Ozturk Hayrettin, Cetinkaya Ayhan, Duzcu Selma Erdogan, Yis Ozgur Mehmet
Bolu Abant Izzet Baysal University, Medical School, Pediatric Surgery, Bolu, Turkey.
Bolu Abant Izzet Baysal University, Medical School, Physiology, Bolu, Turkey.
J Pediatr Urol. 2020 Dec;16(6):806.e1-806.e14. doi: 10.1016/j.jpurol.2020.09.013. Epub 2020 Sep 17.
Although several cytokines, chemokines, and growth factors have been suggested to play a role in the development of bladder fibrosis and functional changes, the mechanisms that are effective in the pathogenesis of partial bladder outlet obstruction (pBOO)-induced bladder fibrosis are not well understood.
We investigated the expressions of nerve growth factor (NGF), monocyte chemoattractant protein-1 (MCP-1), uroplakin III (URPIII), inducible nitric oxide synthase (iNOS), and endothelial NOS (eNOS) that may be involved in fibrosis in rats with partial urethral obstruction for 1, 2 and 3 weeks, and the changes in the associated ischemic and inflammatory processes. After 1, 2, and 3 weeks of pBOO, blood samples were collected for assessment of renal function from the rats under anesthesia. The bladders were dissected for the tissue antioxidant enzyme activities and lipid peroxidation, including malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant status (TAS) and total oxidant status (TOS). The immunohistochemical studies were performed. Histopathologically, the number of urothelial layers was calculated and the thickness of the detrusor smooth muscle and lamina propria were quantitatively measured. Additionally, the edema and congestion in the submucosa were evaluated.
Twenty-eight male Sprague-Dawley rats were used in this study. Three separate experimental groups of pBOO (1 week [n = 7], 2 weeks [n = 7], and 3 weeks [n = 7]) were created, with an additional sham-operated control group (n = 7).
The MDA levels increased in pBOO groups. The SOD values were decreased in the pBOO group for 1 week, and higher in the 3-week pBOO group. The TAS levels were increased in the 3 week pBOO group. The TOS levels increased in the pBOO groups. The number of urothelial layers was decreased in pBOO groups. The lamina propria, the smooth muscle thickness, edema and congestion were increase in the 1 and 2 week pBOO groups. The NGF and MCP-1 expression was increased in the 1-week and 2-week pBOO groups. The expression of URPIII in the epithelium gradually increased in the pBOO groups. In the pBOO groups, iNOS expression in the epithelium cells was significantly elevated. However, the eNOS expression was also significantly increased in the 2 week pBOO group.
Our study shows that overexpression of immunohistochemical parameters together with the negative effects of ischemic and inflammatory processes that subjected to pBOO for 1, 2 and 3 weeks may play a potential role in detrusor fibrosis in the rat bladders induced by pBOO. However, understanding of the immunohistochemical parameters investigated in this experimental study is limited, and further studies targeting their relationship to pBOO could help us develop new strategies.
尽管有多种细胞因子、趋化因子和生长因子被认为在膀胱纤维化及功能改变的发生发展中起作用,但部分膀胱出口梗阻(pBOO)所致膀胱纤维化发病机制中起作用的机制尚未完全明确。
我们研究了在部分尿道梗阻1周、2周和3周的大鼠中,可能参与纤维化的神经生长因子(NGF)、单核细胞趋化蛋白-1(MCP-1)、尿路上皮蛋白III(URPIII)、诱导型一氧化氮合酶(iNOS)和内皮型一氧化氮合酶(eNOS)的表达,以及相关缺血和炎症过程的变化。在pBOO 1周、2周和3周后,对麻醉状态下的大鼠采集血样以评估肾功能。解剖膀胱以检测组织抗氧化酶活性和脂质过氧化水平,包括丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化状态(TAS)和总氧化状态(TOS)。进行免疫组织化学研究。组织病理学上,计算尿路上皮层数,并定量测量逼尿肌平滑肌和固有层的厚度。此外,评估黏膜下层的水肿和充血情况。
本研究使用了28只雄性Sprague-Dawley大鼠。设立了三个单独的pBOO实验组(1周[n = 7]、2周[n = 7]和3周[n = 7]),另有一个假手术对照组(n = 7)。
pBOO组的MDA水平升高。pBOO组1周时SOD值降低,3周pBOO组SOD值升高。3周pBOO组的TAS水平升高。pBOO组的TOS水平升高。pBOO组的尿路上皮层数减少。1周和2周pBOO组的固有层、平滑肌厚度、水肿和充血增加。1周和2周pBOO组的NGF和MCP-1表达增加。pBOO组上皮细胞中URPIII的表达逐渐增加。在pBOO组中,上皮细胞中iNOS表达显著升高。然而,2周pBOO组中eNOS表达也显著增加。
我们的研究表明,免疫组织化学参数的过表达以及pBOO 1周、2周和3周所导致的缺血和炎症过程的负面影响,可能在pBOO诱导的大鼠膀胱逼尿肌纤维化中起潜在作用。然而,对本实验研究中所检测的免疫组织化学参数的了解有限,针对它们与pBOO关系的进一步研究可能有助于我们制定新的策略。