Abstract
Urinary bladder activity involves central and autonomic nervous systems and bladder wall. Studies on the pathogenesis of voiding disorders such as the neurogenic detrusor overactivity (NDO) due to suprasacral spinal cord lesions have emphasized the importance of an abnormal handling of the afferent signals from urothelium and lamina propria (LP). In the LP (and detrusor), three types of telocytes (TC) are present and form a 3D‐network. TC are stromal cells able to form the scaffold that contains and organizes the connective components, to serve as guide for tissue (re)‐modelling, to produce trophic and/or regulatory molecules, to share privileged contacts with the immune cells. Specimens of full thickness bladder wall from NDO patients were collected with the aim to investigate possible changes of the three TC types using histology, immunohistochemistry and transmission electron microscopy. The results show that NDO causes several morphological TC changes without cell loss or network interruption. With the exception of those underlying the urothelium, all the TC display signs of activation (increase in Caveolin1 and caveolae, αSMA and thin filaments, Calreticulin and amount of cisternae of the rough endoplasmic reticulum, CD34, euchromatic nuclei and large nucleoli). In all the specimens, a cell infiltrate, mainly consisting in plasma cells located in the vicinity or taking contacts with the TC, is present. In conclusion, our findings show that NDO causes significant changes of all the TC. Notably, these changes can be interpreted as TC adaptability to the pathological condition likely preserving each of their peculiar functions.
Highlights
The urinary bladder activity is the result of complex interactions involving the central nervous system, the autonomic nervous system and the bladder wall [1]
Immunohistochemical and transmission electron microscopy (TEM) studies of healthy human lamina propria (LP) reported the presence of different types of stromal cells whose nomenclature varies among authors
The TC located in both LP and detrusor show important immunohistochemical and structural changes compared to controls
Summary
The urinary bladder activity is the result of complex interactions involving the central nervous system, the autonomic nervous system and the bladder wall [1]. Immunohistochemical and transmission electron microscopy (TEM) studies of healthy human LP reported the presence of different types of stromal cells whose nomenclature varies among authors. All the patients develop, sooner or later, resistance to the drug efficacy and are forced to surgery intervention It is still matter of debate the exact functions that TC and myofibroblasts play in regulating the afferent inputs to guarantee an adequate bladder activity, it is a common convincement that changes in these cells have a role in the pathogenesis of altered bladder functionality such that present in NDO. In the attempt to bring new data to this debate, we collected samples of full thickness bladder wall from a group of NDO patients comparatively homogenous for aetiology, length of the disease and clinical course with the aim to investigate any morphological changes of the three types of TC previously described in the human bladder by using histological, immunohistochemical and ultrastructural methodologies
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