Abstract

622Urological Surveyare phospholipid bilayered vesicles, and evaluated the urodynamic and immunohistochemical effect on acetic acid induced bladder hyperactivity in rats. Materials and Methods: Liposomes (1 ml), botulinum toxin A (20 U/1 ml saline) or botulinum toxin A en-capsulated in liposomes (lipotoxin, that is 20 U botulinum toxin A plus 1 ml liposomes) was administered in the bladder and retained for 1 hour on day 1 after baseline cystometrogram. Continuous cystometrogram was performed on day 1 by filling the bladder with saline and on day 8 by filling the bladder with saline, followed by 0.3% acetic acid. The bladder was then harvested. Cystometrogram parameters, histology, SNAP25 and calcitonin gene-related peptide expression were measured by Western blotting or immunostaining. Results: The intercontraction interval was decreased 57.2% and 56.0% after intravesical acetic acid instillation in liposome and botulinum toxin A pretreated rats, respectively. However, rats that received lipotoxin showed a significantly decreased intercontraction interval response (21.1% decrease) to acetic acid instillation but without compromised voiding function. Also, lipotoxin pretreated rats had a better decrease in the inflammatory reac-tion and SNAP-25 expression, and increase in calcitonin gene-related peptide immunoreactivity than those in liposome or botulinum toxin A pretreated rats. Conclusions: Intravesical lipotoxin administration cleaved SNAP-25, inhibited calcitonin gene-related peptide release from afferent nerve terminals and blocked the acetic acid induced hyperactive bladder. These results support liposomes as an efficient vehicle for delivering botulinum toxin A without injection.

Highlights

  • The authors speculated that delivery using liposomes, which are phospholipid bilayered vesicles, and evaluated the urodynamic and immunohistochemical effect on acetic acid induced bladder hyperactivity in rats

  • Their results show that Botulinum toxin A can be combined with liposomes to be administered as a liquid instillation without cystoscopic injection, with good therapeutic results in rats

  • Extracorporeal shock wave lithotripsy is the preferred treatment for upper urinary tract renal calculi

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Summary

Introduction

Editorial Comment It has been proved that Botulinum toxin A applied as cystoscopic guided injections into the bladder wall have a therapeutic effect on overactive bladder and interstitial cystitis / painful bladder syndrome. The authors have been searching for a simpler and lower risk method to deliver Botulinum toxin A without injection. Their results show that Botulinum toxin A can be combined with liposomes to be administered as a liquid instillation without cystoscopic injection, with good therapeutic results in rats.

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