Neurourol Urodyn. 2018 Mar;37(3):1162-1168. doi: 10.1002/nau.23414. Epub 2018 Feb 21.
Historically, urine has been viewed primarily as a waste product with little biological role in the overall health of an individual. Increasingly, data suggest that urine plays a role in human health beyond waste excretion. For example, urine might act as an irritant and contribute to symptoms through interaction with-and potential compromise of-the urothelium.
To explore the concept that urine may be a vehicle for agents with potential or occult bioactivity and to discuss existing evidence and novel research questions that may yield insight into such a role, the National Institute of Diabetes and Digestive and Kidney Disease invited experts in the fields of comparative evolutionary physiology, basic science, nephrology, urology, pediatrics, metabolomics, and proteomics (among others) to a Urinology Think Tank meeting on February 9, 2015.
This report reflects ideas that evolved from this meeting and current literature, including the concept of urine quality, the biological, chemical, and physical characteristics of urine, including the microbiota, cells, exosomes, pH, metabolites, proteins, and specific gravity (among others). Additionally, the manuscript presents speculative, and hopefully testable, ideas about the functional roles of urine constituents in health and disease.
Moving forward, there are several questions that need further understanding and pursuit. There were suggestions to consider actively using various animal models and their biological specimens to elaborate on basic mechanistic information regarding human bladder dysfunction.
从历史上看，尿液主要被视为一种废物，在个体的整体健康中几乎没有生物学作用。越来越多的数据表明，尿液在人类健康中除了排泄废物之外还发挥着作用。例如，尿液可能通过与尿路上皮的相互作用——并可能损害尿路上皮——发挥作用，成为一种刺激物，并导致症状。
为了探讨尿液可能是具有潜在或隐匿生物活性的物质的载体的概念，并讨论可能深入了解这种作用的现有证据和新的研究问题，美国国立糖尿病、消化和肾脏疾病研究所于 2015 年 2 月 9 日邀请了比较进化生理学、基础科学、肾脏病学、泌尿科、儿科学、代谢组学和蛋白质组学（等）领域的专家参加了一次尿病学智库会议。
本报告反映了此次会议和当前文献中提出的想法，包括尿液质量的概念、尿液的生物学、化学和物理特性，包括微生物群、细胞、外泌体、pH 值、代谢物、蛋白质和比重（等）。此外，本文还提出了一些关于尿液成分在健康和疾病中的功能作用的推测性、有希望的可测试性想法。
展望未来，有几个问题需要进一步理解和研究。有与会者建议积极考虑使用各种动物模型及其生物标本，以详细阐述有关人类膀胱功能障碍的基本机制信息。
