显示了这些情况下NO途径的可塑性，并提出了有关这些变化的生理作用的重要研究问题。
