Abstract
Urinary dysfunction is a common pathological condition that can significantly decrease the quality of life. Bladder outlet obstruction (BOO) is a major cause of urinary dysfunction, and various lower urinary tract diseases including benign prostatic hyperplasia and urethral stricture disease cause BOO. According to the results of a variety of animal experiments on partial BOO (PBOO), there is a general agreement that ischemic conditions and repeated ischemia/reperfusion of the bladder are closely associated with BOO-induced bladder damage, and that increased oxidative stress by ischemia/reperfusion plays a crucial role in the pathological mechanisms underlying urinary dysfunction. Changes in biomarkers of oxidative stress in PBOO animal models support this association between oxidative stress and urinary dysfunction. Oxidative stress is defined as an imbalance between the production of pro-oxidants, such as free radicals and reactive species, and their elimination through protective mechanisms of antioxidants. Therefore, organizing the knowledge on the state of oxidative stress, changes in biomarkers, and biological roles of antioxidants in systemic and bladder tissues is essential to understand the detailed pathological characteristics of the urinary dysfunction caused by PBOO. Furthermore, information on drugs and supplements that have antioxidant effects is important for defining treatment strategies for urinary dysfunction with PBOO. In this review, we paid special attention to the following three issues; (1) changes in oxidative stress, including its biomarkers, (2) antioxidant status, and (3) previous reports on treatment strategies involving agents with antioxidative activity for urinary dysfunction caused by BOO. In particular, we provide systematic information on the detailed mechanisms underlying the antioxidative effects of agents used to treat PBOO. In addition, we show present research issues and research limitations, as well as suggest possible future antioxidant treatment strategies for patients with PBOO.
Highlights
Oxidative stress plays crucial roles in the development of many chronic diseases, including neurodegenerative diseases, cardiovascular disease, and malignancies [1,2,3,4]
The balance of reactive oxygen species (ROS)/reactive nitrogen species (RNS) levels is tightly controlled by regulation of the production and elimination of ROS/RNS endogenous antioxidants that act as scavengers under physiological conditions
We introduce the pathological roles of oxidative stress including ROS, changes in biomarkers by partial BOO (PBOO), and the state of antioxidants during urinary dysfunction
Summary
Oxidative stress plays crucial roles in the development of many chronic diseases, including neurodegenerative diseases, cardiovascular disease, and malignancies [1,2,3,4]. Antioxidants 2019, 8, 132 and extensive knowledge about the pathological significance of oxidative stress in the bladder is important to understand the cause of diseases and potential treatment strategies for patients with urinary dysfunctions. PBOO-induced oxidative stress in the bladder and play important roles in bladder dysfunction via changes in cellular dysfunction because they damage detrusor mitochondria, depressing energy production and molecular characteristics, including the density of blood vessels and nerves, and the induction and impairing detrusor contractility [27]. Such oxidative stress-induced biological and histological changes in the bladder promote an promote an imbalance in pro-oxidative and antioxidative factors This vicious cycle that begins cyclic ischemia/reperfusion in PBOO leads to further urinary dysfunction. Imbalance with in pro-oxidative and antioxidative factors This vicious cycle that begins with cyclic ischemia/reperfusion in PBOO leads to further urinary dysfunction
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