Portal de investigação
Beyond the urothelium: Interplay between autonomic nervous system and bladder inflammation in urinary tract infection, bladder pain syndrome with interstitial cystitis and neurogenic lower urinary tract dysfunction in spinal cord injury-ICI-RS 2023
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Wyndaele, M
- Hervé, F
- Aronsson, P
- Grundy, L
- Khullar, V
- Wein, A
- Abrams, P
Unidades de investigação
Abstract
IntroductionInflammation and neuronal hypersensitivity are reactive protective mechanisms after urothelial injury. In lower urinary tract dysfunctions (LUTD), such as urinary tract infection (UTI), bladder pain syndrome with interstitial cystitis (BPS/IC) and neurogenic LUTD after spinal cord injury (SCI), chronic inflammation can develop. It is unclear how the protective reactionary inflammation escalates into chronic disease in some patients.MethodsDuring its 2023 meeting in Bristol, the International Consultation on Incontinence-Research Society (ICI-RS) reviewed the urothelial and inflammatory changes after UTI, BPS/IC and SCI. Potential factors contributing to the evolution into chronic disease were explored in a think-tank.ResultsFive topics were discussed. (1) Visceral fat metabolism participates in the systemic pro-inflammatory effect of noradrenalin in BPS/IC and SCI. Sympathetic nervous system-adipocyte-bladder crosstalk needs further investigation. (2) Sympathetic hyperactivity also potentiates immune depression in SCI and needs to be investigated in BPS/IC. Gabapentin and tumor necrosis factor-alpha are promising research targets. (3) The exact peripheral neurons involved in the integrative protective unit formed by nervous and immune systems need to be further identified. (4) Neurotransmitter changes in SCI and BPS/IC: Neurotransmitter crosstalk needs to be considered in identifying new therapeutic targets. (5) The change from eubiosis to dysbiosis in SCI can contribute to UTI susceptibility and needs to be unraveled.ConclusionsThe think-tank discussed whether visceral fat metabolism, immune depression through sympathetic hyperactivity, peripheral nerves and neurotransmitter crosstalk, and the change in microbiome could provide explanations in the heterogenic development of chronic inflammation in LUTD. High-priority research questions were identified.
© 2023 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.
Dados da publicação
- ISSN/ISSNe:
- 0733-2467, 1520-6777
- Tipo:
- Review
- Páginas:
- 1283-1292
- DOI:
- 10.1002/nau.25310
- Link para outro recurso:
- www.scopus.com
Neurourology and Urodynamics Wiley-Liss Inc.
Citações Recebidas na Scopus: 4
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Filiações
Keywords
- autonomic nervous system; bladder pain syndrome; inflammation; interstitial cystitis; spinal cord injury; urinary tract infection; urothelium
Campos de estudo
Proyectos asociados
Management of Neurogenic Detrusor Overactivity Caused by Spinal Cord Injury - The Case of Botulinum Toxin and Resiniferatoxin
Investigador Principal: Célia da Conceição Duarte Cruz
Estudo Clínico Académico . 2020
Citar a publicação
Wyndaele M,Charrua A,Hervé F,Aronsson P,Grundy L,Khullar V,Wein A,Abrams P,Cruz F,Cruz CD. Beyond the urothelium: Interplay between autonomic nervous system and bladder inflammation in urinary tract infection, bladder pain syndrome with interstitial cystitis and neurogenic lower urinary tract dysfunction in spinal cord injury-ICI-RS 2023. Neurourol. Urodyn. 2023. 43(6):p. 1283-1292. IF:2,000. (3).
