Department of Urology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
PLoS One. 2013;8(2):e57477. doi: 10.1371/journal.pone.0057477. Epub 2013 Feb 28.
The objective of this study was to investigate the effects and mechanism of Transcutaneous Electrical Nerve Stimulation (TENS) on the diabetic cytopathy (DCP) in the diabetic bladder. A total of 45 rats were randomly divided into diabetes mellitus (DM)/TENS group (n=15), DM group (n=15) and control group (n=15). The rats in the DM/TENS and TENS groups were electronically stimulated (stimulating parameters: intensity-31 V, frequency-31 Hz, and duration of stimulation of 15 min) for three weeks. Bladder histology, urodynamics and contractile responses to field stimulation and carbachol were determined. The expression of calcitonin gene-related peptide (CGRP) was analyzed by RT-PCR and Western blotting. The results showed that contractile responses of the DM rats were ameliorated after 3 weeks of TENS. Furthermore, TENS significantly increased bladder wet weight, volume threshold for micturition and reduced PVR, V% and cAMP content of the bladder. The mRNA and protein levels of CGRP in dorsal root ganglion (DRG) in the DM/TENS group were higher than those in the DM group. TENS also significantly up-regulated the cAMP content in the bladder body and base compared with diabetic rats. We conclude that TENS can significantly improve the urine contractility and ameliorate the feeling of bladder fullness in DM rats possibly via up-regulation of cAMP and CGRP in DRG.
本研究旨在探讨经皮神经电刺激(TENS)对糖尿病膀胱病变(DCP)的作用及其机制。将 45 只大鼠随机分为糖尿病/电刺激(TENS)组(n=15)、糖尿病组(n=15)和对照组(n=15)。DM/TENS 组和 TENS 组大鼠接受电子刺激(刺激参数:强度 31 V,频率 31 Hz,刺激持续时间 15 min),共 3 周。检测膀胱组织学、尿动力学和对电刺激及卡巴胆碱的收缩反应。通过 RT-PCR 和 Western blot 分析降钙素基因相关肽(CGRP)的表达。结果显示,TENS 治疗 3 周后 DM 大鼠的收缩反应得到改善。此外,TENS 还显著增加了膀胱湿重、排尿阈值和减少了 PVR、V%和膀胱 cAMP 含量。DM/TENS 组背根神经节(DRG)中 CGRP 的 mRNA 和蛋白水平均高于 DM 组。与糖尿病大鼠相比,TENS 还显著增加了膀胱体和基底的 cAMP 含量。我们的结论是,TENS 可通过上调 DRG 中的 cAMP 和 CGRP,显著改善 DM 大鼠的尿收缩性并改善膀胱充盈感。