Baylor College of Medicine, Houston, Texas 77030, USA.
Neurourol Urodyn. 2011 Sep;30(7):1376-81. doi: 10.1002/nau.21068. Epub 2011 Apr 20.
We evaluated a putative central inhibitory effect of intravesical botulinum toxin A (BoNT-A) on the activity of lumbosacral spinal neurons in a chronic spinal cord injury (SCI) model of bladder overactivity.
Female Sprague-Dawley rats underwent T8 spinal cord transection. Four weeks later, once overactive neuropathic detrusor pathways had developed, the animals underwent intravesical instillation with either saline (1 ml) or BoNT-A (Botox®, 20 U/1 ml) for 1 hr. Two days later, the rats then completed a cystometric evaluation prior to spinal cord harvest. Sections from the L4-S1 spinal cord segments were examined for the total number of c-fos immunoreactive cells.
Comparison of the saline and BoNT-A treated groups showed a significant decrease in L6 (i.e., 67%, P < 0.001) and S1 (i.e., 47%, P < 0.01) c-fos expression (43%) in BoNT-A treated rats compared to saline controls. Cystometrogram studies revealed that the frequency of non-voiding bladder contractions was reduced by 73% (P < 0.05) in BoNT-A compared to saline treated rats. No change in the frequency of voiding bladder contractions or amplitude of bladder contraction was observed between the saline and BoNT-A treated groups.
In a SCI model of bladder overactivity, intravesical BoNT-A significantly inhibits the response of bladder afferent activated lumbosacral neurons without significantly impairing efferent bladder function.
我们评估了膀胱内肉毒杆菌毒素 A（BoNT-A）对慢性脊髓损伤（SCI）模型中逼尿肌过度活动的腰骶脊髓神经元活性的潜在中枢抑制作用。
雌性 Sprague-Dawley 大鼠接受 T8 脊髓横断。4 周后，一旦形成了过度活跃的神经性逼尿肌通路，动物接受膀胱内灌洗生理盐水（1ml）或 BoNT-A（Botox®，20U/1ml）1 小时。两天后，大鼠在脊髓收获前完成膀胱测压评估。检查 L4-S1 脊髓节段的切片，以确定 c-fos 免疫反应性细胞的总数。
与生理盐水处理组相比，BoNT-A 处理组的 L6（即 67%，P<0.001）和 S1（即 47%，P<0.01）c-fos 表达（43%）显著降低。膀胱测压图研究表明，BoNT-A 组非排尿性膀胱收缩的频率比生理盐水组降低了 73%（P<0.05）。生理盐水和 BoNT-A 处理组之间排尿性膀胱收缩的频率或膀胱收缩的幅度没有变化。
在逼尿肌过度活动的 SCI 模型中，膀胱内 BoNT-A 显著抑制了膀胱传入激活的腰骶脊髓神经元的反应，而对传出膀胱功能没有明显损害。
