Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
PLoS One. 2013 May 15;8(5):e63760. doi: 10.1371/journal.pone.0063760. Print 2013.
This study was designed to investigate whether increased urothelial cell apoptosis and chronic inflammation might contribute to recurrent urinary tract infection (UTI) in women.
The bladder biopsy specimens were collected from thirty women with recurrent UTI and ten controls. The bladder biopsies were performed at one to two months after UTI episode had been completely resolved and urine analysis and urine culture all showed negative. Immunofluorescence staining of the adhesive protein E-cadherin, mast cell and TUNEL were performed in all the bladder specimens. In addition, western blots were also performed to analyze the inflammatory proteins (phospho-p38, tryptase) and apoptotic protein (Bax) in the bladder mucosa specimens between patients with recurrent UTI and controls.
Immunofluorescence staining showed significantly lower E-cadherin in the recurrent UTI bladder tissue compared with the controls (25.4±8.9 v 42.4±16.7, p<0.0001). The mast cell expression was significantly stronger in the recurrent UTI bladder tissue compared with the controls (2.5±1.8 v 1.3±1.2, p = 0.046). TUNEL staining revealed a significantly higher numbers of apoptotic cells in the recurrent UTI bladder tissue compared with the control bladder tissue (1.5±1.8 v 0.08±0.3, p<0.0001). Western blot analysis also showed that the expressions of tryptase and Bax increased in five recurrent UTI specimens compared with two normal control specimens.
Chronic inflammation, urothelial cell apoptosis and impairment of barrier function of urothelial cells might contribute to recurrent UTI in women.
本研究旨在探讨尿路上皮细胞凋亡和慢性炎症的增加是否与女性复发性尿路感染（UTI）有关。
收集 30 例复发性 UTI 患者和 10 例对照者的膀胱活检标本。所有患者均在 UTI 完全缓解后 1 至 2 个月进行膀胱活检，尿液分析和尿液培养均为阴性。对所有膀胱标本进行黏附蛋白 E-钙黏蛋白、肥大细胞和 TUNEL 的免疫荧光染色。此外，还对复发性 UTI 患者和对照组膀胱黏膜标本中的炎症蛋白（磷酸化 p38、胰蛋白酶）和凋亡蛋白（Bax）进行了 Western blot 分析。
免疫荧光染色显示，复发性 UTI 膀胱组织中的 E-钙黏蛋白明显低于对照组（25.4±8.9 v 42.4±16.7，p<0.0001）。复发性 UTI 膀胱组织中的肥大细胞表达明显强于对照组（2.5±1.8 v 1.3±1.2，p=0.046）。TUNEL 染色显示，复发性 UTI 膀胱组织中的凋亡细胞明显多于对照组（1.5±1.8 v 0.08±0.3，p<0.0001）。Western blot 分析还显示，与 2 例正常对照标本相比，5 例复发性 UTI 标本中胰蛋白酶和 Bax 的表达增加。
慢性炎症、尿路上皮细胞凋亡和尿路上皮细胞屏障功能障碍可能导致女性复发性 UTI。
