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
Summary
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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