You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Basic Research II1 Apr 2012120 MESENCHYMAL STEM CELL (MSC) SECRETED FACTORS FACILITATE PUDENDAL NERVE (PN) RECOVERY AFTER SIMULATED CHILDBIRTH INJURY Charuspong Dissaranan, Emily Holthaus, Michelle Cruz, Brian Balog, Matthew Kiedrowski, Marc Penn, Howard Goldman, and Margot Damaser Charuspong DissarananCharuspong Dissaranan Cleveland, OH More articles by this author , Emily HolthausEmily Holthaus Cleveland, OH More articles by this author , Michelle CruzMichelle Cruz Cleveland, OH More articles by this author , Brian BalogBrian Balog Cleveland, OH More articles by this author , Matthew KiedrowskiMatthew Kiedrowski Akron, OH More articles by this author , Marc PennMarc Penn Akron, OH More articles by this author , Howard GoldmanHoward Goldman Cleveland, OH More articles by this author , and Margot DamaserMargot Damaser Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.168AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES During vaginal delivery the external urethral sphincter (EUS) and its innervation, the PN, can be injured, resulting in stress urinary incontinence. Even 5 years after injury recovery is poor. Previous studies have demonstrated that bone marrow-derived stem cells improve growth and myelination of regenerating axons which may be due to the release of trophic factors. This study investigates if intravenously (IV) injected MSC home to the PN and the EUS and facilitate functional recovery via secretion of paracrine factors after PN crush (PNC). METHODS Age-matched virgin female rats were utilized in 3 experiments: 1. The functional study utilizing MSC had 3 groups: PNC receiving IV phosphate buffered saline (PBS; N=6); PNC receiving 2 million GFP-labeled MSC IV (N=6); and sham PNC receiving IV PBS (N=6). 2. The functional study utilizing media that had been conditioned by MSC and then concentrated (CCM) had 3 groups: PNC receiving CCM by local injection to the crush site of the PN (N=6); PNC receiving local control media injection (N=6); and sham PNC receiving local control media injection (N=6). 3. The homing study had 2 groups: PNC receiving IV MSC (N=11) and sham PNC receiving IV MSC (N=11). All treatments were delivered 1 hour after injury. Urethral function was tested 10 days after injury by simultaneous leak point pressure (LPP) and EUS electromyography (EMG). Mean frequency and amplitude of EUS EMG both at rest and during LPP were calculated. The PN, urethra, vagina, rectum and spleen were harvested and imaged ex-vivo for GFP 2 and 4 days after injection in the homing study. RESULTS LPP was significantly reduced in rats with PNC treated with PBS or control media compared to sham PNC but not in those given IV MSCs or CCM. Similarly, EUS EMG frequency and amplitude were significantly decreased in rats with PNC treated with PBS or control media compared to sham PNC but not in PNC rats treated with IV MSC or CCM. Ex vivo imaging showed significantly increased fluorescence, indicating more MSCs, in the PN and spleen of PNC rats receiving IV MSC. CONCLUSIONS IV infused MSC home to the PN and spleen and facilitate recovery of the PN and continence after simulated childbirth injury. CCM injection locally gave similar results. The mechanism of action leading to restored continence is potentially via secreted paracrine factors. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e48-e49 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Charuspong Dissaranan Cleveland, OH More articles by this author Emily Holthaus Cleveland, OH More articles by this author Michelle Cruz Cleveland, OH More articles by this author Brian Balog Cleveland, OH More articles by this author Matthew Kiedrowski Akron, OH More articles by this author Marc Penn Akron, OH More articles by this author Howard Goldman Cleveland, OH More articles by this author Margot Damaser Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...