Jhang Jia-Fong, Jiang Yuan-Hong, Kuo Hann-Chorng
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 97004, Taiwan.
Biomedicines. 2023 Feb 23;11(3):673. doi: 10.3390/biomedicines11030673.
To investigate the role of urinary biomarkers in discriminating different bladder and bladder outlet dysfunctions in women with frequency-urgency syndrome.
Urine samples collected from 146 women with frequency-urgency syndrome and 34 controls were investigated. All patients were included in previous clinical trials of functional urology studies and underwent a videourodynamic study. Patients with frequency-urgency syndrome were subdivided into idiopathic detrusor overactivity (IDO), neurogenic detrusor overactivity (NDO), dysfunctional voiding (DV), and hypersensitive bladder (HSB) subgroups. Urine samples were collected before any treatment, and urinary inflammatory proteins (interleukin- (IL-) 1β, IL-2, IL-6, IL-8, tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF)), neurogenic proteins (nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and prostaglandin E2 (PGE2)), and oxidative stress biomarkers (8-isoprostane, total antioxidant capacity (TAC), and 8-hydroxydeoxyguanosine (8-OHdG)) were measured and compared between the different OAB subgroups and controls.
Of the 146 patients, 31 had IDO, 41 had NDO, 45 had DV, and 29 had HSB. The control group included 34 women. The patients with HSB had lower urinary TAC and IL-2 levels than the controls. The patients with IDO, NDO, and DV had significantly higher urinary TNF-α levels than those with HSB. The patients with IDO and NDO showed an increase in the urinary 8-isoprostane levels, whereas the patients with IDO had higher urinary IL-2, NGF, and BDNF levels than those with NDO. The other urinary inflammatory biomarkers did not show enough significant differences to discriminate between the different bladder and bladder outlet dysfunctions.
The urinary levels of inflammatory, neurogenic, and oxidative stress biomarkers varied widely among the patients with bladder and bladder outlet dysfunction. This study's results provide evidence that women with frequency-urgency syndrome and different urodynamic subtypes have varying bladder inflammation and oxidative stress conditions, which might have an impact on treatment outcomes.
探讨尿生物标志物在鉴别尿频尿急综合征女性不同膀胱及膀胱出口功能障碍中的作用。
对146例尿频尿急综合征女性患者和34例对照者的尿液样本进行研究。所有患者均纳入既往功能性泌尿学研究的临床试验，并接受了视频尿动力学检查。尿频尿急综合征患者被分为特发性逼尿肌过度活动（IDO）、神经源性逼尿肌过度活动（NDO）、排尿功能障碍（DV）和膀胱过敏（HSB）亚组。在任何治疗前采集尿液样本，检测并比较不同膀胱过度活动症（OAB）亚组和对照者的尿炎症蛋白（白细胞介素-（IL-）1β、IL-2、IL-6、IL-8、肿瘤坏死因子-α（TNF-α）和血管内皮生长因子（VEGF））、神经源性蛋白（神经生长因子（NGF）、脑源性神经营养因子（BDNF）和前列腺素E2（PGE2））以及氧化应激生物标志物（8-异前列腺素、总抗氧化能力（TAC）和8-羟基脱氧鸟苷（8-OHdG））。
146例患者中，31例患有IDO，41例患有NDO，45例患有DV，29例患有HSB。对照组包括34名女性。HSB患者的尿TAC和IL-2水平低于对照组。IDO、NDO和DV患者的尿TNF-α水平显著高于HSB患者。IDO和NDO患者的尿8-异前列腺素水平升高，而IDO患者的尿IL-2、NGF和BDNF水平高于NDO患者。其他尿炎症生物标志物未显示出足够显著的差异来区分不同的膀胱及膀胱出口功能障碍。
膀胱及膀胱出口功能障碍患者的尿炎症、神经源性和氧化应激生物标志物水平差异很大。本研究结果提供了证据，表明尿频尿急综合征及不同尿动力学亚型的女性存在不同的膀胱炎症和氧化应激状况，这可能会影响治疗效果。
