Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK.
Neurourol Urodyn. 2020 Sep;39(7):1930-1938. doi: 10.1002/nau.24450. Epub 2020 Jul 1.
Urofacial syndrome (UFS) is an autosomal recessive disease characterized by detrusor contraction against an incompletely dilated outflow tract. This dyssynergia causes dribbling incontinence and incomplete voiding. Around half of individuals with UFS have biallelic mutations of HPSE2 that encodes heparanase 2, a protein found in pelvic ganglia and bladder nerves. Homozygous Hpse2 mutant mice have abnormal patterns of nerves in the bladder body and outflow tract, and also have dysfunctional urinary voiding. We hypothesized that bladder neurophysiology is abnormal Hpse2 mutant mice.
Myography was used to study bladder bodies and outflow tracts isolated from juvenile mice. Myogenic function was analyzed after chemical stimulation or blockade of key receptors. Neurogenic function was assessed by electrical field stimulation (EFS). Muscarinic receptor expression was semi-quantified by Western blot analysis.
Nitrergic nerve-mediated relaxation of precontracted mutant outflow tracts was significantly decreased vs littermate controls. The contractile ability of mutant outflow tracts was normal as assessed by KCl and the α1-adrenoceptor agonist phenylephrine. EFS of mutant bladder bodies induced significantly weaker contractions than controls. Conversely, the muscarinic agonist carbachol induced significantly stronger contractions of bladder body than controls.
The Hpse2 model of UFS features aberrant bladder neuromuscular physiology. Further work is required to determine whether similar aberrations occur in patients with UFS.
尿面部综合征(UFS)是一种常染色体隐性疾病,其特征是逼尿肌收缩对抗不完全扩张的流出道。这种协同失调导致滴尿性尿失禁和不完全排空。大约一半的 UFS 患者存在 HPSE2 的双等位基因突变,该基因编码肝素酶 2,这种蛋白存在于骨盆神经节和膀胱神经中。Hpse2 纯合突变小鼠的膀胱体和流出道神经模式异常,并且还存在排尿功能障碍。我们假设膀胱神经生理学异常是 Hpse2 突变小鼠的特征。
从小鼠中分离出膀胱体和流出道,使用肌电图研究其功能。在化学刺激或阻断关键受体后,分析肌原性功能。通过电刺激(EFS)评估神经源性功能。通过 Western blot 分析半定量评估毒蕈碱受体表达。
与同窝对照相比,预先收缩的突变型流出道的氮能神经介导的松弛明显减少。通过 KCl 和α1-肾上腺素能受体激动剂苯肾上腺素评估,突变型流出道的收缩能力正常。EFS 诱导的突变型膀胱体的收缩明显弱于对照。相反,毒蕈碱激动剂卡巴胆碱诱导的膀胱体收缩明显强于对照。
UFS 的 Hpse2 模型具有异常的膀胱神经肌肉生理学。需要进一步研究以确定 UFS 患者是否存在类似的异常。