You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2012907 EFFECT OF INTRAVESICAL BOTULINUM TOXIN A DELIVERY (USING DMSO) IN RAT OVERACTIVE BLADDER MODEL Shogo Shimizu, Marcia Wheeler, Motoaki Saito, Robert Weiss, and Adam Hittelman Shogo ShimizuShogo Shimizu New Haven, CT More articles by this author , Marcia WheelerMarcia Wheeler New Haven, CT More articles by this author , Motoaki SaitoMotoaki Saito Yonago, Japan More articles by this author , Robert WeissRobert Weiss New Haven, CT More articles by this author , and Adam HittelmanAdam Hittelman New Haven, CT More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1003AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cystoscopic guided bladder injection of Botulinum Toxin A (BoNT) is becoming an important treatment modality for neurogenic and overactive bladder. Intravesical instillation of BoNT may provide high local drug concentrations with a lower risk of side effects as compared to intramuscular injection into the detrusor. However, BoNT does not easily pass through the urothelial barrier to reach the smooth muscle. DMSO has been shown to enhance bladder absorption. We tested the effects of BoNT instillation into control and an overactive rat bladder model using DMSO as a vehicle. Bladder overactivity was induced by intravesical instillation of acetic acid (AA). METHODS Bladders of 8 weeks old Sprague-Dawley female rats were initially intravesically instilled (2 hr) with 750 ul of the following: Saline; 25% DMSO; 10U BoNT in saline: or 10U BoNT in 25% DMSO. One day prior to sacrifice (6 and 29 days after the initial intravesical instillation), bladders were instilled with saline or with 0.25% AA for 1 hour. Bladders were harvested 24 hours after the second instillation (7 and 30 days). Histology, SNAP-25 and calcitonin gene-related peptide (CGRP) expression were measured by immunohistochemistry (IHC), western blot, and qPCR, respectively. RESULTS Intravesical instillation of BoNT-DMSO, but not BoNT alone, into normal rat bladder decreased SNAP25 protein expression at 7 days (57±3.0% SEM). This effect was not preserved at 30 days. CGRP mRNA expression was increased 4 fold, 7 days after the drug instillation as compared to saline controls. Rats treated with AA had increased bladder inflammation, as demonstrated by a large increase in the number of neutrophils, edema, and thickening of bladder mucosa on H&E slides. BoNT-DMSO decreased inflammatory reaction induced by AA in rat model at 7 days, but not at 30 days. Moreover, BoNT-DMSO treatment decreased SNAP25 immunoreactivity and increased CGRP immunoreactivity by IHC at 7days in AA overactive bladder model, as compared to control AA treated rats. This effect was not observed at 30 days post treatment. CONCLUSIONS Intravesical instillation of BoNT-DMSO reduces inflammation to a greater extent than BoNT alone at 7 days. We speculate that BoNT-DMSO modulates the inflammatory response by inducing CGRP expression in a rat model of overactive bladder. These results also confirm the benefit of DMSO as a delivery vehicle to enhance BoNT absorption. Our data further support the role of BoNT in the management of overactive bladder. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTyagi P, Kashyap M, Yoshimura N, Chancellor M and Chermansky C (2018) Past, Present and Future of Chemodenervation with Botulinum Toxin in the Treatment of Overactive BladderJournal of Urology, VOL. 197, NO. 4, (982-990), Online publication date: 1-Apr-2017. Volume 187Issue 4SApril 2012Page: e370 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shogo Shimizu New Haven, CT More articles by this author Marcia Wheeler New Haven, CT More articles by this author Motoaki Saito Yonago, Japan More articles by this author Robert Weiss New Haven, CT More articles by this author Adam Hittelman New Haven, CT More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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