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published_or_final_version / abstract / Microbiology / Master / Master of Philosophy

Introdução: a cistite intersticial é doença crônica do trato urinário inferior cujos sintomas são: aumento da freqüência urinária, nictúria, dor pélvica ou perineal que piora com a repleção vesical e melhora com a micção. A etiopatogenia não é totalmente conhecida, mas há indícios de que os glicosaminoglicanos e proteoglicanos que revestem o urotélio vesical possam participar da sua gênese. A perda destes componentes protetores facilitaria o contato de íons e solutos presentes na urina com as porções mais profundas do urotélio desencadeando e perpetuando um processo inflamatório local. Para tentar entender seu metabolismo, investigamos o comportamento dos glicosaminoglicanos na urina e no tecido (biópsia do urotélio vesical) de pacientes portadoras de cistite intersticial e de incontinência urinária de esforço genuína. Casuística e métodos: o perfil e expressão gênica de glicosaminoglicanos no tecido, e o perfil dos glicosaminoglicanos da urina de 11 pacientes com cistite intersticial foram comparados aos de 11 pacientes com incontinência urinária de esforço. A análise estatística foi feita através de teste T e Anova, considerando significativos valores p<0,05. Resultados: verificamos que pacientes com cistite intersticial excretam menor concentração de glicosaminoglicanos na urina do que as portadoras de incontinência urinária de esforço (0,45 ± 0,11 x 0,62 ± 0,13 g/mg creatinina, p<0,05), porém sem redução do conteúdo de glicosaminoglicanos no urotélio. Na imunofluorescência o urotélio de pacientes com cistite intersticial mostrou maior marcação de TGF-beta, decorim (um proteoglicano de condroitim/dermatam sulfato), fibronectina e de ácido hialurônico. Foi identificada menor expressão gênica (PCR em tempo real) das sintases e uma hialuronidase do ácido hialurônico no urotélio das cistites intersticiais. Conclusão: a combinação desses resultados sugere que os glicosaminoglicanos podem estar relacionados ao processo contínuo de inflamação e remodelamento do urotélio disfuncional presente na cistite intersticial. O estudo da expressão gênica pode representar uma altenativa para o entendimento da doença. / Introduction: interstitial cystitis is a chronic disease of the lower urinary tract whose symptoms are: increased urinary frequency, nocturia, perineal or pelvic pain that worses with bladder filling and improves with urination. The pathogenesis is not fully known, but there is evidence that proteoglycans and glycosaminoglycans lining the bladder urothelium can participate in its genesis. The loss of these protective compounds facilitate the contact of ions and solutes in the urine with deeper portions of bladder wall triggering and perpetuating a local inflammatory process. We investigated GAG behavior in urine and tissue (biopsy of bladder urothelium) of patients with IC/PBS and genuine stress urinary incontinence (SUI) in an attempt to better understand its metabolism. Patients and Methods: gene expression and glycosaminoglycans profile in tissue, and glycosaminoglycans profile in urine of 11 patients with interstitial cystitis were compared to 11 patients with pure urinary stress incontinence. Statistical analysis were performed using t Student test and Anova, considering significant when p<0,05. Results: patients with interstitial cystitis excreted lower concentration of glycosaminoglycans in urine when compared to those with pure urinary stress incontinence (respectively 0.45 + 0.11 x 0.62 + 0.13 mg/mg creatinine, p< 0.05). However, there was no reduction of the content of glycosaminoglycans in the urothelium of both patients. The immunofluorescence study showed that patients with interstitial cystitis had a stronger staining of TGF-beta, decorin (a proteoglycan of chondroitin/dermatan sulfate), fibronectin and hyaluronic acid. We were able to indentify by real-time PCR lower gene expression of hyaluronic acid synthases and hyaluronidase in the urothelium of patients with interstitial cystitis. Conclusion: the results suggest that glycosaminoglycans may be related to the ongoing process of inflammation and remodeling of the dysfunctional urothelium that is present in the interstitial cystitis. The study of the gene expression may represent an alternative to understand the disease

Interstitial cystitis (IC)/painful bladder syndrome (PBS) is a functional visceral disorder characterized by increased bladder activity and chronic pelvic pain in the absence of a pathobiological condition. Enhanced sensory transduction of peripheral bladder afferents is hypothesized to contribute to the pain and mechanical hypersensitivity of IC/PBS patients. The aim of this thesis is to test the hypothesis that purinergic receptors, including ionotropic P2X and metabotropic P2Y, are important for sensory transmission in bladder afferent neurons and may be involved in bladder hypersensitivity after bladder tissue insults. Electrophysiological, single cell RT-PCR and immunohistochemistry techniques were performed in bladder afferent neurons from naïve and bladder inflamed mice to test the hypothesis. In Chapter 2, I characterized the distribution and function of P2X receptors in thoracolumbar (TL) and lumbosacral (LS) dorsal root ganglia (DRG) neurons innervating the urinary bladder, and found that LS and TL bladder neurons have differential purinergic signaling and distinct membrane electrical properties. In Chapter 3, I examined the sensitization of bladder afferent neurons and the plasticity of P2X receptor function in a mouse model of chemical induced bladder inflammation. P2X-mediated signals in LS and TL bladder neurons after bladder inflammation were enhanced compared with those in saline-treated controls, suggesting the importance of P2X in bladder hypersensitivity associated with cystitis. In Chapter 4, the modulation of P2Y on P2X function and the co-localization of P2Y and P2X were examined in bladder sensory neurons. It has been found that P2Y2 receptor enhances bladder sensory neuron excitability and facilitates the response of homomeric P2X2 receptor to the purinergic agonist (ATP). The present study provides evidence that LS and TL mouse bladder sensory neurons exhibit distinct P2X signaling, and the function of P2X receptors could be facilitated during bladder inflammation and modulated by activation of P2Y2 receptor, indicating an involvement of P2X and P2Y2 receptors as mechano- and chemosensors in bladder sensory transmission under normal conditions and in bladder hypersensitivity associated with inflammation.

Šio darbo tikslas – nustatyti, kokios priežastys dažniausiai įtakoja šlapimo pūslės uždegimą katėms, įvertinti diagnozavimo metodus bei gydymo galimybes. Duomenys tyrimui buvo renkami Klaipėdos privačioje veterinarijos klinikoje UAB „Aumura“. Duomenys rinkti nuo 2012 m. kovo mėn. – iki 2013 m. spalio mėn. Tyrimui buvo atrinkta 30 kačių (10 kačių ir 20 katinų): Britų trumpaplaukiai (n=4), Škotų nulėpausis (n=1), Rusų mėlynieji (n=4), Egzotų trumpaplaukiai (n=2), Persai (n=3), Sfinksas (n=1) bei mišrūnai (n=15). Visais tirtais atvejais buvo atliekamas bendras šlapimo tyrimas analizatoriumi „Urine Analyzer H – 50“ bei optiniu mikroskopu „Nicon Eclipse E200“ tirtos šlapimo nuosėdos. Inkstų ir kitų organų sistemų veiklai įvertinti buvo atliekami biocheminiai kraujo tyrimai analizatoriumi „Arkray Spotchem SP – 4430”, o morfologiniai kraujo parametrai buvo nustatinėjami analizatoriumi “BC – 2800Vet”. 7-ioms katėms buvo atliktas rentgenografinis šlapimo pūslės bei šlapimo takų tyrimas rentgeno aparatu „AMERICOMP spectra 325e“, 3 akmenligės atvejai buvo diagnozuoti ultragarso aparatu “ProSound ALPHA7“. Bakteriologiniai šlapimo mėginių pasėliai buvo auginami ant kraujo agarų COLUMBIA AGAR 5 % bei selektyvinių terpių. Atlikus tyrimą nustatyta, kad pirminė ir dažniausia cistitą sukėlusi priežastis buvo urolitiazė, kurios dažniausias pasireiškimas buvo stebimas tarp patinų. Akmenligė nustatyta 5-ioms katėms ir 15-ai katinų, iš jų – 2 katės ir 12 katinų buvo kastruoti. 3-ims katėms ir... [toliau žr. visą tekstą] / The aim of the master thesis is to investigate the most frequent causes of feline bladder inflammation, methods of diagnosis and possibilities of treatment. Data for the investigation were collected in a private veterinary clinic “Aumura” located in Klaipeda city, during the period from March, 2012 to October, 2013. 30 cats were selected for the investigation (10 female and 20 male). The selected cats were of such breeds: British Shorthair (n=4), Scottish Fold (n=1), Russian Blue (n=4), Exotic Shorthair (n=2), Persian (n=3), Sphynx (n=1) and mongrels (n=15). For every case a urine test was carried out using “Urine Analyzer H – 50” and optical microscope “Nicon Eclipse E200”, urine sediments were tested. To asses functioning kidney or other organs system, biochemical blood tests were performed by “Arkray Spotchem SP – 4430” analyzer and to determine morphological parameters of blood analyzer “BC – 2800Vet” was used. 7 felines had bladder and urinary tract tested by X-Ray generator “AMERICOMP spectra 325e”, 3 cases of bladder stones were diagnosed after examination by ultrasound console “ProSound ALPHA7”. Cultures for urinal samples have been grown on the selective environment. It was investigated, that the main and the most frequent cause of formation of cystitis was urolithiasis, which was more common among males. Bladder stone was diagnosed for 5 females and 15 males (2 females and 12 males of those were castrated). The cause of formation of cystitis for 3 females and 5... [to full text]

Thesis (M. Phil.)--University of Hong Kong, 2007. / Also available in print.

Introdução: a cistite intersticial é doença crônica do trato urinário inferior cujos sintomas são: aumento da freqüência urinária, nictúria, dor pélvica ou perineal que piora com a repleção vesical e melhora com a micção. A etiopatogenia não é totalmente conhecida, mas há indícios de que os glicosaminoglicanos e proteoglicanos que revestem o urotélio vesical possam participar da sua gênese. A perda destes componentes protetores facilitaria o contato de íons e solutos presentes na urina com as porções mais profundas do urotélio desencadeando e perpetuando um processo inflamatório local. Para tentar entender seu metabolismo, investigamos o comportamento dos glicosaminoglicanos na urina e no tecido (biópsia do urotélio vesical) de pacientes portadoras de cistite intersticial e de incontinência urinária de esforço genuína. Casuística e métodos: o perfil e expressão gênica de glicosaminoglicanos no tecido, e o perfil dos glicosaminoglicanos da urina de 11 pacientes com cistite intersticial foram comparados aos de 11 pacientes com incontinência urinária de esforço. A análise estatística foi feita através de teste T e Anova, considerando significativos valores p<0,05. Resultados: verificamos que pacientes com cistite intersticial excretam menor concentração de glicosaminoglicanos na urina do que as portadoras de incontinência urinária de esforço (0,45 ± 0,11 x 0,62 ± 0,13 g/mg creatinina, p<0,05), porém sem redução do conteúdo de glicosaminoglicanos no urotélio. Na imunofluorescência o urotélio de pacientes com cistite intersticial mostrou maior marcação de TGF-beta, decorim (um proteoglicano de condroitim/dermatam sulfato), fibronectina e de ácido hialurônico. Foi identificada menor expressão gênica (PCR em tempo real) das sintases e uma hialuronidase do ácido hialurônico no urotélio das cistites intersticiais. Conclusão: a combinação desses resultados sugere que os glicosaminoglicanos podem estar relacionados ao processo contínuo de inflamação e remodelamento do urotélio disfuncional presente na cistite intersticial. O estudo da expressão gênica pode representar uma altenativa para o entendimento da doença. / Introduction: interstitial cystitis is a chronic disease of the lower urinary tract whose symptoms are: increased urinary frequency, nocturia, perineal or pelvic pain that worses with bladder filling and improves with urination. The pathogenesis is not fully known, but there is evidence that proteoglycans and glycosaminoglycans lining the bladder urothelium can participate in its genesis. The loss of these protective compounds facilitate the contact of ions and solutes in the urine with deeper portions of bladder wall triggering and perpetuating a local inflammatory process. We investigated GAG behavior in urine and tissue (biopsy of bladder urothelium) of patients with IC/PBS and genuine stress urinary incontinence (SUI) in an attempt to better understand its metabolism. Patients and Methods: gene expression and glycosaminoglycans profile in tissue, and glycosaminoglycans profile in urine of 11 patients with interstitial cystitis were compared to 11 patients with pure urinary stress incontinence. Statistical analysis were performed using t Student test and Anova, considering significant when p<0,05. Results: patients with interstitial cystitis excreted lower concentration of glycosaminoglycans in urine when compared to those with pure urinary stress incontinence (respectively 0.45 + 0.11 x 0.62 + 0.13 mg/mg creatinine, p< 0.05). However, there was no reduction of the content of glycosaminoglycans in the urothelium of both patients. The immunofluorescence study showed that patients with interstitial cystitis had a stronger staining of TGF-beta, decorin (a proteoglycan of chondroitin/dermatan sulfate), fibronectin and hyaluronic acid. We were able to indentify by real-time PCR lower gene expression of hyaluronic acid synthases and hyaluronidase in the urothelium of patients with interstitial cystitis. Conclusion: the results suggest that glycosaminoglycans may be related to the ongoing process of inflammation and remodeling of the dysfunctional urothelium that is present in the interstitial cystitis. The study of the gene expression may represent an alternative to understand the disease

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京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18863号 / 医博第3974号 / 新制||医||1008(附属図書館) / 31814 / 京都大学大学院医学研究科医学専攻 / (主査)教授 渡邊 直樹, 教授 岩田 想, 教授 岩井 一宏 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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