Xu Zhenqun, Elrashidy Rania A, Li Bo, Liu Guiming
Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States.
Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China.
Front Med (Lausanne). 2022 Mar 10;9:812967. doi: 10.3389/fmed.2022.812967. eCollection 2022.
Aging and major chronic diseases are risk factors for lower urinary tract symptoms (LUTS). On the other hand, oxidative stress (OS) is one of the fundamental mechanisms of aging and the development of chronic diseases. Therefore, OS might be a candidate mechanism linking these two clinical entities. This article aims to summarize the studies on the prevalence of LUTS, the role of OS in aging and chronic diseases, and the potential mechanisms supporting the putative link. A comprehensive literature search was performed to identify recent reports investigating LUTS and OS in major chronic diseases. In addition, studies on the impact of OS on the lower urinary tract, including bladder, urethra, and prostate, were collected and summarized. Many studies showed LUTS are prevalent in aging and major chronic diseases, including obesity, metabolic syndrome, diabetes, cardiovascular disease, hypertension, obstructive sleep apnea, autoimmune diseases, Alzheimer's disease, and Parkinson's disease. At the same time, OS is a key component in the pathogenesis of those chronic diseases and conditions. Recent studies also provided evidence that exacerbated OS can cause functional and/or structural changes in the bladder, urethra, and prostate, leading to LUTS. The reviewed data support the concept that OS is involved in multiple risk factors-associated LUTS, although further studies are needed to confirm the causative relationship. The specific ROS/RNS and corresponding reactions/pathways involved in chronic diseases and associated LUTS should be identified in the future and could serve as therapeutic targets.
衰老和主要慢性疾病是下尿路症状（LUTS）的风险因素。另一方面，氧化应激（OS）是衰老和慢性疾病发展的基本机制之一。因此，OS可能是连接这两种临床情况的一种潜在机制。本文旨在总结关于LUTS患病率、OS在衰老和慢性疾病中的作用以及支持这种假定联系的潜在机制的研究。进行了全面的文献检索，以确定近期调查主要慢性疾病中LUTS和OS的报告。此外，收集并总结了关于OS对下尿路（包括膀胱、尿道和前列腺）影响的研究。许多研究表明，LUTS在衰老和主要慢性疾病中普遍存在，包括肥胖、代谢综合征、糖尿病、心血管疾病、高血压、阻塞性睡眠呼吸暂停、自身免疫性疾病、阿尔茨海默病和帕金森病。同时，OS是这些慢性疾病和病症发病机制的关键组成部分。近期研究还提供证据表明，加剧的OS可导致膀胱、尿道和前列腺的功能和/或结构改变，从而导致LUTS。所审查的数据支持OS参与多种与风险因素相关的LUTS这一概念，尽管需要进一步研究来证实因果关系。未来应确定慢性疾病及相关LUTS中涉及的特定活性氧/氮化物（ROS/RNS）以及相应的反应/途径，并可将其作为治疗靶点。
