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Evidence for bladder urothelial pathophysiology in functional bladder disorders.

Susan K Keay1, Lori A Birder2, Toby C Chai3

  • 1Division of Infectious Diseases, University of Maryland School of Medicine and the VA Maryland Health Care System, 10 North Greene Street, Room 3B-184, Baltimore, MD 21201, USA.

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Summary
This summary is machine-generated.

The urothelium, the bladder lining, plays a key role in bladder function beyond just acting as a barrier. Abnormalities in urothelial signaling are linked to bladder pain syndrome, feline interstitial cystitis, and overactive bladder.

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Area of Science:

  • Urology
  • Cell Biology
  • Physiology

Background:

  • The urothelium traditionally serves as a protective barrier in the bladder.
  • Emerging evidence suggests the urothelium is also involved in cell signaling crucial for normal voiding function.

Purpose of the Study:

  • To review urothelial abnormalities in bladder pain syndrome/interstitial cystitis (BPS/IC), feline interstitial cystitis (FIC), and idiopathic overactive bladder (OAB).
  • To explore the shared pathophysiology and potential therapeutic targets for these conditions.

Main Methods:

  • Comparison of urothelial protein and mRNA expression in affected subjects versus controls.
  • Utilizing animal models to investigate urothelial responses to injury.
  • Employing transgenic techniques to assess the impact of specific urothelial abnormalities on bladder function.

Main Results:

  • BPS/IC, FIC, and OAB share common features like increased purinergic, TRPV1, and muscarinic signaling.
  • These conditions also exhibit increased urothelial permeability and aberrant urothelial differentiation.
  • Several signaling pathways are abnormally regulated, contributing to bladder dysfunction.

Conclusions:

  • The urothelium is a critical regulator of bladder function, implicated in BPS/IC, FIC, and OAB.
  • Targeting specific urothelial pathophysiology offers a potential therapeutic strategy for these debilitating bladder conditions.