Abstract

PurposeTo study the role of sensory dysfunction of bladder mucosa in bladder oversensitivity of rats with metabolic syndrome.Materials and MethodsFemale Wistar rats were fed a fructose-rich diet (60%) or a normal diet for 3 months. Based on cystometry, the fructose-fed rats (FFRs) were divided into a group with normal detrusor function or detrusor overactivity (DO). Acidic adenosine triphosphate (ATP) solution (5mM, pH 3.3) was used to elicit reflex micturition. Cystometric parameters were evaluated before and after drug administration. Functional proteins of the bladder mucosa were assessed by western blotting.ResultsCompared to the controls, intravesical acidic ATP solution instillation induced a significant increase in provoked phasic contractions in both FFR groups and a significant decrease in the mean functional bladder capacity of group DO. Pretreatment with capsaicin for C-fiber desentization, intravesical liposome for mucosal protection, or intravenous pyridoxal 5-phosphate 6-azophenyl-2′,4′-disulfonic acid for antagonized purinergic receptors can interfere with the urodynamic effects of intravesical ATP in FFRs and controls. Over-expression of TRPV1, P2X3, and iNOS proteins, and down-regulation of eNOS proteins were observed in the bladder mucosa of both fructose-fed groups.ConclusionsAlterations of sensory receptors and enzymes in the bladder mucosa, including over-expression of TRPV1, P2X3, and iNOS proteins, can precipitate the emergence of bladder phasic contractions and oversensitivity through the activation of C-afferents during acidic ATP solution stimulation in FFRs. The down-regulation of eNOS protein in the bladder mucosa of FFRs may lead to a failure to suppress bladder oversensitivity and phasic contractions. Sensory dysfunction of bladder mucosa and DO causing by metabolic syndrome are easier to elicit bladder oversensitivity to certain urothelium stimuli.

Highlights

  • BO, referred to ‘‘increased bladder sensation’’ previously, can be defined as increased perceived bladder sensation during bladder filling with a low maximum cystometric bladder capacity by the International Continence Society in 2010 [1]

  • Compared to the controls, intravesical acidic adenosine triphosphate (ATP) solution instillation induced a significant increase in provoked phasic contractions in both fructose-fed rats (FFRs) groups and a significant decrease in the mean functional bladder capacity of group detrusor overactivity (DO)

  • Pretreatment with capsaicin for C-fiber desentization, intravesical liposome for mucosal protection, or intravenous pyridoxal 5-phosphate 6-azophenyl-29,49-disulfonic acid for antagonized purinergic receptors can interfere with the urodynamic effects of intravesical ATP in FFRs and controls

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Summary

Introduction

BO (bladder oversensitivity), referred to ‘‘increased bladder sensation’’ previously, can be defined as increased perceived bladder sensation during bladder filling with a low maximum cystometric bladder capacity by the International Continence Society in 2010 [1]. BO resulting from afferent noise is one of the important factors causing an overactive bladder (OAB) [2]. Evidence suggests increased expression or release of sensory receptors or neurotransmitters in the mucosal layer of the bladder, including the urothelial layer and suburothelial layer, can generate afferent noise via C fiber pathway and result in OAB [2,4]. The urothelium expresses transient receptor potential vanilloid 1 (TRPV1) and P2X3 receptors. It releases adenosine triphosphate (ATP) and nitric oxide (NO) and can activate C-fiber afferents [2,4]. Overexpression of TRPV1 [6] and P2X3 receptors [7] of urothelium and hypersensitivity of C-fiber pathway [8] are associated with urgency and detrusor overactivity (DO) in humans. DO is associated with increased ATP and decreased constitutive NO release from the urothelium of streptozocin-induced diabetic rats [9]

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