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微小RNA作为预测膀胱逼尿肌内注射A型肉毒毒素后尿潴留风险的潜在生物标志物。

MicroRNAs as potential biomarkers to predict the risk of urinary retention following intradetrusor onabotulinumtoxin-A injection.

作者信息

Chermansky Christopher J, Kadow Brian T, Kashyap Mahendra, Tyagi Pradeep

机构信息

Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

出版信息

Neurourol Urodyn. 2018 Jan;37(1):99-105. doi: 10.1002/nau.23296. Epub 2017 May 11.

Abstract

AIMS

MicroRNAs (miRs) control post-transcriptional gene expression, and this is relevant in understanding better chronic diseases and treatment outcomes. The role of miRs in the pathology and treatment outcomes of overactive bladder (OAB) is unknown. In this study, we assessed the differential expression of miRs in OAB patients responding with either normal or elevated post-void residual volumes (PVRs) ≥200 mL following intradetrusor injection of onabotulinumtoxin-A (onaBoNT-A).

METHODS

Female OAB patients refractory to OAB drugs were consented for this study. Cystoscopic-guided punch bladder biopsy was obtained at the time of injection of onaBoNT-A 100 units. The expression of 13 miR species, selected for their known effect on neurotrophin expression and smooth muscle function, was measured. PVRs and urine nerve growth factor (NGF) levels were measured at baseline and at the follow-up visit.

RESULTS

Fourteen patients with mean age of 66 years were consented. Of these patients, nine maintained PVRs <200 mL after onaBoNT-A injection to comprise the low PVR group. The other five patients with PVRs ≥200 mL comprised the high PVR group. The expression of miR221 and miR125b was upregulated by 11- and 2-fold, respectively, in patients who responded with low PVRs after onaBoNT-A (P < 0.05). Urine NGF levels at baseline were not different between the two groups.

CONCLUSIONS

This study suggests that deficiency in the pretreatment expression of miR221 and miR125b may predispose OAB patients to high PVRs following intradetrusor onaBoNT-A. Additional studies are needed to better understand the role of miRs in OAB.

摘要

目的

微小RNA(miR)控制转录后基因表达,这对于更好地理解慢性疾病和治疗结果具有重要意义。miR在膀胱过度活动症(OAB)的病理及治疗结果中的作用尚不清楚。在本研究中,我们评估了膀胱逼尿肌内注射A型肉毒毒素(onaBoNT - A)后,膀胱过度活动症患者中残余尿量(PVR)正常或升高(≥200 mL)时miR的差异表达。

方法

本研究纳入了对OAB药物治疗无效的女性OAB患者。在注射100单位onaBoNT - A时,通过膀胱镜引导下进行膀胱活检取材。检测了13种miR的表达,这些miR因其对神经营养因子表达和平滑肌功能的已知作用而被选定。在基线和随访时测量PVR及尿神经生长因子(NGF)水平。

结果

14名平均年龄为66岁的患者参与了本研究。其中,9名患者在注射onaBoNT - A后残余尿量维持在<200 mL,组成低PVR组。另外5名残余尿量≥200 mL的患者组成高PVR组。在onaBoNT - A治疗后残余尿量较低的患者中,miR221和miR125b的表达分别上调了11倍和2倍(P < 0.05)。两组患者基线时的尿NGF水平无差异。

结论

本研究表明,miR221和miR125b预处理表达的缺乏可能使OAB患者在膀胱逼尿肌内注射onaBoNT - A后易出现高残余尿量。需要进一步研究以更好地理解miR在OAB中的作用。

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