Zhang Wei, Liu Xiao-Dong, Wang Jia-Wen, Meng Ling-Feng, Zhang Yao-Guang, Wang Jian-Ye
Peking University Fifth School of Clinical Medicine, Beijing 100730, China.
Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.
Chin Med J (Engl). 2020 May 20;133(10):1203-1210. doi: 10.1097/CM9.0000000000000767.
Dysuria is one of the main symptoms of genitourinary syndrome of menopause, which causes serious disruption to the normal life of peri-menopausal women. Studies have shown that it is related to decrease of detrusor contractile function, but the exact mechanism is still poorly understood. Previous results have suggested that the sphingosine-1-phosphate (S1P) pathway can regulate detrusor contraction, and this pathway is affected by estrogen in various tissues. However, how estrogen affects this pathway in the detrusor has not been investigated. In this study, we detected changes of the S1P/RhoA/Rho associated kinases (ROCK)/myosin light chain (MLC) pathway in the detrusor of ovariectomized rats in order to explore the underlying mechanism of dysuria during peri-menopause.
Thirty-six female Sprague-Dawley rats were randomly divided into SHAM (sham operation), OVX (ovariectomy), and E groups (ovariectomy + estrogen), with 12 rats in each group. We obtained bladder detrusor tissues from each group and examined the mRNA and protein levels of the major components of the S1P/RhoA/ROCK/MLC pathway using quantitative real-time polymerase chain reaction and Western blotting, respectively. We also quantified the content of S1P in the detrusor using an enzyme linked immunosorbent assay. Finally, we compared results between the groups with one-way analysis of variance.
The components of the S1P pathway and the RhoA/ROCK/MLC pathway of the OVX group were significantly decreased, as compared with SHAM group. The percent decreases of the components in the S1P pathway were as follows: sphingosine kinase 1 (mRNA: 39%, protein: 45%) (both P < 0.05), S1P (21.73 ± 1.09 nmol/g vs. 18.86 ± 0.69 nmol/g) (P < 0.05), and S1P receptor 2/3 (S1PR2/3) (mRNA: 25%, 27%, respectively) (P < 0.05). However, the protein expression levels of S1PR2/3 and the protein and mRNA levels of SphK2 and S1PR1 did not show significant differences between groups (P > 0.05). The percent decreases of the components in the RhoA/ROCK/MLC pathway were as follows: ROCK2 (protein: 41%, mRNA: 36%) (both P < 0.05), p-MYPT1 (protein: 54%) (P < 0.05), and p-MLC20 (protein: 47%) (P < 0.05), but there were no significant differences in the mRNA and protein levels of RhoA, ROCK1, MYPT1, and MLC20 (all P > 0.05). In addition, all of the above-mentioned decreases could be reversed after estrogen supplementation (E group vs. SHAM group) (all P > 0.05).
In this study, we confirmed that ovariectomy is closely associated with the down-regulation of the S1P/RhoA/ROCK/MLC pathway in the rat detrusor, which may be one mechanism of dysuria caused by decreased contractile function of the female detrusor during peri-menopause.
排尿困难是绝经后泌尿生殖综合征的主要症状之一,严重影响围绝经期女性的正常生活。研究表明,排尿困难与逼尿肌收缩功能下降有关,但其确切机制仍不清楚。以往的研究结果提示,1-磷酸鞘氨醇(S1P)信号通路可调节逼尿肌收缩,且该信号通路在多种组织中受雌激素影响。然而,雌激素如何影响逼尿肌中的这一信号通路尚未见研究报道。本研究检测去卵巢大鼠逼尿肌中S1P/RhoA/Rho相关激酶(ROCK)/肌球蛋白轻链(MLC)信号通路的变化,以探讨围绝经期排尿困难的潜在机制。
将36只雌性Sprague-Dawley大鼠随机分为假手术组(SHAM)、去卵巢组(OVX)和雌激素组(去卵巢+雌激素),每组12只。获取各组大鼠膀胱逼尿肌组织,分别采用实时定量聚合酶链反应和蛋白质印迹法检测S1P/RhoA/ROCK/MLC信号通路主要成分的mRNA和蛋白水平。采用酶联免疫吸附测定法检测逼尿肌中S1P含量。最后,采用单因素方差分析比较各组结果。
与SHAM组相比,OVX组S1P信号通路及RhoA/ROCK/MLC信号通路的成分均显著降低。S1P信号通路各成分降低的百分比分别为:鞘氨醇激酶1(SphK1)(mRNA:39%,蛋白:45%)(均P<0.05)、S1P(21.73±1.09 nmol/g vs. 18.86±0.69 nmol/g)(P<0.05)、S1P受体2/3(S1PR2/3)(mRNA分别为25%、27%)(P<0.05)。然而,S1PR2/3的蛋白表达水平以及SphK2和S1PR1的蛋白和mRNA水平在各组间差异无统计学意义(P>0.05)。RhoA/ROCK/MLC信号通路各成分降低的百分比分别为:ROCK2(蛋白:41%,mRNA:36%)(均P<0.05)、磷酸化肌球蛋白磷酸酶靶向亚基1(p-MYPT1)(蛋白:54%)(P<0.05)、磷酸化肌球蛋白轻链20(p-MLC20)(蛋白:47%)(P<0.05),但RhoA、ROCK1、MYPT1和MLC20的mRNA和蛋白水平差异无统计学意义(均P>0.05)。此外,补充雌激素后上述所有降低均得以逆转(雌激素组与SHAM组比较)(均P>0.05)。
本研究证实,去卵巢与大鼠逼尿肌中S1P/RhoA/ROCK/MLC信号通路下调密切相关,这可能是围绝经期女性逼尿肌收缩功能下降导致排尿困难的机制之一。