Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Glenolden, Pennsylvania 19036-2307, USA.
Am J Physiol Regul Integr Comp Physiol. 2011 Jun;300(6):R1392-400. doi: 10.1152/ajpregu.00804.2010. Epub 2011 Apr 6.
Chronic pelvic pain of unknown etiology is a common clinical condition and may develop as a result of cross-sensitization in the pelvis when pathological changes in one of the pelvic organs result in functional alterations in an adjacent structure. The aim of the current study was to compare transient receptor potential vanilloid 1 (TRPV1) activated pathways on detrusor contractility in vivo and in vitro using a rat model of pelvic organ cross-sensitization. Four groups of male Sprague-Dawley rats (N = 56) were included in the study. Animals received intracolonic saline (control), resiniferatoxin (RTX, TRPV1 agonist, 10(-7) M), 2,4,6-trinitrobenzene sulfonic acid (TNBS, colonic irritant), or double treatment (RTX followed by TNBS). Detrusor muscle contractility was assessed under in vitro and in vivo conditions. Intracolonic RTX increased the contractility of the isolated detrusor in response to electric field stimulation (EFS) by twofold (P ≤ 0.001) and enhanced the contractile response of the bladder smooth muscle to carbachol (CCh). Acute colonic inflammation reduced detrusor contractility upon application of CCh in vitro, decreased bladder capacity by 28.1% (P ≤ 0.001), and reduced micturition volume by 60% (P ≤ 0.001). These changes were accompanied by an increased number of nonmicturition contractions from 3.7 ± 0.7 to 15 ± 2.7 (N = 6 in both groups, P ≤ 0.001 vs. control). Desensitization of intracolonic TRPV1 receptors before the induction of acute colitis restored the response of isolated detrusor strips to CCh but not to EFS stimulation. Cystometric parameters were significantly improved in animals with double treatment and approximated the control values. Our data suggest that acute colonic inflammation triggers the occurrence of detrusor instability via activation of TRPV1-related pathways. Comparison of the results obtained under in vitro vs. in vivo conditions provides evidence that intact neural pathways are critical for the development of an overactive bladder resulting from pelvic organ cross talk.
慢性盆腔疼痛的病因不明是一种常见的临床情况,可能会由于盆腔内的病变导致相邻结构的功能改变,从而导致跨敏化而发展。本研究的目的是比较 TRPV1 激活途径在体内和体外对骨盆器官交叉敏感大鼠模型逼尿肌收缩的影响。研究纳入了 4 组雄性 Sprague-Dawley 大鼠(N = 56)。动物接受了直肠内生理盐水(对照)、辣椒素(TRPV1 激动剂,10(-7) M)、2,4,6-三硝基苯磺酸(直肠刺激物)或双重处理(辣椒素后用 2,4,6-三硝基苯磺酸)。在体外和体内条件下评估逼尿肌肌肉收缩。直肠内辣椒素使离体逼尿肌对电场刺激(EFS)的收缩力增加了两倍(P ≤ 0.001),并增强了膀胱平滑肌对乙酰胆碱(CCh)的收缩反应。急性直肠炎使体外应用 CCh 时逼尿肌收缩力降低,膀胱容量减少 28.1%(P ≤ 0.001),排尿量减少 60%(P ≤ 0.001)。这些变化伴随着非排尿收缩次数从 3.7 ± 0.7 增加到 15 ± 2.7(每组 6 只,P ≤ 0.001 与对照组相比)。在急性结肠炎发生前使直肠内 TRPV1 受体脱敏,可恢复离体逼尿肌对 CCh 的反应,但对 EFS 刺激无反应。双重处理的动物的膀胱测量参数显著改善,接近对照值。我们的数据表明,急性直肠炎通过激活 TRPV1 相关途径触发逼尿肌不稳定的发生。体外和体内条件下获得的结果比较提供了证据,表明完整的神经途径对于骨盆器官相互作用引起的膀胱过度活动是至关重要的。