Can the adrenergic system be implicated in the pathophysiology of bladder pain syndrome/interstitial cystitis? A clinical and experimental study. Issue 5 (24th December 2013)

• Record Type: Journal Article
• Authors: Charrua, Ana; Pinto, Rui; Taylor, Anna; Canelas, André; Ribeiro‐da‐Silva, Alfredo; Cruz, Célia D.; Birder, Lori Ann; Cruz, Francisco
• Is Part Of: Neurourology and urodynamics. Volume 34:Issue 5(2015:Jun.)
• Page Start: 489
• Page End: 496
• Publication Date: 2013-12-24
• Subjects: Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.22542
• Languages: English
• ISSNs: 0733-2467

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="nau22542-sec-0001" sec-type="section"> <title>Aims</title> <p>To evaluate sympathetic system activity in bladder pain syndrome/interstitial cystitis (BPS/IC) patients and to investigate if chronic adrenergic stimulation in intact rats induces BPS/IC‐like bladder modifications.</p> </sec> <sec id="nau22542-sec-0002" sec-type="section"> <title>Methods</title> <p>Clinical study—In BPS/IC patients and aged and body mass index matched volunteers TILT test was undertaken and catecholamines were measured in plasma and 24 hr urine samples. Experimental study—Phenylephrine was injected subcutaneously (14 days) to female Wistar rats. Pain behavior, spinal Fos expression, urinary spotting, number of fecal pellets expelled, frequency of reflex bladder contractions, and urothelial height were analyzed. Urothelium permeability was investigated by trypan blue staining. Immunoreactivity against caspase 3 and bax were studied in the urothelium and against alpha‐1‐adrenoreceptor and TRPV1 in suburothelial nerves. Mast cell number was determined in the sub‐urothelium. In rats with lipopolysaccharide‐induced cystitis, urinary catecholamines, and Vesicular Monoamine Transporter 2 (VMAT2) expression in bladder nerves were analyzed.</p> </sec> <sec id="nau22542-sec-0003" sec-type="section"> <title>Results</title> <p>The TILT test showed an increase of sympathetic activity. Noradrenaline levels in blood at resting conditions and in 24‐hr urine samples were higher in BPS/IC patients. Phenylephrine administration increased visceral pain, spinal Fos expression, bladder reflex activity, urinary spotting and the number of expelled fecal pellets. The mucosa showed urothelial thinning and increased immunoreactivity for caspase 3 and bax. Trypan blue staining was only observed in phenylephrine treated animals. Suburothelial nerves co‐expressed alpha1 and TRPV1. Mastocytosis was present in the suburothelium. Cystitis increased sympathetic nerve density and urinary noradrenaline levels.</p> </sec> <sec id="nau22542-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Excessive adrenergic stimulation of the bladder may contribute to the pathophysiological mechanisms of BPS/IC. <italic>Neurourol. Urodynam. 34:489–496, 2015</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>