Department of Urology, San Diego VA Health Care System & University of California, San Diego, California.
Division of Cardiology, San Diego VA Health Care System & University of California, San Diego, California.
Neurourol Urodyn. 2019 Feb;38(2):607-614. doi: 10.1002/nau.23889. Epub 2018 Dec 21.
Prior studies demonstrate increased incidence of urinary incontinence (UI) in the geriatric population which affects their quality of life. Pathophysiology of UI in the geriatric population and the underlying molecular mechanisms are still unclear. To elucidate these mechanisms, we performed a pre-clinical study in a rabbit model and the objectives were to (i) determine the effect of aging as well as multiparity on urethral sphincter muscle thickness and urethral closing pressure (UCP); (ii) examine the role of fibrosis and atrophy; and (iii) elucidate the molecular pathways that mediate fibrosis and atrophy in the urethral tissue.
New Zealand White female rabbits (n = 6 each; young 6-12 months and old over 30 months of age) were anesthetized and urethral muscle thickness and sphincter closure function were measured. Rabbits were then sacrificed and urethral tissues (bladder neck and mid-urethra) were collected to process for immunostaining as well as for molecular studies for markers for fibrosis (β-catenin which is an important mediator of Wnt signaling, Collagen-1, and TGF-β) and atrophy (MuRF-1).
Our studies showed a significant decrease in the urethral sphincter muscle thickness and closure function with age. Age-related increase in protein and mRNA expression levels of fibrosis, as well as atrophy markers were observed in the bladder neck and mid-urethral tissues.
Age and multiparity related increase in fibrosis and atrophy of urethral sphincter muscles may contribute to impaired urethral closure function seen in old animals.
先前的研究表明,老年人群中尿失禁(UI)的发病率增加,这影响了他们的生活质量。老年人群中 UI 的病理生理学和潜在的分子机制尚不清楚。为了阐明这些机制,我们在兔模型中进行了一项临床前研究,目的是:(i)确定衰老和多产对尿道括约肌肌肉厚度和尿道闭合压(UCP)的影响;(ii)研究纤维化和萎缩的作用;(iii)阐明介导尿道组织纤维化和萎缩的分子途径。
新西兰白兔(n=6 只,年轻 6-12 个月,老年 30 个月以上)麻醉后测量尿道肌肉厚度和括约肌闭合功能。然后处死兔子,收集尿道组织(膀胱颈部和中尿道)进行免疫染色以及纤维化(β-连环蛋白是 Wnt 信号的重要介质)和萎缩(MuRF-1)标志物的分子研究。
我们的研究表明,尿道括约肌肌肉厚度和闭合功能随年龄显著下降。在膀胱颈部和中尿道组织中观察到与年龄相关的纤维化和萎缩标志物的蛋白和 mRNA 表达水平增加。
年龄和多产相关的尿道括约肌纤维化和萎缩的增加可能导致老年动物尿道闭合功能受损。