Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky, USA.
J Spinal Cord Med. 2020 Mar;43(2):165-176. doi: 10.1080/10790268.2019.1661697. Epub 2019 Sep 26.
In order to encourage the inclusion of bladder and bowel outcome measures in preclinical spinal cord injury (SCI) research, this paper identifies and categorizes 1) fundamental, 2) recommended, 3) supplemental and 4) exploratory sets of outcome measures for pre-clinical assessment of bladder and bowel function with broad applicability to animal models of SCI. Drawing upon the collective research experience of autonomic physiologists and informed in consultation with clinical experts, a critical assessment of currently available bladder and bowel outcome measures (histological, biochemical, functional, physiological and electrophysiological tests) was made to identify the strengths, deficiencies and ease of inclusion for future studies of experimental SCI. Based upon pre-established criteria generated by the Neurogenic Bladder and Bowel Working Group that included history of use in experimental settings, citations in the literature by multiple independent groups, ease of general use, reproducibility and sensitivity to change, three fundamental measures each for bladder and bowel assessments were identified. Briefly defined, these assessments centered upon tissue morphology, voiding efficiency/volume and smooth muscle-mediated pressure studies. Additional assessment measures were categorized as recommended, supplemental or exploratory based upon the balance between technical requirements and potential mechanistic insights to be gained by the study. Several fundamental assessments share reasonable levels of technical and material investment, including some that could assess bladder and bowel function non-invasively and simultaneously. Such measures used more inclusively across SCI studies would advance progress in this high priority area. When complemented with a few additional investigator-selected study-relevant supplemental measures, they are highly recommended for research programs investigating the efficacy of therapeutic interventions in preclinical animal models of SCI that have a bladder and/or bowel focus.
为了鼓励在脊髓损伤（SCI）的临床前研究中纳入膀胱和肠道结果测量，本文确定并分类了 1）基本、2）推荐、3）补充和 4）探索性的膀胱和肠道功能临床前评估结果测量，这些测量具有广泛的适用性，适用于 SCI 的动物模型。本文参考自主生理学家的集体研究经验，并在与临床专家协商的基础上，对目前可用的膀胱和肠道结果测量（组织学、生化、功能、生理和电生理测试）进行了批判性评估，以确定未来实验性 SCI 研究的优势、缺陷和易于纳入性。基于神经源性膀胱和肠道工作组预先确定的标准，这些标准包括在实验环境中使用的历史、多个独立小组在文献中的引用、一般使用的便利性、可重复性和对变化的敏感性，确定了膀胱和肠道评估的三个基本措施。这些评估简要定义为集中在组织形态、排空效率/体积和平滑肌介导的压力研究上。根据研究中获得的技术要求和潜在机制见解之间的平衡，将其他评估措施归类为推荐、补充或探索性。有几个基本评估具有相当水平的技术和材料投资，包括一些可以非侵入性和同时评估膀胱和肠道功能的评估。如果在 SCI 研究中更广泛地使用这些评估，将有助于推进这一高优先级领域的进展。当与少数额外的研究相关的补充措施相结合时，强烈推荐用于研究治疗干预在 SCI 临床前动物模型中的疗效的研究计划，这些模型具有膀胱和/或肠道重点。
