neuropeptide-y and Urinary-Bladder--Neurogenic

To observe the altered expressions of neuropeptide Y, substance P and vasoactive intestinal peptide in detrusor of SD rats after spinal cord injury and explore the relationship of the above neuropeptides and neurogenic bladder after spine cord injury.. Twenty male clean-grade SD rats, aged 6 weeks, were selected and randomized into spinal cord injury group (n = 10) and control group (n = 10). Rats in spinal cord injury group were smashed at T10 to cause spinal cord incomplete injury model by the weight drop method while laminectomy alone without smashing was administered in control group. At Week 1 post-operation, all rats were assessed by the maximum bladder capacity, bladder compliance and detrusor pressure for the confirmation of spastic bladder. And all detrusor specimens were marked with argentation and immunohistochemistry for the analyses of nerve fibers, neuropeptide Y, substance P and vasoactive intestinal peptide. The results were evaluated with semiquantitative method to observe the contents of nerve fiber and neuropeptides.. At Week 1 post-operation, the mean maximum bladder compactly, mean maximum detrusor pressure and mean compliance in SCI rats was 0.71 ± 0.24 ml, 32.27 ± 3.12 cm H2O and 0.020 ± 0.009 ml/cm H2O versus 2.0 ± 0.4 ml, 21.0 ± 3.0 cm H2O and 0.090 ± 0.020 ml/cm H2O in normal control group respectively. And the differences were statistically significant (P < 0.01). Meanwhile, the mean content of nerve fibers of neurogenic bladder decreased markedly than that of normal control group (2.58 ± 0.13 vs 5.65 ± 0.26). As compared with the normal control group, the expressions of neuropeptide Y, substance P and vasoactive intestinal peptide (mean integrated optical density: 3.2 ± 0.5, 1.7 ± 0.4 and 2.1 ± 0.4 respectively) decreased dramatically in SCI rats. And the differences were statistically significant (P < 0.01).. The number of nerve fibers and the content of neuropeptides significantly decrease in neurogenic bladder after spinal cord injury in rats. The reduction of neuropeptides may be correlated with the formation of neurogenic bladder after spinal cord injury.

Topics: Animals; Male; Neuropeptide Y; Rats; Rats, Sprague-Dawley; Spinal Cord Injuries; Substance P; Urinary Bladder; Urinary Bladder, Neurogenic; Vasoactive Intestinal Peptide

To evaluate the role of neuropeptide Y in the detrusor of patients with neurogenic detrusor overactivity (NDO), as it has an important role in the neural regulation of the lower urinary tract by exerting differential effects on the release of cholinergic and adrenergic transmitters via autoinhibition and heterosynaptic interactions.. Detrusor biopsies were obtained from 38 patients; 31 had video-urodynamically verified NDO, caused by meningomyelocele in 17 or spinal cord injury in 14. Seven had stress urinary incontinence (SUI) and this group served as a control. All specimens were fixed, paraffin wax-embedded, sectioned and stained with a monoclonal antibody against neuropeptide Y and a general nerve marker protein-gene-product 9.5 (PGP 9.5). The number of PGP 9.5- and neuropeptide Y-containing nerves was quantified by a standardized evaluation using image-analysis software.. The median (range) number of neuropeptide Y-containing nerves in the neurogenic detrusor, at 0.273 (0.126-0.639) per muscle cell nucleus (MCN), was significantly lower (P = 0.014) than that in patients with SUI, at 0.383 (0.267-0.728). In the neurogenic detrusor the number of PGP 9.5-positive nerves, at 0.278 (0.054-0.641)/MCN was also lower (P = 0.111) than in patients with SUI, at 0.368 (0.258-0.497). The ratio of neuropeptide Y to PGP 9.5 counts per biopsy did not differ between the groups (P = 0.628).. The number of PGP 9.5-positive nerves was not significantly and the number of neuropeptide Y-containing nerves was significantly reduced in patients with NDO. This may have been caused by transynaptic nerve degeneration of the detrusor, as described by in patients with spinal cord injury. As neuropeptide Y inhibits the contractile response of the detrusor the reduction of neuropeptide Y-containing nerves may play a role in the development and persistence of DO.

Topics: Adolescent; Adult; Biopsy, Needle; Child; Female; Humans; Immunohistochemistry; Male; Meningomyelocele; Muscle, Smooth; Nerve Tissue; Neuropeptide Y; Spinal Cord Injuries; Urinary Bladder, Neurogenic

Specimens of the detrusor muscle of the bladder from four patients with lower motor neurone lesion and three patients with carcinoma of the bladder used as "controls", were studied immunohistochemically for vasoactive intestinal polypeptide, neuropeptide Y, calcitonin-gene related peptide, substance P and somatostatin. The greatest density of nerves in the bladder from "control" patients contained neuropeptide Y, followed in a decreasing order by vasoactive intestinal polypeptide, calcitonin gene-related peptide, substance P and somatostatin. Neuropeptide Y- and vasoactive intestinal polypeptide-immunoreactive nerves were found throughout the smooth muscle and the base of the mucosa, while calcitonin gene-related peptide-, substance P- and somatostatin-immunoreactive nerves were found predominantly in nerve bundles with a few single fibres at the base of the mucosa. Vasoactive intestinal polypeptide-, neuropeptide Y- and calcitonin gene-related peptide-immunoreactive nerves were also located around blood vessels. In patients with lower motor neurone lesion, there was a decrease in the density of vasoactive intestinal polypeptide-, calcitonin gene-related peptide- and substance P-immunoreactive nerves, but there was little change in neuropeptide Y- or somatostatin-immunoreactive nerves. Urinary retention, bladder areflexia and deficient sensation may be directly linked to neuropeptide neuropathy in patients with lower motor neurone lesion.

Topics: Adult; Calcitonin Gene-Related Peptide; Fluorescent Antibody Technique; Humans; Male; Meningomyelocele; Neuropeptide Y; Somatostatin; Substance P; Urinary Bladder; Urinary Bladder Neoplasms; Urinary Bladder, Neurogenic; Vasoactive Intestinal Peptide

Specimens of urethra were obtained from patients with cervical and thoracic spinal cord lesion with detrusor-sphincter dyssynergia and from patients with lower motor neurone lesion with detrusor areflexia, undergoing transurethral sphincterotomy. Neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP) in nerves associated with both the smooth and striated muscle components of the urethral sphincter were studied immunohistochemically and by immunoassay. In patients with detrusor-sphincter dyssynergia following cervical and thoracic spinal cord injury, NPY- and VIP-immunoreactive varicose nerve fibres were seen in both the smooth and striated muscle components of the urethral sphincter. In the smooth muscle, NPY- and VIP-immunoreactive nerves did not appear to have any particular orientation, but in the striated muscle region they were found to run along the length of individual muscle fibres. In patients with detrusor areflexia following lower motor neurone lesion, while the pattern, density and fluorescence intensity of NPY- and VIP-immunoreactive nerves in the smooth muscle of the sphincter mechanism appeared the same as seen in patients with detrusor-sphincter dyssynergia, there was a marked increase in the density of these nerves in the striated muscle region of the sphincter mechanism. Quantitation of the peptides by immunoassay was consistent with the histochemical findings, with significantly higher levels of both NPY and VIP in the striated muscle of patients with lower motor neurone lesion, compared to those with cervical and thoracic spinal cord lesion, p = 0.04. NPY and VIP levels in urethral smooth muscle were in the same range in lower motor neurone lesion patients and cervical and thoracic spinal cord lesion patients. We conclude that there are increased NPY- and VIP-containing fibres in striated muscle of the intrinsic external urethral sphincter in patients with areflexic bladder compared with those with detrusor-sphincter dyssynergia.

Topics: Adult; Enzyme-Linked Immunosorbent Assay; Humans; Male; Muscles; Neurons; Neuropeptide Y; Radioimmunoassay; Spinal Cord Injuries; Urethra; Urinary Bladder, Neurogenic; Vasoactive Intestinal Peptide