Knippschild S, Frohme C, Olbert P, Hofmann R, Hegele A
Klinik für Urologie und Kinderurologie, Universitätsklinikum Gießen und Marburg GmbH - Standort Marburg, Baldingerstraße, 35043 Marburg, Deutschland.
Urologe A. 2012 Mar;51(3):379-83. doi: 10.1007/s00120-011-2726-0.
Several studies discussing the pathology of overactive bladder suggested changes in urinary proteins. The neurotrophin "nerve growth factor" (NGF) seems to be an important marker in overactive bladder syndrome (OAB). In this prospectively designed study we evaluated NGF blood levels (sNGF) initially and after injection of botulinum toxin type A (BTX-A) in the detrusor muscle in patients suffering from idiopathic OAB.
Blood samples were obtained from 26 patients (66.5 years, 28-83) with idiopathic OAB. sNGF levels were measured before and 4 weeks after BTX-A treatment by enzyme-linked immunosorbent assay (ELISA). A group of 32 healthy persons with normal bladder function served as controls (41 years, 19-60). sNGF was evaluated in relation to clinical data and the severity of OAB (wet/dry).
Significantly higher sNGF levels were detected in patients with OAB compared to the control group (58.8 vs 2.0 pg/ml, p<0.005). Further, sNGF levels were elevated in patients with wet OAB compared to patients with dry OAB (85.0 vs 0.73 pg/ml, p<0.005). Patients > 60 years showed significantly higher sNGF levels (77.2 vs 8.9 pg/ml, p<0.05) compared to younger OAB patients. After BTX-A therapy sNGF levels decreased significantly compared to baseline (p<0.005).
NGF appears to play a decisive role in OAB. Its use as a biomarker in both the diagnostics and follow-up after therapy seems promising. To what extent sNGF can be useful as a biomarker or in therapy monitoring needs to be examined prospectively in a larger population.
多项探讨膀胱过度活动症病理学的研究表明尿蛋白存在变化。神经营养因子“神经生长因子”（NGF）似乎是膀胱过度活动症（OAB）的一个重要标志物。在这项前瞻性设计的研究中，我们评估了特发性OAB患者在初始阶段以及在逼尿肌注射A型肉毒杆菌毒素（BTX - A）后的NGF血液水平（sNGF）。
从26例（平均年龄66.5岁，年龄范围28 - 83岁）特发性OAB患者中采集血样。通过酶联免疫吸附测定（ELISA）在BTX - A治疗前和治疗后4周测量sNGF水平。选取32例膀胱功能正常的健康人作为对照组（平均年龄41岁，年龄范围19 - 60岁）。根据临床数据和OAB的严重程度（有/无尿失禁）对sNGF进行评估。
与对照组相比，OAB患者的sNGF水平显著更高（58.8对2.0 pg/ml，p<0.005）。此外，有尿失禁的OAB患者的sNGF水平高于无尿失禁的OAB患者（85.0对0.73 pg/ml，p<0.005）。与年轻的OAB患者相比，年龄大于60岁的患者sNGF水平显著更高（77.2对8.9 pg/ml，p<0.05）。BTX - A治疗后，sNGF水平与基线相比显著降低（p<0.005）。
NGF似乎在OAB中起决定性作用。将其用作诊断和治疗后随访的生物标志物似乎很有前景。sNGF在多大程度上可作为生物标志物或用于治疗监测，需要在更大规模的人群中进行前瞻性研究。
