Urothelial Dysfunction and Chronic Inflammation in Diabetic Patients with Overactive Bladder

Area of Science:

• Urology
• Gastroenterology
• Immunology

Background:

• Overactive bladder (OAB) is a condition affecting many patients, often with underlying urothelial dysfunction.
• The role of diabetes mellitus (DM) in the pathogenesis and severity of OAB remains an area of active investigation.
• Understanding cellular and molecular changes in the bladder is crucial for developing targeted therapies.

Purpose of the Study:

• To investigate urothelial dysfunction, suburothelial inflammation, and muscarinic receptor expression in diabetic patients with overactive bladder (OAB).
• To compare these findings between OAB patients with and without diabetes mellitus (DM).

Main Methods:

• The study included 19 OAB patients with DM, 14 OAB patients without DM, and 10 healthy controls.
• Immunofluorescence staining assessed E-cadherin, ZO-1, tryptase (mast cells), and apoptosis in bladder tissues.
• Western blotting measured muscarinic receptors (M2, M3) and P2X3 receptor levels, with analysis of video urodynamic studies.

Main Results:

• Both OAB groups showed significant differences in E-cadherin and mast cell expression compared to controls (P < 0.05).
• No significant differences in E-cadherin, mast cells, apoptosis, or ZO-1 were found between OAB patients with and without DM.
• M3 muscarinic protein expression was significantly higher in OAB patients (with or without DM) than in controls, but urodynamic parameters did not correlate with these molecular findings.

Conclusions:

• Urothelial dysfunction and chronic suburothelial inflammation are implicated in OAB pathogenesis.
• Diabetes mellitus does not appear to exacerbate the severity of urothelial inflammation in patients with OAB.
• Elevated M3 muscarinic receptor expression may play a role in OAB, irrespective of diabetic status.