Khera Mohit, Somogyi George T, Salas Nilson A, Kiss Susanna, Boone Timothy B, Smith Christopher P
Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA.
Urology. 2005 Jul;66(1):208-12. doi: 10.1016/j.urology.2005.01.055.
To analyze the in vivo effects of botulinum toxin type A (BTX-A) on visceral sensory function in chronic spinal cord-injured (SCI) rats.
One group of rats underwent spinal cord transection at the T8-T9 level (SCI) and the other group was left untreated. In 21 days, baseline open cystometrography (CMG) was performed. The rats were then treated intravesically with either 1 mL of 1% protamine sulfate (PS) to increase urothelial permeability or saline, followed by either 1 mL of BTX-A (20 U) or saline. CMG was repeated 48 hours after instillation, and any changes in the bladder contraction frequency and amplitude were evaluated.
After the instillation of PS and BTX-A or BTX-A alone, the bladder contraction frequency was significantly decreased in the SCI rats compared with the control rats (P < 0.05); no change was seen in the contraction amplitude. When normal rats were given intravesical PS and/or BTX-A, or SCI animals were treated with PS alone, neither the frequency nor the amplitude of the contractions was affected. Also, no significant differences were found in the bladder contraction frequency or amplitude of contractions in any animal treated with instillation of saline alone.
Intravesical BTX-A inhibits bladder sensory mechanisms by reducing the frequency of bladder contractions in an SCI rat model. Furthermore, our results suggest that intravesically applied BTX-A does not penetrate to the smooth muscle layer even after PS disruption of the bladder urothelium. These findings may have important clinical applications in treating overactive bladders after SCI.
分析A型肉毒杆菌毒素（BTX-A）对慢性脊髓损伤（SCI）大鼠内脏感觉功能的体内作用。
一组大鼠在T8-T9水平进行脊髓横断（SCI），另一组不做处理。21天后，进行基线膀胱压力容积测定（CMG）。然后给大鼠膀胱内注射1 mL 1%硫酸鱼精蛋白（PS）以增加膀胱上皮通透性或注射生理盐水，随后注射1 mL BTX-A（20 U）或生理盐水。滴注48小时后重复CMG，评估膀胱收缩频率和幅度的任何变化。
与对照大鼠相比，SCI大鼠在注射PS和BTX-A或单独注射BTX-A后，膀胱收缩频率显著降低（P < 0.05）；收缩幅度未见变化。当给正常大鼠膀胱内注射PS和/或BTX-A，或给SCI动物单独注射PS时，收缩频率和幅度均未受影响。此外，单独注射生理盐水的任何动物的膀胱收缩频率或收缩幅度均未发现显著差异。
膀胱内注射BTX-A通过降低SCI大鼠模型中的膀胱收缩频率来抑制膀胱感觉机制。此外，我们的结果表明，即使在PS破坏膀胱上皮后，膀胱内应用的BTX-A也不会渗透到平滑肌层。这些发现可能在治疗SCI后膀胱过度活动症方面具有重要的临床应用价值。
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